bluuebunny/crossref_metadata_2025 huggingface dataset:
[BMIM]BF4 Mediated Multi-component Synthesis of Phenyl-4-(1Hpyrazol-
5-yl)-1H-pyrazolo[3,4-b]quinolin-5(4H)-ones and Evaluation of
their Anti-cancer Activity
Authors: Srinivas A. , Shree A.J. , Goud S.S.K.
Published: September 2023

Pyrazolo bridged quinolones scaffolds are an important building block in many of the medicinally
active new chemical entities. In the current work, synthesis of phenyl-4-(1H-pyrazol-5-yl) conjugated
with 1H-pyrazolo[3,4-b]quinolin-5(4H)-ones derivatives has been achieved by one-pot threecomponent
reaction of 3-methyl-1-phenyl-1H-pyrazol-5-amine 1, 5,5-dimethylcyclohexane-1,3-diones
2, and 1H-pyrazole-5-carbaldehydes 3 using [BMIM]BF4 as green reaction medium with good yields.
Furthermore, the synthesized compounds were evaluated for cytotoxic potential towards HeLa and
DU145 cells. Of the eight derivatives, compound 4d exhibited good cytotoxicity with an IC50 value of
8.5 and 8.9 μM against DU145 and HeLa cells, respectively. The molecular docking studies revealed
that compound 4d displayed good binding energy (-8.4 kcal/mol) against human checkpoint kinase 1.
Review on Monoclonal Antibodies (mAbs) as a Therapeutic Approach for
Type 1 Diabetes
Authors: Agarwal Gaurav , Patel Mayank
Published: September 2023

Monoclonal antibodies have been successfully utilized in a variety of animal models to treat auto-immune illnesses for a long time. Immune system responses will either be less active or more active depending on how the immune system is operating abnormally. Immune system hypoactivity reduces the body's capacity to fight off various invading pathogens, whereas immune system hyperactivity causes the body to attack and kill its own tissues and cells. For maximal patient compliance, we will concentrate on a variety of antibody therapies in this study to treat Type 1 diabetes (an autoimmune condition). T cells are responsible for the auto-immune condition known as T1D, which causes irregularities in the function of β-cells in the pancreas. As a result, for the treatment and prevention of T1D, immunotherapies that selectively restore continuous beta cell-specific self-tolerance are needed. Utilizing monoclonal antibodies is one way to specifically target immune cell populations responsible for the auto-immune-driven disease (mAb). Numerous mAbs have demonstrated clinical safety and varied degrees of success in modulating autoimmunity, including T1D. A targeted cell population is exhausted by mAb treatments, regardless of antigenic specificity. One drawback of this treatment is the loss of obtained protective immunity. Immune effector cell function is regulated by nondepleting monoclonal antibodies (mAb). The antigen-focused new drug delivery system is made possible by the adaptability of mAbs. For the treatment of T1D and T cell-mediated autoimmunity, different existing and potential mAb therapy methods are described in this article.
Ultrasound Diagnostic: Rapid Detection of Second Metatarsal Stress Fracture,
Case Report and Literature Study
Authors: Poenaru Daniela
Published: September 2023

Introduction:

Ultrasound is extensively used for soft tissue pathology. Scanning bone superficial structures may reveal clear pathologic features to aid diagnosis.

Case presentation:

We present the case of a stress fracture in the second metatarsal, with the clinical aspect of a gouty attack. Ultrasound examination showed cortical thickening and disruption, hypoechoic periosteal swelling, hyperemia, soft tissue edema, and displacement of the extensor tendon. The diagnosis was confirmed by X-ray and MRI. The value of different diagnostic tools is discussed, and the importance of gray-scale and color Doppler ultrasound as a first-hand modality is underlined.

Conclusion:

Sonography clearly identifies cortical and periosteal abnormalities, differentiates surrounding soft tissue pathologies, and offers dynamic evaluation, and follow-up possibility with low cost, high accessibility, and no risks. Periosteal and cortical irregularities are important diagnostic issues when performing ultrasound examinations for soft tissue pathology.
Nanofibers Approach for Gastro Retentive Cancer
Authors: Patel Anand J. , Patel Bhavin R. , Shah Pranav
Published: September 2023

Gastric cancer is the world's second leading cause of cancer-related death.
Due to inadequate drug release and limited residence time at the absorption site,
traditional oral dose forms have poor/low bioavailability. GRDDS is particularly useful
for increasing the bioavailability of medications with a narrow absorption window in
the gastrointestinal tract and for treating local diseases. Polymeric nanofibers have
sparked a lot of attention among the numerous nanomaterials used in high-tech
applications because of their simplicity of production, controlled size/shape, and
characteristics. Filtration, barrier fabrics, wipes, personal care, and biological and
pharmaceutical applications have been intensively researched with polymeric
nanofibers. Electrospun polymeric nanofibers have recently been demonstrated to be a
promising approach for drug delivery systems. The nanofiber method allows for
stomach-specific drug release for a more extended period and improves local drug
action due to the drug's extended contact time with the gastric mucosa. As a result,
nanofiber technology appears to be a promising strategy for gastric retention drug
delivery systems.
Recent Development and Advancement in Microneedle-Assisted Drug Delivery System Used in the Treatment of Cancer
Authors: Thakkar Vaishali , Dalwadi Saloni
Published: September 2023

