Potential Rationales Research Articles

Medical care for transgender individuals at a hospital in southern Brazil: why do they drop out from our service?

The objective of the study was to investigate dropout rates and discern potential factors contributing to the discontinuation of treatment provided to transgender individuals by the Transdisciplinary Gender Identity Program at the Hospital de Clínicas de Porto Alegre (PROTIG). This study employs a descriptive, cross-sectional, retrospective design to analyze socio-demographic and clinical data obtained from medical records of patients treated at PROTIG between 2000 and 2018. A structured form, devised by PROTIG's professional team, was utilized to extract and evaluate several variables including: age, gender, education level, diagnosis of F64 according to the International Classification of Diseases (ICD-10: Version: 2010), clinical comorbidities (coded by ICD-10), laboratory diagnosis of sexually transmitted infections, distance between patients' residence and the hospital, and year of entry into PROTIG. The patient cohort was stratified into two categories based on their duration of attendance: dropout (defined as attendance for up to 365 days) and non-dropout (attendance exceeding 365 days). Categorical variables between dropout and non-dropout groups were compared using Pearson's chi-square test. Additionally, Poisson regression analysis was utilized, employing a 95% confidence interval (CI) and setting the significance level at 0.05. The study included a total of 888 patients accessing PROTIG, with 275 (31%) classified in the dropout group. Of the patient population, 65.5% (n = 582) self-identified as transgender women, while 34.5% (n = 306) identified as transgender men. Significant differences were noted between the dropout and non-dropout groups. Specifically, differences were noted among transgender women (p < 0.001), individuals with lower levels of education (p < 0.001), those with fewer diagnoses classified under ICD-10 as F64 (p < 0.001), individuals exhibiting fewer clinical comorbidities recorded in ICD-10 (p < 0.001), and those who commenced inclusion in PROTIG after 2010 (p < 0.001). There exists a notable rate of treatment discontinuation among individuals receiving care at PROTIG, with statistically significant variances observed between groups. We posit potential rationales for this discontinuation, informed by care experiences and feedback from group attendees: Increased accessibility to outpatient services in our jurisdiction for Transgender Care, along with heightened societal awareness of gender identity fostering diverse gender expression avenues devoid of reliance on gender-affirming surgical interventions.

Abstract 587: Tumor treating fields induce the integrated stress response, alter the transcriptional signatures of cellular metabolism, and modulate immune-related cytokines dependent and independent of p53

Abstract Tumor treating fields (TTFields) are an FDA-approved therapy for the treatment of glioblastoma and pleural mesothelioma. TTFields employ alternating electric fields delivered by cutaneous transducer arrays to induce cytostatic and cytotoxic effects on solid tumors. Additionally, recent studies suggest that TTFields may enhance anti-tumor immunity. We performed RNA-seq and multiplexed cytokine profiling in HCT116 wild-type and HCT116 p53-/- human colorectal cancer cells to elucidate TTFields’ effects on the transcriptome and secretome. TTFields lead to profound changes in the transcriptome related to metabolism, including downregulation of transcripts coding for multiple enzymes involved in the Krebs cycle, fatty acid synthesis, and glycolysis. Furthermore, though only HCT116 p53-wild type cells strongly induced the p53 pathway, both cell types’ transcriptomes showed strong downregulation of cell cycle progression. Our cytokine data showed that key tumor-promoting cytokine IL-8 was downregulated independently of p53. We identified upregulation of immunomodulatory cytokines MIF and MICB independently of p53. While MICB promotes NK cell activation, MIF drives tumor progression. Therefore, MICB may be one way in which TTFields enhance anti-tumor immunity; targeting MIF during TTFields treatment may lead to synergy by abolishing its pro-tumor effects. We also identified a p53-dependent decrease in the TRAIL decoy receptor DcR3, which normally protects tumor cells from TRAIL-induced apoptosis. Further mechanistic work showed that TTFields induce EIF2-alpha phosphorylation, the central protein involved in activating the integrated stress response (ISR), across multiple cancer types, leading to suppression of global protein translation. TTFields treatment also resulted in increased expression of surface calreticulin, an endoplasmic reticulum stress marker, which activates the ISR. Future mechanistic work will explore the impact of identified cytokines and the ISR on anti-tumor immunity both in vitro and in vivo, as well as metabolic alterations induced by TTFields. This work identifies potential biomarkers and rationales for therapeutic combinations exploiting TTFields-induced molecular alterations. Citation Format: Praveen R. Srinivasan, Andrew George, Charissa Chou, Maximilian Pinho-Schwermann, Maryam Ghandali, Vida Tajiknia, Yaara Porat, Moshe Giladi, Andrea Armstead, Alper Uzun, Eric T. Wong, Wafik S. El-Deiry. Tumor treating fields induce the integrated stress response, alter the transcriptional signatures of cellular metabolism, and modulate immune-related cytokines dependent and independent of p53 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 587.

