bluuebunny/crossref_metadata_2025 huggingface dataset:
Low and Moderate Intensity Exercise Decreased Body Fat and Increased Free Fatty Acid in Overweight Women
Authors: Dyaksa Rizky Sota , Liben Paulus , Mintarto Edy
Published: December 2021

Highlight:Aerobic exercise was reduced body fat and increased free fatty acids.LICT and MICT decreased body fat and increased free fatty acids. Abstract:Overweight is fat imbalances can affect the health. It is one of the problems in many countries, especially Indonesia recorded an increase case in 2007 (8.8%) to 2013 (13.5%). Overweight categorized by 25-30 kg/m2 body mass index in units (Organization  2018). Figures overweight can be pressed to provide some treatments, such as aerobics sports activities. This study aimed to determine the effect of Continuous Low Intensity Training (LICT) and Moderate Intensity Continuous Training (MICT) to decrease body fat content (FM) and increase in free fatty acids (FFA) in overweight women. 18 female subjects completed the study 4X/week exercise LICT or MICT for 5 weeks. LICT and MICT performed for 30 minutes with an additional 5 minutes warm-up and 5 minutes of cooling down with LICT intensity of 60%-70% and MICT 70%-80% of maximum HR where both types of exercise using ergo cycle while measurement FM and FFA were measured before and after practice. LICT occurred decreasing in body fat and increasing in free fatty acids that significant pre and post LICT (p < 0.05). MICT occurred decreasing in body fat and increasing in free fatty acids that significant pre and post MICT (p<0.05). In the second comparison group (LICT and MICT) were decline against body fat and an increased in free fatty acids between workouts Low-Intensity Continuous Training (LICT) greater tendency than Moderate-Intensity Continuous Training (MICT) with delta FM (p = 0.120) and delta FFA (p=0.131) in which the value is >0.05. LICT and MICT was increase while body fat was decreased. The results of a comparison test occur list downward trend in body fat while in free fatty acids was increased.
A Case of Malignant Right Coronary Artery: Frequent Angina in Young Person
Authors: Purwowiyoto Sidhi Laksono , Surya Steven Philips
Published: December 2021

Highlight:A young adult has activity-triggered atypical chest pain and diagnosed malignant RCA.Congenital anomalies  needed to be aware by cardiologists to help clinical practice.Planning a treatment about management of the CAAs condition should be undertaken by the inter-specialist team. Abstract:We presented a case a young adult with activity-triggered atypical chest pain and diagnosed with anomalous origin of right coronary artery (RCA) from the left coronary sinus with an interarterial course between the aorta and the main pulmonary artery that was detected by CT coronary angiography. This anomaly has been called malignant RCA. Coronary artery anomaly is a congenital condition. Most of the cases remain asymptomatic. This condition is also one of the most causes of sudden cardiac death, because the coronary artery examination is not regularly done. Nevertheless, during high intensity activity, it could be symptomatic and might be lethal. Diagnosing coronary artery anomalies might be tricky and cardiologists must be aware of this. The CAAs condition is a rare situation. The CAAs condition is associated with sudden death, especially intense physical activity. There was no rigid guideline for the management of the CAAs condition, so that planning a treatment in the inter-specialist team should be done.
IL-17 and Disease Activity in Spondyloarthitis
Authors: Yuliasih Yuliasih , Lanasakti Yusdeny
Published: December 2021

Highlight:The correlation of IL-17 to disease activity by The Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (ASDAS-CRP) was identified. IL-17 level is strongly correlated to disease activity in SpA patients. Abstract:IL-17 is a new cytokine involved in the pathogenesis of Spondyloarthritis (SpA). Recent studies show that IL-17 level correlates to disease activity, and it is used as a basis in treating SpA patients who do not respond to anti-TNF-α. This study identified the correlation of IL-17 to disease activity measured by The Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (ASDAS-CRP). This study was a cross-sectional study involving SpA patients according to the 2009 ASAS criteria in Dr. Soetomo General Academic Hospital, Surabaya. Disease activity and IL-17 level were analyzed using Spearman correlation test to see the strength of correlation. Forty SpA patients showed mean age of 53.58 ± 9.28 years with a body mass index of 24.36 ± 3.23 kg/m2, ESR of 39.50 ± 18.76 mm/hour, clinically obtained Schober Test of 13.11 ± 1.22 cm, chest extension test of 1.45 ± 0.77 cm, and tragus-to-wall test 13.53 ± 1.99 cm. The median CRP and IL-17 were 0.3 (0.10-5.70) mg/dL and 9.30 (7.70-13.60) pg/dL, respectively. Based on the ASDAS-CRP system, the patients showed disease activities that fall into the category was high (62.5%), moderate (35%), and inactivity (2.5%). IL-17 level is strongly correlated to disease activity in SpA patients (p=0.000, r = 0.711).
Kebijakan Bea Masuk Impor Barang E-commerce Dalam Kaitannya Dengan Hukum Persaingan Usaha
Authors: Windyaka Adelia Rizky
Published: December 2021

