bluuebunny/crossref_metadata_2025 huggingface dataset:
A PARTICIPAÇÃO DA SOCIEDADE NA INCLUSÃO DA PESSOA COM DEFICIÊNCIA
Authors: Garcez Calil Mário Lúcio , Pozzoli Lafayette , Martins Gislaene
Published: September 2020

O presente trabalho tem por objetivo central discutir a questão da efetividade dos direitos fundamentais das pessoas com deficiência sob a ótica da fraternidade. Para a pesquisa, foi utilizada a metodologia dedutiva, por intermédio de levantamento bibliográfico de obras que tratam do tema, com o objetivo de provocar uma reflexão sobre a participação da sociedade no cenário da inclusão social das pessoas com deficiência sob o aspecto fraternal dos seres humanos. Justifica-se, assim, o presente estudo, tendo em vista a inegável importância da promoção da igualdade por intermédio dos direitos humanos. Concluiu-se que mesmo que os direitos das pessoas com deficiência encontrem regulamentação e promoção estatal, sua concretização não estará completa até a incorporação e a efetiva prática da fraternidade, a fazer com que a pessoa atue de maneira fraterna para com essas pessoas
Meeting SDG6 in the Kingdom of Tonga: The Mismatch between National and Local Sustainable Development Planning for Water Supply
Authors: White Ian , Falkland Tony , Kula Taaniela
Published: September 2020

UN 2030 Sustainable Development Goal 6 presents difficulties for small island developing states such as the Kingdom of Tonga, which relies on rainwater and groundwater lenses for freshwater supply. Planning and managing water resources to supply demands in dispersed small islands under variable climate and frequent extreme events is challenging. Tensions between water planning using top-down versus bottom-up processes have long been recognized. Tonga’s overarching national planning instrument is the Tonga Strategic Development Framework, 2015-2025 (TSDFII). This identifies desired national outcomes and is used to direct and resource Ministries and address international and regional commitments. Water supply was a low priority in the three-month consultations that led to TSDFII. Community Development Plans (CDPs), developed by rural villages throughout Tonga’s five Island Groups over nine years, involved participation from 80% of each village population who ranked local priorities. Analysis of priorities in 117 available village CDPs reveals improvements to village water supply was the highest overall priority in all five Island Groups and ranked within the top three priorities by 76% of all villages, with women, youth and men returning figures of 83%, 66% and 80% respectively. The mismatch between top-down and bottom-up priorities appears to result from an urban/rural divide.
Alcohol-Based Hand Sanitizers – A Multidimensional Perspective
Authors: Nyamwweya Nasser N. , Abuga Kennedy O.
Published: September 2020

The global use of alcohol based hand sanitizers (ABHS) as a means of controlling the transmission of infectious disease increased dramatically in 2020 as governments and public health agencies across the world advocated hand hygiene as a preventative measure during the COVID-19 pandemic. Although the performance of these products is most commonly defined as a function of their alcohol concentration, they are multifaceted products in which an interplay of several factors is important in determining efficacy. The hand sanitizer tetrahedron, is a novel concept that considers both ABHS formulation factors and product performance factors from a multi-dimensional perspective. The four faces of the tetrahedron represent input/formulation factors: 1) the type and amount of alcohol, 2) inactive ingredients, 3) the type of formulation/delivery system and 4) manufacturing practices. The four corners of the tetrahedron represent output/product performance factors: 1) efficacy, 2) sensory characteristics, 3) usage, usability and compliance and 4) product safety/adverse effects. All factors are of importance to ensuring the effectiveness and utility of these products.
PENGARUH KONSENTRASI STPP DAN LAMA PERENDAMAN TERHADAP KARAKTERISTIK PATI KIMPUL TERMODIFIKASI IKATAN SILANG
Authors: Suga Krisna Kharisma , Aini Nur , Setyawati Retno
Published: September 2020

