bluuebunny/crossref_metadata_2025 huggingface dataset:
Bell Model with Hidden Variables and Bohr Quantum Postulate on the Existence of Indivisible Quantum of Action Given by Planck Constant H.
Authors: Khrennikov Andrei
Published: July 2020

This note is a part of my efforts for getting rid of nonlocality from quantum mechanics (QM). Quantum nonlocality is two faced Janus, one face is apparent quantum mechanical nonlocality (assigned with projection postulate), another face is nonlocality of Bell's model with the hidden variables. This paper is directed against the latter. The main casualty of Bell's model is that it contradicts to the Heinsenberg's uncertainty and Bohr's complementarity principles. The aim of this note is to point to the physical seed of the aforementioned principles. This is the {\it quantum postulate}: the existence of indivisible quantum of action given by the Planck constant. Bell's model by contradicting to the basic principles of QM implies rejection of this postulate. Thus, it contradicts not only to the QM-formalism, but also to the fundamental feature of the quantum world that was initially discovered by Planck.
Treatment of Acute Respiratory Distress Syndrome with Vasoactive Intestinal Peptide
Authors: Youssef Jihad Georges , Said Sami , Javitt Matthew , Javitt Jonathan
Published: July 2020

Purpose: To assess the clinical safety and possible effectiveness of Vasoactive Intestinal Peptide in the treatment of Acute Respiratory Distress Syndrome (ARDS) related to sepsis. Methods: Under FDA Investigational New Drug clearance, 8 patients with ARDS related to sepsis were treated with 50 pmole/kg/hr – 100 pmole/kg/hr of Vasoactive Intestinal Peptide by intravenous infusion for 12 hours. All patients were on mechanical ventilation and full telemetery. Results: No drug-related serious adverse events were seen. Hypotension was seen in association with two infusions and diarrhea in association with one, but did not necessitate cessation of therapy. Bigeminy was seen in association with one infusion without sequelae. Seven of eight patients demonstrated a successful course during intensive care and were successfully removed from mechanical ventilation and discharged from intensive care. The eighth patient succumbed to purulent secretions in the lungs. Of those who were discharged from the ICU, six demonstrated successful 30 day survival. The seventh died from a cerebral infract at day 30, deemed unrelated to treatment with VIP. Serum levels of Tumor Necrosis Factor α were obtained in 6 patients at baseline and 24 hours and were seen to decrease with treatment in five patients. Conclusions: Initial clinical results of treatment with VIP in patients with ARDS demonstrated a safety profile consistent with previous studies in normal volunteers. The successful clinical course seen in 7 of 8 patients in the setting of an expected 50% survival may suggest that VIP shows promise in the treatment of other infectious conditions that damage the pulmonary epithelium, particularly COVID-19.
Molecular evidence of Francisella noatunensis sub sp. orientalis in Oreochromis niloticus in Yunnan Province, south-western China
Authors: Niu Guoyi , Khattiya Rutch , Boonyayatra Sukolrat , Wongsathein Dilok , Hueston William
Published: July 2020

Francisella sp. is an emerging bacterial pathogen affecting tilapia Oreochromis niloticus This study surveyed presence of Francisella sp. in tilapia raised in Yunnan Province, south-western China along with water quality parameters and management practices. A total of 224 tilapia specimens were sampled from 28 farms between June and September 2017. Necropsy of the sampled fish revealed no granulomatous lesions and the standard bacterial isolation protocols proved negative for Francisella sp. However, the presence of Francisella sp. was confirmed by polymerase chain reaction in 18 samples (8%) from 8 of the 28 farms (28.6%) sampled, though no increasing mortality was reported from these farms. The 16S ribosomal RNA gene sequences revealed 99.7% identity with F. noatunensis sub sp. orientalis. The presence of Francisella sp. infection showed significant association with water temperature.
Efektivitas Pembelajaran Sejarah Kebudayaan Islam dengan Menggunakan Multimedia Autoplay di Kelas XI Madrasah Aliyah Kota Samarinda
Authors: Rumainur Rumainur , Razak Abdul
Published: July 2020

