bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPERIMENTAL JUSTIFICATION OF THE USE OF SCLEROSANT AETOXISCLEROL IN THE TREATMENT OF HEMANGIOMA IN CHILDREN
Authors: Okunev N. A. , Okuneva A. I. , Balashov V. P. , Shchekin O. A.
Published: July 2020

The aim of the study was to study the changes in tissues after interstitial administration of aethoxysclerol (5 and 10 mg/ml) in comparison with 70% ethanol in the experimental model of hemangioma (chicken caruncle). After the introduction of 70% ethyl alcohol into the chicken, disintegration of fibers and amorphous substancecaruncle from the 1st day, thrombosis of large and small vessels, perivascular edema of connective tissue were detected. By the 14th day, there was observed necrosis of the caruncle tooth, into which ethanol was injected. By the 21st day, under the area of necrosis, in the part of the scallop, a coarse keloid scar was formed with deformation of the tissues. Introduction of aethoxiclerol in dose of 5 mg/ml into the caruncle led to the compaction of the structure of the caruncle due to the proliferation of fibrous tissue. Partial thrombosis of small and large vessels of both superficial and deep layers of the caruncle was observed with a small number of inflammatory cells. By the 21st day, the compaction of the tissues was combined with the large-lamellar desquamation of the caruncle on the site of infiltration of the drug without necrosis. In the fibrous-fat layer, there was a substitution of fat tissue by fibrous, which was distributed evenly. In the dynamics, there was an increase in the compaction of all the layers of the caruncle without formation of the coarse scar tissue. An increase in the dose of aethoxysclerol to 10 mg/ml was accompanied by necrosis and gross morphological changes, similar to the administration of 70% ethanol.
FEATURES OF THE DIFFERENTIAL DIAGNOSIS OF OVARIAN TUMORS IN GIRLS (OBSERVATION FROM THE PRACTICE)
Authors: Adamyan L. V. , Koltunov I. E. , Sibirskaya E. V. , Sharkov S. M. , Korotkova S. A. , Moksyakova E. G. , Movsesyan E. Kh.
Published: July 2020

Tumors of the ovaries in girls represent an actual problem in modern gynecology. First of all, this is due to diagnostic difficulties, caused by the absence of characteristic complaints, asymptomatic course and the complexity of the gynecological examination, which leads to making of an erroneous diagnosis, the lack of correct and timely treatment and, as a result, complications that often negatively affect the reproductive function of the female patient in further. The differential diagnosis of ovarian tumors in girls is still one of the most important problems of modern practical gynecology. In many patients, the presence of a combined pathology, which is 30-40% according to WHO data, puts the problem of the possibility of simultaneous correction of such pathology by both surgeons and gynecologists. In connection with the difficulty of diagnosing, the diagnosis of such patients must necessarily include an examination of a pediatric surgeon and a children’s gynecologist with ultrasound examination of the retroperitoneal space, abdominal cavity organs, and small pelvis. Errors in the differential diagnosis of genital and extragenital diseases occur quite often and are mainly due to the similarity of clinical symptoms. This article presents a clinical case of the diagnosis and management of a 14-year-old female patient with an adjacent diagnosis, as well as criteria for the diagnostic search for the differential diagnosis of gynecological and surgical pathologies.
THE SUBSTANTIATION OF THE DIFFERENTIATED APPROACH IN DIAGNOSTICS AND SURGICAL CORRECTION OF THE FUNNEL-SHAPED DEFORMATION OF THE CHEST IN CHILDREN
Authors: Gatsutsyn V. V. , Nalivkin A. E. , Kuzmichev V. A. , Mashkov A. E. , Pykhteev D. A.
Published: July 2020

Funnel-shaped deformation of the chest (pectus excavalus) is a congenital pathology of the anterior thoracic wall, manifested by the retraction of the sternum and sternocostal cartilages in various forms and degrees. There are many options for correcting this deformation, which can be conditionally divided into open and minimally invasive methods. In the leading clinics for this pathology, there is recently used the most minimally invasive method of correction by Nass. Unfortunately, for today there is no the only as an algorithm for preoperative examination of patients with this pathology, as well as the decision on the choice of surgical correction method.
MORPHOLOGICAL CRITERIA FOR ESTIMATION OF THE DEGREE OF TESTICULAR HYPOPLASIA IN CHILDREN WITH CRYPTORCHIDISM
Authors: Komarova S. Yu. , Tsap N. A. , Valamina I. E. , Meshcheryakova E. Yu.
Published: July 2020