Kimpul is one type of tubers that is high in carbohydrate content so it canbe used as a source of starch. Natural starch generally still has severaldisadvantages. One of method that can be done to overcome theseweaknesses is by modifying cross-linked starch. The objectives of thisstudy are: 1) to know the effect of STPP concentration on chemical andphysical characteristics of modified kimpul starch; 2) to know the effect ofsoaking time on chemical and physical characteristics of modified kimpulstarch; 3) to determine the best combination treatment between STPPconcentration and soaking time on the chemical and physicalcharacteristics of modified kimpul starches. This is an experimentalresearch with Randomized Block Design. The factors studied were theconcentration of sodium trypolyphosphate (1, 2 and 3%) and soaking time(60 and 90 minutes). The variables tested were moisture content, starchcontent, amylose content and calcium oxalate content, brightness, swellingpower, sollubility and its amylographic properties. The results showedthat both STPP concentration factors and soaking time affected themodified chemical and physical characteristics of kimpul starchcrosslinking methods. The chemical and physical characteristics of crossbonded modified kimpul starch increased with STPP concentration andsoaking time used. Modified kimpul starch using 3% STPP concentrationand 90 minutes soaking time had moisture content, starch content, amylosecontent, calcium oxalate content, brightness and high swelling power. Thebest modified kimpul starch is modified kimpul starch using 2% STPPconcentration and 60 minutes soaking time. It has a water content of7,88%, starch content of 63,13%, amylose content of 17,28%, oxalatecontent of 15,84 ppm, swelling power 15,79 g/g, sollubility 11,55%,brightness of 44.13, initial gelatinization temperature of 78,75oC, peakviscosity of 5152.5 cP, hot paste viscosity of 2310,4 cP, breakdownviscosity of 2815 cP, setback viscosity of 1563 cP and cold paste viscosityof 3873,5 cP
Geriatricians’ Standpoint of the Informed Consent Process among Patients with Alzheimer's Disease: The Lebanese Context
Authors: Fakhro Mohammed Ali
Published: September 2020

BackgroundDespite the existence of laws that ensure that patients’ capacity to consent is assessed systematically, many gray areas remain with that regard. As dementia progresses, some patients lose their capacity to make decisions. The aim was to characterize Lebanese geriatricians’ perspectives about decision-making capacity (DMC) of their patients with Alzheimer’s disease (AD). Moreover, to propose an algorithm for a reliable, comprehensive, and valid assessment of DMC. MethodsA cross-sectional descriptive study was designed to empirically collect data via an e-survey. Accordingly, a comprehensive list of geriatricians was provided by the Lebanese Order of Physicians. Geriatricians were approached via a phone call, to provide them with study-specific information. Those who accepted to participate received a link to the study’s survey via an e-mail.ResultsAmong the eligible geriatricians, 75% had successfully completed the e-survey, with a mean of 14.7 ± 9.6 years of experience. More than half of the geriatricians failed to recognize that assessing the patients’ DMC is an integral component of the informed consent (IC) process. Yet, 88.9% assessed the DMC of their patients with AD using different modalities. However, the majority were unable to clearly justify their judgment of DMC based on the tools they have selected.ConclusionLebanese geriatricians have demonstrated a poor understanding of the concept of autonomy and the need for the DMC assessment as part of the IC’s process. Moreover, they were unable to select adequate tools to assess and judge the DMC of their patients with AD.
A Comparison of Global Surgery Tariffs and the Actual Cost of Bills at Hazrate Rasoole Akram Educational and Medical Center
Authors: abutorabi ali , radinmanesh maryam , rezapour aziz , afshari mahnaz , taheri ghasem
Published: September 2020

Background: the health service tariff is an appropriate policymaking tool and the financial leverage of the health system control which affects quality, availability, cost, efficiency, equity and accountability of health services. Global surgeries include 91 common cases of general and specialized surgeries in hospitals; fixed tariffs are annually defined for these surgeries, and insurance companies must pay medical centers based on these tariffs. The aim of this study was to examine and compare hospital bills with global surgery tariffs at Hazrate Rasoole Akram Educational and Medical Center in 2017.Methods: This descriptive-analytic study was conducted retrospectively and compared the global and actual costs of global surgeries performed in the third quarter of the year 2017 at Hazrate Rasoole Akram Educational and Medical Center. Required data on the actual costs of surgeries was collected through the Hospital Information System (HIS) and patients’ records. Information on the global costs was obtained from the Annual Circulars of Insurance Council for the studied period about the cost of global surgeries. Linear regression (STATA13 software) was used to investigate the effect of items on tariff and invoice differences; concerning other calculations, EXCEL software was used.Results: The highest frequency of global surgeries was related to ophthalmic surgery which accounted for approximately half of total surgeries performed at Hazrate Rasoole Akram Hospital. The most significant difference between global tariff and invoice was also related to ophthalmic surgery (188709.3 Dollar a year).Overall, the actual hospital bills were much higher than the tariffs approved for global surgeries, and the total difference was 461805.5 Dollar. The results revealed that there was a significant relationship between some of the items such as the cost of operating rooms, anesthesia and other services.Conclusions: Referral hospitals which are at the level three of referral networks usually treat more complex patients; this should be taken into account when defining surgery tariffs of these centers. On the other hand, hospitals need to control the costs and reduce the end cost of these surgeries by improving clinical management and cost management. In addition, prospective and case-based payment methods can control health costs.
Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system
Authors: Shattnawi Khulood Kayed , Khader Yousef S. , Alyahya Mohammad S. , Al-Sheyab Nihaya , Batieha Anwar
Published: September 2020