AbstractThe government made Law Number 5 of 1999 concerning the prohibition of monopolistic practices and unfair business competition to regulate business actors in carrying out activities related to buying and selling in the market. The birth of this regulation provides a limit for business actors to create healthy business competition. The presence of a platform for online shopping also makes trading activities easier today. The development of this shopping style also affects the number of imported goods that enter Indonesia. There is a policy regarding the setting of the value for import duties on imported goods which has increased from the previous one. The change in the value of this import duty is a step by the government to protect domestic business actors.Keywords: Law; Bussiness competition; Policy; Import.AbstrakPemerintah membuat Undang – Undang Nomor 5 tahun 1999 tentang larangan praktek monopoli dan persaingan usaha tidak sehat untuk mengatur pelaku usaha dalam melakukan kegiatan yang berkaitan dengan jual beli didalam pasar. Lahirnya peraturan ini memberikan batasan bagi pelaku usaha agar menciptakan persaingan usaha yang sehat. Hadirnya platform untuk berbelanja online juga mempermudah kegiatan perdagangan saat ini. Berkembangnya gaya berbelanja ini juga berpengaruh terhadap banyaknya barang impor yang masuk ke Indonesia. Terdapat kebijakan mengenai pengaturan besaran nilai bagi bea masuk barang impor yang mengalami kenaikan dari sebelumnya. Berubahnya nilai bea masuk ini sebagai langkah pemerintah melindungi pelaku usaha domestik.Kata Kunci: Hukum; Persaingan Usaha; Kebijakan; Impor.
Tanggung Gugat Akun Media Sosial Tanpa Identitas Asli Atas Perbuatan Melanggar Hukum
Authors: Pratini Desy Ramadhani
Published: December 2021

AbstractLiability (aansprakelejikeheidcausing) is a condition in which a party or a legal subject, if after committing an act of breaking the law, and losses to other parties must bear it. Unlawful acts can also be found on a social media platform, along with the types of accountability. There is a tendency for illegal acts committed by owners of social media accounts without identity because one of the social media platforms is not accompanied by verification of personal identity at the time of account creation. This unlawful act through social media accounts without real identity is an insult and defamation which is a special form of an illegal act. On the other hand, for the losses suffered by the victim, a civil suit against the law can be filed. However, due to difficulties in the civil lawsuit process, namely by not knowing the identity of the account owner. Then this can only be done if there is a final legally binding decision regarding criminal law.Keywords: Unlawful; Liability of Liability; Social Media Accounts.AbstrakTanggung gugat (Liability/aansprakelejikeheid) merupakan suatu kondisi dimana pihak atau subjek hukum apabila setelah melakukan perbuatan melanggar hukum, dan membawa kerugian bagi pihak lain, ia harus menanggungnya. Perbuatan melanggar hukum dapat pula ditemui dalam suatu platform media sosial, disertai dengan jenis tanggung gugatnya. Kecenderungan terdapatnya perbuatan melanggar hukum yang dilakukan oleh pemilik akun media sosial tanpa identitas disebabkan oleh salah satu platform media sosial tidak disertai verifikasi identitas pribadi pada saat pembuatan akun. Perbuatan melanggar hukum melalui akun media sosial tanpa identitas asli ini adalah penghinaan dan pencemaran nama baik yang merupakan bentuk khusus dari perbuatan melanggar hukum. Di sisi lain, atas kerugian yang dialami oleh korban, dapat diajukannya upaya gugatan keperdataan dengan gugatan perbuatan melanggar hukum. Namun, dikarenakan terdapatnya kesulitan dalam proses gugatan keperdataan, yaitu dengan tidak diketahuinya identitas pemilik akun. Maka hal tersebut baru dapat dilakukan apabila terdapat putusan yang berkekuatan hukum tetap mengenai hukum pidana. Kata Kunci: Perbuatan Melanggar Hukum; Tanggung Gugat; Akun Media Sosial.
Karakteristik Penguasaan Pasar Perusahaan Transportasi Online
Authors: Alkemsky Ranesya Maharani
Published: December 2021

AbstractMarket mastery is an activity that is often carried out by the business with the aim to dominate the market which can furthermore provide great benefits to the business actor. In order to gain power in the market, business actors often take actions that are contrary to the law, so as to potentially cause anti-competition in the market concerned. In the field of online transportation, mainly in Indonesia there are two large companies, namely PT Gojek and PT Grab. Both companies are said to be the holders of dominant positions, due to their status as large companies. Its existence in this dominant position is easy to have the potential to dominate the market, and if it happens then both companies can deter other business actors who are in the same market share.Keywords: Market Mastery; Business Actors; Anti-Competition; Market Concerned; Dominant Position.AbstrakPenguasaan pasar merupakan kegiatan yang kerap dilakukan oleh pelaku usaha dengan tujuan untuk menguasai pasar yang selanjutnya dinilai dapat memberikan keuntungan besar kepada pelaku usaha tersebut. Demi mendapatkan kekuasaan pada pasar tersebut, pelaku usaha tak jarang melakukan tindakan yang bertentangan dengan hukum, sehingga berpotensi mengakibatkan adanya anti persaingan pada pasar bersangkutan. Dalam bidang transportasi online utamanya di Indonesia terdapat dua perusahaan besar yakni PT Gojek dan PT Grab. Kedua perusahaan tersebut dikatakan sebagai pemegang posisi dominan, karena statusnya yang adalah perusahaan besar. Keberadaannya pada posisi dominan ini mudah untuk memliki potensi menguasai pasar, dan apabila hal itu terjadi maka kedua perusahaan tersebut dapat menghalangi pelaku usaha lainnya yang berada pada pangsa pasar yang sama.Kata Kunci: Penguasaan Pasar; Pelaku Usaha; Anti Persaingan; Pasar Bersangkutan; Posisi Dominan.
Model Regulasi Uang Elektronik yang Menerapkan Value Protection
Authors: Pratidhatama Thoriq Hendika
Published: December 2021

