bluuebunny/crossref_metadata_2025 huggingface dataset:
N-3 Polyunsaturated Fatty Acids and Gut Microbiota
Authors: Lim Sun Young , Jayapala Hettiarachchige Priyanga Sajeewanie
Published: July 2022

For several decades, studies have reported that n-3 polyunsaturated fatty acids (PUFAs)
play a beneficial role in cardiovascular, immune, cognitive, visual, mental and metabolic health.
The mammalian intestine is colonized by microbiota, including bacteria, archaea, viruses, protozoans,
and fungi. The composition of the gut microbiota is influenced by long-term dietary habits,
disease-associated dysbiosis, and the use of antibiotics. Accumulating evidence suggests a relationship
between n-3 PUFAs and the gut microbiota. N-3 PUFAs can alter the diversity and abundance
of the gut microbiome, and gut microbiota can also affect the metabolism and absorption of n-3
PUFAs. Changes in the populations of certain gut microbiota can lead to negative effects on
inflammation, obesity, and metabolic diseases. An imbalanced consumption of n-3/n-6 PUFAs
may lead to gut microbial dysbiosis, in particular, a significant increase in the ratio of Firmicutes to
Bacteroidetes, which eventually results in being overweight and obesity. N-3 PUFA deficiency disrupts
the microbiota community in metabolic disorders. In addition, accumulating evidence indicates
that the interplay between n-3 PUFAs, gut microbiota, and immune reactions helps to maintain
the integrity of the intestinal wall and interacts with host immune cells. Supplementation with
n-3 PUFAs may be an effective therapeutic measure to restore gut microbiota homeostasis and correct
metabolic disturbances associated with modern chronic diseases. In particular, marine extracts
from seaweed contain a considerable dry weight of lipids, including n-3 PUFAs such as eicosapentaenoic
acid (EPA, C20: 5) and docosahexaenoic acid (DHA, C22: 6). This review describes how
gut microbiota function in intestinal health, how n-3 PUFAs interact with the gut microbiota, and
the potential of n-3 PUFAs to influence the gut-brain axis, acting through gut microbiota composition.
Overexpression of Efflux Pumps AcrAB and OqxAB Contributes to
Ciprofloxacin Resistance in Clinical Isolates of K. pneumoniae
Authors: Albarri Osman , AlMatar Manaf , Öcal Melda Meral , Köksal Fatih
Published: July 2022

Background:

Infection caused by multidrug-resistant K. pneumoniae is regarded as a severe public health concern worldwide, with most countries reporting an increase in fatality rates over time. Efflux pumps are significant determinants of acquired and/or intrinsic resistance in K. pneumoniae.

Objectives:

Our aim is to explore efflux-mediated resistance mechanisms in K. pneumoniae by using quantitative real-time PCR in order to evaluate the expression of efflux pump genes (acrA, acrB, oqxA, and oqxB) and pump regulators (marA, soxS, and rarA).

Method:

Efflux pump inhibitor CCCP was able to a reduce MIC values of ciprofloxacin by 2 to 64-fold in 43/46 (93%) of MDR-K. pneumoniae isolates.

Results:

Compared to the control strain (untreated one), our results demonstrated that acrA, acrB, oqxA, oqxB, marA, soxS, and rarA were overexpressed in 29 (63%), 24 (52%), 29 (63%), 24 (52%), 17 (37%), 16 (35%), and 16 (35%) of K. pneumoniae isolates, respectively. Additionally, a positive correlation was established between the expressions of acrAB and marA (r = 0.50, r = 0.45, respectively) and oqxAB and rarA (r = 0.462912, r = 0.519354, respectively).

Conclusion:

Ciprofloxacin resistance was caused by overexpression of the efflux pump genes acrAB and oqxAB, as well as the transcriptional regulators marA, soxS, and rarA in clinical isolates of K. pneumonia.
Plasma Phage Load is Positively Related to the Immune Checkpoints in
Patients Living with Human Immunodeficiency Virus
Authors: Su Fei-Fei , Zheng Xiao‑Qun , Huang Kai‑Zhao , Ye Hui , Fang Yang-Yang , Li Tao , Pei Shun-Jie , Wu Lian-Peng
Published: July 2022

Background:

Microbial translocation (MT) and altered gut microbiota are involved in immune activation and inflammation, whereas immune checkpoint proteins play an important role in maintaining immune self-tolerance and preventing excessive immune activation.

Objective:

This study aims to investigate the relationship between plasma phage load and immune homeostasis in people living with HIV(PLWH).

Methods:

We recruited 15 antiretroviral therapy (ART)-naive patients, 23 ART-treated (AT) patients, and 34 healthy participants (HP) to explore the relationship between the plasma phage load and immune checkpoint proteins. The deoxyribonucleic acid (DNA) load of the lambda (λ) phage was detected using fluorescence quantitative polymerase chain reaction (PCR). The immune checkpoints (ICPs) were detected using multiplex immunoassay.