Background: Annually, 2.6 million stillbirths occur around the world, with approximately 98% occurring in low- and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyze, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analyzed.Results: A total of 10,328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths), with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of the placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations, deformations and chromosomal abnormalities, other specified intrapartum disorders, and intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of the placental cord and membranes. In the multivariate analysis, small for gestational age (SGA) pregnancies were associated with a significant 3-fold increased risk of stillbirth compared to appropriate for gestational age (AGA) pregnancies.Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for the early identification of high-risk pregnancies, including the early detection of SGA pregnancies, and ensuring adequate antenatal obstetric interventions.
Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study
Authors: Schönenberger Nicole , Sottas Beat , Merlo Christoph , Essig Stefan , Gysin Stefan
Published: September 2020

Background: Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices.Methods: We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis.Results: The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and style of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion: Our results suggested that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seemed to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.
Does Additional Extracorporeal Shock Wave Therapy Improve the Effect of Isolated Percutaneous Radiofreqency Coblation in Patients with Insertional Achilles Tendinopathy? Study Protocol for A Randomized Controlled Clinical Trial
Authors: Song Yu-Jie , Xuan Wen-Kai , Hua Ying-Hui
Published: September 2020

Background: No conclusive evidence recommends a prior treatment for insertional Achilles tendinopathy (IAT). It is theorized that both percutaneous radiofreqency coblation and extracorporeal shockwave therapy (ESWT) relieve pain within the insertion. However, no clinical evidence shows that either treatment promote the regeneration of the tendon or if the combination of these 2 interventions offer better function and less pain than one therapy. Methods: The study is a randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients with insertional Achilles tendinopathy who are not satisfied with the effect of conservative treatment will be screened. A minimum of 38 patients will be enrolled after deciding to participate in the trial on an informed basis. Then the intervention group and the control group perform radial ESWT and sham-ESWT respectively at 6 months after percutaneous radiofreqency coblation. The primary outcome will be the Victorian Institute of Sports Assessment Achilles (VISA-A) Score. Secondary outcome measures will be Foot and Ankle Outcome Score (FAOS) scale, Visual Analogue Scale (VAS), Tegner Score, and MRI ultra-short echo time (UTE) T2* value. The assessments will occur in 6 months, 1 year, and 2 years post-operatively. The differences between 2 groups will be conducted as intention-to-treat basis. Discussion: We aim to investigate if radiofreqency coblation associated with ESWT can provide more encouraging imaging findings as well as functional and clinical outcomes regarding the treatment of the IAT comparing to the single radiofreqency coblation treatment.Trial registration: ChiCTR1800017898; Pre-results. Registered on 20 August 2018.
Effects of Prenatal Mindfulness-Based Childbirth Education on Child-Bearers’ Trajectories of Distress: A Randomized Control Trial
Authors: Sbrilli Marissa Danielle , Duncan Larissa G. , Bardacke Nancy , Laurent Heidemarie K.
Published: September 2020

Background. The perinatal period is a time of immense change, which can be a period of stress and vulnerability for mental health difficulties. Mindfulness-based interventions have shown promise for reducing distress, but further research is needed to identify long-term effects and moderators of mindfulness training in the perinatal period. Methods. The current study used data from a pilot randomized control trial (RCT) comparing a condensed mindfulness-based childbirth preparation program—the Mind in Labor (MIL)—to treatment as usual (TAU) to examine whether prenatal mindfulness training results in lower distress across the perinatal period, and whether the degree of benefit depends on child-bearers’ initial levels of risk (i.e., depression and anxiety symptoms) and protective (i.e., mindfulness) characteristics. Child-bearers (N=30) in their third trimester were randomized to MIL or TAU and completed assessments of distress—perceived stress, anxiety, and depressive symptoms—at pre-intervention, post-intervention, six-weeks post-birth, and one-year postpartum. Results. Multilevel modeling of distress trajectories revealed greater decreases from pre-intervention to 12 months postpartum for those in MIL compared to TAU, especially among child-bearers who were higher in anxiety and/or lower in dispositional mindfulness at baseline. Conclusions. The current study offers preliminary evidence for durable perinatal mental health benefits following a brief mindfulness-based program and suggests further investigation of these effects in larger samples is warranted.Trial registration: The ClinicalTrials.gov identifier for the study is: NCT02327559. The study was retrospectively registered on June 23, 2014. https://clinicaltrials.gov/ct2/show/NCT02327559
Relationship between the atlantodental interval and T1 slope after atlantoaxial fusion in patients with rheumatoid arthritis
Authors: Ha Byeong Jin , Won Yu Deok , Ryu Jeil , Han Myung-Hoon , Cheong Jin Hwan , Kim Jae Min , Chun Hyoung-Joon , Bak Koang-Hum , Bae In-Suk
Published: September 2020