The possible risk of the development of hypogonadism, infertility, and malignant neoplasm of the testicles in adults dictates the need to develop and implement diagnostic criteria. The identification of such morphological signs as a decrease in the number and diameter of the tubules, the number of germ cells, the development and progression of fibrosis of interstitium may have prognostic significance. The aim of the study is to develop morphological criteria for assessing the severity of testicular hypoplasia in cryptorchidism in children of different age groups. Material and methods. In the study there were identified three groups, taking into account the age of children with cryptorchidism. Group, I included 12 (34.3%) children aged from 1 to 3 years. Group II was presented by 14 (40%) patients aged from 4 to 10 years. Group III included 9 (25.7%) patients aged from 11-14 years. Results and discussion. Morphological changes in the testicle in cryptorchidism children of different age groups vary: in Group I moderate and pronounced structural changes were detected in 53% of cases, in group II - in 50% and in group III - in 72% of cases. Taking into account the morphological criteria of testicular tissue hypoplasia, in our study in cryptorchidism children, hypoplasia of the mild degree was revealed in 17.1% of cases, a moderate degree - in 31.4%, a severe degree - in 31.4% of cases. Conclusion. Morphological criteria for estimating hypoplasia and grading of the severity of hypoplasia of testicular tissue were determined on the basis of a scoring of morphological characters and morphometric indices.
DIFFERENTIATED APPROACH TO THE PROBLEM OF REHABILITATION OF BABIES WITH SEPSIS
Authors: Shamsiev A. M. , Rabbimova D. T. , Shamsiev Zh. A.
Published: July 2020

A comparative study in two groups of children received a complex of restorative therapy during the rehabilitation period, with measures for correction of intestinal biocenosis, neurometabolic therapy, and immunotherapy with Viferon and children receiving the immunomodulator T-activin only showed the significant efficacy of the integrated approach in rehabilitation. In addition, a relatively fast positive immunological effect is achieved, a good tolerance of the drug Viferon, a non-invasive route of administration and the absence of adverse responses with the immunorehabilitation method described allow us recommending this drug in the complex of immunoresponsive measures in infants who have had suffered from sepsis.
STEP-BY-STEP THERAPY OF INTRACRANIAL HYPERTENSION IN THE ACUTE PERIOD OF SEVERE MECHANICAL TRAUMA IN CHILDREN
Authors: Kolykhalkina I. A. , Amcheslavsky V. G. , Ivanova T. F. , Lukyanov V. I. , Roshal L. M.
Published: July 2020

Aim of the study to improve the results of treatment of children with intracranial hypertension in the acute period of severe mechanical trauma by virtue of the use of the “Protocol of step-by-step therapy” Material and methods. The article is devoted to the problem of intracranial hypertension in children with severe mechanical trauma. An analysis of 148 case histories of children with severe mechanical trauma, including brain trauma hospitalized in an intensive care unit. 27 patients out of 148 were excluded from the inclusion criteria: 6 patients (22.2%) due to the “late” admission (more than 72 hours from the time of injury); 21 patients - (77,8%) due to the persistent condition of atonic coma from the moment of trauma. 121 patients, according to indications, monitored intracranial pressure and intensive therapy of intracranial hypertension. All patients were divided into two groups: one group (the main one - 84 patients), in which the treatment was carried out according to the “Protocol of step-by-step therapy of intracranial hypertension” and approved in the Scientific Research Institute of Emergency Children’s Surgery and Traumatology, characterized by a strict sequence of treatment measures (“steps”), with clear indications for prescribing each subsequent “step” and the time frame for the duration of the “steps” taken; 2 group (control group - 37 patients), in which the treatment was carried out according to existing international guidelines for the management of patients with severe head injury. Conclusion. Comparative evaluation of treatment results showed outcomes of trauma in the main group to be better, including a statistically significantly less mortality rate (p = 0.0002, p < 0.05).
Increased Accuracy Of Sequence To Sequence Models With The CNN Algorithm For Multi Response Ranking On Travel Service Conversations Based On Chat History
Authors: Widiyanto Wahyu Wijaya , Rizki Uli , Susena Edy
Published: July 2020

Building a chatbot cannot be separated from the knowledge base. The knowledge base can be obtained from data that has been labeled by the developer, documents that have been converted into pre-processing data, or information taken from social media. In this case, the data used as knowledge is chat history. In the chat history there are certainly many variations of answers and allowing a question to give rise to many answers. To overcome these multi responses, response was made. The existence of ranking, of course the response desired by the user will be more appropriate. Challenge in ranking is how to get the essence a question and find pairs questions and answers from the data. This can be solved by a sequence to sequence model. However, the problem that will arise is the consistency of the answers. The existence of a lot of chat history certainly raises many explanations, even though the question's essence is the same. For this reason the CNN algorithm as a solution to the problem. This research uses convolutional sequence to sequence which will be applied for ranking responses. We compare the efficiency of this model. By making comparisons, this model shows an accuracy of 86.7%
PEMIKIRAN KYAI HAJI HASYIM ASY’ARI TENTANG PENDIDIKAN AL-QUR’AN DI INDONESIA
Authors: Afif Muhammad
Published: July 2020

Peran sentral Kyai Haji Hasyim Asy’ari dalam pemikiran pendidikan al-Qur’an di Indonesia tidak dapat diragukan. Melalui Pesantren Tebuireng di Jombang Jawa Timur yang demikian fenomenal, Kyai Hasyim mempraktikan pendidikan al-Qur’an kepada para santri dan masyarakat dalam memperbaharui pendidikan Islam Indonesia yang pada waktu itu tertinggal jauh dari pendidikan barat yang digagas oleh Belanda. Bagi Kyai Hasyim, pendidikan al-Qur’an merupakan dasar yang utama dalam mengembangkan pendidikan Islam Indonesia ke depan.