The history of Islamic culture is one of the subjects that emphasizes more on historical stories. Multimedia autoplay is one of the media that helps SKI learning more interesting and innovative, not just to present conventional learning. This is in accordance with the development of the industrial revolution era 4.0. The purpose of this research was to determine the effectiveness of learning outcomes of the history of Islamic culture by using multimedia autoplay in class XI Madrasah Aliyah Samarinda City. This type of research used in this research is quasi-experimental design with pretest-posttest control group design. The population in this research were all Madrasah Aliyah, Samarinda City, East Kalimantan Province and the samples used in this research were two classes from three schools namely MAN 2 Samarinda, MA Terpadu Al Uswah, and MA Al Mujahidin with the purposive sampling technique. Data collection techniques used are tests and documentation. The data analysis technique used is the t test with the prerequisites for normality tests using Kolmogorov Smirnov and homogeneity tests using Levene's. Judging from the average learning outcomes, the results of this research are that using Multimedia Autoplay is greater than the conventional method. Thus the used of Multimedia Autoplay is effective against learning outcomes of the history of Islamic culture in Madrasah Aliyah, Samarinda City.
Short Report on an Intensive Archeological Survey for the City Of Lockhart’s Proposed Sidewalk Improvements Project, Lockhart, Caldwell County, Texas
Authors: Haefner Josh , Sarich Steven
Published: July 2020

On behalf of the City of Lockhart (the City), TRC Environmental Corporation (TRC) recently conducted an intensive archeological survey for the City’s sidewalk improvements project located in Lockhart, Caldwell County, Texas. According to design plans, the project will entail the construction of a 10-foot (ft) wide by 2,220 ft long concrete sidewalk that will enhance connectivity and accessibility through Lockhart City Park (Figures 1-1 and 1-2). The Area of Potential Effects (APE) is 0.98 acres in size (Appendix A: Design Plans). Concrete path construction will cause disturbance of up to one foot below the existing grade along the alignment of the path. As the project will be located on lands under purview of an entity of the State of Texas, the project is subject to compliance with the Antiquities Code of Texas (ACT). During coordination with the Texas Historical Commission (THC) it was determined that the APE located east of State Highway (Hwy) 183 would require survey prior to construction (Appendix B: Regulatory Correspondence).

Archeological survey was conducted on October 8, 2019 by Benjamin Johnson and Steven Sarich and on October 17, 2019 by Pollyanna Clark, Josh Haefner, Benjamin Johnson and Steven Sarich. During the survey, five shovel tests were excavated and four no dig locations were recorded. Due to the proximity of the APE to marked graves, the presence of the broken grave marker deposited downslope, and the inaccuracy of the currently mapped cemetery boundary on the THC Atlas, TRC recommended that the portion of the APE that coincides with the Lockhart Cemetery be subject to machine scraping. On November 5, 2019 the survey area was revisited to conduct mechanical scraping where the APE was noted to be in proximity to marked burials. No evidence of any cultural materials or grave shafts were encountered during monitoring of scraping.
Cultural Resources Survey of the Proposed Moore Park Athletic Complex, Plano, Collin County, Texas
Authors: Lang Brett , Green Melissa
Published: July 2020

In March 2020, an intensive cultural resources survey of the proposed Moore Park athletic complex in Plano, Collin County, Texas was completed in order to inventory all cultural resources. The project parcel currently lies within an open field at the southwest corner of the intersection of Chaparral Road and Cottonwood Creek. It is bounded by Chaparral Road on the north, Cottonwood Creek to the east, Bright Star Way on the south, and Cloverhaven Way on the west in a densely residential developed area. A North Texas Municipal Water District building is located in the far northwestern corner near Cottonwood Creek. The archeological area of potential effects (APE) covers an area of approximately 103 acres (42 hectares). Because the project is owned and funded by the City of Plano, a political subdivision of the State of Texas, the project is subject to the Antiquities Code of Texas (9 Texas Natural Resources Code [TNRC] 191), which requires consideration of effects on properties designated as—or eligible to be designated as—State Antiquity Landmarks (SALs), which includes archeological resources. The survey was carried out for the City of Plano, Parks and Recreation under Texas Antiquities Permit 9334 by Brett Lang (Project Archeologist) of Cox|McLain Environmental Consulting, Inc. (CMEC). Melissa M. Green was the Principal Investigator. The parcel is situated on an upper terrace above Cottonwood Creek. From the western boundary, an unnamed tributary of Cottonwood Creek flows from the northwest corner to the southwest corner of the project parcel (as the terrace slopes southeastward) into Cottonwood Creek approximately 860 meters or 2821.5 feet away. Cottonwood Creek parallels the eastern boundary of the APE. Ground surfaces within the project area parcel were mostly covered in short, ankle-high prairie grasses used for active cattle grazing allowing for some limited visibility ranging from 20 to 50 percent. A densely wooded section was observed along the eastern boundary and along part of the tributary, allowing for 30 to 80 percent ground visibility. In all, 19 shovel test units were excavated judgmentally across the project area, of which none contained cultural materials. All materials (notes, photographs, administrative documents, and other project data) generated from this work will be housed at the Center for Archeological Studies at Texas State University at San Marcos, where they will be made permanently available to future researchers per 13 Texas Administrative Code 26.16-17. If any unanticipated cultural materials or deposits are found at any stage of clearing, preparation, or construction, the work should cease and Texas Historical Commission personnel should be notified immediately. The Texas Historical Commission concurred with the findings and recommendations of this report on 8 May 2020.
Famous Barriers Within the Bowtie Levels Analysis: Creating Middle and Senior Management Understanding About the Relative Importance of Management Activities. Providing Mathematical Methods
Authors: Hudson Timothy , Hudson Peter
Published: July 2020