Background: Atlantoaxial fusion has been widely used for the treatment of atlantoaxial instability (AAI). However, atlantoaxial fusion sacrifices the motion of atlantoaxial articulation, and postoperative loss of cervical lordosis and aggravation of cervical kyphosis are observed. We investigated various factors under the hypothesis that the atlantodental interval (ADI) and T1 slope may be associated with sagittal alignment after atlantoaxial fusion in patients with rheumatoid arthritis (RA).Methods: We retrospectively investigated 64 patients with RA who underwent atlantoaxial fusion due to AAI. Radiological factors, including the ADI, T1 slope, Oc-C2 angle, cervical sagittal vertical axis, and C2-C7 angle, were measured before and after surgery.Results: The various factors associated with atlantoaxial fusion before and after surgery were compared according to the upper and lower preoperative ADIs. There was a significant difference in the T1 slope 1 year after surgery (p=0.044) among the patients with lower preoperative ADI values. The multivariate logistic regression analysis showed that the preoperative ADI (>7.92 mm) defined in the receiver-operating characteristic curve analysis was an independent predictive factor for the increase in the T1 slope 1 year after atlantoaxial fusion (odds ratio, 4.59; 95% confidence interval, 1.34-15.73; p=0.015).Conclusion: We found an association between the preoperative ADI and difference in the T1 slope after atlantoaxial fusion in the patients with RA. A preoperative ADI (>7.92 mm) was an independent predictor for the increase in the T1 slope after atlantoaxial fusion. Therefore, performing surgical treatment when the ADI is low would lead to better cervical sagittal alignment.
MiR-146a-5p targeting SMAD4 and TRAF6 inhibits adipogenensis through TGF-β and AKT/mTORC1 signal pathways in porcine intramuscular preadipocytes
Authors: Zhang Que , Cai Rui , Tang Guorong , Zhang Wanrong , Pang Weijun
Published: September 2020

Background: Intramuscular fat (IMF) content is a vital parameter for assessing pork quality. Increasing evidence has shown that microRNAs (miRNAs) play an important role in regulating porcine IMF deposition. Here, a novel miRNA implicated in porcine IMF adipogenesis was found, and its effect and regulatory mechanism were further explored with respect to intramuscular preadipocyte proliferation and differentiation.Results: By porcine adipose tissue miRNA sequencing analysis, we found that miR-146a-5p is a potential regulator of porcine IMF adipogenesis. Further studies showed that miR-146a-5p mimics inhibited porcine intramuscular preadipocyte proliferation and differentiation, while the miR-146a-5p inhibitor promoted cell proliferation and adipogenic differentiation. Mechanistically, miR-146a-5p suppressed cell proliferation by directly targeting SMAD family member 4 (SMAD4) to attenuate TGF-β signaling. Moreover, miR-146a-5p inhibited the differentiation of intramuscular preadipocytes by targeting TNF receptor-associated factor 6 (TRAF6) to weaken the AKT/mTORC1 signaling downstream of the TRAF6 pathway.Conclusions: MiR-146a-5p targets SMAD4 and TRAF6 to inhibit porcine intramuscular adipogenesis by attenuating TGF-β and AKT/mTORC1 signaling, respectively. These findings provide a novel miRNA biomarker for regulating intramuscular adipogenesis to promote pork quality.
Preoperative false-negative transthoracic echocardiographic results in native valve infective endocarditis patients: a retrospective study from 2001 to 2018
Authors: Ren Zuning , Zhang Jian , Chen Hongjie , Mo Xichao , Cai Shaohang , Peng Jie
Published: September 2020

Background: Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results.Methods: Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018.Results: A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (<10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors.Conclusions: Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.
Isoperistaltic versus antiperistaltic uncut Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A propensity score matched analysis.
Authors: hangtian cui , Huabing Huang , Tianhang Luo , Xiaoyi Yin , Guoen Fang
Published: September 2020

Background

The uncut Roux-en-y anastomosis (URYA) has some clinical advantages after distal gastrectomy (DG). Little evidence exists regarding the influence of peristalsis on this anastomosis. We aimed to evaluate short-term outcomes of isoperistaltic URYA (iso-URYA) comparing with antiperistaltic URYA (anti-URYA) after DG.

Method

Patients who underwent URYA for gastric cancer (GC) between January 2016 and December 2018 were selected from Shanghai Changhai Hospital, Navy Medical University. Short-term outcomes were compared between iso-URYA group and anti-URYA group after 1: 1 propensity score matching (PSM).