AbstractElectronic money has been used by the Indonesian people as a means of payment, such as in toll payment transactions or buying and selling. However, electronic money circulating in Indonesia has a risk, namely the value of electronic money contained in electronic money storage instruments cannot be returned to consumers if the electronic money storage instrument is lost. This raises the question of whether Indonesia's electronic money regulations have fulfilled the consumer protection aspect and what electronic money regulation models can provide protection to consumers because there are still risks that cannot be prevented by applicable regulations. These questions can be answered with a legal, conceptual and comparative approach. The answer to the question is that the applicable electronic money regulation does not meet the principles of consumer security and safety because it does not regulate Value Protection.Keywords: Autopilot Cars; Transportation Law; Legality of Auto Pilot Cars; Government Act.AbstrakUang elektronik telah digunakan oleh masyarakat Indonesia sebagai alat pembayaran seperti pada transaksi pembayaran tol ataupun jual beli. Namun uang elektronik yang beredar di Indonesia memiliki risiko yaitu nilai uang elektronik yang terdapat pada instrumen penyimpanan nilai uang elektronik tidak bisa di kembalikan kepada konsumen jika instrumen penyimpanan uang elektronik hilang. Hal tersebut menimbulkan pertanyaan apakah regulasi uang elektronik yang berlaku Indonesia telah memenuhi aspek perlindungan konsumen dan apa model regulasi uang elektronik yang dapat memberikan perlindungan pada konsumen karena masih ada risiko yang tidak bisa di cegah oleh regulasi yang berlaku. Pertanyaan tersebut dapat dijawab dengan pendekatan peraturan undang-undang, konseptual dan komparatif. Jawaban pertanyan tersebut adalah regulasi uang elektronik yang berlaku belum memenuhi asas keamanan dan keselamatan konsumen karena tidak mengatur mengenai Value Protection. Kata Kunci: Uang Elektronik; Perlindungan Konsumen; Value Protection.
Logistics and logistics processes in a tourism destination
Authors: Mrnjavac Edna , Ivanović Saša
Published: December 2021

Logistics is a scientific discipline, a business function and an activity that, in recent times, is increasingly being applied to economic and social activities, because it enables the production of a quality product at a moderate cost. With regard to the trend for globally applying the principles of logistics to all spheres of human activities, the phenomenon of tourism presents a special challenge. Moreover, it is becoming evident that a quality tourism product, the design of which is linked to a tourism destination, depends largely on the scale of optimisation of all flows (goods, people, information, energy, waste, capital and knowledge) within a destination. The purpose of this paper is to define the function of logistics in tourism and in a tourism destination. Also defined are the concepts of tourism logistics and tourism destination logistics, the concept of a tourism logistics system and its elements – subsystem, as well as logistics processes - chains. Special emphasis is placed on the importance of optimising logistics processes in a destination, in which logistics management and process management are indispensable.
PREREQUISITES TO THE SUCCESS OF HOTEL PRODUCTS
Authors: Galičić Vlado , Ivanović Slobodan
Published: December 2021

Actual basic characteristics of tourist movements of globalization, standardization, market segmentation and computerization, impose to the responsible managers the need of defining that kind of hotel product which would be so attractive with its content to find that part of the consumers which will finally consume that product. This fact goes in favor to the fact that for the entire hotel offer is important the element of exploration of tourist market and defining the segment of tourist demand which has to draw attention, wake up the interest, provoke the desire and initiate on the action with its attractiveness. The hotel product, as the first element of marketing mix, is made of material and unmaterial services which are offered to the hotel guests, and same thing is with hotel service that is in fact a group of many services with which we fulfill the guest’s needs of accommodation, food and drink, and other services that are paid in the usual way in hotelery. When it is mentioned usual and specific hotelery way that means the way on which the guest will satisfy his own needs and motives of traveling. Working we explore the necessary assumptions which have to be fullfiled for better placing of hotel product on the more squemish and demanding tourist market.
LIMITES DA CONSTITUCIONALIZAÇÃO DO DIREITO INTERNACIONAL NO SISTEMA INTERAMERICANO: UMA ANÁLISE DOS MODELOS TEÓRICOS DO PLURALISMO CONSTITUCIONAL E DO CONSTITUCIONALISMO MULTINÍVEL
Authors: Rocha Isly Queiroz Maia
Published: December 2021

O objetivo do artigo é de estabelecer um olhar comparado sobre as propostas de adaptação do pluralismo constitucional e do constitucionalismo multinível para o contexto da América Latina, englobando o Sistema Interamericano de Proteção dos Direitos Humanos. As novas teorias constitucionalistas tem em comum a abordagem heterárquica da relação entre direito internacional e direito interno, bem como a defesa do processo de constitucionalização do direito internacional dos direitos humanos por meio das jurisdições regionais. Nesse contexto, as teorias são abordadas segundo os desdobramentos práticos, as ferramentas empregadas na promoção do diálogo interjurisdicional e o grau de constitucionalização proposto. Ao final, concluiu-se que o pluralismo constitucional apresenta uma abordagem descritiva, ao passo que o constitucionalismo multinível tem um teor propositivo no cenário interamericano.
OS CONTRATUALISTAS E A FORMAÇÃO DO ESTADO MODERNO
Authors: Da Silva Barreto Júnior Williem , Cademartori Sérgio Urqhart de
Published: December 2021