The paper discusses extending the use of the Frequency Adjusted Measured Effectiveness (FAME) methodology (SPE-190633)(SPE-197793) to the operational, organisational and cultural levels in bowties. The method enables risk management functions to steer senior management toward effective management actions at the middle management level, allows greater understanding of the cultural and regulatory factors impacting those management activities, and provides a clearer understanding of where the most important impact can be achieved through organisational change.

This paper develops Bowtie concepts by applying FAME (SPE-190633)(SPE-197793) to the bowtie ‘levels analysis’ (SPE 127180). The ‘levels analysis’ defines the barriers at the levels of a bowtie as the workplace (Level 1, L1), organisational (Level 2, L2), and cultural and regulatory factors (Level 3, L3). FAME quantifies the relative importance of barriers within bowtie systems as a whole. The paper uses these concepts to provide simple ways of providing middle and senior managers with understanding about how well their risks are being managed.

The disconnect between what management does and what actually needs to be done has been shown to contribute strongly to accidents. Without the support of analytical tools to steer decision-making, management activities are generally prioritised on an ad-hoc basis, usually guided by an individual manager's experience as well as senior management pressures. This can lead to important management activities not being conducted as rigorously as they require. The Levels Analysis improves understanding of the middle and senior management roles involved in the management of the risks of the operation, while the FAME methodology supports the understanding of the relative importance of those activities, allowing prioritisation. When applied this allows risk-based decision-making to be applied not only to frontline tasks but also to higher-level management functions. This approach, by looking at all the management functions controlling barriers, allows risk managers to communicate clearly the priority safety critical management functions require to senior managers.

This allows the conversation to change from "why wasn't he wearing his gloves?" to "how did we not have a start-up audit on this contract?" The emphasis is moved from immediate causes that are hard to control to factors that are within the span of control of middle and senior managers. This paper introduces a method for clearly communicating to middle and senior management what their own critical management functions are, which are most important and what they can and should be held accountable for.
Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs
Authors: Zhou Lixin , Wu Bo , Wu Liyong , Cheng Xin , Hu Bo , Yao Ming , Zhu Yicheng , Peng Bin , Cui Liying , Ni Jun
Published: July 2020

Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredit neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredit Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.
Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: Is superiority a one-sided understanding?
Authors: Zhu Yangmin , Gao Qingyan , Hu Jing , Guan Dongrui , Liu Xu , Zhang Fengkui
Published: July 2020

Acquired aplastic anemia (AA) is a rare hematologic disease characterized by a profound pancytopenia and hypocellular bone marrow. To comprehensively compare the efﬁcacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with immunosuppressive therapy (IST) as a front-line treatment for patients with AA. We searched the Medline, Embase, and Cochrane Registry of Controlled Trials databases from January 2000 to March 2019. Studies comparing allo-HSCT with IST as a first-line therapy for patients with AA were included. Fifteen studies including a total of 5336 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival (OS) was 0.4 (95% CI 0.074–0.733, P = 0.016, I2 = 58.8%) and the pooled HR for failure-free survival (FFS) was 1.962 (95% CI 1.43–2.493, P = 0.000, I2 = 0%). The pooled relative risk (RR) for overall response rate (ORR) was 1.691 (95% CI 1.433–1.996, P = 0.000, I2 = 11.6%). Although survival was significantly longer among AA patients undergoing first-line allo-HSCT compared to those undergoing first-line IST, the selection of initial treatment for patients with newly diagnosed AA still requires comprehensive evaluation of donor availability, patient age, expected quality of life, risk of disease relapse or clonal evolution after IST, and potential use of adjunctive eltrombopag.
Cost-effective joint Optimisation of BBU Placement and Fronthaul Deployment in Brown-field Scenarios
Authors: Marotta Andrea , Correia Luis Manuel
Published: July 2020