Pilot observational cohort study to determine whether waveform and flow traces from mechanical insufflation–exsufflation (MI-E) can be used to identify laryngeal responses to MI-E and thus optimise treatment algorithms in neuromuscular patients in a tertiary centre: a protocol description

IntroductionPatients with neuromuscular disease often have a weak and ineffective cough due to respiratory muscle weakness. One treatment option is mechanical insufflation–exsufflation (MI-E), also known as cough assist, which is...

Different approaches make comparing studies of burn severity challenging: a review of methods used to link remotely sensed data with the Composite Burn Index

The Composite Burn Index (CBI) is commonly linked to remotely sensed data to understand spatial and temporal patterns of burn severity. However, a comprehensive understanding of the tradeoffs between different methods used to model CBI with remotely sensed data is lacking. To help understand the current state of the science, provide a blueprint towards conducting broad-scale meta-analyses, and identify key decision points and potential rationale, we conducted a review of studies that linked remotely sensed data to continuous estimates of burn severity measured with the CBI and related methods. We provide a roadmap of the different methodologies applied and examine potential rationales used to justify them. Our findings largely reflect methods applied in North America – particularly in the western USA – due to the high number of studies in that region. We find the use of different methods across studies introduces variations that make it difficult to compare outcomes. Additionally, the existing suite of comparative studies focuses on one or few of many possible sources of uncertainty. Thus, compounding error and propagation throughout the many decisions made during analysis is not well understood. Finally, we suggest a broad set of methodological information and key rationales for decision-making that could facilitate future reviews.

Pre-Existing and Acquired Resistance to PARP Inhibitor-Induced Synthetic Lethality.

The advanced development of synthetic lethality has opened the doors for specific anti-cancer medications of personalized medicine and efficient therapies against cancers. One of the most popular approaches being investigated is targeting DNA repair pathways as the implementation of the PARP inhibitor (PARPi) into individual or combinational therapeutic schemes. Such treatment has been effectively employed against homologous recombination-defective solid tumors as well as hematopoietic malignancies. However, the resistance to PARPi has been observed in both preclinical research and clinical treatment. Therefore, elucidating the mechanisms responsible for the resistance to PARPi is pivotal for the further success of this intervention. Apart from mechanisms of acquired resistance, the bone marrow microenvironment provides a pre-existing mechanism to induce the inefficiency of PARPi in leukemic cells. Here, we describe the pre-existing and acquired mechanisms of the resistance to PARPi-induced synthetic lethality. We also discuss the potential rationales for developing effective therapies to prevent/repress the PARPi resistance in cancer cells.

NR1H3 (LXRα) is associated with pro-inflammatory macrophages, predicts survival and suggests potential therapeutic rationales in diffuse large b-cell lymphoma.

The role of macrophages (Mo) and their prognostic impact in diffuse large B-cell lymphomas (DLBCL) remain controversial. By regulating the lipid metabolism, Liver-X-Receptors (LXRs) control Mo polarization/inflammatory response, and their pharmacological modulation is under clinical investigation to treat human cancers, including lymphomas. Herein, we surveyed the role of LXRs in DLBCL for prognostic purposes. Comparing bulk tumors with purified malignant and normal B-cells, we found an intriguing association of NR1H3, encoding for the LXR-α isoform, with the tumor microenvironment (TME). CIBERSORTx-based purification on large DLBCL datasets revealed a high expression of the receptor transcript in M1-like pro-inflammatory Mo. By determining an expression cut-off of NR1H3, we used digital measurement to validate its prognostic capacity on two large independent on-trial and real-world cohorts. Independently of classical prognosticators, NR1H3high patients displayed longer survival compared with NR1H3low cases and a high-resolution Mo GEP dissection suggested a remarkable transcriptional divergence between subgroups. Overall, our findings indicate NR1H3 as a Mo-related biomarker identifying patients at higher risk and prompt future preclinical studies investigating its mouldability for therapeutic purposes.