Paling tidak terdapat empat alasana kenapa Kyai Haji Hasyim Asy’ari melakukan pendidikan al-Qur’an di Indonesia kala itu, yaitu: Pertama, Kyai Hasyim sangat sadar bahwa untuk melepaskan bangsa Indonesia dari belenggu penjajahan Kolonial Belanda harus dimulai dari pembaruan pendidikan Islam yang bertumpu pada al-Qur’an. Kedua, Kyai Hasyim sangat prihatin melihat kondisi bangsa Indonesia kala itu yang miskin, bodoh, dan ditindas oleh pemerintah Kolonial Belanda, maka untuk membebaskan mereka tiada jalan kecuali membangkitkan mereka dari keterpurukannya melalui pendidikan al-Qur’an. Ketiga, modernisasi yang dilakukan pemerintah Kolonial Belanda membawa dampak negatif bagi perkembangan sosial-budaya bangsa Indonesia kala itu sehingga masyarakat harus dibentengi dengan ajaran al-Qur’an, dan Keempat, untuk memperkuat umat Islam, khususnya Jam’iyah NU, harus dibentengi dengan nilai-nilai dasar al-Qur’an.
Tulisan ini bermaksud mengurai pemikiran pendidikan al-Qur’an Kyai Haji Hasyim Asy’ari dalam mengembangkan pendidikan Islam Indoneia. Dari pemikiran Kyai Hasyim ini jelas nampak terdapat hubungan positif terhadap perkembangan pendidikan Islam dewasa ini
Keadilan Dalam Al-Qur'an (Kajian Semantik Kata al-‘Adl dan al-Qisṭ dalam al-Qur’an)
Authors: Muhajirin Muhajirin , Nur Ngaisah Zulaikhah Fitri
Published: July 2020

Tulisan ini menafsirkan ayat-ayat al-Qur’an terkait keadilan yang menggunakan term al-‘Adl dan al-Qisṭ. Karena adil dalam al-Qur’an mempunyai aspek dan objek yang beragam, seperti pembicaraan adil dalam hukum (Qs, An-Nisa’:58) dan adil dalam memperlakukan anak yatim (Qs, An-Nisa’:3) maka peneliti ini mengaplikasikan Semantik Toshihiko Izutsu yang dapat dilihat dari makna dasar, makna relasional (sintagmatik paradigmatik), integrasi antar konsep, sinkronik diakronik hingga sampai pada Welthanschauung. Dengan aplikasi tersebut dapat disimpulkan bahwa hubungan antar dua kata tersebut saling terkait satu sama lain. Sehingga peneliti mengambil kata al-Musāwāh sebagai titik temu dan mata rantai pengikat kedua kata tersebut. Sedangkan letak perbedaannya, kata al-‘Adl merupakan keadilan yang tidak nampak secara langsung (tersembunyi) seperti keadilan dalam hukum. Sedangkan kata al-Qisṭ merupakan perbuatan yang lebih banyak berbicara tentang sesuatu yang nampak, jelas (zahir) dan bersifat materil, seperti memenuhi harta anak yatim.
Khataman Qur’an Pra-Acara Alako Gebhai Desa Grujugan, Sumenep, Media Untuk Menangkal Bala’ Dan Memperoleh Berkah
Authors: Wedi Agus
Published: July 2020

This paper to dercribe the practice of khataman Qur'an in the Pra-Acara Alako Gabhai tradition practiced by Grujugan, Sumenep, Madura island society ethnographically, in order to find its meaning. Based on the interpretation (Externalization, Objectification, and Internalisation) of cultures theory found out that interpreted the Grujugan society recognizes the concepts that are based on the religious basis, which has ultimate meaning as a way to get the salvation and blessings. These concepts were then believe as the true and real, which then formulated into various syimbols in the Grujugan tradition. These symbols have the full meaning that returns to those concepts and suggested living traditions or action tradition, which is delivered persuasively by Kyai. Through those concepts people were then motivated to perform khataman Qur'an in the Pra-Acara Alako Gabhai tradition. The practice of this tradition was able to create reseption and moods of a person, which then reflected into the daily life, felt as if to justify the existing concepts, so that the feeling is uniquely realistic
Orthopaedic Considerations Following COVID-19
Authors: Patel Manan S. , Gutman Michael J. , Abboud Joseph A.
Published: July 2020

» As the novel coronavirus disease 2019 (COVID-19) outbreak continues to grow, with 2.5 million cases and 169,006 deaths as of late April 2020, according to the U.S. Centers for Disease Control and Prevention, orthopaedic surgeons should anticipate the complications of pharmacotherapy, namely osteonecrosis, in the next several years.

» The rate of osteonecrosis in patients with severe acute respiratory syndrome (SARS) treated with high-dose corticosteroids is 5% to 58% and occurs mostly in the first year following the initiation of high-dose corticosteroid therapy.

» Patients who had a cumulative corticosteroid dose of ≥3,000 mg and were treated for >25 days are at the highest risk.

