Background
Social conditions and dietary behaviors have been implicated in the rising burden of gastrointestinal cancers (GIC). The “food environment” reflects influences on a community level ...relative to food availability, nutritional assistance, and social determinants of health. Using the US Department of Agriculture‐Food Environment Atlas (FEA), we sought to characterize the association of food environment on GIC presenting stage and long‐term survival.
Methods
Patients diagnosed with GIC between 2013 and 2017 were identified using the SEER database. FEA‐scores were based on 282 county‐level food security variables, store‐restaurant availability, SNAP/WIC enrollment, pricing/taxes, and producer vicinity adjusted‐for factors of socioeconomic status, race‐ethnicity, transportation access, and comorbidities. Relative FEA rankings across US counties were averaged into a composite score and assigned to patients by county‐of‐residence. The association of FEA, cancer stage, and survival were analyzed using multiple logistic regression and cox‐proportional hazard models relative to White/non‐White race/ethnicity.
Results
Among 287,148 patients, the most common GIC‐sites were colon (n = 97,942, 34%), pancreas (n = 49,785, 17.3%), liver (n = 31,098, 11.0%) and esophagus (n = 16,271, 5.7%). A worse food environment was independently associated with increased odds of late‐stage diagnosis (esophageal odds ratio OR: 1.03, 95% confidence interval CI: 1.01–1.05; hepatic OR: 1.06, 95% CI: 1.03–1.08; pancreatic OR: 1.04, 95% CI: 1.01–1.06) among all patients; in contrast, food environment was associated with colorectal cancer stage among non‐White patients only (OR: 1.04, 95% CI: 1.03‐1.06). Worse food environment was associated with worse 3‐year survival (colon OR: 1.03, 95% CI: 1.01–1.04; hepatic OR: 1.12, 95% CI: 1.08–1.17; gastric OR: 1.07, 95% CI: 1.01–1.13). Similar associations were noted relative to overall survival among the entire cohort (biliary tract hazard ratio HR: 1.03, 95% CI: 1.01–1.05; esophageal HR: 1.02, 95% CI: 1.01–1.04; hepatic HR: 1.07, 95% CI: 1.06–1.09; pancreatic HR: 1.04, 95% CI: 1.02–1.05; rectum HR: 1.03, 95% CI: 1.01‐1.04; gastric HR: 1.05, 95% CI: 1.03–1.07), as well as among non‐White patients (biliary HR: 1.04, 95% CI: 1.01‐1.07; colon HR: 1.03, 95% CI: 1.01–1.05; esophageal HR: 1.05, 95% CI: 1.02–1.08; hepatic HR: 1.08, 95% CI: 1.06–1.10) (all p < 0.003).
Conclusions
Food environment was independently associated with late‐stage tumor presentation and worse 3‐year and overall survival among GIC patients. Interventions to address inequities across communities relative to food environments are needed to alleviate disparities in cancer care.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background
Prior studies in social determinants (SDoH) of truncal‐extremity melanomas (TEM) have analyzed race, income, and environmental factors relative to their effect on health disparities. ...However, they are limited by the narrow scopes of SDoH and study population, while lacking analyses of interrelational contribution of SDoH on TEM disparities.
Methods
This retrospective cohort study of adult TEM patients (1975–2017) assessed linear regression trends in months of survival, as well as logistic regression trends in advanced presenting stage, surgery, and chemotherapy receipt across TEM subtypes with increasing overall social vulnerability and vulnerability in 15 SDoH variables grouped into socioeconomic status (SES), minority‐language status (ML), household composition (HH), and housing‐transportation (HT) themes measured by the SVI. SVI measures are ranked/compared across all US counties for relative vulnerability in a specific SDH and their total composite while accounting for sociodemographic–regional differences.
Results
Across 325 760 TEM patients, increasing overall social vulnerability demonstrated significant decreases in the survival period for 7/13 TEM histology types (p < 0.001), with relative decreases in the survival period as high as 44.0% (67.0–37.5 months) for epithelioid cell. SES and HH were the highest‐magnitude contributors to these overall trends. For many patients with TEM, increased odds of advanced presenting stage (highest with acral‐lentiginous: odds ratio OR, −1.18; 95% confidence interval CI, 1.02–1.36), decreased odds of indicated surgery receipt (lowest with amelanotic, 0.79; 0.71–0.87), and increased odds of indicated chemotherapy (highest with melanoma in giant nevi: 1.50; 1.01–2.44) were observed; SES and ML followed by HH and HT contributed to these trends.