Results:

Our study demonstrated that the plasma phage load was increased in people living with HIV (PLWH) (P<0.05), but not in the ART-naive and AT groups (P>0.05). Plasma ICPs, including cluster of differentiation 27 (CD27), soluble glucocorticoid-induced tumor necrosis factor (TNF) receptor (sGITR), soluble cluster of differentiation 80 (sCD80), sCD86, soluble glucocorticoid-induced TNF receptor-related ligand (sGITRL), soluble induced T-cell costimulatory (sICOS), sCD40, soluble toll-like receptor 2 (sTLR2), and sCD28, were markedly decreased among the ART-naive group (P<0.05) but not in the AT and HP groups (P>0.05). The plasma phage load was positively correlated with ICP and C-reactive protein (CRP) levels in PLWH (P<0.05).

Conclusion:

Our study indicated that the plasma phage load in PLWH was positively related to the expression of ICPs and inflammation, which may be used as a promising marker for the immune level of PLWH.
The Therapeutic Potential of Panax Ginseng and Ginger on Postsurgical
Adhesion Band Formation
Authors: Nazari Seyedeh Elnaz , Khalili-Tanha Ghazaleh , Mobasheri Leila , Asgharzadeh Fereshteh , Naimi Hamideh , Eskandari Moein , Askarnia-Faal Mohammad-Mostafa , Hassanian Mehr Seyed Mahdi , Gharib Masoumeh , Ghorbani Hamid Reza , Aliakbarian Mohsen , Ferns Gordon A , Khazaei Majid , Avan Amir
Published: July 2022

Background:

Peritoneal adhesions (PA) are a common complication of abdominal operations.
Previous studies indicate that inhibition of inflammation and fibrosis at sites of peritoneal damage may
prevent the development of intra-abdominal adhesions. Zingiber officinalis Roscoe (ginger) and Panax
ginseng (P. ginseng) are herbal products with antioxidant and anti-inflammatory effects that can have
restorative properties.

Objective:

This research aimed to examine the impact of ginger and p. ginseng on prevention of PA in a rat model after surgery.

Methods:

Following a laparotomy, the wall of the cecum was rubbed to induce intra-abdominal adherence
in Wistar rats. Ginger (400mg/kg) and P. ginseng (500mg/kg) were orally adminstered to the animals.
The animals were sacrificed on the 10th day after surgery, and the Nair and Leach scoring system
was used to assess adhesion. The microscopic histology of the induced cecal adhesions was evaluated. An
enzyme-linked immunosorbent assay (ELISA) was used to determined tissue levels of transforming
growth factor-beta (TGF-β) on homogenized PA tissue. Real-time PCR was performed to quantify the
mRNA expression of IL-1β, TNF-α, Col 1a1, and Col 3a1 in rat tissue.

Results:

The adhesion score and histopathological rating based on the Nair and Leach scoring criteria
showed lower adhesion scores in the group of rats treated with P. ginseng compared to the control group
(p<0.05). Treatment with ginger and P. ginseng was associated with reduced tissue level of TGF-β and
mRNA expression of TNF-α and IL-1β. The gene expression level of Col 1a1 and Col 3a1 were markedly
decreased in the P. ginseng group.

Conclusion:

The study's outcome recommends that P. ginseng could be an effective agent for preventing
the PA and inflammation during the post-operative stage.
Novel Delivery Technologies: Triggering the Biopharmaceutical Potential
of Boswellic Acids
Authors: Marbaniang Daphisha , Das Anup Kumar , Pal Paulami , Gogoi Niva Rani , Saikia Ananta , Ray Subhabrata , Mazumder Bhaskar
Published: July 2022

Boswellic acids are a series of pentacyclic triterpenes derived from the gum resin of Boswellia
Genus, mostly from Boswellia serrata Roxb. (Burseraceae) tree commonly known as Indian
Frankincense or salai guggul and traditionally used as an anti-inflammatory agent. It acts by inhibiting
5-Lipoxygenase, C3-convertase, cyclooxygenase, preferably COX-1, Human Leukocyte Elastase, NF-
κB expression, Topoisomerase I and II and microsomal Prostaglandin E2 synthase-1. Boswellia species
are reported to have various pharmacological potentials like anti-inflammatory, anti-cancer, antimicrobial,
anti-arthritic, immunomodulatory activity, neuroprotective activity, and are also proved to
be effective against ileitis, ulcerative colitis, hypolipidemic, hypertension and hepatotoxicity. Regardless
of their multiple uses, pharmacokinetic studies of Boswellic acids revealed their poor oral bioavailability,
high lipophilicity, and their degradation by the hepatic Phase I mechanism. With low solubility
and poor bioavailability, different approaches have been applied to improve the poor pharmacokinetic
profile of Boswellic acids. Designing and developing novel delivery systems for their enhanced
permeability and improved bioavailability with better efficacy have been of great interest.
Assessment of Shear Bond Strength and Cytotoxicity of Orthodontic
Adhesive with Addition of Silver Nanoparticles in Varying Concentrations
Authors: Soans Crystal R. , Shashidhar Keerthan , Shersha Shalin , Mansoor Rahila , Gauthami K.
Published: July 2022

Background:

Prolonged treatment with fixed orthodontic appliances tend to compromise oral hygiene maintenance in patients, increasing their susceptibility to white spot lesions and caries. Incorporating silver nanoparticles into adhesives and orthodontic appliances is known to improve its antimicrobial properties.