» Screening with serum markers and treating with bisphosphonates, extracorporeal shock wave therapy, hyperbaric oxygen, enoxaparin, and/or lipo-prostaglandin E1 may be effective means to curb the progression to collapse and the consequent need for joint replacement in these relatively young patients.
Detection of Pulmonary Embolism with Gallium-68 Macroaggregated Albumin Perfusion PET/CT: An Experimental Study in Rabbits
Authors: Gültekin Aziz , Çayır Mustafa Çağdaş , Uğur Ayşe , Bir Ferda , Yüksel Doğangün
Published: July 2020

This study was designed to evaluate the accuracy of to detect pulmonary emboli (PE) the Technegas SPECT/CT combined with 68Ga PET/CT in a rabbit model. One hour after artificial PE (n=6) and sham (n=6) models were created, Technegas SPECT/CT ventilation and 68Ga-MAA PET/CT perfusion scan (V/Q scan) were performed. All cases were performed ventilation imaging first. Technegas SPECT/CT and 68Ga-MAA PET/CT images were evaluated by a nuclear medicine physician who recorded the presence, number, and location of PE on a per-lobe basis. The sensitivity, specificity, and accuracy of Technegas SPECT/CT and 68Ga-MAA PET/CT for detecting PE were calculated using a histopathological evaluation as a reference standard.A total of 60 lung lobes were evaluated in 12 rabbits, and PE was detected in 20 lobes in V/Q scans and histopathological analysis. The overall sensitivity, specificity and accuracy were 100%, 100%, and 100%, respectively, for both the Technegas SPECT/CT and 68Ga-MAA PET/CT V/Q scans. Technegas/68Ga-MAA V/Q scans have good sensitivity, specificity and accuracy in the detection of PE in this animal model study.
Which behaviour change techniques are effective to promote physical activity and reduce sedentary behaviour in adults: a factorial randomized trial of an e- and m-health intervention
Authors: Schroé Helene , Dyck Delfien Van , De Paepe Annick , Poppe Louise , Loh Wen Wei , Verloigne Maïté , Loeys Tom , De Bourdeaudhuij Ilse , Crombez Geert
Published: July 2020

Background E- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it’s not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this experimental study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB) against a background set of other BCTs.Methods In a 2 (action planning: present vs absent) x2 (coping planning: present vs absent) x2 (self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention ‘MyPlan2.0’ for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n=335,age=35.8,28.1% men) or SB (n=138,age=37.8,37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB. Results First, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t=2.735,p=0.007) and reduced SB (t=-2.573,p=0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t=2.302,p=0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2=8,849,p=0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2=3.918,p=0.048). To increase PA, action planning was always more effective in combination with coping planning (x2=5.590,p=0.014;x2=17.722,p<0.001;x2=4.552,p=0.033) compared with using action planning without coping planning. Of note, the use of action planning alone reduced PA compared with using coping planning alone (x2=4.389,p=0.031) and self-monitoring alone (x2=8.858,p=003), respectively.Conclusions This study provides indications that different (combinations of) BCTs may be effective to promote PA and reduce SB. More experimental research to investigate the effectiveness of BCTs is needed, which can contribute to improved design and more effective e- and m-health interventions in the future.Trial registration This study was preregistered as a clinical trial (ID number: NCT03274271). Release date: 20 October 2017, http://clinicaltrials.gov/ct2/show/NCT03274271
Phenotypic Overlap between Atopic Dermatitis and Autism
Authors: Shin Kyong-Oh , Crumrine Debra , Kim Sungeun , Lee Yerin , Kim Bogyeong , Abuabara Katrina , Park Chaehyeong , Uchida Yoshikazu , Wakefield Joan , Meyer Jason , Jeong Sekyoo , Park Byeong Deog , Park Kyungho , Elias Peter M.
Published: July 2020

Background: Though multifactorial in etiology, approximately 10% of autism spectrum disorders (ASD) are associated with atopic dermatitis (AD). Moreover, ASD prevalence increases further as AD severity worsens, though these disorders share no common causative mutations. We assessed here the link between these two disorders in the standard, valproic acid mouse model of ASD. In prior studies, there was no evidence of skin involvement, but we hypothesized that cutaneous involvement could be detected in experiments conducted in hairless mice.Methods: We performed our studies in valproic acid (VPA)-treated hairless mice. Mid-trimester pregnant mice received a single intraperitoneal injection of either valproic acid sodium salt dissolved in saline or saline alone on embryonic day 12.5, and these mice were housed individually until postnatal day 21. Only the brain and epidermis appeared to be affected, while other tissues remain unchanged. At various post-natal time points, brain, skin and blood samples were obtained for histology and for quantitation of tissue sphingolipid content and cytokine levels.Results: AD-like changes in ceramide content occurred by day one post-partum in both VPA-treated mouse skin and brain. The temporal co-emergence of AD and ASD, and the AD phenotype-dependent increase in ASD prevalence correlated with the early appearance of Th2 markers (i.e., interleukin [IL]-4, 5, & 13, mast cells) both in the skin and brain. The high levels of interferon (IFN)g not only in skin, but also in brain likely account for a significant decrease in very-long-chain N-acyl fatty acids in brain ceramides that again mimicked known IFNg-induced changes in AD.Conclusion: The baseline involvement of both AD and ASD could reflect concurrent neuro- and epidermal toxicity, possibly because both the epidermis and neural tissues originate from the embryonic neuroectoderm. These studies illuminate the shared susceptibility of the brain and epidermis to a known neurotoxin, and suggest further that ASD could be included within the atopic diathesis.
Clinical characteristics, treatment status and complications in women with tube ovarian abscess and endometriosis: a retrospective study
Authors: Li Hui , Zhao Yan , Chang Xiao-hong , Wang Yue , Zhu Hong-lan
Published: July 2020