O presente artigo tem por objetivos: a) apresentar as principais teorias sobre o contrato social, protagonizadas por Thomas Hobbes, John Locke e Jean-Jacques Rousseau, sob um prisma comparativo; e b) analisar os antecedentes, implicações e peculiaridades do estado moderno, contextualizando-o histórica, política e juridicamente. Em sentido conclusivo, sustenta-se a relevância dos teóricos contratualistas para a estruturação do novel arquétipo estatal e a superação da noção patrimonialista de estado, que abriu espaço para a emergência da coisa pública. Para tanto, a pesquisa é feita com base numa abordagem de natureza qualitativa, empregando-se a metodologia hipotético-dedutiva, em associação com o método bibliográfico, através do qual são analisados livros, artigos científicos e teses de prestígio junto à comunidade acadêmica.
A ASSISTÊNCIA AO PRESO DURANTE A EXECUÇÃO DA PENA E SUA INFLUÊNCIA NA REINSERÇÃO SOCIAL DO APENADO
Authors: Oliveira Tarsis Barreto , Ribeiro José Roberto Ferreira
Published: December 2021

A reinserção social dos detentos é tarefa conjunta do Estado e da sociedade. O desenvolvimento de tal processo depende do oferecimento de condições básicas de saúde, higiene, alimentação, assistência jurídica e proteção religiosa que visam garantir a manutenção da dignidade da pessoa humana. Além da proteção legal aos direitos do cidadão enquanto encarcerado, normas e tratados de direitos humanos recomendam ações mínimas de organização dos presídios para que não falte ao apenado o interesse pelo processo de reinserção social. Dentre tais parâmetros, a adequada assistência ao preso constitui ferramenta indispensável à sua regeneração. O abandono social, causado pela falta de assistência aos internos do sistema prisional, reflete diretamente na recuperação do preso e representa prejuízos à execução penal, contribuindo para a animosidade nas cadeias e os elevados índices de reincidência. Nesse sentido, o presente trabalho tem como objetivo evidenciar a assistência ao preso durante a execução da pena como mecanismo apto a promover potenciais possibilidades de sua reinserção social, o que requer, como condição viabilizadora, a oferta de direitos mínimos previstos na Lei de Execução Penal brasileira.
A NOVA PERSPECTIVA SOBRE A INTERRUPÇÃO VOLUNTÁRIA DA GRAVIDEZ À LUZ DO FUNCIONALISMO PENAL
Authors: Ferreira Renan Azevedo Leonessa
Published: December 2021

Na atualidade tem se verificado intenso debate acerca da criminalização do aborto, o que reverberou no Supremo Tribunal Federal por meio da Arguição de Descumprimento de Preceito Fundamental n.º 442. Por meio desta pesquisa, visa-se trazer uma nova abordagem para as hipóteses de interrupção voluntária da gravidez, para além de uma muito aventada ponderação entre o direito de autonomia da mulher e a vida do embrião/feto. A partir de uma ótica do funcionalismo penal, busca-se utilizar avanços médico-científicos para uma delimitação dinâmica e normativa do bem jurídico tutelado. Ademais, a partir de um alinhamento político-criminal, sob a ótica de subsidiariedade e fomento das finalidades preventivas do direito penal, é proposta a atipicidade da interrupção voluntária da gravidez nas primeiras doze semanas após a fecundação, desde que precedida de detido acompanhamento estatal, na esteira legislativa moderna adotada na seara internacional.
COVID-19 Pandemic Impact on the National Health Care Surveys
Authors: Ward Brian W. , Sengupta Manisha , DeFrances Carol J. , Lau Denys T.
Published: December 2021

While underscoring the need for timely, nationally representative data in ambulatory, hospital, and long-term-care settings, the COVID-19 pandemic posed many challenges to traditional methods and mechanisms of data collection.

To continue generating data from health care and long-term-care providers and establishments in the midst of the COVID-19 pandemic, the National Center for Health Statistics had to modify survey operations for several of its provider-based National Health Care Surveys, including quickly adding survey questions that captured the experiences of providing care during the pandemic.

With the aim of providing information that may be useful to other health care data collection systems, this article presents some key challenges that affected data collection activities for these national provider surveys, as well as the measures taken to minimize the disruption in data collection and to optimize the likelihood of disseminating quality data in a timely manner. (Am J Public Health. 2021;111(12):2141–2148. https://doi.org/10.2105/AJPH.2021.306514 )
Comparing the COVID-19 Responses in Cuba and the United States
Authors: Powell Mary Anne , Erwin Paul C. , Bermejo Pedro Mas
Published: December 2021

The purpose of this analytic essay is to contrast the COVID-19 responses in Cuba and the United States, and to understand the differences in outcomes between the 2 nations.

With fundamental differences in health systems structure and organization, as well as in political philosophy and culture, it is not surprising that there are major differences in outcomes. The more coordinated, comprehensive response to COVID-19 in Cuba has resulted in significantly better outcomes compared with the United States. Through July 15, 2021, the US cumulative case rate is more than 4 times higher than Cuba’s, while the death rate and excess death rate are both approximately 12 times higher in the United States. In addition to the large differences in cumulative case and death rates between United States and Cuba, the COVID-19 pandemic has unmasked serious underlying health inequities in the United States.