Aim and objectives:

The aim of the present study was to assess and compare the bond strength of orthodontic adhesive when Silver Nanoparticles were added in varying concentrations and also to assess their cytotoxicity on periodontal ligament fibroblasts.

Materials and methods:

Various concentrations of silver nanoparticles (1%, 5%, 10%w/w) were incorporated into Transbond XT composite adhesive and their shear bond strength and cytotoxicity were compared to a control group. Brackets were bonded to extracted premolar teeth and shear bond strength was assessed using Instron Universal Testing Machine. The viability of periodontal ligament fibroblasts was assessed after incubating with the experimental composite for 24 hours and 1 week using MTT assay.

Results:

There was a decrease in the shear bond strength when 1% and 5% of silver nanoparticles were incorporated into the adhesive.However, it was within the clinically recommended range for bonding brackets. When the concentration was increased to 10%, the SBS was not acceptable for orthodontic bonding. The composite incorporated with silver nanoparticles was cytotoxic to fibroblasts at all concentrations at both time intervals.

Conclusion:

The shear bond of orthodontic adhesive with nanosilver is comparable to plain transbond XT in low concentrations, however, the addition of silver nanoparticles seems to increase the time-bound cytotoxicity of orthodontic adhesive.
Establishment of Analyzing Method of Fenpropathrin Residue in
Angelica dahurica Radix and Osterici Radix
Authors: Hur Jang-Hyun , Ham Hun-Ju , Lee Byung-gi , Choi Jeong-Yoon , Ahmed Ishag Abd Elaziz Sulieman
Published: July 2022

Background:

Angelica dahurica Radix and Osterici radix, are perennial herbs belonging to the family Umbelliferae, which were attacked by red spiders, thus fenpropathrin was registered. Fenpropathrin is important in improving productivity and quality of medicinal herbs due to timely pest control. However, residue may likely remain after harvest, and therefore, the residue analysis is important to ensure pesticides safety management.

Objective:

This study aimed to establish analysis method for fenpropathrin residues in A. dahurica Radix and O. radix using GLC-ECD and GC-MS/MS.

Methods:

Samples were moisturized with distilled-water and extracted with acetonitrile. The interferences were removed using SPE cartridges and analyzed by GLC-ECD and GC-MS/MS.

Results:

Based on pre-experiment results, the analysis method was optimized using double-cleanup method (SPE-GCB/NH2 & SPE silica cartridges). Fenpropathrin peak confirmed by GC-MS at the same retention time and with its mass numbers. Nevertheless, the cleanup processes are laborious and require a rather long time. Thus, additional effortless analysis method was developed using the d-SPE method that can apply to highly selective and sensitive GC-MS/MS. The LOD of GC-ECD and GC-MS/MS was 0.1 and 0.01 ng, respectively. While the LOQ was 0.04 mg/kg for both. Linearity (r2) was > 0.998 (GLC-ECD) and 0.999 (GC-MS/MS). The recoveries at three spiking levels ranged 83.6-103.1% and 89.6-98.0% for A. dahurica Radix and O. radix, respectively.

Conclusion:

Accuracy of the improved method met the standard of the Korean Ministry of Food and Drug Safety. Therefore, the developed methods expected to be used for analyzing pesticide residues in herbal medicines in Korea and other countries.
Caregiver Burden of Children with Chronic Disease at Teaching Hospital
Authors: Hashim Noraini , Turiman Norlizah , Salehen Nur’shafinaz , Suryanto Suryanto
Published: July 2022

Handling children with chronic diseases may negatively impact caregivers' quality of life. This research objective is to identify the caregiver burden in children with chronic disease care. A cross-sectional study used the PedsQl Family Impact Module questionnaire to identify the caregiver burden among 230 caregivers of children with chronic diseases at UMCC. The participant perceived burden (n=154, 67%) with mean M=1.67 (SD 0.47). However, age and gender are not significantly associated with caregiver burden. In conclusion, caregivers perceive the burden of caring for children with chronic diseases. Therefore, continuous support from healthcare providers may help reduce the caregiver burden.
Keywords: Caregiver, burden, children, chronic disease
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3300
Dietary Behaviour and Mental Health Status among Students of Higher Education Institutes in Malaysia
Authors: Muniandy Naleena Devi , Syed Azhar Sharifah Nurhuzira , Aulia Dewi Agil Dhiemitra , Ibrahim Dhiya’ Nurfatimah
Published: July 2022