Cancer is one of the most common and distressing diseases. Cancer-related
mortality and prevalence have both grown in the last 50 years. Due to its intricacy and
progressive nature, cancer remains one of the most debilitating diseases in humans, and
clinical care for this lethal disease remains a challenge in the twenty-first century. New
and better cancer medicines are constantly needed. Due to the rising global incidence
of cancer, the development of novel alternatives to traditional medicines is unavoidable
to overcome constraints, such as limited efficacy, comorbidities and high cost.
Microneedle arrays (MNs) have just been introduced as an innovative, low-cost, and
minimally invasive technique. MNs can safely and precisely deliver micromolecular
and macromolecular pharmaceuticals, as well as nanoparticles (NPs), to tumor tissue.
However, only a few lipophilic pharmacological compounds with low molecular
weight and a rational Log P value were able to pass the skin barrier. Microneedles
(MNs) can circumvent these constraints by piercing the body's outermost skin layer and
delivering a variety of medications into the dermal layer. MN patches have been made
with a variety of materials and application methods. Recently, three-dimensional (3D)
printing “A touch button approach” gives the prototyping and manufacturing methods
the flexibility to produce the MN patches in a one-step manner with high levels of
shape complexity and duplicability.
Artificial Neural Networks for Data Processing: A Case Study of Image Classification
Authors: Ramasamy Jayaraj , Ravikumar R. N. , Shitharth S.
Published: September 2023

An Artificial Neural Network (ANN) is a data processing paradigm inspired
by the way organic nervous systems, such as the brain, process data. The innovative
structure of the information processing system is a crucial component of this paradigm.
It is made up of a huge number of highly linked processing components (neurons) that
work together to solve issues. Neural networks handle data in the same manner that the
human brain does. The network is made up of several densely linked processing units
(neurons) that operate in parallel to solve a given problem. They are unable to be
programmed to execute a specific activity. ANN, like humans, learns by example.
Through a learning process, an ANN is trained for a specific application, such as
pattern recognition or data categorization. In biological systems, learning includes
changes to the synaptic connections that occur between neurons. This is also true for
ANNs. Artificial Neural Networks are used for classification, regression, and grouping.
Stages of image processing are classified as preprocessing, feature extraction, and
classification. It can be utilized later in the process. ANN should be provided with
features and output should be classified. This paper provides an overview of Artificial
Neural Networks (ANN), their operation, and training. It also explains the application
and its benefits. Artificial Neural Network has been used to classify the MNIST
dataset.
Medicinal Importance of Turmeric (Curcuma Longa) and its Natural Products
Authors: Kumar Punit , Sujata  , Archana
Published: September 2023

It is believed that natural products exhibiting medicinal benefits do not cause
systemic side effects or they cause acceptable side effects. Due to the increase in
research output and increased awareness about the importance of natural products,
nowadays, a large fraction of the population is now shifting their orientation towards
the use of natural products in daily use. Turmeric (Curcuma longa) is one such blessing
for all of us. It is one of the most important and abundant spices used in Asian food. It
is cultivated around the world and originated in India, Indonesia, and Southeast Asia.
Turmeric powder has a bitter, sharp taste and is yellow. It is used to provide color and
flavor to various food products such as; butter, mustard, cheese, etc. Turmeric belongs
to the Zingiberaceae family. It is one of the most commonly used medicinal herbs in
India and China and is used for the treatment of jaundice and liver problems. Turmeric
is known to have a wide range of pharmacological properties such as anti-microbial,
anti-protozoal, anti-malarial, anti-venom, anti-proliferative, anti-aging, anti.inflammatory, anti-tumor, etc. It is identified that the yellow color of the turmeric is
due to the presence of Curcumin which is the most important and potent bioactive
compound of turmeric. Curcumin is a curcuminoid that is extracted from the rhizomes
of Curcuma Longa. Curcumin possesses remarkable medicinal properties and can also
be used in cosmetic products. Curcumin has powerful anti-inflammatory and
antioxidant properties. It helps to treat various diseases, some of them are; hay fever,
depression, Alzheimer’s, treat cholesterol, itching, and osteoarthritis. It is involved in
maintaining the functioning of the brain and reduces the risk of brain and heart
diseases. Investigators are focusing to find out the therapeutic role of curcumin in
asthma, diabetes, cancer, indigestion, and many other disorders. In this chapter, we will
discuss the natural compounds present in turmeric and their medicinal importance.
Molecular Mechanisms of Flavonoids Mediated Therapy and Chemoprevention of Cancer
Authors: Kaur Sandeep , Verma Shagun , Pandit Kritika , Kaur Jeevanjot , Samiksha  , Singh Drishtant , Sohal Satwinder Kaur
Published: September 2023

Flavonoids derived from daily dietary source and plant products play a crucial role in the prevention and treatment of various degenerative diseases and cancer. Flavonoids are further subdivided into subclasses such as flavones, flavan-3- ols, flavonols, flavanones, isoflavones and anthocyanidins. There has been a resurgence in the research on flavonoids due to enhancement in the evidence that proves the health benefits of flavonoids. Several preclinical and epidemiological studies revealed that dietary intake of flavonoids may be found helpful in the reduction of risk of tumors like colon, breast, lung, pancreas and prostate. It also acts on the reactive oxygen species, and cellular signal transduction pathways associated with cellular proliferation, angiogenesis and apoptosis. Flavonoids are non-toxic in nature, so intensively studied the broad, vast aspect of their efficacy in biological activities that in turn promotes health benefits and also added to its availability in abundance in our daily diets, for instance, fruits, green leaves, tea, red wine and vegetables. Overall, the exciting data obtained so far elicit that dietary flavonoids have been considered a beneficial cancer preventive approach. This chapter unravels the molecular mechanisms involved in potential cancer preventive efficacy accomplished by the novel biological approach of flavonoids.
Biomarkers as Tools for the Early Detection of Cancer
Authors: Singh Sumit , Diksha  , Sharma Avinash , Mahajan Evani , Sohal Satwinder Kaur , Gupta Shallina
Published: September 2023