The vaccine rollout presents its own set of challenges for both countries, and future studies can examine the comparative successes to identify effective strategies for distribution and administration. (Am J Public Health. 2021;111(12):2186–2193. https://doi.org/10.2105/AJPH.2021.306526 )
The Impacts of the COVID-19 Pandemic on the Medical Expenditure Panel Survey
Authors: Zuvekas Samuel H. , Kashihara David
Published: December 2021

The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health.

We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates.

We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157–2166. https://doi.org/10.2105/AJPH.2021.306534 )
Disparities Among Industry’s Highly Compensated Orthopaedic Surgeons
Authors: Robin Joseph X. , Murali Sudarsan , Paul Kyle D. , Kofskey Alexander M. , Wilson Anthony L. , Almaguer Adam M. , Wills Bradley W. , McGwin Gerald , Momaya Amit M. , Brabston Eugene W. , Ponce Brent A.
Published: December 2021

Background:

The prosperous financial relationship between physicians and industry remains a highly scrutinized topic. Recently, a publicly available website was developed in conjunction with the U.S. Affordable Care Act to shed light on payments from industry to physicians with the goal of increasing transparency. The purpose of this study was to assess possible relationships between industry payments and orthopaedic surgeon gender, subspecialty training, and practice settings.

Methods:

A retrospective analysis was performed using publicly available information from the Centers for Medicare & Medicaid Services (CMS) to identify the 25 orthopaedic surgeons with the highest compensation from each of the 10 largest orthopaedic companies from 2013 to 2017. Statistical analyses were conducted to investigate the factors that contributed to payment differences.

Results:

Among the 347 highest-compensated orthopaedic surgeons, only 1 woman (0.29%) was identified. Orthopaedic surgeons in the subspecialties of spine (32.9%), adult reconstruction (27.9%), and sports medicine (14.5%) made up a majority of the 25 highest earners. A larger proportion of the physicians in this study worked in private practice (57.6%) compared with an academic setting (42.4%). Orthopaedic surgeons who subspecialize in sports medicine had significantly higher total mean payment amounts when compared with all other specialties. The primary method of compensation was found to be through licensing or royalty payments.

Conclusions:

The large majority of orthopaedic surgeons who are highly compensated from industry are men. Among these, the greatest number specialize in the spine, while sports medicine surgeons receive significantly higher total mean payment amounts. Additional studies are warranted to evaluate the disparities between men and women and encourage policies to promote gender equality.
Association Between Serum Testosterone Levels and Cutibacterium Skin Load in Patients Undergoing Elective Shoulder Arthroplasty
Authors: Schiffman Corey J. , Hsu Jason E. , Khoo Kevin J. , Whitson Anastasia , Yao Jie J. , Wu John C. , Matsen Frederick A.
Published: December 2021

Background:

Cutibacterium periprosthetic joint infections are important complications of shoulder arthroplasty. Although it is known that these infections are more common among men and that they are more common in patients with high levels of Cutibacterium on the skin, the possible relationship between serum testosterone levels and skin Cutibacterium levels has not been investigated.

Methods:

In 51 patients undergoing shoulder arthroplasties, total serum testosterone, free testosterone, and sex hormone binding globulin levels obtained in the clinic before the surgical procedure were compared with the levels of Cutibacterium on the skin in clinic, on the skin in the operating room prior to the surgical procedure, and on the dermal wound edge of the incised skin during the surgical procedure.

Results:

Clinic skin Cutibacterium loads were strongly associated with both clinic free testosterone levels (tau, 0.569; p < 0.001) and total serum testosterone levels (tau, 0.591; p < 0.001). The prepreparation skin and wound Cutibacterium levels at the time of the surgical procedure were also significantly associated with both the clinic total serum testosterone levels (p < 0.001) and the clinic free testosterone levels (p < 0.03). A multivariate analysis demonstrated that serum testosterone was an independent predictor of high skin Cutibacterium loads, even when age and sex were taken into account. Patients taking supplemental testosterone had higher free testosterone levels and tended to have higher skin Cutibacterium loads. Patients who underwent the ream-and-run procedure had higher total and free testosterone levels and higher skin Cutibacterium loads.

Conclusions:

Testosterone levels are predictive of skin Cutibacterium levels in patients undergoing shoulder arthroplasty. This relationship deserves further investigation both as a risk stratification tool and as a potential area for intervention in reducing shoulder periprosthetic joint infection.

Level of Evidence:

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Rotational Stability of Proximally Unlocked Retrograde Femoral Nail In Damage Control Surgery – Biomechanical Study
Authors: Muzaffar Rahil , Zeedi Muadh Hamood Nasser Al , Alam Khurshid , Yaseen Ahmed , Maskari Sultan Al
Published: December 2021