In this work , one proposes a model to evaluate the optimal deployment of Centralised Radio Access Network (C- RAN ) architecture elements , i.e. Base Band processing Units ( BBUs ) and fronthaul links , in a brown- field scenario, in which traditional base stations are already deployed and a physical network is present. The proposed optimisation framework jointly optimises BBU placement and access network infrastructures deployment . It clusterises the Remote Radio Heads in the scenario through a Multicommodity Flow approach , and solves the minimum cost fronthaul network deployment through a Rooted Delay - Constrained Minimum Spanning Tree approach . Optical fibre and microwave links are considered as fronthaul infrastructures . The proposed optimisation framework is validated through a comparison with a theoretical output for a canonical scenario, being afterwards applied to a real scenario. A cost analysis for different scenario configurations is presented , and trade - offs and guidelines for a cost optimal deployment of C- RAN are provided . The analysis of results for the real scenario of the city of Lisbon and its surrounding areas shows that the delay budget in the fronthaul network highly impacts on capital expenditures as well as on operational ones . It is shown that a larger delay budget enables an annual cost reduction up to 72 % in urban areas and 54 % in rural ones .
A knowledge-based intensity-modulated radiation therapy treatment planning technique for locally advanced nasopharyngeal carcinoma radiotherapy
Authors: Bai Penggang , Weng Xing , Quan Kerun , Chen Jihong , Dai Yitao , Xu Yuanji , Lin Fasheng , Zhong Jing , Wu Tianming , Chen Chuanben
Published: July 2020

BackgroundTo investigate the feasibility of a knowledge-based automated intensity-modulated radiation therapy (IMRT) planning technique for locally advanced nasopharyngeal carcinoma (NPC) radiotherapy.Methods140 NPC patients treated with definitive radiation therapy with the step-and-shoot IMRT techniques were retrospectively selected and separated into a knowledge library (n=115) and a test library (n=25). For each patient in the knowledge library, the overlap volume histogram (OVH), target volume histogram (TVH) and dose objectives were extracted from the manually generated plan. 5-fold cross validation was performed to divide the patients in the knowledge library into 5 groups before validating one group by using the other 4 groups to train each neural network (NN) machine learning models. For patients in the test library, their OVH and TVH were then used by the trained models to predict a corresponding set of mean dose objectives, which were subsequently used to generate automated plans (APs) in Pinnacle planning system via an in-house developed automated scripting system. All APs were obtained after a single step of optimization. Manual plans (MPs) for the test patients were generated by an experienced medical physicist strictly following the established clinical protocols. The qualities of the APs and MPs were evaluated by an attending radiation oncologist. The dosimetric parameters for planning target volume (PTV) coverage and the organs-at-risk (OAR) sparing were also quantitatively measured and compared using Mann-Whitney U test and Bonferroni correction.ResultsAPs and MPs had the same rating for more than 80% of the patients (19 out of 25) in the test group. Both AP and MP achieved PTV coverage criteria for no less than 80% of the patients. For each OAR, the number of APs achieving its criterion was similar to that in the MPs. The AP approach improved planning efficiency by greatly reducing the planning duration to about 17% of the MP (9.85±1.13 min vs. 57.10±6.35 min).ConclusionA robust and effective knowledge-based IMRT treatment planning technique for locally advanced NPC is developed. Patient specific dose objectives can be predicted by trained NN models based on the individual’s OVH and clinical TVH goals. The automated planning scripts can use these dose objectives to efficiently generate APs with largely shortened planning time. These APs had comparable dosimetric qualities when compared to our clinic’s manual plans.
Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization
Authors: Ishida Yukako , Shigematsu Hideki , Tsukamoto Shinji , Morimoto Yasuhiko , Iwata Eiichiro , Okuda Akinori , Kawasaki Sachiko , Tanaka Masato , Fujii Hiromasa , Tanaka Yasuhito , Kido Akira
Published: July 2020

Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL.Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses.Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within seven days (p < 0.05) and in patients who could survive longer than three months after the surgery (p < 0.05).Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.
Digital Crowdsourcing in Promoting HIV testing Among MSM in China: Study Protocol for A Cluster-Randomized Controlled Trial
Authors: Ren Ci , Tucker Joseph David , Tang Weiming , Tao Xiaorun , Liao Meizhen , Wang Guoyong , Jiao Kedi , Xu Zece , Zhao Zhe , Yan Yu , Lin Yuxi , Li Chuanxi , Wang Lin , Li Yijun , Kang Dianmin , Ma Wei
Published: July 2020