Every year, millions of people around the world lose their lives to different types of cancer, mostly in developing countries. The foremost challenge for the human race in to fight against cancer is its early detection, followed by the appropriate treatment. Currently, one of the most promising and dynamic strategies for early cancer diagnostics as well as for therapeutics, is the use of cancer biomarkers. Generally, biomarkers represent changes in the constituents or composition of cells, tissues, or body fluids, offering a means for comparable classification of diseases as well as the risk factor involved, and thereby providing information about the underlying pathogenesis of the disease. Similarly, a cancer biomarker (CB) is defined as a ‘molecular signature’ that can potentially provide valid information regarding staging as well as the mechanisms underlying the origin of cancer. Cancer biomarkers (CB) are biomolecules synthesized either by the cancer cells or by other cells of the body in response to cancer. Every cell type has its distinctive molecular signature and recognizable features, such as levels or activities of the myriad of genes, proteins, or other molecular characteristics; therefore, cancer biomarkers can facilitate the molecular definition of cancer. Endoscopy, X-rays, magnetic resonance imaging, computed tomography, invasive tissue biopsies, etc., are the traditional cancer diagnostic methods. However, the use of biomarkers as cancer screening tools have several advantages over these traditional approaches. The emergence of “omics” technologies, like metabolomics, genomics, epigenomics, proteomics, etc., has led to an increase in the number of potentially investigated biomarkers, such as DNA, RNA, miRNA, or other protein biomolecules. In this chapter, we have summarized the importance of biomarkers as powerful and dynamic tools for the early diagnosis of various types of cancers, the phases in the biomarker discovery, the criteria for the selection of biomarkers, the advantages of their preference over traditional methods, various categories of cancer biomarkers, examples of cancer biomarkers currently in use and the future prospectives.
¿El sector informal peruano tiene un límite? Evidencia de los efectos de la migración venezolana
Authors: Vera Rojas Celia , Jiménez Silva Bruno
Published: September 2023

La crisis política, económica, social y humanitaria que atraviesa Venezuela ha impulsado la migración masiva de ciudadanos venezolanos hacia América Latina. El Perú es el segundo mayor receptor de migrantes venezolanos en la región, albergando, a julio de 2019, a más de 850 mil ciudadanos provenientes de este país (Superintendencia Nacional de Migraciones). Evidencia preliminar sugiere que la magnitud y rapidez de la inmigración venezolana estaría incidiendo en el funcionamiento del mercado de trabajo nacional y en la provisión de servicios públicos, desnudando las limitaciones estructurales de la institucionalidad estatal peruana para facilitar la integración social y económica de la población migrante en diversos ámbitos de la vida social (Koechlin, Solórzano, Larco y Fernández-Maldonado, 2019; Valdiglesias, 2018).
Sobre la implementación de Pagos por Servicios Ecosistémicos en el Perú: El caso del agua potable
Authors: Loyola Roger
Published: September 2023

Así como en varios países de la región los Pagos por Servicios Ecosistémicos fueron propuestas de políticas ambiental ampliamente promovidas en el Perú. Para ello en el 2014 se crea un marco normativo específico para ello. Aun a pesar de que la lógica era que esta tuviese un impacto sobre todos los sectores económicos que hiciesen uso de estos servicios en la práctica esta solo se materializó en el sector público de agua potable, específicamente en las empresas de agua potable. La realidad muestra que aun quedan preguntas y tareas pendientes a ser respondidas, teóricas sobre qué negociaciones pueden funcionar en determinado contexto generalmente cuando este fue pensado para privados y no públicos como el caso peruano y; prácticas para ver su grado de replicabilidad más allá de este sector. Es en este contexto que se evalúa la implementación de este tipo de mecanismos en el caso peruano.
Aprendiendo matemática de manera divertida desde el hogar: factores asociados al uso de la plataforma online Conecta Ideas
Authors: Sugimara Claudia
Published: September 2023

El objetivo de este estudio consiste en analizar los factores asociados al uso en el hogar de la plataforma online “Conecta Ideas” por parte de estudiantes de 4to de primaria de instituciones públicas de Lima Metropolitana en el año 2019. El estudio se basa en un Modelo de Aceptación de Tecnología (TAM), el cual predice la adopción de una tecnología mediada por la percepción de utilidad, facilidad percibida, y disfrute. Utilizando un modelo estadístico de ecuaciones estructurales multi-nivel, se encuentra que el disfrute percibido es la variable que mejor predice el uso de la plataforma. A su vez, las estudiantes mujeres muestran mayores niveles de uso. Finalmente, estudiantes con mayor preocupación por la matemática muestran menores niveles de uso.
DETERMINACIÓN EXPERIMENTAL DE ÍNDICES DE REFRACCIÓN EN PELÍCULAS SEMICONDUCTORAS: CDS, TI3O5
Authors: Rodríguez Laura Sandro , Miculicich Egoavil Osar , Oliva Chirinos Christian , Fiorentini Arturo , Valera Palacios Aníbal
Published: September 2023