Using Twitter data to understand public perceptions of approved versus off-label use for COVID-19-related medications.

ObjectiveUnderstanding public discourse on emergency use of unproven therapeutics is essential to monitor safe use and combat misinformation. We developed a natural language processing (NLP)-based pipeline to understand public perceptions of and stances on COVID-19-related drugs on Twitter across time.MethodsThis retrospective study included 609,189 US-based tweets between January 29th, 2020 and November 30th, 2021 on four drugs that gained wide public attention during the COVID-19 pandemic: 1) Hydroxychloroquine and Ivermectin, drug therapies with anecdotal evidence; and 2) Molnupiravir and Remdesivir, FDA-approved treatment options for eligible patients. Time-trend analysis was used to understand the popularity and related events. Content and demographic analyses were conducted to explore potential rationales of people’s stances on each drug.ResultsTime-trend analysis revealed that Hydroxychloroquine and Ivermectin received much more discussion than Molnupiravir and Remdesivir, particularly during COVID-19 surges. Hydroxychloroquine and Ivermectin were highly politicized, related to conspiracy theories, hearsay, celebrity effects, etc. The distribution of stance between the two major US political parties was significantly different (p < 0.001); Republicans were much more likely to support Hydroxychloroquine (+55%) and Ivermectin (+30%) than Democrats. People with healthcare backgrounds tended to oppose Hydroxychloroquine (+7%) more than the general population; in contrast, the general population was more likely to support Ivermectin (+14%).ConclusionOur study found that social media users with have different perceptions and stances on off-label versus FDA-authorized drug use across different stages of COVID-19, indicating that health systems, regulatory agencies, and policymakers should design “targeted” strategies to monitor and reduce misinformation for promoting safe drug use. Our analysis pipeline and stance detection models are made public at https://github.com/ningkko/COVID-drug.

Comprehensive Analysis of R-Spondin Fusions and RNF43 Mutations Implicate Novel Therapeutic Options in Colorectal Cancer

Gene fusions involving R-spondin (RSPOfp) and RNF43 mutations have been shown to drive Wnt-dependent tumor initiation in colorectal cancer. Herein, we aimed to characterize the molecular features of RSPOfp/RNF43 mutated (mut) compared with wild-type (WT) colorectal cancers to gain insights into potential rationales for therapeutic strategies. A discovery cohort was classified for RSPOfp/RNF43 status using DNA/RNA sequencing and IHC. An independent cohort was used to validate our findings. The discovery cohort consisted of 7,245 colorectal cancer samples. RSPOfp and RNF43 mutations were detected in 1.3% (n = 94) and 6.1% (n = 443) of cases. We found 5 RSPO fusion events that had not previously been reported (e.g., IFNGR1-RSPO3). RNF43-mut tumors were associated with right-sided primary tumors. No RSPOfp tumors had RNF43 mutations. In comparison with WT colorectal cancers, RSPOfp tumors were characterized by a higher frequency of BRAF, BMPR1A, and SMAD4 mutations. APC mutations were observed in only a minority of RSPOfp-positive compared with WT cases (4.4% vs. 81.4%). Regarding RNF43 mutations, a higher rate of KMT2D and BRAF mutations were detectable compared with WT samples. Although RNF43 mutations were associated with a microsatellite instability (MSI-H)/mismatch repair deficiency (dMMR) phenotype (64.3%), and a tumor mutation burden ≥10 mt/Mb (65.8%), RSPOfp was not associated with MSI-H/dMMR. The validation cohort replicated our genetic findings. This is the largest series of RSPOfp/RNF43-mut colorectal cancers reported to date. Comprehensive molecular analyses asserted the unique molecular landscape associated with RSPO/RNF43 and suggested potential alternative strategies to overcome the low clinical impact of Wnt-targeted agents and immunotherapy.

Going Green in Asia? Green parties in a non-western setting

ABSTRACT Green parties, first established in the early 1970s, have now become established political actors in most western European countries, and indeed most western nations. In other parts of the globe, however, they have generally been far less successful, not the least in the Asia Pacific region. In part this can be seen as an outcome of unfavourable electoral conditions in many countries in the region, but can also be linked to western notions of Green politics embedded in post-materialism, as well as country-specific issues of clientalism, electoral violence or electoral manipulation. While Green parties in both Australia and New Zealand are well established participants in parliaments and government, by contrast the number and level of success of Green parties in Asia is both small and weak. This article will explore the range of the possible explanations for the non-success of Green parties in this rapidly democratizing region, and consider potential rationales for party failure.