Background: The aim of our present study was to investigate the clinical characteristics, treatment status and complications in women with endometriosis and tube ovarian abscess (TOA) to determine the possible association between TOA and endometriosis.Methods: Medical records were used to analyze the clinical characteristics, treatment and complications. Twenty women who were diagnosed with TOA with endometriosis were compared with 93 women diagnosed as having TOA without endometriosis between January, 2008 and December, 2018. Statistical analysis was performed using SPSS Version 20.Results: In this study, TOA patients with endometriosis were significantly more likely to have a lower age range (20–39years) than the non-endometriosis group (11/20 (55.0%) vs 27/93 (29.0%), p=0.036). In addition, TOA patients with endometriosis were associated with a significantly lower rate of parity (11/20 (55.0%) vs 75/93 (80.6%), p=0.021), higher rates of infertility (8/20(40%) vs 0/93(0%), p=0.000) and a significantly lower incidence of elevated blood platelet counts (5/20 (25%) vs 43/93 (53.8%), p = 0.026). Furthermore, women with endometriosis had greater blood loss (347±445.77 vs 204.67±289.46, p= 0.014) and an increased complication rate (3/20(15%) vs 0/93(0%), p = 0.000). Among the 3 patients who had complications in the endometriosis group, 2 patients had septic shock and 1 patient had intestinal obstruction. And 1 case who had septic shock followed by IVF treatment. There was no significance difference on other factors.Conclusions: The present study indicated that endometriosis did not increase the difficulty and time of treatment in patients with TOA, but increased bleeding during surgery and serious complications. It is suggested that doctors should pay more attention to postoperative treatment and nursing in women with TOA and endometriosis, especially those who have a history of recent infertility treatment and related procedures.
Determination of the Factors Affecting Sexual Violence against Women in Turkey: A Population-Based Analysis
Authors: Alkan Ömer , Tekmanlı Hasan Hüseyin
Published: July 2020

Background: Sexual violence is among the most threatening type of violence and one of the most investigated by national and international decision makers. The purpose of this study was to detect the factors that affect sexual violence against women in Turkey.Methods: In this study, a micro data set of from the survey titled Research on Domestic Violence against Women conducted by the Hacettepe University Institute of Population Studies was employed. By utilizing binary logistic and probit regression analysis, influential factors for a woman's exposure to sexual violence were detected.Results: Findings obtained from the analysis indicated that a woman's exposure to sexual violence was influenced by a variety of factors such as region, age, level of education, employment, health condition, marital status, number of children as well as exposure to physical, economic, and verbal abuse. In addition, it was found that the level of education, employment status, drug use, infidelity and other variables related to the husband/partner of the women who participated in the survey.Conclusion: Among women residing in rural and less developed regions, there remains a higher probability of exposure to sexual violence. A decrease in the woman’s level of education elevated her probability of exposure to sexual violence. An increase in women's age and an increase in the level of education of the woman’s husband/partner lowered the probability of the woman's exposure to sexual violence. Among women who had experienced physical, economic, and verbal abuse, there was a higher probability of exposure to sexual violence.
Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data
Authors: He Jingyi , Ghorveh Mohsen Ghiasi , Hurst Jillian H. , Tang Monica , Alhanti Brooke , Lang Jason E. , Goldstein Benjamin
Published: July 2020

Background: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and carbon monoxide (CO), which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods: To test this hypothesis, we assessed the association between asthma exacerbations and the distance to two types of roadways in Durham County, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6,208 children with asthma between 2014 – 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results: There was a consistent weak effect of residential distance from 55+ MPH highway and any asthma exacerbation (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)), but there was no effect from distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)). Conclusions: While the results were negative, characteristics of a study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to this. Compared to previous work which often relied on self-report measures, we are able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts of disease.
Digital Proximity Tracing in the COVID-19 Pandemic on Empirical Contact Networks
Authors: Cencetti Giulia , Santin Gabriele , Longa Antonio , Pigani Emanuele , Barrat Alain , Cattuto Ciro , Lehmann Sune , Salathé Marcel , Lepri Bruno
Published: July 2020