This study explored students' eating behaviour and mental health status from higher education institutes (HEI) in Malaysia. A sequential mixed-method approach was employed. 438 participants were assessed using an online questionnaire cross-sectionally. In the second phase, selected participants were interviewed using a grounded theory approach. Findings indicated that 51% of the students were depressed, 67% were anxious, and 43% were stressed. Financial freedom emerged as a theme, including transportation and food choices explaining the significant association in the quantitative phase. Prospective intervention should focus on understanding the causal pathways that increase mental health issues among HEI students.
Keywords: ecological factors; eating behaviour; mental health; higher education institutes; mixed-method
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3394
Relief for Psychiatric Patients in Malaysia: Results from expert interviews
Authors: Kamarunzaman Nur Zafifa , Che Soh Mazlan , Liu Jia , Mohd Rani Nur Dalilah
Published: July 2022

This study aims to 1) identify and describe agencies’ role in helping psychiatric patients and 2) evaluate whether there is a synergy in building a concrete framework for the patients. Semi-structured interviews were conducted with eight mental health experts. The data were transcribed, and thematic analysis was performed using NVivo software. Findings revealed that empowering the patients was one of the strategies to assist them. Nevertheless, the multisectoral collaboration did not translate well within the aid networks despite the efforts by the government agencies to bridge their services to the patients.
Keywords: Psychiatric Care, Aid Agencies, Integration Strategy, Collaboration Networks
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., U.K. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3447
Perceived Social Support and Depression Level Among Elderly Living in Institution
Authors: Azman Nur Atiqah , Mohd Isa Ayu Azila , A. Rahman Padma , Chupradit Supat
Published: July 2022

The Elderly is commonly withdrawn and live alone due to a lack of social support, which impacts psychological issues. This study was conducted to identify the relationship between perceived social support and the level of depression among the elderly. This cross-sectional study enrolled 92 older people who lived at Rumah Seri Kenangan Cheng, Malacca. They completed the Multidimensional Scale for Perceived Social Support and Geriatric Depression Scale, which measured levels of social support and levels of depression, respectively. Findings indicated the elderly received moderate social support from family and friends, that affecting the level of depression in the elderly population.
Keywords: Elderly, institutionalization, social support, depression.
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3449
Assessing Illness Acceptance and Quality of Life among the End Stage Renal Disease (ESRD) Patients Undergoing Hemodialysis
Authors: Sham Fatimah , Abdul Wahid Pereira Karina , Abdul Latif Nurulhafizza , Ayat Al-Sawad
Published: July 2022

Haemodialysis is the best treatment for the long-term survival of end-stage renal disease patients that requires the acceptance of illness, which can maintain patients' Quality of life. Three hundred thirty-seven hemodialysis patients were involved in this study, which reported the acceptance of illness was moderate and was lowest among the males. The Quality of life was good and supported by the emotional well-being, dialysis staff encouragement, social support, and the acceptance of illness. Multidisciplinary intervention should be targeted to address the physical status and disease-specific core aiming to reduce further health complications and improve Quality of life.
Keywords: acceptance to illness; quality of life; hemodialysis, end-stage renal disease patients
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3458
Mobile Games among University Students: A symptom and functional severity for Carpal Tunnel Syndrome
Authors: Majid Norhaini , Ismail Mohamad Aidiel Emran , Masar Muhammad Luqman , Sitti Syabariyah
Published: July 2022

Carpal Tunnel Syndrome (CTS), the chronic trapping of the median nerve on the wrist, is the most common peripheral lesion in the nerve. Patients usually experience nocturnal discomfort, paraesthesia and admiration affecting the innervated digits of the median nerve. A Boston Carpal Syndrome Questionnaire was used in the study. The questionnaires were distributed to 373 undergraduate students, aged between 18 till 25 in one of the public university in Selangor. Findings indicate the respondent have mild symptoms and functional severity of CTS. The majority of the respondents reported that they have mild symptoms of CTS, such as numbness and tingling.
Keywords: Risk; Carpal Tunnel Syndrome; mobile games
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3479
Men Health Seeking Behaviour: A literature review
Authors: Abdullah Nik Nairan , Mohd Arsat Mohd Haffis , Aziz Noor Rafizah Aminah , Al-Kubaisy Waqar
Published: July 2022

Gender equality between males and females is a Sustainable Development Goal (SDG) that the nation must address. However, compared to women, the health status of men lags. The objectives are to describe and summarize the factors influencing men's health-seeking behaviour in various health problems from published literature. Methods: The literature search was performed using online databases in Scopus, Web of Science and ScienceDirect. Findings: In a total of  22 studies that fulfilled the inclusion criteria, the factors identified were predisposing factors (socio-demographic, health belief), enabling factors (healthcare services and facilities, alternative medicine, social support), and need factors (perceived need).
Keywords: Men; Health-seeking; Factors; Review
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3484
Knowledge, Attitude, And Practice Towards Handling Covid-19 Among Nurses in a teaching hospital
Authors: Isa Roslinda , Hamzah Noor Hafazieran , Jaffar Norzanni Sharmila , Dwi Priyantini
Published: July 2022