Background: Men who have sex with men (MSM) are an important key population in China. However, HIV testing rates among MSM remain suboptimal. Digital crowdsourcing may be a useful tool to reach this marginalized population. The proposed cluster randomized controlled trial (RCT) study aims to assess the effectiveness of digital crowdsourcing in improving HIV testing and sexual behaviors change among Chinese MSM. Methods: A two-arm, cluster-randomized controlled trial will be implemented in eleven cities (ten clusters) in Shandong Province, China. Target study enrollment will be 250 participants per arm and 50 participants per cluster. MSM who are 18 years old or above, live in the study city, have not been tested for HIV in the past 3 months, are not living with HIV or have never been tested for HIV, and are willing to provide informed consent, will be enrolled. MSM will be recruited through banner advertisements on Blued, the largest gay dating app in China, and in-person at community-based organizations (CBOs). Participants will be followed-up quarterly during the 12-month period. The primary outcome will be the self-reported uptake of HIV testing. Secondary outcomes will include change in condomless sex, self-test efficacy, social network engagement, HIV testing social norms, and testing stigma.Discussion: Innovative approaches to HIV testing among marginalized population are urgently needed. Through this cluster randomized controlled trial, we expected that we can evaluate effectiveness of a digital crowdsourcing approach, improve the HIV testing rate among MSM and provide a resource in related public health fields.Trial Registration: ChiCTR1900024350. Registered on 6 July 2019, identifier http:// chictr.org.cn/.
Precarious working conditions and psychosocial work stress act as a risk factor for symptoms of postpartum depression during maternity leave: results from a longitudinal cohort study
Authors: Karl Marlene , Schaber Ronja , Kress Victoria , Kopp Marie , Martini Julia , Weidner Kerstin , Garthus-Niegel Susan
Published: July 2020

Introduction: Most Western women work during their reproductive years, but past research has often neglected the influence of work-related factors on postpartum health. Especially postpartum depression (PPD) puts an enormous psychological burden on mothers. Therefore, this study aims to investigate the prospective impact of precarious working conditions and psychosocial work stress (such as work-privacy conflict and effort-reward imbalance at the job) during pregnancy on symptoms of maternal PPD. Methods: In the prospective-longitudinal cohort study DREAM ( DR esdner Studie zu E lternschaft, A rbeit und M entaler Gesundheit), N = 587 employed women were questioned about their work during pregnancy and mental health 8 weeks after delivery. Results: Multiple regression analyses revealed that work-privacy conflict, low reward at work, and precarious working conditions significantly predicted symptoms of PPD, even when controlling for lifetime depression, anxiety, education, parity, and age. Conclusion: Our results indicate that psychosocial work stress and precarious working conditions have important implications for maternal peripartum mental health and might act as prospective risk factors for PPD even during the period of maternal leave. Hence, preventative measures targeting work life need to be investigated in more detail.
Three-dimensional length from the center of the liver is a prognostic factor of colorectal cancer with liver metastasis: a retrospective analysis
Authors: Bong Jun Woo , Ju Yeonuk , Seo Jihyun , Kang Sang Hee , Park Pyoung-Jae , Choi Sae-Byeol , Lee Sun Il , Oh Sang Cheul , Min Byung Wook
Published: July 2020

Background Resectability of liver metastasis is important to establish a treatment strategy for colorectal cancer patients. We aimed to evaluate the effect of distance from metastasis to the center of the liver on the resectability and patient outcomes after hepatectomy.Methods Clinical data of a total of 124 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as “Centrality”. Predictive effects on positive resection margin and overall survival of centrality were statistically analyzed.Results The value as a predictive factor for the positive resection margin of centrality was analyzed by the receiver operating characteristic curve (area under the curve = 0.72, P<0.001) and centrality ≤ 1.5 cm was an independent risk factor the positive resection margin in multivariate analysis. Total number of metastases ≥ 3 and centrality ≤ 1.5 cm were significant risk factors of overall survival after Cox regression analysis. Patients with these two risk factors (n=21) had worse 5-year overall survival (10.7%) than patients with one (n=35, 58.3%) or no risk factor (n=68, 69.2%).Conclusion Centrality was related with the positive resection margin of deeply located liver metastasis. Centrality should be considered to establish the surgical strategy for patients with advanced colorectal cancer with liver metastasis.
Metadichol ® a novel nano lipid that inhibits In Vitro, SARS-COV-2 and a multitude of pathological viruses
Authors: Raghavan Palayakotai R
Published: July 2020

New pathogenic virus outbreaks, occurring with increasing regularity, are leading us to explore novel approaches, which will reduce the reliance on time-consuming vaccine modes to halt the outbreaks. The requirement is to find a universal approach to disarm any new and as yet unknown viruses as they appear. A promising approach could be targeting lipid membranes, which are common to all viruses and bacteria.The ongoing pandemic of severe acute respiratory syndrome-coronavirus 2 (SARS-COV-2) has reaffirmed the importance of interactions between components of the host cell plasma membrane and the virus envelope as a critical mechanism of infection. Metadichol®, a nano lipid emulsion, has been examined and shown to be a strong candidate to help stop the proliferation of SARS-COV-2.Naturally derived substances, such as long-chain saturated lipid alcohols, reduce the infectivity of various types of viruses, including coronaviruses such as SARS-COV-2, by modifying lipid-dependent attachment to human host cells. SARS-COV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.Metadichol®, a nano lipid formulation of long-chain alcohols, has been shown to inhibit TMPRSS2 (EC50 96 ng/ml). Compared to the inhibitor camostat mesylate (EC50 26000 ng/ml), it is 270 times more potent. Additionally, Metadichol® is also a weak inhibitor of ACE2 at 31 µg/ml. Further a live virus assay in Caco2 cells, Metadichol® inhibited SARS-CoV-2 replication with an EC90 of 0.16 µg/ml.
Targeted deletions of complement lectin pathway genes improve outcome in traumatic brain injury
Authors: Mercurio Domenico , Oggioni Marco , Fumagalli Stefano , Lynch Nicholas , Roscher Silke , Minuta Denise , Perego Carlo , Ippati Stefania , Wallis Russell , Schwaeble Wilhelm , Simoni Maria-Grazia De
Published: July 2020