Role of genistein on the yield, structure and immunomodulatory activity of Monascus exopolysaccharides.

Manipulating the structures, physicochemical properties, and monosaccharide compositions of exopolysaccharides (EPS) isolated from microorganisms has been reported to enhance their biological activities. Hence, the aim of this work was to examine the effects of genistein addition during fermentation on the amount, physicochemical properties, and immunomodulatory activity of EPS secreted by M. purpureus. Results showed that genistein addition significantly increased M. purpureus biomass and EPS yield to 2.42 g L-1 and 6.08 g L-1, respectively, and affected the physicochemical properties and structures of EPS. Furthermore, EPS produced by genistein-treated M. purpureus (G-EMP) improved the immunomodulatory activity of RAW264.7 macrophages by increasing the secretion of nitric oxide and cytokines. Moreover, phospho-Jun N-terminal kinase (p-JNK), phospho-extracellular regulated protein kinase (p-ERK), phospho-p38 (p-p38) mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) phospho-p65 (p65) proteins were remarkably upregulated by G-EMP stimulation, blocking Toll-like receptor 4 (TLR4) that dramatically reduced the pinocytic and phagocytic capacities. Overall, these findings provide potential rationales for the application of genistein in improving the EPS yield of M. purpureus.

Expanding Geographical Indication protection at any cost? A critique of the EU law of evocation

As the major pillar of the EU’s quality policy on agricultural products, Geographical Indications (GIs) are protected in the EU at a level significantly higher than in other jurisdictions. Through multilateral and bilateral negotiations, the EU aims to ensure a similar high protection level as is provided in other countries’ national legislations, which has already generated much debate globally. This article focuses on a recent trend in the EU for further enhancing the level of GI protection. By way of reviewing the CJEU’s application of the EU GI regulations that protect GIs against evocation, this article reveals that the scope of GI protection has been extended greatly with an increasingly broad interpretation of evocation by the CJEU. It further traces the source of the evocation provision and examines potential rationales behind GI protection against evocation. It concludes that it lacks legislative tradition and solid justifications to expand the scope of GI protection via the evocation clause. Such a high level of GI protection against evocation, mostly driven by reasons of policy, will lead to a risk of monopoly of techniques and production of certain types of products, and is enforced at the cost of the freedom of communication, trade and industry of other agricultural operators in the EU. Moreover, non-EU countries need to understand the European approach to GI protection, particularly concerning the scope of protection, before they support or adopt it.

Switching of oral anticoagulants in patients with nonvalvular atrial fibrillation: A narrative review.

Approval of direct-acting oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation (AF) was an important milestone, providing a wider range of treatment options and creating the possibility for drug switching after initiation. In addition to improved utilisation of oral anticoagulants (OACs) for stroke prevention, reports of switching among OACs are growing in the literature; switching may influence clinical outcomes, healthcare costs and patient satisfaction. This review aimed to summarise the current literature on the pattern of OAC switching in patients with AF, including reasons for switching and clinical consequences following switching. A literature search was conducted in PubMed, Scopus and Embase on 27 June 2020. We included 39 articles published after 2013, following the introduction of apixaban. The review found that switching among OACs was common in clinical practice, significantly varying with the type of OAC. Studies reporting the reason for switching and clinical outcomes were comparatively limited. The decision to switch was often related to safety issues (usually bleeding), poor anticoagulation control and ease of use. Patient characteristics, clinical conditions and drug interactions were found to be associated with switching from OACs. Findings regarding bleeding outcomes following switching were inconsistent, possibly confounded by the rationale for switching and the switching protocol. Noting the limited number of studies included and their relatively short follow-up periods, switching did not have a significant impact on the risk of stroke and other thrombotic outcomes. Further prospective studies are needed to understand better potential rationales for switching and the clinical outcomes.

Damages in the Australian human rights context

ABSTRACT The article engages with the relationship between statutory rights and damages in Australia. It begins by examining the architecture of the rights statutes in Victoria, Queensland, and the Australian Capital Territory to then determine the justification that Australian legislatures had for precluding damages. Two potential rationales for the non-provision of damages are canvassed: pragmatic-political concerns about government liability and principled concerns about the co-existence of damages and the Commonwealth dialogue model. The article demonstrates that these concerns are not borne out in practice and that the current remedial architecture is inadequate to achieve the statutes’ purposes. It argues that damages play a fundamental role in protecting statutory rights and analyses the suitability of two damages models to the Australian context.