Result

A total of 612 patients were selected. 392 patients underwent iso-URYA and 220 patients underwent anti-URYA. After PSM, 183 patients for each group were included in the final analysis. No differences were found between them in terms of short-term complications,nutritional status and quality of life one year after surgery. Endoscopic examination showed that anti-URYA group had more severe gastritis (P=0.036). In addition, the recanalization rate was significantly higher when the afferent loop was blocked by stapler.

Conclusion

The iso-URYA and anti-URYA group present similar results in short term outcomes. Ligation blocking afferent loop leads to lower recanalization rate.
Influence of inoculated gut bacteria on the development of Bactrocera dorsalis and on its susceptibility to the entomopathogenic fungus, Metarhizium anisopliae
Authors: Gichuhi Joseph , Khamis Fathiya , Berg Johnnie Van den , Mohamed Samira , Ekesi Sunday , Herren Jeremy K.
Published: September 2020

Symbiotic interactions between insects and bacteria have been associated with a vast variety of physiological, ecological and evolutionary consequences for the host. A wide range of bacterial communities have been found in association with the oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae), an important pest of cultivated fruit in most regions of the world. We evaluated the diversity of gut bacteria in B. dorsalis specimens from several populations in Kenya and investigated the roles of individual bacterial isolates in the development of axenic (germ-free) B. dorsalis fly lines and their responses to the entomopathogenic fungus, Metarhizium anisopliae. We sequenced 16S rRNA to evaluate microbiomes and coupled this with bacterial culturing. Bacterial isolates were mono-associated with axenic B. dorsalis embryos. The shortest embryonic development period was recorded in flies with an intact gut microbiome while the longest period was recorded in axenic fly lines. Similarly, larval development was shortest in flies with an intact gut microbiome. Adult B. dorsalis flies emerging from embryos that had been mono-associated with a strain of Lactococcus lactis had decreased survival when challenged with a standard dosage of M. anisopliae ICIPE69 conidia. However, there were no differences in survival between the germ-free lines and flies with an intact microbiome. These findings will contribute to the selection of probiotics used in artificial diets for B. dorsalis rearing and the development of improved integrated pest management strategies based on entomopathogenic fungi.
Impact of Lockdown during COVID-19 on Annual Effective Dose Equivalent values of Natural Gamma Radiation
Authors: Jindal Manoj Kumar , Sar Santosh Kumar
Published: September 2020

The study aimed to find the impact of COVID-19 on values of Annual Effective Dose Equivalent of the natural Gamma dose rate from Balod, Durg and Bemetara districts of Chhattisgarh (India). COVID-19 is a severe problem for many countries and to control and prevent the spread of this problem implemented the lockdown approach in many countries, including India. In this lockdown situation, almost all people are staying at home for 24 hours. Due to the present status of COVID-19, the Indian government also fixed the 67 days lockdown and one day was already successfully done as Janta Curfew, which worked the same as a lockdown. The value of indoor gamma dose rates was reported higher in most places as compared to the outdoor gamma dose rate, but in this pandemic situation, occupancy factor values are not applicable as recommended by UNSCEAR for calculation of Annual Effective Dose Equivalent (AEDE). Therefore, the present study introduces the new equations, which can measure the extra AEDE value during the lockdown for adults, children and infants.
Using Item Response Theory (IRT) to Improve the Efficiency of the Simple Clinical Colitis Activity Index (SCCAI) for Patients with Ulcerative Colitis
Authors: Walsh Alissa , Cao Rena , Wong Darren , Kantschuster Ramona , Matini Lawrence , Wilson Jean , Cohort Oxford IBD , Kormilitzin Andrey , South Matthew , Travis Simon , Bauermeister Sarah
Published: September 2020

BackgroundThe SCCAI was designed to facilitate assessment of disease activity in ulcerative colitis (UC). We aimed to interrogate the metric properties of individual items of the SCCAI using item response theory (IRT) analysis, to simplify and improve its performance. MethodsThe original 9-item SCCAI was collected through TrueColours, a real-time software platform which allows remote entry and monitoring of patients with UC. Data were securely uploaded onto Dementias Platform UK Data Portal, where they were analysed in Stata 16.1 SE. A 2-parameter (2-PL) logistic IRT model was estimated to evaluate each item of the SCCAI for its informativeness (discrimination). A revised scale was generated and re-assessed following systematic removal of items. ResultsSCCAI data for 516 patients (41 years, SD=15) were examined. After initial item deletion (Erythema nodosum, Pyoderma gangrenosum), a 7-item scale was estimated. Discrimination values (information) ranged from 0.41 to 2.52 suggesting selected item inefficiency. Systematic item deletions found that a 4-item scale (bowel frequency day; bowel frequency nocturnal; urgency; rectal bleeding) was more informative and discriminatory of trait severity (discrimination values of 1.50 to 2.78). The 4-item scale possesses higher scalability and unidimensionality, suggesting that the responses to items are either direct endorsement or non-endorsement of the trait (disease activity). Conclusion Reduction of the SCCAI from the original 9-item scale to a 4-item scale provides optimum trait information that will minimise response burden. This new 4-item scale needs validation against other measures of disease activity such as faecal calprotectin, endoscopy and histopathology.
Nurses' Awareness and Stress on Perinatal Bereavement Care
Authors: Kim Eunhui , Kim Hae Won
Published: September 2020