Digital contact tracing is increasingly considered as a tool to control infectious disease outbreaks. As part of a broader test, trace, isolate, and quarantine strategy, digital contract tracing apps have been proposed to alleviate lock-downs, and to return societies to a more normal situation in the ongoing COVID-19 crisis. Early work evaluating digital contact tracing did not consider important features and heterogeneities present in real-world contact patterns which impact epidemic dynamics. Here, we fill this gap by considering a modeling framework informed by empirical high-resolution contact data to analyze the impact of digital contact tracing apps in the COVID-19 pandemic. We investigate how well contact tracing apps, coupled with the quarantine of identified contacts, can mitigate the spread of COVID-19 in realistic scenarios such as a university campus, a workplace, or a high school. We find that restrictive policies are more effective in confining the epidemics but come at the cost of quarantining a large part of the population. It is possible to avoid this effect by considering less strict policies, which only consider contacts with longer exposure and at shorter distance to be at risk. Our results also show that isolation and tracing can help keep re-emerging outbreaks under control provided that hygiene and social distancing measures limit the reproductive number to 1.5. Moreover, we confirm that a high level of app adoption is crucial to make digital contact tracing an effective measure. Our results may inform app-based contact tracing efforts currently being implemented across several countries worldwide.
Evolution of practices in a French trauma centre: decrease in blood transfusions and fresh frozen plasma to red blood cell ratios.
Authors: PERNOD Cyril , Fraticelli Laurie , Marcotte Guillaume , Floccard Bernard , Girardot Thibaut , Claustre Clément , Khoury Carlos El , Durand Maeva , Rimmelé Thomas
Published: July 2020

Background: Uncontrolled haemorrhage is still the leading cause of preventable death following trauma. Coagulation resuscitation strategies can be plasma-based or fibrinogen concentrate-based. The aim of this study was to describe the evolution of transfusion practices following the introduction of tranexamic acid (TXA) and ROTEM® in a trauma centre from a teaching hospital.Methods: This is a single-centre, retrospective study at a Trauma Resuscitation Unit (TRU) from a French teaching hospital. All trauma patients aged 18 years or more and transfused with at least 4 red blood cells (RBCs) within 24 hours after trauma, from 2011 to 2016, were included. The primary objective was to analyse transfusion practices over this time period.Assessment of the annual proportion of patients transfused with more than 4 RBCs at 24h, proportion of application of high fresh frozen plasma (FFP):RBC ratio (≥ 1:2 ), and proportion of administration of fibrinogen with ROTEM® protocol and TXA was performed. The secondary objectives aimed at assessing differences between populations according to the FFP:RBC ratio applied and compare all-cause mortality at D30.Results: A total of 122 patients were included. Between 2011 and 2016, there was a significant decrease in the proportion of patients requiring at least 4 RBCs 24h after trauma (9% vs. 3%, Ptrend < 0.0001) as well as a decrease in the proportion of patients with a high FFP:RBC ratio (86% vs. 62% at 6h, Ptrend = 0.0056 and 86% vs. 56% at 24h, Ptrend = 0.0047). After 2013, fibrinogen was administered to more than 70% of patients and TXA to 100% of them. Adherence to the ROTEM® protocol for the administration of fibrinogen was significant. The observed mortality was lower than the predicted one, irrespective of FFP:RBC ratio.Conclusion: From 2011 to 2016, an important evolution of practices occurred in the TRU including a decrease in the proportion of transfusions and use of high FFP:RBC ratios. The origin of these changes is multifactorial, likely including the systematic use of TXA and optimisation of the ROTEM® protocol for fibrinogen administration.
Design and Development of Multi-target Directed 1,2,3-rriazole-dimethylaminoacryloyl-chromenone Derivatives with Potential use in Alzheimer's Disease
Authors: Askarani Hajar Karimi , Iraji Aida , Rastegari Arezoo , Bukhari Syed Nasir Abbas , Firuzi Omidreza , Akbarzadeh Tahmineh , Saeedi Mina
Published: July 2020

To discover multifunctional agents for the treatment of Alzheimer's disease (AD), a new series of 1,2,3-triazole-chromenone derivatives were designed and synthesized based on the multi target-directed ligands approach. The in vitro biological activities were evaluated including acetylcholinesterase (AChE), butylcholinesterase (BuChE), and Aβ1−42 aggregation inhibition as well as neuroprotective effects and metal-chelating properties. The results indicated highly selective BuChE inhibitory activity with IC50 values of 21.71 µM for compound 10 h as the most potent compound. Besides, compound 10 h could inhibit self-induced Aβ1−42 aggregation and AChE-induced Aβ aggregation with 32.6% and 29.4% inhibition value, respectively. A Lineweaver–Burk plot and molecular modeling study also showed that compound 10 h targeted both the catalytic active site (CAS) and peripheral anionic site (PAS) of BuChE. It should be noted that compound 10 h was potent as a selective Cu2+ chelator. Thus, the designed scaffold could be considered as multifunctional agents for AD drug discovery developments.
Quality Analysis of Chinese Popular Scientific Articles Pertaining to Novel Coronavirus Pneumonia
Authors: Liao Shichong , Shichong Liao , Xinyue Chen , Yi Tu , Shengrong Sun , Shan Zhu , Jinxin Li
Published: July 2020