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EVIDENCIA EMPÍRICA DE LOS MÍNIMOS CUADRADOS EN EL MODELO DE REGRESIÓN DE COEFICIENTES ALEATORIOS
Authors: Huamanchumo de la Cuba Luis
Published: September 2023

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DISEÑO E IMPLEMENTACIÓN DE UN SISTEMA DE CONTROL NO LINEAL POR MODOS DESLIZANTES MULTIVARIABLE APLICADO A UN MANIPULADOR ROBÓTICO TRASLACIONAL 2DOF
Authors: Rodriguez Bustinza Ricardo
Published: September 2023

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DISEÑO E IMPLEMENTACIÓN DEL CONTROLADOR FST APLICADO A UN SISTEMA IDENTIFICADO DE SEGUNDO ORDEN USANDO LA NIDAQ USB-6008
Authors: Rodríguez Bustinza Ricardo , Maguiña Camones Jimmy
Published: September 2023

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ANÁLISIS DE SENSIBILIDAD EN LA SELECCIÓN DE SISTEMAS DE COGENERACIÓN CON GAS NATURAL
Authors: Pineda León Roberto , Nahui Ortiz Johnny
Published: September 2023

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CYFRA 21-1 Protein - a Potential Marker of Endometriosis
Authors: Višnić Alenka , Čanadi Jurešić Gordana , Barišić Dubravko , Smajla Nataša , Sušanj Šepić Tina , Smiljan Severinski Neda
Published: September 2023

Endometrioza je kronična upalna bolest karakterizirana pojavom i rastom endometrija izvan maternice. Etiopatogeneza nije razjašnjena, a postoji više teorija nastanka endometrioze. Patološki procesi prisutni u endometriozi jesu adhezija, invazija, proliferacija, angiogeneza i promijenjena imunost. Moguće je da procesi invazije i proliferacije uzrokuju povećanu sintezu određenih proteina koji se zatim izlučuju urinom. Protein citokeratin 19-9 (CYFRA 21-1) pojačano se izlučuje u urinu pacijentica s endometriozom te je potencijalni marker u ranim stadijima ove bolesti kada nije moguće slikovnim metodama postaviti sumnju na bolest ili ciljanu dijagnozu.
A Novel Observational Strategy for Nonfunctional Pancreatic Neuroendocrine Neoplasms With Texture Analysis: A Multicenter Retrospective Study
Authors: SHIOZAKI HIRONORI , GOCHO TAKESHI , SHIRAI YOSHIHIRO , TAKANO YUKI , OHKI KAZUYOSHI , SUKA MACHI , OKAMOTO TOMOYOSHI , FUJIOKA SHUICHI , TOYA NAOKI , IKEGAMI TORU
Published: September 2023

Background/Aim: Surgical resection is recommended for nonfunctional pancreatic neuroendocrine neoplasms (NF-pNENs). However, metastasis is rare in patients with small lesions with histological grade 1 (G1); thus, observation is an optional treatment approach for small NF-pNENs. Texture analysis (TA) is an imaging analysis mode for quantification of heterogeneity by extracting quantitative parameters from images. We retrospectively evaluated the utility of TA in predicting histological grade of resected NF-pNENs in a multicenter retrospective study. Patients and Methods: The utility of TA in preoperative prediction of grade were evaluated with 29 patients treated by pancreatectomy for NF-pNEN who underwent preoperative dynamic computed tomography scan between January 1, 2013 and December 31, 2020 at three hospitals affiliated with the Jikei University School of Medicine. TA was performed with dedicated software for medical imaging processing for determining histological tumor grade using dynamic computed tomography images. Results: Histological tumor grades based on the 2017 World Health Organization Classification for Pancreatic Neuroendocrine Neoplasms were grade 1, 2 and 3 in 18, 10 and one patient, respectively. Preoperative grades by TA were 1 and 2/3 in 15 and 14 patients, respectively. The sensitivity, specificity and area under the curve for TA-oriented grade 1 lesions were 1.00, 0.889 and 0.965 (95% confidence interval=0.901-1.000), respectively. Conclusion: TA is useful for predicting grade 2/3 NF-pNEN and can provide a safe option for observation for patients with small grade 1 lesions.
Trends in Opioid Medication Adherence During the COVID-19 Pandemic: Retrospective Cohort Study
Authors: Marashi Amir , Warren David , Call Gary , Dras Mark
Published: September 2023

Background

The recent pandemic had the potential to worsen the opioid crisis through multiple effects on patients’ lives, such as the disruption of care. In particular, good levels of adherence with respect to medication for opioid use disorder (MOUD), recognized as being important for positive outcomes, may be disrupted.

Objective

This study aimed to investigate whether patients on MOUD experienced a drop in medication adherence during the recent COVID-19 pandemic.

Methods

This retrospective cohort study used Medicaid claims data from 6 US states from 2018 until the start of 2021. We compared medication adherence for people on MOUD before and after the beginning of the COVID-19 pandemic in March 2020. Our main measure was the proportion of days covered (PDC), a score that measures patients’ adherence to their MOUD. We carried out a breakpoint analysis on PDC, followed by a patient-level beta regression analysis with PDC as the dependent variable while controlling for a set of covariates.