A new coronavirus was discovered in China that causes serious respiratory diseases. Nurses play an important role in handling patients with COVID-19. This study aims to assess the level of knowledge, attitude, and practice towards handling COVID-19 among nurses. A descriptive cross-sectional study was done, with questionnaires on nurses' knowledge, attitude, and practice regarding handling COVID-19. The majority of nurses (99.2%) have good knowledge, while 39.0% had a positive attitude, and 65.9% of nurses had good practice in handling patients with COVID-19. There is a significant relationship with weak correlation between attitude and practice (p= 0.024, r= 0.204).
Keywords: Knowledge, attitude, practice, COVID-19.
eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v7i20.3492
Validation of the Optimum Timing of Assessment of Tumor Infiltrating Lymphocytes During Preoperative Chemotherapy for Breast Cancer
Authors: KASHIWAGI SHINICHIRO , ASANO YUKA , TAKADA KOJI , GOTO WATARU , KOUHASHI RIKA , YABUMOTO AKIMICHI , TAUCHI YUKIE , MORISAKI TAMAMI , OGISAWA KANA , SHIBUTANI MASATSUNE , TANAKA HIROAKI , OHIRA MASAICHI
Published: July 2022

Background/Aim: Tumor microenvironment (TME) assessment is considered to play an important role in the prediction of prognosis and therapeutic response following breast cancer treatment. No consensus has been reached regarding evaluation methods despite reports on the utilization of tumor-infiltrating lymphocytes (TILs) for immune TME (iTME) monitoring. Optimum timing of iTME assessment has not yet been established. Patients and Methods: Two hundred thirty-nine patients were treated with neoadjuvant chemotherapy (NAC). During the period from diagnostic needle biopsy to NAC initiation for breast cancer, the optimal evaluation timing was examined using a receiver operating characteristic (ROC) curve analysis. Results: A significant correlation between TILs and pathological complete response (pCR) was only observed in the short-term group (≤35 days) (p=0.033). Prognostic analysis revealed that in the short-term group, patients with high TIL levels had a significantly better survival prognosis relative to those with low TIL levels (>35 days) [disease-free survival (DFS): p=0.001, overall survival (OS): p=0.021]. TILs were identified as an independent factor affecting DFS in a multivariate analysis (p=0.008, hazard ratio=0.130). Conclusion: TIL assessment during NAC for breast cancer is a prognostic predictor only when performed at ≤35 days before NAC initiation.
Fibulo-Scapho-Lunate Arthrodesis With Free Vascularized Fibular Graft for a Japanese Kyudo Archer With Osteosarcoma of the Left Distal Radius: A Case Report
Authors: SASAKI NOBUYUKI , KAWAKAMI RYOICHI , TOSHIKI NARIHIRO , YAMADA HITOSHI , HAKOZAKI MICHIYUKI , KONNO SHIN-ICHI
Published: July 2022

Background: Recent progress in the chemotherapy and surgical procedures for osteosarcoma have enabled the preservation of limb function even when cancer occurs in the distal radius, a rare primary site of osteosarcoma. Case Report: We describe a case of osteosarcoma that occurred in an 18-year-old, male Kyudo (Japanese archery) archer’s left distal radius. Since the patient desired to resume Kyudo and the left hand was quite important for gripping a bow, we chose partial wrist arthrodesis (fibulo-scapho-lunate arthrodesis) with free vascularized fibular grafting (FVFG) as the reconstruction procedure following wide resection. After the wide resection, the major axis of bone defect was 8 cm. We harvested a free vascularized fibular graft with fascio-cutaneous flap with wide fascia to reconstruct the gliding surface of the extensor tendon. Fibula-proximal radius and fibulo-scapho-lunate fixation was performed by locking plates individually. Vascular anastomosis was performed between the radial artery and peroneal artery in a flow-through manner. Two peroneal veins were anastomosed with the radial vein and cephalic vein. Conclusion: Fibulo-scapho-lunate arthrodesis with FVFG may provide satisfied stability and function even in a Kyudo archer. The patient obtained sufficient wrist stability and grip strength, and could resume Kyudo.
Providing Accessible ReCreation Outdoors–User-Driven Research on Standards: Protocol for Mobile and Web-Based Interviews for Winter Assessments
Authors: Prescott Mike , Gamache Stéphanie , Mortenson W Ben , Best Krista L , Grandisson Marie , Mostafavi Mir Abolfazl , Labbé Delphine , Morales Ernesto , Mahmood Atiya , Borisoff Jaimie , Sawatzky Bonita , Miller William C , Bulk Laura Yvonne , Robillard Julie M , Routhier François
Published: July 2022

Background

Although there have been recent efforts to improve access to Canadian national parks, many remain not fully accessible to people with disabilities. Winter conditions, in particular, present challenges that limit their participation in outdoor activities.