The complement system is believed to contribute to inflammation in acute brain injury. This work defines the neurobehavioral response to traumatic brain injury (TBI) modeled by controlled cortical impact in wild-type mice and in mice carrying gene-targeted deficiencies of individual components of the lectin pathway of complement activation to identify the key components contributing to pathology. Targeted gene deletions include: the recognition subcomponents ficolin-A, CL-11, MBL-C and MBL-A, both individually and combined, and the serine proteases MASP-1, MASP-2 and MASP-3. Our results demonstrate that MASP-2 deficiency brings the highest protective phenotype, countering long-term neuroinflammatory injury following TBI, as shown by reduced neuronal deficits and neuronal cell loss compared to wild-type mice. This study highlights MASP-2 as a promising pharmacological target in patients suffering from TBI, a leading cause of death and disability.
MULocDeep: A deep-learning framework for protein subcellular and suborganellar localization prediction with residue-level interpretation
Authors: Jiang Yuexu , Wang Duolin , Yao Yifu , Eubel Holger , Künzler Patrick , Møller Ian , Xu Dong
Published: July 2020

Prediction of protein localization plays an important role in understanding protein function and mechanism. In this paper, we propose a general deep learning-based localization prediction framework, MULocDeep, which can predict multiple localizations of a protein at both subcellular and suborganellar levels. We collected a dataset with 45 suborganellar localization annotations in 10 major subcellular compartments, the most comprehensive suborganelle localization dataset to date. We also experimentally generated an independent dataset of mitochondrial proteins in Arabidopsis thaliana cell cultures, Solanum tuberosum tubers, and Vicia faba roots and made this dataset publicly available. Evaluations using the above datasets show that overall MULocDeep outperforms other major methods at both subcellular and suborganellar levels. Furthermore, MULocDeep assesses each amino acid’s contribution to localization, which provides insights into the mechanism of protein sorting and localization motifs. A web server can be accessed at http://mu-loc.org/.
Targeting the N-terminus of α-synuclein Monomer Reduces Fibril-induced Aggregation in the Brain
Authors: Szegõ Éva M. , Szegő Éva M. , Boß Fabian , Komnig Daniel , Gärtner Charlott , Höfs Lennart , Shaykhalishahi Hamed , Wördehoff Michael , Saridaki Theodora , Schulz Jörg B. , Hoyer Wolfgang , Falkenburger Björn H.
Published: July 2020

Background

Removing α-synuclein aggregates or preventing their formation constitutes a plausible strategy against Parkinson’s disease (PD). As we recently demonstrated, the β-wrapin protein AS69 binds an N-terminal region in monomeric α-synuclein (aSyn), interferes with fibril nucleation and reduces aSyn aggregates in vitro and in a fruit fly model of A53T aSyn toxicity. Here we tested whether AS69 could also reduce aSyn pathology in mammalian neurons and in mouse brain.
Methods

Primary mouse neurons were exposed to pre-formed fibrils (PFF) of human WT aSyn or PFF was injected into the striatum of A30P-aSyn transgenic mice to induce aSyn pathology. Densities of phospho-aSyn positive somatic inclusions and dystrophic neurites, degeneration of dopaminergic axon terminals in the striatum and the glial response were determined.
Results

PFF were readily taken up by primary mouse neurons, and AS69 did not alter PFF uptake. aSyn pathology, as determined by phospho-aSyn staining, was much more pronounced 72 h after PFF addition than after 24 h, and was reduced by AS69. In the striatum, PFF increased aSyn pathology, induced degeneration of dopaminergic axon terminals and glial activation at 90 days after PFF injection. The extent of terminal loss correlated with the density of dystrophic neurites, but not with the number of somatic inclusions. Co-injection of AS69 with PFF abrogated the induction of somatic inclusions and dystrophic neurites, reduced the loss of dopaminergic axon terminals and the reaction of astroglia, but not the effect on microglia.
Conclusion