Results

A total of 79,991 PDC scores were calculated for 37,604 patients (age: mean 37.6, SD 9.8 years; sex: n=17,825, 47.4% female) between 2018 and 2021. The coefficient for the effect of COVID-19 on PDC score was –0.076 and was statistically significant (odds ratio 0.925, 95% CI 0.90-0.94).

Conclusions

The COVID-19 pandemic was negatively associated with patients’ adherence to their medication, which had declined since the beginning of the pandemic.
We Cannot Put This Genie Back in the Bottle: Qualitative Interview Study Among Family Medicine Providers About Their Experiences With Virtual Visits During the COVID-19 Pandemic
Authors: Spiess Saskia T , Gardner Elena , Turner Cindy , Galt Annie , Fortenberry Katherine , Ho Tiffany , Knox Jordan , Ose Dominik
Published: September 2023

Background

When a genie is freed from its bottle, things cannot be restored to the way they were before. At the beginning of the global COVID-19 pandemic, health care systems adjusted how they delivered care overnight. Primary care practices switched from seeing patients in person to virtual care applications, including video and phone visits, e-visits, e-consults, and messaging with clinicians. Prior to the pandemic, these applications were not as widely used, but discussions around their advantages and disadvantages in some settings were being explored. Emergency regulatory changes spurred by the pandemic freed this virtual care “genie” from its bottle. Wide-scale adoption of virtual care in family medicine has much potential, as primary care services are often a patient’s first point of contact with the health care system.

Objective

This study aims to analyze family medicine providers’ experiences using virtual visits during the pandemic, perceived outcomes of the shift to virtual visits, and discusses its implications for the future of family medicine.

Methods

This qualitative study took place at 3 academic primary care clinics between June and December 2020. Data were collected through one-on-one Zoom (version 5.2.1) interviews with family medicine clinical faculty who experienced the rapid transition of in-person visits to mostly “virtual” visits. The interviews were recorded, deidentified, and transcribed. We adopted a constructivist approach to qualitative content analysis to evaluate the results.

Results

In total, 25 participants were eligible, and 20 individuals participated in this study (80% participation rate). The mean age was 43.4 years, and 85% (17/20) of the participants were female. We identified 3 main themes: the care process, patient engagement, and team-based care.

Conclusions

This study highlights the transition from in-person to virtual visits during the pandemic from the perspective of family medicine providers. Generally, family medicine providers’ perceptions of the shift to virtual visits were positive, especially regarding team-based care. Challenges involved virtual inhibition, particularly for providers. Providers described ways they integrated virtual care with aspects of in-person care, creating a hybrid environment. The genie is out of the bottle—things will not be the same—but family medicine now has the opportunity to evolve.
Trends in Opioid Medication Adherence During the COVID-19 Pandemic: Retrospective Cohort Study (Preprint)
Authors: Marashi Amir , Warren David , Call Gary , Dras Mark
Published: September 2023

BACKGROUND

The recent pandemic had the potential to worsen the opioid crisis through multiple effects on patients’ lives, such as the disruption of care. In particular, good levels of adherence with respect to medication for opioid use disorder (MOUD), recognized as being important for positive outcomes, may be disrupted.

OBJECTIVE

This study aimed to investigate whether patients on MOUD experienced a drop in medication adherence during the recent COVID-19 pandemic.

METHODS

This retrospective cohort study used Medicaid claims data from 6 US states from 2018 until the start of 2021. We compared medication adherence for people on MOUD before and after the beginning of the COVID-19 pandemic in March 2020. Our main measure was the proportion of days covered (PDC), a score that measures patients’ adherence to their MOUD. We carried out a breakpoint analysis on PDC, followed by a patient-level beta regression analysis with PDC as the dependent variable while controlling for a set of covariates.

RESULTS

A total of 79,991 PDC scores were calculated for 37,604 patients (age: mean 37.6, SD 9.8 years; sex: n=17,825, 47.4% female) between 2018 and 2021. The coefficient for the effect of COVID-19 on PDC score was –0.076 and was statistically significant (odds ratio 0.925, 95% CI 0.90-0.94).

CONCLUSIONS

The COVID-19 pandemic was negatively associated with patients’ adherence to their medication, which had declined since the beginning of the pandemic.
Using HIV Risk Self-Assessment Tools to Increase HIV Testing in Men Who Have Sex With Men in Beijing, China: App-Based Randomized Controlled Trial (Preprint)
Authors: Luo Qianqian , Wu Zunyou , Mi Guodong , Xu Jie , Scott Sarah Robbins
Published: September 2023

BACKGROUND

Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate.

OBJECTIVE

This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexual risk behaviors in Chinese MSM.

METHODS

We recruited MSM from Beijing, China, who used the GSN platform Blued in October 2017 in this 12-month double-blinded randomized controlled trial. From October 2017 to September 2018, eligible participants were randomly assigned to use a self-reported HIV risk assessment tool that provided tailored feedback according to transmission risk (group 1), access to the same HIV risk assessment without feedback (group 2), or government-recommended HIV education materials (control). All interventions were remotely delivered through the mobile phone–based app Blued, and participants were followed up at 1, 3, 6, and 12 months from baseline. The number of HIV tests over the 12-month study was the primary outcome and was assessed using an intention-to-treat analysis with an incident rate ratio (IRR). Unprotected anal intercourse (UAI) over 6 months was assessed by a modified intention-to-treat analysis and was the secondary outcome. All statistical analyses were conducted in SAS 9.3 (SAS Institute, Inc.), and a P value <.05 was considered statistically significant.