BACKGROUND: This biomechanical study was performed to look into the rotational stability of retrograde femoral intramedullary nail when it is used without proximal locking as a damage control device for management of femoral shaft fractures in emergency situations. This study compares this technique with the accepted methods for femoral shaft fixations in damage control surgeries. An alternative technique of using lateral compression screw to provide additional rotational stability is described.METHODS: Experiments were divided into four different sets. Distally locked retrograde nail was passed across the fracture without any proximal fixation in set 1, a compression screw passed from lateral cortex in set 2, a proximal locking screw fixation in set 3. In set 4, Saw bone was fixed with external fixator.The lateral compression screw group was further sub divided into three subgroups based on the amount of torque applied manually.The torsion test was applied to create an rotational displacement of 10 degrees and the maximum load required to create the rotational displacement was noted.RESULTS: Application of a compression screw improved the rotational stability significantly in comparison to no proximal locking. In the subgroup III of lateral compression screw application, the rotational stability was found to be equivalent to stability achieved with Nail with proximal locking and was found to be greater in comparison to external fixator application.CONCLUSION: This study shows that the addition of a lateral compression screw significantly improves rotational stability and has the potential to be used in emergency lifesaving procedures.
Mid-Upper Arm Circumference as an Indicator of Quality of Life of Patients with Advanced Cancer
Authors: Won Seon-Hye , Hiratsuka Yusuke , Suh Sang-Yeon , Bae Hayoung , Choi Sung-Eun , Kim Yu Jung , Kang Bodeul , Lee Si Won , Suh Koung Jin , Kim Ji-Won , Kim Se Hyun , Kim Jin Won , Lee Keun-Wook
Published: December 2021

Purpose
Mid-upper arm circumference (MUAC) has been used to assess malnutrition and health status across various disease groups. However, it is unclear whether MUAC is associated with quality of life (QOL) of patients with advanced cancer. Our goal was to investigate the relationship between MUAC and QOL in ambulatory out-patients with advanced cancer.
Method
This was a cross-sectional study conducted in a tertiary cancer center in South Korea. A total of 200 patients with advanced cancer at oncology clinics of Seoul National University Bundang Hospital from March 2016 to January 2019 were enrolled. Out-patients with advanced cancer whose survival was expected to be less than one year by their oncologists were enrolled. QOL of patients was evaluated using the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30). Associations of QOL with MUAC and nutritional parameters were examined with generalized linear models.
Results
The most common cancer sites were the lung, colon or rectum, and genitourinary tract. In univariate analyses, significant factors associated with higher summary score of EORTC QLQ-C30 were higher MUAC (≥ 26.5 cm, p < 0.001), higher body mass index (BMI) (≥ 22 kg/m2, p < 0.001), higher serum albumin (≥ 3.7 g/dL, p = 0.004), higher creatinine (≥ 0.8 mg/dL, p = 0.023), and higher uric acid (≥ 5 mg/dL, p = 0.001). In multivariate analysis, higher serum albumin (≥ 3.7 g/dL, p < 0.01) and higher MUAC (≥ 26.5 cm, p = 0.03) were independently associated with better summary score of EORTC QLQ-C-30.
Conclusion
MUAC was highly associated with QOL in terms of summary score and overall health status. Thus, MUAC, with its simplicity, can be a useful tool to reflect QOL in patients with advanced cancer.
Impact of Salivary and Pancreatic Amylase Gene Copy Numbers on Diabetes, Obesity, and Functional Profiles of Microbiome in Northern Japanese Population
Authors: Hasegawa Takanori , Kakuta Masanori , Yamaguchi Rui , Sato Noriaki , Mikami Tatsuya , Murashita Koichi , Nakaji Shigeyuki , Itoh Ken , Imoto Seiya
Published: December 2021

Amylase genes reside in a structurally complex locus, and their copy numbers vary greatly, and several studies have reported their association with obesity. The mechanism of this effect was partially explained by changes in the oral and gut microbiome compositions; however, a detailed mechanism has been unclarified. In this study, we showed their association with diabetes in addition to obesity, and further discovered a plausible mechanism of this association based on the function of commensal bacterial. First, we confirmed that the amylase copy number in the population tends to be larger than that reported in other studies and that there is a positive association between obesity and diabetes (p=1.95E-2 and 3.28E-2). Second, we identified that relative abundance of some genus level microbiome, Capnocytophaga, Dialister, and previously reported bacteria, were significantly associated with amylase copy numbers. Finally, through functional gene-set analysis using shotgun sequencing, we observed that the abundance of genes in the Acarbose pathway in the gut microbiome was significantly decreased with an increase in the amylase copy number (p-value = 5.80E-4). Our findings can partly explain the mechanism underlying obesity and diabetes in populations with high amylase copy numbers.
Creation of a Tool to Evaluate Supportive Care: Experiences from Socioesthetics
Authors: Giacchero Damien , Buiret Guillaume , Grosjean Cecile , TAIEB CHARLES , Saghatchian Mahasti , Krakowski Ivan
Published: December 2021

The absence of a specific tool to evaluate the impact of Supportive care in general and socioesthetics in particular as a rendered medical service is undoubtedly at the origin of the lack of published research based on scientific standards.In this context, we developed one supportive-care patient-reported outcome [PRO] using the multistep methods following COSMIN recommendations. Its construction followed all recommended steps: elaboration of the questionnaire, measurement properties of the questionnaire, internal and external validation, test-retest validation and translation, cross-cultural adaptation and cognitive debriefing. In total, our questionnaire includes11 items. It is scored by adding each VAS, making it range from 0 to 110, with a higher benefit when the score is higher. The Cronbach’s α coefficient is 0.88 for the entire questionnaire. The questionnaire thus constructed is a reflection of the patient's feelings, and it is quite natural that the name The “patient centricity questionnaire” (PCQ) was retained and validated by the Scientific Committee. The PCQ correlated negatively and moderately with the PSS, positively and moderately with the mental dimension of the and poorly with the WB12, the physical dimension of the SF-12 and the satisfaction EVA. Constructed according to the recommendations, the PCQ meets the prerequisite for this type of questionnaire. Its short format (11 questions) and simplicity of use allow it to be used by a large number of people and provides an pragmatic answer by making available to research teams a simple, reliable, easy-to-use and validated tool. It makes possible randomized studies to prove the impact on quality of life of the Supportive care in general and socioesthetics" in particular.
Development of a Kriging Assessment Framework and Impact Pathway for Researching Contamination With Potentially Toxic Elements in Urban Landfill Soil
Authors: Bakar Azizi Abu , Yoneda Minoru , Mahmood Noor Zalina
Published: December 2021

