Background: Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however, researchers have not examined whether hyperglycemia can modify the association between dietary acid load and breast cancer recurrence. Methods: We studied 3081 early-stage breast cancer survivors enrolled in the Women’s Healthy Eating and Living study who provided dietary information through 24-h recalls at baseline and during follow-up and had measurements of hemoglobin A1c (HbA1c) at baseline. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Results: After an average of 7.3 years of follow-up, dietary acid load was positively associated with recurrence when baseline HbA1c levels were ≥ 5.6% (median level) and ≥5.7% (pre-diabetic cut-point). In the stratum with HbA1c ≥ 5.6%, comparing the highest to the lowest quartile of dietary acid load, the multivariable-adjusted hazard ratio was 2.15 (95% confidence interval [CI] 1.34-3.48) for PRAL and was 2.31 (95% CI 1.42-3.74) for NEAP. No associations were observed in the stratum with HbA1c levels were <5.6%. P-values for interactions were 0.01 for PRAL and 0.05 for NEAP. Conclusions: Our study demonstrated for the first time that even at or above normal to high HbA1c levels, dietary acid load was associated with increased risk of breast cancer recurrence among breast cancer survivors. Impacts: Our study provides strong evidence for developing specific dietary acid load guidelines based on HbA1c levels.

Disputes over farmland constitute an important challenge for tenure security, economic growth and social stability. Land titling is a theoretically promising policy instrument that can enhance tenure security and reduce the occurrence of farmland disputes in the developing world. However, the impact of land titling on the occurrence of disputes has been found to be highly conditional. Empirical evidence on this issue has been surprisingly limited and has often lacked the consideration of a specific context. In this study, whether land titling affects the incidence of farmland disputes in the context of China is investigated, focusing particularly on the interaction between land titling and social capital and household capability. Both the probit and CLL models are applied, using household data entailing a total of 3693 samples located in rural China. The results show that (1) land titling in China reduces the incidence of farmland disputes, and that (2) the analysis based on interaction terms indicates that households who are disadvantaged in social capital and household capability are more likely to experience fewer disputes. Implications for the government and organizations are as follows: (1) the titling programme should seriously consider the current tenure arrangement. Confirmation of current tenure is recommended over the establishment of a new system to avoid possible institutional shopping and overlapping claims; and (2) land titling, if well implemented, is recommended to redress local power asymmetry and to help vulnerable groups defend their property.

Background Recruiting to multi-site trials is challenging, particularly when striving to ensure the randomized sample is demographically representative of the larger disease-suffering population. While previous studies have reported disparities by race and ethnicity in enrollment and randomization, they have not typically investigated whether disparities exist in the recruitment process prior to consent. To identify participants most likely to be eligible for a trial, study sites frequently include a prescreening process, generally conducted by telephone, to conserve resources. Collection and analysis of such prescreening data across sites could provide valuable information to improve understanding of recruitment intervention effectiveness, including whether traditionally underrepresented participants are lost prior to screening. Methods We developed an infrastructure within the National Institute on Aging (NIA) Alzheimer’s Clinical Trials Consortium (ACTC) to centrally collect a subset of prescreening variables. Prior to study-wide implementation in the AHEAD 3–45 study (NCT NCT04468659), an ongoing ACTC trial recruiting older cognitively unimpaired participants, we completed a vanguard phase with seven study sites. Variables collected included age, self-reported sex, self-reported race, self-reported ethnicity, self-reported education, self-reported occupation, zip code, recruitment source, prescreening eligibility status, reason for prescreen ineligibility, and the AHEAD 3–45 participant ID for those who continued to an in-person screening visit after study enrollment. Results Each of the sites was able to submit prescreening data. Vanguard sites provided prescreening data on a total of 1029 participants. The total number of prescreened participants varied widely among sites (range 3–611), with the differences driven mainly by the time to receive site approval for the main study. Key learnings instructed design/informatic/procedural changes prior to study-wide launch. Conclusion Centralized capture of prescreening data in multi-site clinical trials is feasible. Identifying and quantifying the impact of central and site recruitment activities, prior to participants signing consent, has the potential to identify and address selection bias, instruct resource use, contribute to effective trial design, and accelerate trial enrollment timelines.

In the Multi-user Generalized Spatial Modulation (MU-GSM) System, as channel gain matrix isn't in full rank, conventional linear precoding algorithms can't be directly applied in this system. Given this, a method called Multi-user Generalized Spatial Modulation Partial Linear Precoding (MU-GSM-PLP) is proposed for MU-GSM system. MU-GSM system is established in this method that the antennas at the transmitter are grouped and Generalized Spatial Modulation (GSM) is adopted in each antenna group. Then, dimensional reduction is made on channel gain matrix as well as transmitting signal matrix, and the equivalent channel gain matrix and transmitting signal matrix are obtained. Finally, Partial Linear Precoding (PLP) precoding is carried out by utilizing the equivalent channel gain matrix. The simulation results show that this method have a better error performance and higher system capacity.

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