RESULTS

In total, 9280 MSM were recruited from baseline and were randomly assigned to group 1 (n=3028), group 2 (n=3065), or controls (n=3187). After follow-up, 1034 (34.1%), 993 (32.4%), and 1103 (34.6%) remained in each group, respectively. Over 12 months, group 1 took 391 tests (mean of 2.51 tests per person), group 2 took 352 tests (mean of 2.01 tests per person), and controls took 295 tests (mean of 1.72 tests per person). Group 1 had significantly more HIV testing than the control group (IRR 1.32, 95% CI 1.09-4.58; P=.01), while group 2 did not differ significantly from the controls (IRR 1.06, 95% CI 0.86-1.30; P=.60). The proportion of UAI was not statistically different among different groups, but all 3 groups had UAI, which declined from baseline.

CONCLUSIONS

Repeated HIV risk assessments coupled with tailored feedback through GSN apps improved HIV testing. Such interventions should be considered a simple way of improving HIV testing among MSM in China and increasing awareness of HIV status.

CLINICALTRIAL

ClinicalTrials.gov NCT03320239; https://clinicaltrials.gov/study/NCT03320239
Evaluation of a Digital Decision Support System to Integrate Type 2 Diabetes Mellitus and Periodontitis Care: Case-Vignette Study in Simulated Environments (Preprint)
Authors: Kalmus Olivier , Smits Kirsten , Seitz Max , Haux Christian , Robra Bernt-Peter , Listl Stefan
Published: September 2023

BACKGROUND

As highlighted by the recent World Health Organization Oral Health Resolution, there is an urgent need to better integrate primary and oral health care. Despite evidence and guidelines substantiating the relevance of integrating type 2 diabetes mellitus (T2DM) and periodontitis care, the fragmentation of primary and oral health care persists.

OBJECTIVE

This paper reports on the evaluation of a prototype digital decision support system (DSS) that was developed to enhance the integration of T2DM and periodontitis care.

METHODS

The effects of the prototype DSS were assessed in web-based simulated environments, using 2 different sets of case vignettes in combination with evaluation surveys among 202 general dental practitioners (GDPs) and 206 general practitioners (GPs). Each participant evaluated 3 vignettes, one of which, chosen at random, was assisted by the DSS. Logistic regression analyses were conducted at the participant and case levels.

RESULTS

Under DSS assistance, GPs had 8.3 (95% CI 4.32-16.03) times higher odds of recommending a GDP visit. There was no significant impact of DSS assistance on GP advice about common risk factors for T2DM and periodontal disease. GDPs had 4.3 (95% CI 2.08-9.04) times higher odds of recommending a GP visit, 1.6 (95% CI 1.03-2.33) times higher odds of giving advice on disease correlations, and 3.2 (95% CI 1.63-6.35) times higher odds of asking patients about their glycated hemoglobin value.

CONCLUSIONS

The findings of this study provide a proof of concept for a digital DSS to integrate T2DM and periodontal care. Future updating and testing is warranted to continuously enhance the functionalities of the DSS in terms of interoperability with various types of data sources and diagnostic devices; incorporation of other (oral) health dimensions; application in various settings, including via telemedicine; and further customization of end-user interfaces.
Effectiveness of Telemonitoring in Reducing Hospitalization and Associated Costs for Patients With Heart Failure in Finland: Nonrandomized Pre-Post Telemonitoring Study (Preprint)
Authors: Kokkonen Jorma , Mustonen Pirjo , Heikkilä Eija , Leskelä Riikka-Leena , Pennanen Paula , Krühn Kati , Jalkanen Arto , Laakso Jussi-Pekka , Kempers Jari , Väisänen Sami , Torkki Paulus
Published: September 2023

BACKGROUND

Many patients with chronic heart failure (HF) experience a reduced health status, leading to readmission after hospitalization despite receiving conventional care. Telemonitoring approaches aim to improve the early detection of HF decompensations and prevent readmissions. However, knowledge about the impact of telemonitoring on preventing readmissions and related costs remains scarce.

OBJECTIVE

This study assessed the effectiveness of adding a telemonitoring solution to the standard of care (SOC) for the prevention of hospitalization and related costs in patients with HF in Finland.

METHODS

We performed a nonrandomized pre-post telemonitoring study to estimate health care costs and resource use during 6 months on SOC followed by 6 months on SOC with a novel telemonitoring solution. The telemonitoring solution consisted of a digital platform for patient-reported symptoms and daily weight and blood pressure measurements, automatically generated alerts triggering phone calls with secondary care nurses, and rapid response to alerts by treating physicians. Telemonitoring solution data were linked to patient register data on primary care, secondary care, and hospitalization. The patient register of the Southern Savonia Social and Health Care Authority (Essote) was used. Eligible patients had at least 1 hospital admission within the last 12 months and self-reported New York Heart Association class II-IV from the central hospital in the Southern Savonia region.

RESULTS

Out of 50 recruited patients with HF, 43 completed the study and were included in the analysis. The hospitalization-related cost decreased (49%; P=.03) from €2189 (95% CI €1384-€2994; a currency exchange rate of EUR €1=US $1.10589 is applicable) during SOC to €1114 (95% CI €425-€1803) during telemonitoring. The number of patients with at least 1 hospitalization due to HF was reduced by 70% (P=.002) from 20 (47%) out of 43patients during SOC to 6 (14%) out of 43 patients in telemonitoring. The estimated mean total health care cost per patient was €3124 (95% CI €2212-€4036) during SOC and €2104 (95% CI €1313-€2895) during telemonitoring, resulting in a 33% reduction (P=.07) in costs with telemonitoring.