Landfill post-closure with contaminant concentration in soil below permissible limit assessed at limited spot does not represent the contamination issue. Assessment limit to professionals also does not gives a potential of change to practice constant assessment to a wider context of assessor - citizen living nearby - as a collaborative effort to sustain a safe environment. Therefore sizeable, qualitative, and cost-effective analysis of the concentrations of contaminants is needed and this work recommends kriging assessment and the logical impact pathway framework as factors of change in landfill aftercare management. The kriging framework is developed utilising lead (Pb) and chromium (Cr) data from inductively coupled plasma mass spectrometry (ICP-MS) analysis. The development of the kriging framework is conducted based on the observation of censored data from ICP-MS analysis. The estimation analysis involves the analysis of ordinary kriging with regression analysis, showing the interpolation of spatial correlation and regression error. Hence, ordinary kriging with regression of the variable of interest, i.e., Pb, using the data of the explanatory variable, i.e., Cr, is inappropriate. Further investigation with the utilisation of guess-field kriging analysis hypothetically exposed a potential contaminated area using an existing but limited number of explanatory variables; although, guess-field kriging may possibly result immense uncertainty at the area where the explanatory variable does not exist. Besides, this work anticipated outcomes in societal impact and sustainability practices from the proposed kriging framework by recommending a logical impact pathway. The development of the kriging framework and impact pathway reassure the necessary actions to be executed by responsible parties and act as the stimulus of a wider spectrum of improvement initiatives to oversee real issues, such as the time of occurrence, and to prevent negative impacts on the environment and humans.
Clinical Study of THSD7A, SOD2 and AR Antigens in Idiopathic Membranous Nephropathy
Authors: Wang Honggang , Zhao Tingting , Dong Jianwei , Zhou Yan , Huang Jing , Gao Caifeng , Chen Lei , Li Jiatong , Wang Rong , Chen Bing
Published: December 2021

Background

To explore the expression of THSD7A, SOD2 and AR podocyte antigens in the renal tissue of patients with idiopathic membranous nephropathy (IMN) and its clinical diagnostic value in IMN.
Method

This study retrospectively collected 150 renal tissue specimens and clinical data of patients undergoing renal biopsy in the Department of Nephrology, Shandong Provincial Hospital, including 130 IMN and 20 non-IMN patients. We use immunohistochemical staining to detect the expression of THSD7A, SOD2, AR antigens in the kidney tissue of patients. We focus on analyzing the clinical and pathological characteristics of IMN patients with positive THSD7A antigen expression, and analyze the prognosis of THSD7A-IMN patients and tumor occurrence. Meanwhile, the sensitivity and specificity of those antigens for the diagnosis of IMN were discussed.
Results

There were only 6 patients with THSD7A positive expression among 150 patients with glomerular disease, of which 5 patients were all IMN patients, and the patients' serum anti-PLA2R antibodies(anti-PLA2R-ab) were all negative. The positive rate of THSD7A in IMN was 3.85%, and the positive rate in IMN patients with anti-PLA2R-ab negative was 5.50%. Meanwhile, the sensitivity and specificity of renal tissue THSD7A in diagnosing IMN is 4.0% and 95%. In addition, the IgG subtype of THSD7A-IMN was mainly IgG4; Among them, 2 patients with IMN had both THSD7A and PLA2R antigen staining. This study also suggests that there is no significant difference in clinical and pathological characteristics between THSD7A positive and negative group. The follow-up of THSD7A-IMN patients found no tumors. This study also showed that there were 11 cases of anti-PLA2R-ab negative IMN patients with SOD2 antigen expression (8.56%), 10 cases of anti-PLA2R-ab negative and 4 cases of anti-PLA2R-ab positive IMN patients with AR antigen expression (10.77%), but no obvious SOD2 and AR antigen expression in SMN and other glomerular diseases.
Conclusions

Glomerular THSD7A antigen has a certain expression rate and high specificity in IMN, but its expression rate is low, and it can be used as a specific diagnostic index for IMN supplement. Kidney tissue SOD2, AR podocyte target antigens have a low positive rate in IMN, and further research is needed to evaluate the condition of IMN.
Species-Specific Effects of Microplastics On Juvenile Fishes
Authors: Zhang Chaonan , Wang Qiujie , Zuo Zhiheng , Pan Zhengkun , Wang Shaodan , Xu Guohuan , Zou Jixing
Published: December 2021