Objective

This study aimed to develop a novel method to assess park access during winter, which will inform recommendations for national park standards to meet the needs of all park visitors (regardless of ability) during winter conditions.

Methods

A larger participatory mixed methods research project exploring park access was adapted. A 3-phase approach has already been proposed to achieve the study objectives. In the first phase, a scoping review of the existing accessibility standards will be conducted. In the second phase, objective audits of trails and features in 6 parks, 3 in western Canada and 3 in eastern Canada, will be conducted, as well as mobile interviews with 24 various participants in each region regarding their experiences of and recommendations for improving the park’s accessibility. In the final phase, a Delphi participatory consensus development process will be used, based on the data gathered in the first 2 phases, to prioritize recommendations for standards. This paper will focus on the second phase of the study, specifically on whether the in-person winter mobile interviews (ie, walking and wheeling interviews) with people who have a wide range of disabilities while visiting 3 parks in 2 provinces were modified. Changes were made to accommodate the extreme winter weather conditions in Quebec while using safe and informative data collection methods.

Results

In Quebec, one park, where winter conditions are safer, has been assessed in person (n=4). Web-based interviews were used to facilitate the assessment of other winter and summer conditions in two other parks (n=8). Winter and web-based interviews were completed in April 2022. Data are currently being collected and analyzed, and results will be completed by December 2022.

Conclusions

We expect that adapting the protocol to gather further information on winter conditions and access to parks will provide high-quality and rich data to better inform park access standards. This participatory mixed methods research will inform the development of park standards that consider the accessibility needs of all people.

International Registered Report Identifier (IRRID)

DERR1-10.2196/38715
Examining the Individual Response to a Low Sodium Diet Intervention in Hypertensive Patients: Protocol for Pilot Randomized Controlled Trial (Preprint)
Authors: Ko Jisook , Wang Jing , Chung Misook , Sharma Kumar
Published: July 2022

BACKGROUND

Excessive dietary sodium intake is an independent risk factor for hypertension and cardiovascular disease (CVD). Despite the large body of evidence concerning the effects of dietary interventions on blood pressure (and CVD outcomes), trials have often reported low adherence to lower sodium intake, likely due in part to heterogeneous blood pressure responses. To address these challenges in dietary interventions, recent clinical findings have suggested a personalized dietary approach combining metabolomics, genetics, and digital health technologies for the prevention and treatment of chronic diseases including hypertension. Precision nutrition, also called personalized nutrition, seeks to deliver more preventive and practical dietary advice than ‘one-size-fits-all’ guidelines and weigh the personal risk of developing specific diseases. In addition, one important single‐nucleotide polymorphism that influences blood pressure in humans is the salt sensitivity (SS) factor. However, the evidence on how the SS variant influences urinary metabolite profiles and blood pressure control following a low sodium diet intervention among individuals with hypertension is currently lacking.

OBJECTIVE

Therefore, the purpose of this randomized controlled trial is to pilot a 2-month low sodium diet program to improve urinary metabolite profiles and blood pressure control.

METHODS

A total of 60 hypertensive patients will be randomized assigned to either a low sodium diet group (n=20) or standard care group (n=10) for 2 months. Outcomes of interest include post-intervention changes in targeted urinary metabolite profiles, urinary sodium excretion, and blood pressure.

RESULTS

This study is approved by the University of Texas Health Science Center at San Antonio Institutional Review Board (#HSC20200054H). To date, interventionist training is completed, and participant enrollment began in April 2021. Thus far, we recruited 21 participants and expect preliminary results to be available in fall 2022.

CONCLUSIONS

This study will provide essential evidence on which to base a future larger clinical trial and could eventually be translated into an approach to improve the health of millions of Americans with hypertension.

CLINICALTRIAL

Clinicaltrials.gov NCT04764253
An artificial neural network model based on standing lateral radiographs for predicting sitting pelvic tilt in healthy adults (Preprint)
Authors: Zhao Minwei , He Yuanbo , Li Shuai , Chen Huizhu , Li Weishi , Tian Hua
Published: July 2022