Background: To evaluate the quality, reliability, comprehensiveness and accuracy of the popular science information related to the Corona Virus Disease 2019 (COVID-19) on the Chinese website.Methods: Searching for scientific articles with the keywords of "novel coronavirus pneumonia" in Baidu, Sogou and 360 search engine at 14:00 on May 22, 2020, and collecting information such as article source, length, upload time, etc. Using JAMA score and 5-point DISCERN scale, two specialists independently analyzed the reliability and quality of scientific articles. Combined with the "Novel Coronavirus Pneumonia Diagnosis and Treatment Program (Trial Version 6)", we made corresponding evaluation on the comprehensiveness and accuracy of articles. Results: A total of 45 scientific articles were included in the study. The average number of words is 2692.27±1267.61, and the average upload time is 11.8±10.80 days. Those popular scientific articles are mainly uploaded by government agencies and individuals. However, the JAMA score, DISCERN score, content comprehensiveness and accuracy of the articles were generally low. Among the 45 popular scientific articles, 27 articles were classified as accurate-content group and 18 articles were classified as misleading-content group. Scientific articles of accurate-content groups mainly came from government agencies, universities and hospitals. The publication date of articles in the accurate-content group is closer, the scores of JAMA, DISCERN and content comprehensiveness were higher (P<0.05). The results also showed that JAMA score, DISCERN score, content comprehensiveness and accuracy of popular science articles uploaded by government agencies, universities and hospitals were higher (P<0.05). The results indicated that there was a significant positive correlation between the scores of JAMA, DISCERN, comprehensiveness and accuracy (P<0.05). Conclusion: Although there are many scientific articles related to the novel coronavirus pneumonia on the Chinese website, the overall detection rate of high-quality scientific articles were low. We are Looking forward to more high-quality medical scientific articles published by government agencies, universities and hospitals. It is suggested that search engines adopt a more optimized sorting method to help more readers get high-quality information.
Thetha Nami: Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and young men and women in rural South Africa
Authors: Shahmanesh Maryam , Okesola Nonhlanhla , Chimbindi Natsayi , Zuma Thembelihle , Mdl Sakhile , Mthiyane Nondumiso , Adeagbo Oluwafemi , Dreyer Jaco , Herbst Carina , Mdl Sakhile , McGrath Nuala , Harling Guy , Sherr Lorraine , Seeley Janet
Published: July 2020

BackgroundDespite effective biomedical tools, adolescents and young men and women carry the dual burden of high HIV incidence and high morbidity/mortality in South Africa. We integrated community-based participatory research (CBPR) with biomedical interventions to develop a peer-led biosocial intervention for HIV care and prevention in young people living in rural KwaZulu-Natal (KZN).MethodsBetween March 2018 and September 2019 we used CBPR to iteratively co-create and contextually adapt a biosocial peer-led intervention to support HIV prevention. Men and women aged 18–30 years were selected by community leaders of 21 intervention implementation areas (izigodi) and underwent 20 weeks of training as peer-navigators. We synthesised quantitative and qualitative data collected between 2016 and 2018 into 17 vignettes illustrating the local drivers of HIV. During two participatory intervention development workshops and community mapping, the peer-navigators discussed the vignettes in small groups, brainstormed solutions and mapped the components to their own izigodi. The intervention components were plotted to a Theory of Change (ToC). Following a six-month pilot, the peer-navigators used process evaluation data and experience to refine the ToC in a third workshop.ResultsFollowing written and oral assessments 57 of the 108 initially selected participated in the two workshops to discuss the vignettes and co-create the Thetha Nami (talk to me) intervention. During the pilot the peer-navigators approached 6871 young people, of whom 6141 (89%) accepted health promotion and 438 linked to care. During semi-structured interviews peer-navigators described the appeal of providing sexual health information to peers of a similar age and background but wanted to provide more than just “onward referral”. In the third participatory workshop 54 peer-navigators refined the Thetha Nami intervention to include:· Structured assessment tool to tailor support.· Safe spaces and community advocacy to create an enabling environment for HIV prevention.· Peer-led sexual health promotion to improve self-efficacy and demand for HIV prevention.· Accessible youth-friendly clinical services to improve uptake of HIV prevention.· Peer-mentorship to navigate resources and improve retention in HIV prevention.Conclusion﻿Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention and care.
Exploring socioeconomic inequalities in maternal and child health coverage in Latin America and the Caribbean
Authors: Colomé-Hidalgo Manuel , Campos Juan Donado , De Miguel Ángel Gil
Published: July 2020

Background. Maternal and child health have shown important advances in the world in recent years. However, national averages indicators hide large inequalities in access and quality of care in population subgroups. We explore socioeconomic inequalities affecting health coverage and interventions in reproductive, maternal, newborn, and child health in Latin America and the Caribbean.Methods. We analyzed representative national surveys from 15 countries conducted between 2001 and 2016. We estimated maternal-child health coverage gaps using the Composite Coverage Index – a weighted average of interventions that include family planning, maternal and newborn care, immunizations, and treatment of sick children. We measured absolute and relative inequality to assess gaps by wealth quintile. Pearson’s correlation coefficient was used to test the association between the coverage gap and population attributable risk.Results. The Composite Coverage Index showed patterns of inequality favoring the wealthiest subgroups. In eight countries the national coverage was higher than the global median (78.4%; 95% CI: 73.1-83.6) and increased significantly as inequality decreased (Pearson r = 0.9; p <0.01).Conclusions. There are substantial inequalities between socioeconomic groups. Reducing inequalities will improve coverage indicators for women and children. Additional health policies, programs, and practices are required to promote equity.
High-carbohydrate, High-fat Diet-induced Hyperlipidemia Hampers the Differentiation Balance of Bone Marrow Mesenchymal Stem Cells by Suppressing Autophagy via the AMPK/ mTOR Pathway in Rat Models
Authors: Shang Zhenzhen , Zhang Ting , Jiang Mengyang , Yin Xiaojie , Sun Hui Qiang , Liang Xing
Published: July 2020