AS69, an aSyn monomer-binding protein, reduces aSyn pathology and loss of dopaminergic terminals in primary neurons and in a mouse model. Therefore, our data suggests, that small aSyn-monomer binding proteins, such as AS69, could be promising new therapeutic approaches against Parkinson's disease.
A qualitative study exploring barriers to adequate uptake of antenatal care in pre-conflict Syria: Implications for post conflict interventions addressing the demand-side barriers
Authors: Mourtada Rima , Bashour Hyam , Houben Fiona
Published: July 2020

Background

Until the onset of the conflict in 2011, Syria has made noticeable progress in reducing maternal mortality and morbidity. Despite the improvement in antenatal care (ANC) coverage and patterns of use, analyses of national surveys demonstrated wide regional variations in uptake, timing and number of visits even after controlling for women’s socio-demographic characteristics. The main aim of this study is to highlight the barriers to women’s adequate uptake of ANC that existed in Syria pre-conflict, comparing two governorates: Latakia, where uptake of antenatal care was high and Aleppo, where uptake of ANC was low.
Methods

This qualitative study carried out 30 in-depth interviews with (18–45 year old) pregnant women from Aleppo and Latakia and conducted 15 participant observation sessions in different types of health facilities that provide ANC. Participants were purposively recruited from randomly selected rural and urban, public and private health facilities, and independent midwives’ clinics, with onward sampling of women who did not attend ANC. Transcripts and fieldnotes were analyzed using the framework approach.
Results

Inadequate uptake of ANC in Aleppo included not attending ANC, discontinuing care or seeking care with unqualified providers. Three themes emerged that explained the disparities in uptake of ANC in Aleppo compared to Latakia: women’s assessment of their own health status in pregnancy, women’s evaluation of the risks of seeking ANC, and women’s appraisal of the value of different types of service providers. These evaluations were connected with the availability, accessibility (geographical and financial) and acceptability of ANC services however women’s views were shaped by the knowledge and prevailing opinions in their families and community.
Conclusions

Findings are utilized to discuss low-cost interventions addressing the disparities in uptake of ANC. Interventions should be aimed at increasing vulnerable women’s capacity and capabilities to make informed decisions. Women’s groups that foster education and empowerment and which have been effective in other low resource settings are worth exploring in Syria. Increased use of mobile phones and social media platforms that were not present pre-conflict, suggests mobile health technologies (mHealth) may present efficient platforms to deliver these interventions.
Assessment of Blood Consumption score for pediatrics (ped-ABC score) predicts transfusion requirements for children with trauma.
Authors: Komori Akira , Deshpande Gautam A. , Aoki Makoto , Saitoh Daizoh , Naito Toshio , Abe Toshikazu
Published: July 2020

Background

Although transfusion is one of primary life-saving elements, the assessment of requirement for transfusion in children with trauma at an early phase has been challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma.
Methods

This is a retrospective cohort study, which employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included the patients aged < 16 years with blunt trauma between 2004 and 2015. An Assessment of Blood Consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤ 90 mmHg; heart rate ≥ 120/min; Glasgow Coma Scale (GCS) < 15; and positive result on focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cut-off points for different ages.
Results

In total, 540 patients had transfusion within 24 hours after trauma among the eligible 5,943 pediatric patients with trauma. The in-hospital mortality rate was 2.6% (145/5,615). Transfusion increased from 7.6% (430/5,631) to 35.3% (110/312) in patients with systolic blood pressure ≤ 90 mmHg (1 point); from 6.1% (276/4,504) to 18.3% (264/1,439) for heart rate ≥ 120/min (1 point); from 4.1% (130/3,198) to 14.9% (410/2,745) for disturbance of consciousness with GCS < 15 (1 point); and from 7.4% (400/5,380) to 24.9% (140/563) for FAST positivity (1 point). The ped-ABC score of 0, 1, 2, 3, and 4 points were associated with the transfusion rates of 2.2% (48/2,210), 7.5% (198/2,628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% CI, 0.74–0.78).
Conclusions

The ped-ABC score using the vital signs and FAST may be helpful in predicting the transfusion requirements within 24 hours for children with trauma.
Diagnostic value of combined pleural IL-33, ADA and peripheral T-SPOT.TB for tuberculous pleurisy
Authors: Fenhua Jin , Daohui Wang , Hui Lin , Xiaodong Xia , huang wen
Published: July 2020