Microplastics contamination have been extensively reported in aquatic ecosystem and organisms. It is wildly acknowledged that the ingestion, accumulation and elimination of microplastics in fishes are species-specific, which mainly depending on the feeding behavior. This study aims to investigate the effects of microplastics on the morphology and inflammatory response in intestines of fishes with different feeding types. Largemouth bass (carnivorous fish), grass carp (herbivorous fish) and Jian carp (omnivorous fish) were used as organism model. The contributing concentration and size of microplastics are explored as well as the response time and legacy effect in fishes. Two different sizes of polystyrene microplastics (8 μm and 80 nm) were set at three concentrations. And samples were analyzed at different exposure times and depuration times. Histological analysis indicated that multiple abnormalities in intestines are presented in three species fishes after acute exposure microplastics. The mRNA abundance of immune-related genes in the intestine tissues of fishes were significantly induced or restrained. There were differential expressions of genes coping with differential sizes and concentrations of microplastics exposure in different fishes. The reason for the difference effects of microplastics on fishes was still unclear but could be due to the difference in the structure and function of the digestive system. These results provide a theoretical basis to further analysis of the mechanism of fish intestinal pathology caused by microplastics.
Differential Responses of Ceratitis Capitata to Infection by the Entomopathogenic Fungus Purpureocillium Lilacinum.
Authors: Djobbi Wafa , Guerfali Meriem Msaad , Vallier Agnès , Charaabi Kamel , Maire Justin , Parisot Niclas , Charles Hubert , Hamden Haytham , Fadhl Salma , Heddi Abdelaziz , Cherif Ameur
Published: December 2021

Ceratitis capitata (medfly), is one of the most injurious pests of fruits with quarantine importance because of its extremely wide host range. The use of entomopathogenic fungi constitutes a promising approach for potential applications in integrated pest management. Nonetheless, developing methods of insect control can also involve the use of fungal machinery to produce metabolic disturbance that can increase its effectiveness by producing a detrimental effect on insect development. Insect species, such as Ceratitis capitata, depend on reproduction potential, nutrient reserves, metabolic activities and immune response for their survival. Accordingly, the purpose of this study is to use the entomopathogenic fungus Purpureocillium lilacinum to investigate, its sublethal effects on Ceratitis capitata. Laboratory bioassays were conducted on medfly V8 strain. The bioassays were monitored to determine the virulence of P. lilacinum on the fruit fly. P. lilacinum was tested against 5 days-old males and females, through abdominal topical applications. Following the fungal inoculation, we showed (i) a significant increase of sugar amount in tissues, (ii) a significant decrease in carbohydrase activities, digestive glycosyl hydrolase and proteinase activities in whole midguts of treated flies, (iii) an over-expression of Takeout and Attacin-A genes induced by infection. Moreover, the up-regulations observed for relish, cecropin 1, ceratotox-A and defensin genes are due to physiological mechanisms occurring during infection.
How Will Foreign Trade Affect Green Economic Efficiency in Sub-developed Region? An Empirical Research Based on the Data From Central China
Authors: Zhang Jianqing , Gong Enze , Zhao Cuizehao
Published: December 2021

Foreign trade in sub-developed regions may lead to serious environmental problems. Impact of foreign trade in sub-developed regions on green economic efficiency and its possible impact channels are qualitatively analyzed, empirical tests are conducted based on the data of 80 Prefecture-level cities in Central China. Results show that: 1. Foreign trade of Central China will have a significant direct negative impact on green economic efficiency, which is not conducive to green growth. 2. Expanding the scale of foreign trade in Central China will stimulate industries agglomerate to big cities and promote the level of industrial specialization within the region, which will have indirect negative impacts on green economic efficiency. 3. Foreign trade in Central China will improve the policy environment for industrial development, then have an indirect positive impact on green economic efficiency, whereas its impact on technological innovation is not significant. 4. Impact of foreign trade in different cities in Central China on green economic efficiency are heterogeneous from the perspective of spatial heterogeneity and from the perspective of city characteristic heterogeneity, and when environmental regulation exceeds a certain threshold, the negative impact of foreign trade on green economic efficiency will turn to positive. Policy implications are proposed.
Nonlinear Chen-Lee Chaotic System Based Deep Convolutional Generative Adversarial Nets for Chatter Diagnosis
Authors: Kuo Ping-Huan , Luan Po-Chien , Tseng Yung-Ruen , Yau Her-Terng
Published: December 2021

Chatter has a direct effect on the precision and life of machine tools and its detection is a crucial issue in all metal machining processes. Traditional methods focus on how to extract discriminative features to help identify chatter. Nowadays, deep learning models have shown an extraordinary ability to extract data features which are their necessary fuel. In this study deep learning models have been substituted for more traditional methods. Chatter data are rare and valuable because the collecting process is extremely difficult. To solve this practical problem an innovative training strategy has been proposed that is combined with a modified convolutional neural network and deep convolutional generative adversarial nets. This improves chatter detection and classification. Convolutional neural networks can be effective chatter classifiers, and adversarial networks can act as generators that produce more data. The convolutional neural networks were trained using original data as well as by forged data produced by the generator. Original training data were collected and preprocessed by the Chen-Lee chaotic system. The adversarial training process used these data to create the generator and the generator could produce enough data to compensate for the lack of training data. The experimental results were compared with without a data generator and data augmentation. The proposed method had an accuracy of 95.3% on leave-one-out cross-validation over ten runs and surpassed other methods and models. The forged data were also compared with original training data as well as data produced by augmentation. The distribution shows that forged data had similar quality and characteristics to the original data. The proposed training strategy provides a high-quality deep learning chatter detection model.