Conclusions
There were detriments in TEM care & prognosis in the United States with increasing social vulnerability. Identifying which SDH quantifiably are associated more with disparities in interrelational, real‐world contexts is important to provide nuance to inform future research and initiatives to address TEM disparity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
PurposeIn the construction sector, the knowledge-based process outgrows its emphasis on technological aspects. Yet, there is a lack of applied studies showing how a procurement system (PS) could be ...selected in the digital age. In particular, there is a radical need to establish an innovative process to visualise novel PS decision. Therefore, this paper aims to present a knowledge visualised framework for aiding construction PS decision-making.Design/methodology/approachThis paper describes the construction of process innovation. The framework (process) is supported by four influential decision supporting methods (mean utility values, analytic hierarchy process, fuzzy set theory and Delphi method) and computer programming (Matlab).FindingsThere are four stages of this framework: (1) uniform rating for decision alternatives; (2) group decision for determining the decision attribute; (3) determining the final choice; (4) reporting the cognitive computing process. Supported by individual and groups decision dynamics, this framework emphasises how the dashboard aided innovative approach enables the induction of understanding, cognitive computing for decision-making and how the information would precisely be represented, which are vital requirements of modern construction.Originality/valueThe contribution of this paper presents two leverage points that support the modern PS decision. Firstly, this paper provides a holistic view of the decision supporting methods on the basis of how a suitable PS would be systematically sought. Based on the existing studies, this paper upgrades into a visualised knowledge decision supporting process. It helps the participants understand and improve their cognitive learning. Secondly, this framework allows the participants to have a view of the individual and group decisions. It sheds light on the development of the collaborative decision-making process.
Background
Modern‐day internet access and technology usage substantially impacts aspects of surgical care but remain ill‐defined for their associations with gastrointestinal‐cancer (GIC) outcomes. We ...sought to develop the Digital Inequity Index (DII), a novel, a self‐adapted tool to quantify access to digital resources, to assess the impact of “digital inequity” on GIC care and prognosis.
Methods
Adult (20+) patients with gastrointestinal malignancies between 2013 and 2017 were identified from the Surveillance, Epidemiology, and End Results Program database. DII was calculated based on 17 census‐tract level variables derived from the American Community Survey and Federal Communications Commission. Variables were categorized as infrastructure‐access (i.e., electronic device ownership, broadband type, internet provider availability, income‐broadband subscription ratio) or sociodemographic (i.e., education, income, disability status), ranked relative across all US counties, and then averaged into a composite score. The association between DII and surgery receipt, staging, surveillance period, and survival time were assessed with multiple logistic and linear regressions.
Results
Among 287 228 patients, increasing DII was associated with increased odds of late‐stage disease (highest odds ratio OR: 1.08, 95% confidence interval CI: 1.05–1.10 for hepatic) and decreased odds of receiving surgery (lowest OR: 0.94, 95% CI: 0.93–0.96 for hepatic). Higher DII was associated with shorter postoperative surveillance length (largest decrease −20.4% for hepatic) and overall survival length (largest decrease −16.0% for pancreatic). Sociodemographic and infrastructure‐access factors contributed equivalently to surveillance time disparities, while infrastructure‐access factors contributed more to survival disparities across GIC types.
Conclusions
As technology dependence has increased, inequities in digital access should be targeted as a contributor to surgical oncologic disparities.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
This paper presents a comprehensive literature review that addresses procurement selection criteria associated with procurement system evaluation in the construction sector. The aim is to consolidate ...the knowledge of construction procurement selection criteria (PSC) and provide future research directions. A systematic literature review (SLR) of 37 peer-reviewed journal articles from 1998 to 2019 in the construction procurement system selection process is carried out to understand the extant theoretical and practical foundations of the field. Two hundred fifty-six PSC have been identified. Descriptive and material analysis reveals (1) PSC evolved to match the promotion of emerging procurement systems in the construction industry; (2) three emerging themes of PSC have been identified, namely procurement systems, decision aid tools, and PSC identification methods; (3) PSC could be classified into generic criteria and unique criteria; (4) geographic location may not have a significant impact on the choice of procurement systems. This work identifies and discusses potential research interests in improving PSC identification. The research path, current trends, and future research directions in construction procurement selection are revealed. The paper provides the foundation and impetus for further investigation into procurement system selection practices.