A Model for the Solution Structure of Human Fe(II)-Bound Acireductone Dioxygenase and Interactions with the Regulatory Domain of Matrix Metalloproteinase I (MMP-I).

The metalloenzyme acireductone dioxygenase (ARD) shows metal-dependent physical and enzymatic activities depending upon the metal bound in the active site. The Fe(II)-bound enzyme catalyzes the penultimate step of the methionine salvage pathway, converting 1,2-dihydroxy-5-(methylthio)pent-1-en-3-one (acireductone) into formate and the ketoacid precursor of methionine, 2-keto-4-thiomethyl-2-oxobutanoate, using O2 as the oxidant. If Ni(II) is bound, an off-pathway shunt occurs, producing 3-methylthiopropionate, formate, and carbon monoxide from the same acireductone substrate. The solution structure of the Fe(II)-bound human enzyme, HsARD, is described and compared with the structures of Ni-bound forms of the closely related mouse enzyme, MmARD. Potential rationales for the different reactivities of the two isoforms are discussed. The human enzyme has been found to regulate the activity of matrix metalloproteinase I (MMP-I), which is involved in tumor metastasis, by binding the cytoplasmic transmembrane tail peptide of MMP-I. Nuclear magnetic resonance titration of HsARD with the MMP-I tail peptide permits identification of the peptide binding site on HsARD, a cleft anterior to the metal binding site adjacent to a dynamic proline-rich loop.

Considering Proximal Urea Cycle Disorders in Expanded Newborn Screening.

Proximal urea cycle disorders (PUCDs) have adverse outcomes such as intellectual disability and death, which may benefit from newborn screening (NBS) through early detection and prevention with early treatment. Ornithine transcarbamylase deficiency (OTCD) and carbamoyl phosphate synthetase 1 deficiency (CPS1D) are screened in six and eight states in the United States. We analyzed current evidence to see if it supports inclusion of PUCDs in the NBS panels based upon prevention potential, medical, diagnostic, treatment, and public health rationales. A literature review was performed in PubMed using MESH terms for OTCD, CPS1D, and NAGSD. A systematic review was performed in the hallmark of NBS inclusion criteria. We reviewed 31 articles. Molecular and biochemical diagnosis is available to provide diagnostic evidence. Untreated PUCDs have a significant burden with considerable developmental delay and mortality that may improve with early treatment. Tandem mass spectrometry can be used for NBS for PUCDs; however, citrulline and glutamine alone are not specific. Medical treatments currently available for PUCDs meet existing medical, diagnostic, treatment, and public health rationales. Improvement in NBS algorithms to increase sensitivity and specificity will allow earlier diagnosis and treatment to potentially improve disability and mortality rates.

A study of tour formation: pre-, during, and post-recession analysis

This study examines changes in activity-travel patterns of employed people during a recession by using a tour-based representation of the activity-based approach. The term tour is defined as a sequence of trips and activities that begins and ends at home and contains at least one non-home activity. Tours are classified based on the presence of work and/or non-work activities. We are interested in investigating how a recession can affect an individual’s tour choices. We developed a rigorous methodological framework by using multi-group structural equation modeling (SEM) to analyze changes in tour choice. In particular, we developed a causal structure conceptualsizing the interrelationships among socio-demographic and economic characteristics, activity-travel participation, and the choice of various work and non-work tours. Using data from the American Time Use Survey (ATUS), the study found that activity-travel relationships and their role in tour choice differed in the recession year (2009) compared to pre- and post-recession years (2009 and 2012, respectively). By analyzing temporal changes in causal structure, we identified four sub-trend groups defined by: (1) norms that did not change in pre-, during, and post-recession years, (2) norms that changed during the recession but returned to the old norm, (3) norms that changed during the recession and were maintained as new norm, and finally (4) 2006 norms that did not change during the 2009 recession but changed after the recession. Via analysis of multiple group SEM, we identified instances of each of these cases and provided potential rationales in the context of how a recession can influence norms and thus can affect activity-travel behavior.

Combining prostate cancer radiotherapy with therapies targeting the androgen receptor axis.