Background: A descriptive study was conducted to examine nurses’ awareness and stress related to perinatal bereavement care (PBC), improving nurses’ capabilities related to PBC.Methods: 136 nurses who had experienced perinatal death at least once participated. Data were analyzed using descriptive statistics in SPSS version 25.0 for Windows. Nurses’ awareness was assessed in terms of three subdomains (attitudes, importance of policies related to PBC, and importance of training related to PBC). Results: The participants high scores for the attitude-related items of “giving sufficient time to bereaved parents to mourn for their dead baby” (4.54 points) and “nurses should treat bereaved parents with respect and dignity” (4.51 points), and they perceived a high level of importance for the policy-related items of “every staff member in the hospital should understand the policies relevant for PBC” and “when nurses feel emotional exhaustion, they should seek support” (4.58 points). Nurses’ stress was high when performing PBC in combination with a heavy workload (4.25 points) and when informing parents of a poor prognosis (4.25 points). Nurses’ attitude toward PBC was associated with the perceived importance of policies (r=0.40, p<.001), the perceived importance of PBC-related training (r=0.61, p<.001), and stress related to PBC (r=0.29, p<.001). Conclusions: Establishing hospital policies related to PBC and providing PBC training for nurses could positively affect nurses’ attitudes toward PBC. A stress management program for nurses could reduce the stress caused by PBC.
Rapid Four-component Synthesis of Dihydropyrano[2,3-c]pyrazoles using Nano-egg Shell/Ti(IV) as a Highly Compatible Natural Based Catalyst
Authors: Tafti Arefeh Dehghani , Mirjalili Bi BiFatemeh , Bamoniri Abdolhamid , Salehi Naeimeh
Published: September 2020

Nano-egg shell/Ti(IV) (NEST) as a novel naturally based catalyst was prepared, characterized and applied for the synthesis of dihydropyrano[2,3-c]pyrazole [DHPP] derivatives. The characterization of NEST was performed using Fourier Transform Infrared (FT-IR) spectroscopy, X-ray Diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), Energy-Dispersive X-ray Spectroscopy (EDX), and Thermo Gravimetric Analysis (TGA). DHPPs were synthesized in the presence of NEST via a four component reaction of aldehydes, ethyl acetoacetate, malononitrile and hydrazine hydrate at room temperature under solvent free conditions. The principal affairs of this procedure are easy work-up, high yields of pure products without the use of any toxic organic solvents, mild condition and short reaction times.
Management of COVID-19 in Liver Transplant Recipients with Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry
Authors: Sheikhalipour Zahra , kermani Touraj Asvadi , Kakaei Farzad , Khalili Azizeh Farshbaf , Vahedi Leila
Published: September 2020

Background: Following the pandemic of COVID-19 and the increased COVID-19 risk in transplant patient receptions, the authors assessed the prevalence, clinical course, and the outcome of the COVID-19 infection among liver transplant receptions. Methods: By designing and the use of researcher made questionnaire and the use of medical services, liver transplantation recipients under our center surveyed in terms of COVID-19 infection.Results: Seven patients infected with COVID-19 were identified from 265 liver transplantation recipients. The majority of patients were male and had COVID-19 despite being in-home quarantine. All patients received immunosuppressive drugs during infection with COVID-19 with no change in the routine immunosuppressive therapy. Among the identified patients, 5 recovered and 2 died. One of the dead patients, in addition to having a liver transplant, suffered brain cancer with metastasis to the lungs. Conclusion: It seems that the in liver transplants infected with COVID-19, the immunosuppressive drugs causes mild to moderate illness, and even recover from the disease.However, more evidence is needed to prove this hypothesis. It is also recommended that transplant recipients should be warned about personal hygiene and closely be monitored by organ transplant centers.
Profiles of Innate Immune Cell Infiltration and Related Core Genes in Psoriasis
Authors: Gong Xiaoting , Wang Wei
Published: September 2020