UNSTRUCTURED

Background: Spinopelvic motion, the cornerstone of the sagittal balance of the human body, is pivotal in patient-specific total hip arthroplasty. Purpose: This study aims to develop a novel model using back propagation neural network (BPNN) to predict how the pelvic parameters change when one sits down based on standing lateral spinopelvic radiographs. Methods: Healthy volunteers of 18 to 30 years old were screened for symptoms and radiographic signs for the spine, pelvic and hip diseases. On their standing and sitting radiographs, 18 spinopelvic parameters were taken, such as pelvic incidence (PI), pelvic tilt (PT) and so on. First, standing parameters correlated with sitting PT and SS were identified via Pearson correlation. Then, with these parameters as inputs and sitting PT and SS as outputs, the BPNN-based prediction network was established. Finally, the prediction results were evaluated based on relative error (RE), prediction accuracy (PA), and normalized root mean squared error (NRMSE). Results: The study included 145 volunteers of 23.1±2.3 (19-
29) years old, of whom 51 were men and 94 were women. Pearson analysis
revealed sitting PT was correlated with six standing measurements and sitting SS with five. The best BPNN model achieved 78.48% and 77.54% accuracy in predicting PT and SS, measures changing per pelvic tilt. As for PI, a constant for pelvic morphology, the prediction accuracy was 95.99%. Conclusion: In this small cohort study, the BPNN model yielded desirable accuracy in predicting sitting spinopelvic parameters. The study provides new insights and tools for characterizing spinopelvic parameters throughout the motion cycle.
Prototyping Apps for the Management of Sleep, Fatigue, and Behavioral Health in Austere Far-Forward Environments: Development Study (Preprint)
Authors: Germain Anne , Wolfson Megan , Pulantara I Wayan , Wallace Meredith L , Nugent Katie , Mesias George , Clarke-Walper Kristina , Quartana Phillip J , Wilk Joshua
Published: July 2022

BACKGROUND

Military service inherently includes frequent periods of high-stress training, operational tempo, and sustained deployments to austere far-forward environments. These occupational requirements can contribute to acute and chronic sleep disruption, fatigue, and behavioral health challenges related to acute and chronic stress and disruption of team dynamics. To date, there is no centralized mobile health platform that supports self- and supervised detection, monitoring, and management of sleep and behavioral health issues in garrison and during and after deployments.

OBJECTIVE

The objective of this study was to adapt a clinical decision support platform for use outside clinical settings, in garrison, and during field exercises by medics and soldiers to monitor and manage sleep and behavioral health in operational settings.

METHODS

To adapt an existing clinical decision support digital health platform, we first gathered system, content, and context-related requirements for a sleep and behavioral health management system from experts. Sleep and behavioral health assessments were then adapted for prospective digital data capture. Evidence-based and operationally relevant educational and interventional modules were formatted for digital delivery. These modules addressed the management and mitigation of sleep, circadian challenges, fatigue, stress responses, and team communication. Connectivity protocols were adapted to accommodate the absence of cellular or Wi-Fi access in deployed settings. The resulting apps were then tested in garrison and during 2 separate field exercises.

RESULTS

Based on identified requirements, 2 Android smartphone apps were adapted for self-monitoring and management for soldiers (Soldier app) and team supervision and intervention by medics (Medic app). A total of 246 soldiers, including 28 medics, received training on how to use the apps. Both apps function as expected under conditions of limited connectivity during field exercises. Areas for future technology enhancement were also identified.

CONCLUSIONS

We demonstrated the feasibility of adapting a clinical decision support platform into Android smartphone–based apps to collect, save, and synthesize sleep and behavioral health data, as well as share data using adaptive data transfer protocols when Wi-Fi or cellular data are unavailable. The AIRE (Autonomous Connectivity Independent System for Remote Environments) prototype offers a novel self-management and supervised tool to augment capabilities for prospective monitoring, detection, and intervention for emerging sleep, fatigue, and behavioral health issues that are common in military and nonmilitary high-tempo occupations (eg, submarines, long-haul flights, space stations, and oil rigs) where medical expertise is limited.
Use of vocal biomarkers for remote monitoring of Covid-19 and Long Covid in clinical practice and research: recommendations for successful implementation (Preprint)
Authors: Fischer Aurelie , Elbeji Abir , Aguayo Gloria , Fagherazzi Guy
Published: July 2022

UNSTRUCTURED

The Covid-19 pandemic accelerated the use of remote patient monitoring in clinical practice or research for safety and emergency reasons, justifying the need for innovative digital health solutions to monitor key parameters or symptoms related to Covid-19 or Long Covid. The use of voice-based technologies, and in particular vocal biomarkers, is a promising approach, voice being a rich, easy-to-collect medium with numerous potential applications for healthcare, from diagnosis to monitoring. In this perspective, we provide an overview of the potential benefits and limitations of using voice to monitor Covid-19, Long COVID, and related symptoms. We then describe an optimal pipeline to bring a vocal biomarker candidate from research to clinical practice and discuss recommendations to achieve such a clinical implementation successfully.
Postoperative outcomes of digital program rehabilitation after total knee arthroplasty: a retrospective, observational feasibility study (Preprint)
Authors: Hong Mindy , Loeb Joey , Yang Manshu , Bailey Jeannie F.
Published: July 2022

BACKGROUND

Clinical guidelines typically recommend conservative interventions before invasive procedures in people with chronic musculoskeletal (MSK) pain. However, conservative treatment is not effective for everyone, and surgery can sometimes be the best solution. There is a lack of social support, care, and assistance in helping patients both prepare and recover from surgery. A digital MSK surgical care program was developed to address these care gaps and subsequent impacts on care quality and outcomes.