【Objective】To investigate the correlation between pleural fluid interleukin-33(IL-33) and adenosine deaminase ༈ADA༉ and peripheral blood tuberculosis T cell spot detection ༈T-SPOT.TB༉,and the combined value of the three tests for the diagnosis of tuberculous pleurisy.【Method】79 patients with pleural effusion admitted from June 2017 to December 2018 were enrolled. They were divided into tuberculous pleural effusion ༈TPE༉ group (57 cases, 72.2%) and malignant pleural effusion group(17 cases,21.5%), pneumonia-like pleural effusion group (5 cases, 6.3%). Correlation between pleural fluid IL-33,pleural effusion ADA and peripheral blood T-SPOT.TB was analyzed, comparison of the three separate and combined diagnostic efficacy was also performed.【Result】The levels of IL-33, ADA and peripheral blood T-SPOT.TB in patients with TPE were significantly higher than those in non-TPE (P < 0.001). The level of pleural fluid IL-33 was positively correlated with pleural effusion ADA and peripheral blood T-SPOT.TB. The Area under the ROC curve༈AUC༉of TPE diagnosed by pleural IL-33, ADA and peripheral blood T-SPOT.TB were 0.753, 0.912 and 0.865, respectively. AUC for combined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB is the largest, with a value of 0.962. Specificity is 100% and sensitivity is 88.5%.【Conclusion】Combined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB can improve the diagnostic efficacy of tuberculous pleurisy.
Bolstering Maternity Insurance to Support Family Health of Ethnic-Minority Women under Universal Two-Child Policy: Empirical Evidence from China’s Ningxia-Hui Autonomous Region
Authors: Antwi Henry Asante , Zhou Lulin , Antwi Maxwell Opuni , Boafo-Arthur Ama , Mustafa Tehzeeb
Published: July 2020

Background Despite the overwhelming feeling of great happiness, joyful excitement and rituals that heralds the arrival of a child, for too many women (especially in developing countries), child bearing is associated with suffering, ill health and even death. The need to consolidate and support women to procreate in tranquillity has inspired international and domestic agencies to harness the resources at their disposal to protect the health of women especially during pregnancy, child birth and the post-partum period. Methods The study applied a systems dynamic model to selected data to establish the influence of the universal two-child policy in China on maternity insurance fund income. The study also established sensitivity analysis of the appropriate rate of contribution to keep the fund active. Results The study revealed that increases in utilisation rate as results of increase in number of births under the universal two-child policy increased the accumulated deficit of the maternity insurance fund income in the Ningxia-Hui Autonomous Region. At the current rate, the entire fund will be depleted by the end of 2021 unless the contribution rate is increased from 0.5% to 0.75%. Conclusions Maternal health is a “sentinel event” requiring an unprecedented global resource mobilisation to safeguard the future of humanity. Thus maternity insurance schemes in China require new methods of fund raising to keep a sustainable maternity insurance fund in the region. Study also reveals that population reform is not done in isolation but require changes in the fundamental social structures to ensure its sustainability.
A Strategic Action Plan to Enhance the Accessibility of Healthcare in Rural Areas of Zimbabwe
Authors: Mangundu Manenji , Roets Lizeths , Rensburg Janse Van
Published: July 2020

Background: Accessibility to health care in rural areas of Zimbabwe is challenging. Developing a strategic action plan was in essence, a road map leading to a required potential like achieving a goal. Wider consultation with communities, healthcare leaders and policymakers to inform development of strategic action plan, often overlooked has necessitated this research. The aim was to identify strategies and develop a strategic action plan to enhance accessibility to healthcare in rural areas of Zimbabwe through active involvement of key stakeholders like healthcare users, healthcare workers, leaders and legislators.Methods: A multiple methods approach were used and study was carried out in 4 phases. In Phase 1 (quantitative), data was collected from professional nurses using self-administered questionnaire and health care users using interview questionnaire. Phase 2 (qualitative) collected data through a nominal group with national health directors. A strategic action plan was developed in phase 3 using findings from phase 1 and 2, the Systems Model and a literature control. In phase 4, the strategic action plan was finalised and validated by members of parliamentary portfolio committee on health who were members of parliament of Zimbabwe. Two districts (Masvingo and Chegutu) in two provinces (Masvingo and Mashonaland West) were included in the study, targeting 45 public health facilities in rural areas of Zimbabwe.Participants included in the study were conveniently sampled professional nurses (90), health care users (445) using the sampled public health facilities (phase 1), conveniently sampled 5 national health coordinators (phase 2) and all-inclusive 5 members of the parliamentary portfolio committee on health (phase 4).Results: The study contributed to the development and validation of the strategic action plan with 6 strategies. These included improving the health infrastructure, provision of medical drugs, health workers, medical equipment, reviewing the health worker workload and addressing shortages, and improving the capacity of the health care system.Conclusion: The active participation at all phases by professional nurses, health care users, national health directors and members of parliament contributed to development of a strategic action plan with 6 strategies to enhance accessibility to health care in rural areas of Zimbabwe.