CONCLUSIONS

The results suggest that the telemonitoring solution can reduce hospital-related costs for patients with HF with a recent hospital admission.
Age-based differences in the influence of technology-use on patient-centered communication among cancer survivors (Preprint)
Authors: Warner Echo , Trivedi Neha , Gilbert-Gard Kacy , Siembida Elizabeth J.
Published: September 2023

BACKGROUND

While user-based technology has profoundly impacted modern-day communication, including in oncology care, adoption of new technology differs by age.

OBJECTIVE

We aimed to characterize cancer survivors’ health information technology (HIT) use and evaluate associations with patient-centered communication (PCC) by age at diagnosis.

METHODS

We analyzed responses from cancer survivors with a regular healthcare provider who were diagnosed ≥15 years of age (N=748) from the Health Information National Trends Survey (HINTS) 4 Cycles 3 and 4. We summarized demographics, cancer-related factors, and HIT use by age at diagnosis (15-39, 40-64, ≥65 years). We estimated the influence of HIT use on PCC using multiple linear regression and applied sampling weights and jackknife replications.

RESULTS

Our primary outcome, PCC, ranged from 0-100 (mean: 82.3), with higher scores indicating better communication. More cancer survivors diagnosed ages between ages 40-64 were very/somewhat interested in using electronic appointment reminders, medication reminders, and lab/test results compared to those diagnosed at other ages (all P<0.01). Only 8.9% of those diagnosed ≥65 years emailed healthcare professionals compared to approximately 23% of those between 15-64 years (P=0.016). Rural survivors who were interested in using electronic medication reminders had a 6.31-point higher PCC score compared to urban survivors (95% confidence interval: 0.15-12.47, P=0.046), while smartphone owners and survivors with good or fair/poor health status had a PCC score between -6.25- -8.77 lower (all P<0.01) than their counterparts.

CONCLUSIONS

While health technology cannot replace the need for high-quality PCC, age-based targeting of HIT may improve PCC. Availability of HIT to facilitate survivor self-management may provide more time for providers to engage survivors on critical communication topics (e.g., uncertainty, emotions).
On the discourse and propaganda of anti-terrorism
Authors: Kim Gal
Published: September 2023

The subject of my inquiry will be the public discourse on terrorism, which has explicitly unfolded since the “terrorist” attack on the World Trade Centre. In the first part I will focus on some propagandistic schemes that have become apparent in the last few months, then I will continue to analyse some theoretical concepts of the ideological matrix of anti-terrorism and terrorism, which leads me to a critique of war. This article is theoretically based on the legacy of Louis Althusser (his theory on ideology and its effects, as interpreted by Rastko Močnik) and some other contemporary thinkers like Richard Falk.
Origins Of Terrorism
Authors: Gavrilov Gorazd
Published: September 2023

It has always been very clear to me what terrorism is, who terrorists are and what they have been doing. So I decided to take the challenge of co-ordinating a workshop1 entitled Origins of terrorism, as (of course!) I already knew everything about it. How wrong was I!
The governance of the European Union a new institutionalist approach
Authors: Braziunaite Viktorija
Published: September 2023

The hypothesis: The main aim of this paper is to analyse three central issues of the governance of the EU. It seeks to locate the EU institutions in a comparative politics context, which allows us to go beyond the detailed configurative studies of the EU institutions that already exist and place them in a context, which allows differentiation between formal political institutions, informal conventions and the norms and beliefs embedded within those institutions. The shortcomings of employing the new institutional approach to the study of the EU are more related to the general weaknesses of this particular perspective. The problem is that little but common scepticism toward atomistic accounts of social processes and a common conviction that institutional arrangements and social processes matter unites various branches of the new institutionalism. New institutionalism seeks to impose a unity of perspective on a set of figures that actually have little in common.
The solving of the democratic deficit
Authors: Wenneker Geertjan
Published: September 2023

It seems to be a very simple point. Everyone agrees that the European Union must become more democratic. But how exactly to do that is a huge problem. Some say that the European Parliament (EP) already has as much power as a ‘regular’ parliament has. (Dutch secretary of state for European Affairs Atzo Nicolaï for example1 ). Still, many others think the EP has not that much power and the lack of power is not the only democratic deficit problem in the E.U. And if there existed the chance to give the EP more powers would the problem than be solved? My intention for this paper is not to loose ourselves in the endless flood of information that is available on the internet and in the libraries about all sorts of ‘democratic deficits’. That is why I will try to focus on a small part of the whole discussion about the democratic deficit and see in what different manners it is described in the literature and what it exactly means. I will try to focus mainly on the EP and on its relations with the European Commission.
Hermit Kingdom’s Quest for Nuclear Weapons
Authors: Fulop Gabriela Zina
Published: September 2023