Background: Psoriasis is an inflammatory skin disease with substantial morbidity. Numerous patients with psoriasis experience recurrence after therapy. The underlying mechanism about psoriasis is still not fully understood. Some evidences suggest that innate immunity may play an unexpected and important role in active severe psoriasis. In this work, the deconvolution algorithm CIBERSORT was conducted to identify the infiltration of innate immune cells and related core genes in psoriatic plaque.Results: Datasets from the Gene Expression Omnibus, including 407 psoriasis lesional, 373 non-lesional and 91 normal skin samples, were downloaded for analysis. Considerable differences of the innate immune cell composition were uncovered between psoriatic plaque and control skin. Results revealed that γδ T cells, resting NK cells, M0 macrophages, M1 macrophages, activated dendritic cells and neutrophils were significantly increased in psoriatic skin, while resting mast cells and active NK cells were significantly decreased. Moreover, the proportion of M0 macrophages or resting mast cells was found to be associated with disease severity. Spearman correlation analysis suggests that RORC and S100A12 genes were related to disease severity, while genes including S100A12, CLEC4C, IL-19, AIM2, IL-17F, PPARGC1A, were correlated with biologics treatment response.Conclusions: Collectively, this work displays innate immune status in psoriatic skin, and provides novel clues for clinical decisions and mechanism study.
An Effective Method to Facilitate Personalized and Precise Medicine for Schizophrenia Treatment Based on Pharmacogenomics
Authors: Shi Yixiang , Zhang Xiong , Gu Xiaoping , Huang Chengchen , Zhang Yue , Qi Dong-dong
Published: September 2020

Background: Schizophrenia is a serious mental illness affecting 0.3% - 0.7% of people in the whole world. It is a classic quantitative genetic disease and is affected by a variety of common and rare genetic variants. Methods: To facilitate personalized and precise medicine for schizophrenia treatment, we designed a program by genotyping a panel of related genes, including cytochrome P450 genes CYP1A2, CYP2D6, CYP3A4, dopamine 2 receptor gene (DRD2), 5-Hydroxytryptamine Receptor 1A and 2C genes (HTR1A and HTR2C) as well as melanocortin4 receptor (MC4R) gene, for the schizophrenia patients using MassArray time-of-flight mass spectrometry. Results: The program is tested in an observational clinical study conducted at the Hulunbuir Mental Health Center of China. In the study, a total of 254 patients diagnosed with schizophrenia were recruited and genotyped. The genotyping results were used to generate reports listing where the 16 included antipsychotics should be placed: 'Use as directed', 'Use with caution' or 'Use with caution and with frequent blood concentration monitoring' columns. However, the medication would not change regardless. 72 of the patients completed the 24-week follow-up observation, during which their PANSS scores were assessed at eight time points. For all of them, the PANSS scores dropped significantly, showing the effectiveness of the treatments. The treatments for those cohorts initially in the 'Use with caution' or 'Use with caution and with frequent blood concentration monitoring' categories were more effective than those in the 'Use as directed' category in a shorter term sense, up to three months. However, in the longer term, it was still those who were initially in the 'Use as directed' column fared better, whose PANSS scores dropped more significantly. Conclusions: This research indicated that our pharmacogenomic-based program could be a suitable and effective tool to facilitate precise medicine in schizophrenia treatment.
Comparison of Pancreatic Cancer Treatment Outcomes: A Real-World Data Analysis
Authors: Vikström Jacob , Shangin Georgii , Viitanen Tommi , Eigeliene Natalja , Jekunen Antti
Published: September 2020

Background
Since the ground-breaking phase III MPACT trial showed clear benefit of gemcitabine-nab-paclitaxel, this regimen has emerged as the standard of care for advanced pancreatic adenocarcinoma (PAC). Prior to this study, few studies have shown how results from randomized controlled trial translate to the real world. This study investigated how patients fared in the real world.
Methods
This single-centre, retrospective study was conducted in the Vaasa Central Hospital, Finland. 148 patients with PAC (ICD-10 C25) between 1/2011-12/2016 were identified with resectable, locally advanced or metastatic disease. Information about the basic characteristics, treatment regimens and adverse effects (AEs) were extracted from patient files and analysed.
Results
The median overall survival (OS) was 10.4 months for treated and 2.8 months for untreated patients. For metastatic disease OS was 4.9 months, for locally advanced 9.1 months. Patients who received 3 or more treatment lines had OS 19.1 months, while those who received 2 or 1 line had 11.3 and 6.2 months, respectively. The following grade 2–4 haematologic toxicities occurred: anaemia (n = 19), leukopenia (n = 49), neutropenia (n = 55) and thrombocytopenia (n = 9). Febrile neutropenia occurred 7 times. A total of 12 grade 5 AEs were recorded in 7 patients, and 3 other patients died of unknown complications.
Conclusion
This study shows that active treatment is worth pursuing in most PAC patients and study results from this real-world data study differ from randomized controlled trials. Special caution should be applied when continuing chemotherapy in patients with ECOG 2 and who are older than 70 years.
Evaluation of Chromosomal Abnormalities and Copy Number Variations in Fetuses with Ultrasonic Soft Markers
Authors: Cai Meiying , Lin Na , Xu Liangpu , huang hailong
Published: September 2020