Prostate cancer (pca) is the most common non-dermatologic cancer and the 3rd leading cause of male cancer mortality in Canada. In patients with high-risk localized or recurrent pca, management typically includes the combination of long-term androgen deprivation therapy (adt) and radiotherapy (rt). New androgen-receptor-axis targeted therapies (arats), which await validation, offer an option to intensify therapy. In this narrative review, we report the relevant history that has supported combining adt with rt. The literature in PubMed was searched for studies involving pca and novel arats (abiraterone acetate, enzalutamide, apalutamide, darolutamide) published between 1995 and 2019. Literature discussing clinical trials in which those modalities were combined was extracted and synthesized into a combined molecular and clinical discussion. Potential treatment intensification mechanisms and rationales are explored. Early results from three phase i/ii trials demonstrated that concurrent abiraterone acetate, adt, and rt is safe, improves the extent of chemical castration, and is associated with limited treatment failures. A single in vitro study implies synergy for radiosensitization beyond that facilitated by conventional adt. Studies investigating the combination of other arats with rt are under way, including multiple phase iii trials, but short-term results are not yet available.

Third Mission Activities at Austrian Universities of Applied Sciences: Results from an Expert Survey

This article looks at third mission activities as an integral part of universities of applied sciences (UAS) and sheds light on the wide portfolio of third stream initiatives at the Austrian applied higher education sector. In a pilot study, this research explores how the sector (consisting of 21 UAS) perceives its role as an enabler for prosperity, innovation and knowledge transfer in the local areas. In addition, we sought to identify the wide range of potential rationales behind regional engagement, attempted to differentiate between concepts that primarily target the traditional roles of universities (teaching and research) and seek to integrate third mission elements (Entrepreneurial University, Triple Helix, Mode 2) with an eye on economic gains and those that foreground additional responsibilities at the tertiary level for societal purposes. In this sense, we sought to carve out to what extent institutions also engage in third mission activities predominantly for non-economic reasons (Engaged University, Regional Innovation Systems, Sustainable University). Such a differentiation may have the potential to outline the paradigms for third mission activities in a more systematic and structured way. In addition, this analysis may allow Austrian UAS to make more informed decisions along the lines of third-stream initiatives that are based on their strategic positioning and profile.

Taxing Publicly Traded Entities

Publicly traded entities are generally treated as corporations for U.S. tax purposes. Under various exceptions, however, publicly traded entities may obtain special treatment if they earn predominately certain specified types of qualifying income. This Article examines potential rationales for granting special tax treatment to certain publicly traded entities. As the analysis in this Article will show, many of the potential rationales are unconvincing. In addition, to the extent that some rationales may be persuasive, the current rules are not designed in a way that best comports with these potential justifications. Therefore, reform is needed. To reform the current system, this Article proposes narrowing the scope of what may be classified as qualifying income so that special tax treatment is bestowed upon publicly traded entities only when warranted by underlying policy justifications. Specifically, this Article proposes that income that is classified as qualifying income under current law should not be classified in that manner unless it is earned by holding a publicly traded asset. In addition, current law grants favorable treatment to all income earned by a publicly traded entity if and only if the entity earns predominately qualifying income. This Article assesses whether tax law should, instead, grant special tax treatment to only qualifying income earned by a publicly traded entity, but with the special treatment applying regardless of whether the entity earns predominately qualifying income. Ultimately, this Article concludes that, on balance, concerns about complexity justify continuation of a regime under which beneficial treatment applies to all income earned by a publicly traded entity if and only if the entity earns predominately qualifying income, provided that the scope of what may be classified as qualifying income is narrowed in the manner proposed by this Article.

Why have many U.S.-listed Chinese firms announced delisting recently?

In this study, we propose a new rationale for firms' delisting and going private decision: voluntary delist then reissue shares and relist in the “home” country, because of favorable government economic policy and regulatory changes. 29 (27) out of 127 U.S.-listed Chinese ADRs announced going private during 2015 alone (2011–14). Using these two waves of Chinese ADRs going private, we first examine three potential rationales proposed by prior literature, namely, undervaluation, free cash flows and cash holdings, and financial visibility. We find support for them generally, especially for the undervaluation hypothesis. More importantly, we provide evidences supporting our new rationale: government policy changes, which played a significant role in the 2015 wave of Chinese ADRs going private. Overall, our study highlights intensive competition among major international stock exchanges and the importance of government policy in the modern era of increasingly inter-connected global capital markets.