North Korea’s disclosure in October 2002 of its nuclear program based on uranium enrichment and its withdrawal from the Non-Proliferation Treaty (NPT) in January 2003, have led to an acute international crisis. The North Korean crisis is not new; the world has witnessed a similar crisis in 1992, when North Korea threatened to withdraw from the NPT and which eventually led to the 1994 Agreed Framework. The United States does not have a clear policy on North Korea to date. Due to a high degree of mistrust and to limited and confusing information coming from Pyongyang, two different views have been developed on North Korea. The first view is that North Korea does have real security concerns and Kim Jung Il is merely trying to assure his position as a leader and to safeguard against a U.S. attack. The second view which seems to be embraced by the majority of American politicians is that North Korea is using its nuclear weapon program to blackmail the U.S. and to receive such benefits as oil and food. In this paper I will try to explore the two opposing views and try to come to a conclusion on the whether North Korea’s security concerns are grounded or not.
Microbial Etiology and Resistance Patterns of Urinary Tract Infection at a Tertiary Care Centre – A Hospital based Study
Authors: Khan Shoaib , Maroof Peer , Amin Umara
Published: September 2023

Urinary tract infections (UTIs) are among the most common infections diagnosed in clinical practice. Treatment is often initiated before microbiological confirmation and anti-microbial susceptibility testing. With the rapidly rising antibiotic resistance treatment failures are not uncommon. Beta-lactamase production by gram-negative bacteria causing UTI is the commonest mode of drug resistance. The aim of current study was to detect and determine the hospital based prevalence of UTI, causative uropathogens and their antimicrobial susceptibility patterns. A total of 9,518 clean catch, mid stream urine samples were processed over 2 years. Semi-quantitative urine cultures and AST were performed. Diverse underlying resistance mechanisms were determined by detecting ESBLs, Carbapenemases, AmpC β-Lactamases, and Metallo-β-Lactamases through various standardized phenotypic methods. Out of the 9,518 samples tested 1171 (12.3%) were culture positive. Majority (66.7%) were from female patients. Highest prevalence (60%) was seen in patients > 40 years of age. E. coli (48%) was the predominant causative organism, followed by Enterococcus spp. (23%). Among GNB high resistance rates were observed against Beta-lactams, Beta-lactam/β-lactamase inhibitor combinations, and fluoroquinolones. 34.5% of GNB were confirmed as ESBL, 40% as carbapenemase, 36.5% as AmpC β-Lactamase, and 41.5% as MBL producers. We found very high levels of resistance against a broad range of antibiotics including the most widely used β-lactam group. With the resistance slopes getting steeper and steeper empirical treatment of UTIs might be fraught with the danger of many failures. Culturing and performing AST for all patients with UTI might be a prudent step for their rationale treatment and a step forward in halting the emergence of further resistance.
Harnessing the Power of Bio Adsorbents: A Review on Sustainable Approach to Eliminate Antibiotic Residues in Wastewater for Better Public Health
Authors: Sardar Chayan , Bhadra Sukanta , Jana Hare Krishna , Mondal Sandhimita
Published: September 2023

Antibiotic overuse in animal and human healthcare has led in the accumulation of potentially hazardous antibiotic residues, known as emerging contaminants. These residues contaminate animal products including meat, milk, and eggs, which humans then ingest. Furthermore, antibiotic residues from pharmaceutical firms, hospitals, and households reach wastewater treatment plants, providing an environment conducive to bacterial growth and dissemination. This, in turn, can result in the spread of antibiotic resistance genes (ARGs) among bacterial cells, posing serious threats to both human health and the environment. In the case of ARGs, conventional approaches for eliminating antibiotic residues from wastewater and aquatic habitats have proven ineffective. Recent study, however, has shown that the adsorption technique, particularly when low-cost and environmentally acceptable bioadsorbents such as sawdust, prawn shell waste, algae, and fungi are used, is highly successful in removing antibiotic residues. Bioadsorbents Microalgae, Terminalia catappa leaf, and siris seed pods, in particular, have shown outstanding removal efficiency for antibiotics such as tetracycline, dicloxacillin, and nitromidazole, reaching up to 98.74%. These investigations have shed insight on the fundamental principles of the adsorption process, revealing its ability to target ARGs and antibiotic-resistant bacteria as well as remove antibiotic residues. As a result, addressing the issue of antibiotic residues in the environment has become critical in order to protect human health and prevent the spread of antibiotic resistance. Adsorption, particularly when bioadsorbents are used, appears to be a promising and efficient method of combating antibiotic residues and limiting the spread of antibiotic resistance genes and antibiotic-resistant bacteria in aquatic settings.
Research on ‘Conversation Poems’ as a Mutual Communication System in Tang Period
Authors:   Institute of Foreign Literature, Jang Junyoung
Published: September 2023

This paper analyzes the characteristics of communication revealed in the process of questioning and answering the giving-and-answer poems of the Tang Dynasty. First, 'xingjuan(行卷)', 'tongbang(通榜)', 'tongyou(同遊)', and 'shiyan(詩宴)' were examined regarding the formation of society through poetry and political relationships among writers. Second, with the theme of ‘multi-cubic of love', how people create a 'semantic space' through giving-and-answer poems and how they develop a dedicated 'channel' are analyzed. Third, under the theme of 'intersection' between art and practical culture, various reactions when giving-and-answer poems collide with practicality are analyzed. Finally, the idea of how to apply the various practical functions and social and cultural meanings of gift-and-answer poetry as a mutual communication system in our lives and societies are considered. The ways communication can be accepted as a culture and ‘gift-giving poetry’ can be developed into the conditions and possibilities for living art are examined from the viewpoint of truth, goodness, and beauty.