OBJECTIVE

To demonstrate safety, engagement, and acceptability and explore clinical outcomes, healthcare use, and satisfaction among participants of a digital MSK surgical care program

METHODS

The intervention group registered for a digital MSK surgical care program, which included health coaches, physical therapists (PTs), customized exercises, and tailored educational articles to provide pre and postoperative support to those who recently underwent total knee arthroplasty (TKA). Comparison group members received standard-of-care treatment. Engagement and acceptability were examined among those in the intervention group. Postoperative safety, clinical outcomes, healthcare use, and experience outcomes were compared against a comparison group.

RESULTS

53 participants (intervention: 22, comparison: 31) were included in this study, of which 35 (66.0%) were female and 25 (47.2%) were ages 45-60 years. On average, the intervention group completed 23 exercise therapy sessions (ETs), read 2.7 educational articles, sent 45.5 text messages to their health coach, and were actively engaged for 6 weeks after their operation. 14 out of 21 participants (66.7%) self-reported as Promoters on the Net Promoter Score (NPS). Intervention group members reported fewer postoperative complications (intervention: 6 out of 22 participants [27.3%], comparison: 15 out of 31 participants [48.4%]) and experienced better outcomes in function (mean KOOS-PS; intervention: 23.0, comparison: 32.5), depression (mean PHQ-2; intervention: 0.4, comparison: 1.6), anxiety (mean GAD-2; intervention: 0.6, comparison: 1.5), and impression of change (median PGIC; intervention: 7.0, comparison: 6.0), than comparison group members. The intervention group also reported less healthcare use, better adherence to their PT exercises, and higher surgery satisfaction.

CONCLUSIONS

A digital surgical care MSK program shows promising levels of engagement and acceptability among those who recently underwent TKA. The surgical care program may also help with improving postsurgical complications and clinical outcomes, as well as lowering healthcare use.
Information Technology Utilization Of Young Educated Farmers In Agricultural Entrepreneurship
Authors: Nurlaela Siti , Bihrajihant Raya Alia , Hariadi Sunarru Samsi
Published: July 2022

Information technology can help farmers develop their farming, but its utilization is still very low for farmers. This study aims to reveal the personal characteristics of educated young farmers, their entrepreneurial characteristics, their behaviour in using information technology, and their obstacles in utilizing it. This research is a descriptive exploratory with a quantitative approach. The data collection technique used a questionnaire on 124 Yogyakarta-Magelang Agricultural Development Polytechnic students in March-June 2019. Respondents were collected using the census method. The results revealed that educated young farmers prefer entrepreneurial cultivation.Meanwhile, the behaviour of utilizing information technology is moderate. Information technology is used to expand the market scope and seek information.  Cultivation and market opportunities are the most information that young farmers need. The obstacles faced are internal group problems and insufficient time to integrate their business activities with information technology. Business assistance and information technology can help strengthen young farmer groups' management in agricultural entrepreneurship.
Childhood as a Theme of Interest for Artwork: A Study of Contrasting Representations of Childhood in Medieval and Post-Eighteenth Century Art
Authors: Joshi Nandini
Published: July 2022

The documentation of children and their narratives has been considered one of the least accounted for in history. It can be placed within the contribution of literature and art towards shaping the societal view, stemming from the space it provides to the representation of certain themes and identities. The presence, or lack thereof, of children from these spaces can be put under a scrutinizing light, observing the significant changes it underwent over the centuries. This paper attempts to observe the emergence of this space and its increasing intricacy over time – from children being painted in a religious light, to their one dimensional portrayal as young-adults, to an eventual, layered representation of the experience of childhood and the complexity of a child as an individual. The study will refer to several artworks throughout the course of history, contrasting medieval art with art from eighteenth century onwards. The focus will primarily be on their references to childhood and how their portrayal of children corresponds to the time the artworks were first created in.
The Role of social media in Developing English Language Writing Skills: Moulay Ismail University as a Case Study
Authors: Lakhal Mounim
Published: July 2022

The use of social media in the field of education has taken effect for quite some time. Social media applications offer learners good learning opportunities of using the language. The most important thing they provide learners with is that they promote authentic language use making it possible for students to improve their grammar knowledge and writing skills. Social media, as a learning platform, offers online platforms for users to generate and share information with other users and to interact with them synchronously or asynchronously by written and spoken word. Research has indicated that social media apps could be an efficacious platform for language learning. This study, therefore, comes to explore the effects of social media in the development of university students’ English writing skills and see how EFL students perceive social media in terms of usefulness and ease of use.It also examined whether or not there is any correlation between these variables. The sample consisted of 153 EFL university students using the convenience sampling technique. The obtained data were analyzed using SPSS version 20 and descriptive statistical tools were used to gain an in-depth understanding of the research topic. The results reveal that social media plays a key role in the development of EFL university students’ writing performance.