Hierarchical hollow manganese dioxide nanosheets with intricate and well‐controlled 3D morphologies are synthesized by combining the Kirkendall effect with a sacrificial crystalline template. The ...as‐prepared MnO2 nanomaterials (see figure) exhibit a good absorbing ability, useful in the removal of organic pollutants from waste water.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The property of biomaterials to control the sequential release of growth factors has been widely concerned in the field of bone repair and regeneration. Double-factor sustained-release scaffolds have ...good biocompatibility and bioactivity. O‑Carboxymethyl chitosan microspheres (O-CMCS) has antimicrobial activity, biodegradability, biocompatibility and film formation. This study developed scaffolds materials with microspheres with a purpose of forming a controlled slow release secondary structure. O-CMCS were used as drug carrier to construct the compound sustained-release system with rhBMP-2 and VEGF double factors release. The O-CMCS were loaded with rhBMP-2 and the hydroxyapatite collagen (HC) scaffolds were loaded with VEGF to prepare the scaffolds. These were double factors composite sustained-release system scaffolds. The biocompatibility of the sustained-release system was evaluated by in vitro and in vivo experiments. HC composite scaffolds were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction detection (XRD), in vitro sustained release test, in vitro cell culture and in vivo animal experiments. The results showed that rhBMP-2/VEGF in HC composite scaffolds (HCBV) successfully achieved the sequential release of the double factors, which could benefit bone regeneration.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective
The bacterial community structure of buccal mucosa in patients with oral lichen planus was evaluated and compared with healthy control.
Subjects and Methods
Buccal scraping samples have ...been taken on 43 oral lichen planus patients (21 erosive and 22 non‐erosive) and 21 mucosal healthy volunteers. The V3 hypervariable 16S rDNA region was amplified and sequenced by high‐throughput 454 pyrosequencing.
Results
94.26% of the total buccal bacteria were classified into 15 abundant genera. Eight of these abundant genera could be detected in all cases, namely Streptococcus, Prevotella, Haemophilu, Neisseria, Fusobacterium, Leptotrichia, Veillonella and Actinomyces. Four abundant bacteria showed significantly different prevalence at the genus level: Streptococcus was more abundant (P < 0.01) in healthy control group, while Fusobacterium (P < 0.01), Leptotrichia (P < 0.001) and Lautropia (P < 0.001) showed higher abundance in OLP group. Few differences can be found between erosive and non‐erosive OLP. In general, 19 ‘core’ OTUs at three levels were defined to be OLP specific, comparing with healthy control group.
Conclusions
These results suggest that OLP is associated with dysbiosis of the oral microbiome. Further studies should be taken to elucidate the inner relationship between these observed changes and OLP development.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The 3 biological domains delineated based on small subunit ribosomal RNAs (SSU rRNAs) are confronted by uncertainties regarding the relationship between Archaea and Bacteria, and the origin of ...Eukarya. The similarities between the paralogous valyl-tRNA and isoleucyl-tRNA synthetases in 5398 species estimated by BLASTP, which decreased from Archaea to Bacteria and further to Eukarya, were consistent with vertical gene transmission from an archaeal root of life close to Methanopyrus kandleri through a Primitive Archaea Cluster to an Ancestral Bacteria Cluster, and to Eukarya. The predominant similarities of the ribosomal proteins (rProts) of eukaryotes toward archaeal rProts relative to bacterial rProts established that an archaeal parent rather than a bacterial parent underwent genome merger with bacteria to generate eukaryotes with mitochondria. Eukaryogenesis benefited from the predominantly archaeal accelerated gene adoption (AGA) phenotype pertaining to horizontally transferred genes from other prokaryotes and expedited genome evolution via both gene-content mutations and nucleotidyl mutations. Archaeons endowed with substantial AGA activity were accordingly favored as candidate archaeal parents. Based on the top similarity bitscores displayed by their proteomes toward the eukaryotic proteomes of Giardia and Trichomonas, and high AGA activity, the Aciduliprofundum archaea were identified as leading candidates of the archaeal parent. The Asgard archaeons and a number of bacterial species were among the foremost potential contributors of eukaryotic-like proteins to Eukarya.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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