Background: Disorders of bone metabolism caused by hyperlipidemia is not conducive to osseointegration of implants. Autophagy, an evolutionarily conserved, lysosomal-mediated degradation process, is indispensable for bone homeostasis, its effects on hyperlipidemia-induced osteoporosis remain to be elucidated. The objective of this study was to determine whether autophagy affects bone metabolism and implant osseointegration through regulating the function of bone marrow mesenchymal stem cells (BMMSCs) in rats with hyperlipidemia and to confirm signaling pathway involved in the regulation of autophagy. Methods: Hyperlipidemia models were established through a long-term high-carbohydrate, high-fat diet in 6-week-old male Sprague-Dawley rats. The impact of hyperlipidemia on bone metabolism and early osseointegration of implants was explored by the methods including serum biochemical detection, micro-computed tomography and bone morphology detection. Biological properties and autophagy levels of BMMSCs were also determined. Further, we determined if autophagy was involved in bone metabolism changes resulting from high-fat diet by focusing on the lineage differentiation of BMMSCs. The signaling pathway involved in the regulation of autophagy was also explored.Results: The high-carbohydrate, high-fat diet (HCHF) was given to the rats for seven months aggravated bone loss in the cancellous bone and reduced osseointegration of implants. BMMSCs from hyperlipidemia rats exhibited decreased osteogenesis, increased adipogenesis and decreased autophagic activity compared with regular diet (RD) BMMSCs. Rapamycin treatment restored the impaired osteogenic differentiation and inhibited the adipogenic differentiation of HCHF-BMMSCs through the activation of autophagy. Further, AMPK/mTOR signaling pathways was related to the impairment of autophagy of HCHF-BMMSCs. Conclusions: Our data indicate that long-term high-carbohydrate, high-fat diet-induced hyperlipidemia hampers the differentiation balance of bone marrow mesenchymal stem cells by suppressing autophagy via the AMPK/ mTOR pathway, which ultimately led to aggravated bone loss in the cancellous bone and reduced osseointegration of implants in rat models.
Adapting evidence-based clinical practice guidelines for people with attention deficit hyperactivity disorder in Saudi Arabia: process and outputs of a national initiative
Authors: Bashiri Fahad A. , Albatti Turki H. , Hamad Muddathir H. , Al-Joudi Haya F. , Daghash Hadeel F. , Al-Salehi Saleh M. , Varnham Jeremy L. , Alhaider Fatimah , Almodayfer Omar , Alhossein Abdulkarim , Aldhalaan Hesham , Ad-Dab'bagh Yasser , Backer Nouf Al , Altwaijri Waleed , Alburikan Khalid , Buraik Maysaa , Ghaziuddin Mohammad , Nester Michael J. , Wahabi Hayfaa , Alhabib Samia , Jamal Amr A. , Amer Yasser Sami
Published: July 2020

Background: We recently adapted the published National institute for Health and Care Excellence (NICE) Attention deficit hyperactivity disorder (ADHD) diagnosis and management guideline to the Saudi Arabian context. It has been postulated that adaptation of evidence-based clinical practice guidelines to the local healthcare context rather than de-novo development will improve their adoption and implementation without imposing a significant burden on resources. The objective of this paper is to describe the adaptation process methodology utilized for the generation of the first national guideline for management of people with ADHD in Saudi Arabia.Methods: We used the KSU-Modified-ADAPTE methodology for the guideline adaptation process. We describe the full process in detail including the three phases of set-up, adaptation, and finalization. The process was conducted by a multidisciplinary guideline adaptation group in addition to an external review for the clinical content and methodology.Results: The group adapted ten main categories of recommendations from one source CPG (NICE). The recommendations include; (i) service organisation and training, (ii) recognition, identification and referral, (iii) diagnosis, (iv) support, (v) managing ADHD, (vi) dietary advice, (vii) medication, (viii) maintenance and monitoring, (ix) adherence to treatment, and (x) review of medication and discontinuation. Several implementation tools were compiled and developed to enhance implementability including a clinical algorithm, quality measures, coding system, medication tables, translations, patient information, and online resources.Conclusions: The finalized clinical practice guideline provides healthcare providers with applicable evidence-based guidance for the management of people with ADHD in Saudi Arabia. The project also demonstrated the effectiveness of KSU-Modified-ADAPTE, and emphasized the value of a collaborative clinical and methodological expert group for adaptation of national guidelines.