Background: Some ultrasonic soft markers can be found during ultrasound examination. However, the etiology of the fetuses with ultrasonic soft markers is still unknown. This study aimed to evaluate the genetic etiology and clinical value of chromosomal abnormalities and copy number variations (CNVs) in fetuses with ultrasonic soft markers.Methods: Among 1131 fetuses, 729 had single ultrasonic soft marker, 322 had two ultrasonic soft markers, and 80 had three or more ultrasonic soft markers. All fetuses underwent conventional karyotyping, followed by single nucleotide polymorphism (SNP) array analysis. Results: Among 1131 fetuses with ultrasonic soft markers, 46 had chromosomal abnormalities. In addition to the 46 fetuses with chromosomal abnormalities consistent with the results of the karyotyping analysis, the SNP array identified additional 6.1% (69/1131) abnormal CNVs. The rate of abnormal CNVs in fetuses with ultrasonic soft marker, two ultrasonic soft markers, three or more ultrasonic soft markers were 6.2%, 6.2%, and 5.0%, respectively. No significant difference was found in the rate of abnormal CNVs among the groups.Conclusions: Genetic abnormalities affect obstetrical outcomes. The SNP array can fully complement conventional karyotyping in fetuses with ultrasonic soft markers, improve detection rate of chromosomal abnormalities, and affect obstetrical outcomes.
A Potential Role for GLUT4 in Predicting Sepsis in Critically ill Children
Authors: Peng Qiuyan , Liu Guangming , Li Peiqing , Wu Xiaohui , Zeng Qiyi , Zhu Cuiping
Published: September 2020

Background: Glucose transporter (GLUT) 4 is an insulin-sensitive transporter that uptakes blood glucose into muscles and adipose tissue. This study aimed to investigate serum GLUT4 levels in critically ill children and to examine the potential relationship between serum GLUT4 levels and illness severity.Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls; routine health check-up) who were admitted between 07/2015 and 05/2016. Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed.Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 µg/L, P<0.001), and in septic shock compared with sepsis (116.8 vs. 64.3 µg/L, P<0.05), but not compared to non-sepsis/systemic inflammatory response syndrome (105.7 µg/L, P>0.05). Compared to healthy children, hyperglycemic patients (n=48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P<0.001). Serum GLUT4 levels were higher in patients who died (n=16, P<0.05) than in those who survived (n=57). Serum GLUT4 levels were positively correlated with the neutrophil count, creatine kinase levels, and glucose levels (P<0.05). GLUT4 levels for the diagnosis of sepsis had an area under the curve of 0.70 (P=0.03) when using a 51-µg/L cut-off value, resulting in 74.6% sensitivity and 80% specificity.Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity in critically ill children.
Development and Validation of Nomograms Predicting the Overall and the Cancer-Specific Survival in Endometrial Cancer Patients
Authors: Li Xingchen , Dong Yangyang , Cheng Yuan , Zhou Jingyi , Wu Xiaotong , Shen Boqiang , Yang Xiao , Wang Zhiqi , Li Xiaoping , Wang Jianliu
Published: September 2020

Background: The present study was aimed at developing nomograms estimating the overall survival (OS) and cancer-specific survival (CSS) of endometrial cancer (EC)-affected patients.Patients and Methods: We retrospectively collected 145,445 EC patients between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors were identified via univariate and multivariate Cox analyses. These risk factors were used to establish nomograms to predict 3- and 5-year OS and CSS rates. Internal and external data were used for validation. The predictive accuracy and discriminative ability were measured by using concordance index (C-index) and risk group stratification.Results: A total of 63,510 patients were collected and randomly assigned into the training cohort (n=42,340) and validation cohort (n=21,170). Age at diagnosis, marital status, tumor size, histologic type, lymph node metastasis, tumor grade, and clinical stage were identified as independent prognostic factors for OS and CSS (p<0.05 according to multivariate Cox analysis) and were further used to construct the nomograms. The area under the receiver operating characteristics (ROC) curve was greater than that of International Federation of Gynecology and Obstetrics (FIGO) staging system for predicting OS (0.83 vs 0.73, p<0.01) and CSS (0.87 vs 0.79, p<0.01) in the training cohort. The stratification into different risk groups ensured a significant distinction between survival curves within different FIGO staging categories. Conclusion: We constructed and validated nomograms that accurately predict OS and CSS in EC patients. The nomograms can be used for estimating OS and CSS of individual patients and establishing their risk stratification.