bluuebunny/crossref_metadata_2025 huggingface dataset:
INTEGRASI SIMULASI DALAM AUGMENTED REALITY PADA SISTEM PERNAPASAN MANUSIA
Authors: Aji Selo , Tosida Eneng Tita , Maesya Aries
Published: January 2020

Sistem pernapasan adalah proses mengambil oksigen, melepaskan CO2 dan menggunakan energi yang dihasilkan. Sistem pernapasan terdiri dari rongga hidung, faring, laring, trakea, cabang bronkial, dan paru-paru. Sistem pernapsan pada manusia dapat dipelajari secara langsung dan tidak langsung. Namun, sumber belajar ini kurang menarik dan kurang interaktif. Oleh karena itu teknologi Augmented reality (AR) adalah solusi yang tepat untuk mengatasi masalah ini. Penelitian ini bertujuan untuk membuat aplikasi menggunakan teknologi augmented reality Tracking Markerkess Based dengan mengintegrasikan simulasi pernaapasan dengan animasi 3d. Sehingga memanfaatkan fitur kamera pada perangkat smartphone untuk mendeteksi permukaan datar, simuali animasi 3D akan muncul. Augmented reality adalah penggabungan suatu objek yang ada di dunia nyata (virtual) ke duania nyata dalam bentuk 2D atau 3D yang dapat dilihat dan didengar secara real time. Metode yang digunakan dalam penelitian ini adalah Markerless Based Tracking. Aplikasi integrase simulai dalam system pernapasan manusia augmented reality dapat digunakan oelh siswa, mahasiswa, generasi milenial dan masyarakat umum, sehingga memanfaatkan fitur kamera pada perangkat smartphone untuk mendeteksi permukaan data, simulasi animasi 3D akan muncul. Aplikasi ini akan berjalan pada platform mobile Android 7.0 (Nougeat) dan mendukung ArCore dengan kapasitas aplikasi 36,4MB.
SISTEM INFORMASI DARURAT PADA MINI MARKET MENGGUNAKAN MIKROKONTROLER ESP8266 BERBASIS INTERNET OF THINGS
Authors: Deris Anugrah
Published: January 2020

Increasing levels of crime have encouraged instrumentation and technology systems to deal with and expose crime cases. Emergency information systems on the mini market use ESP8266 microcontroller and have been built and analyzed to overcome this on the basis of the Internet of Things. Signals generated from this tool at shopping centers provide emergency information on the Website of the security unit. The results of the system test produced 3.6 seconds delay for power supply connections to NodeMcu. while the delay to calculate the Transmission (response signal) of the Security Unit, and the delay for the time the alarm sounds is 0 seconds. In this system, the website can receive information in the form of coordinate points and Minimarket addresses
PERANCANGAN SISTEM PAKAR PENENTUAN USAHATANI BUDIDAYA PADI MENGGUNAKAN METODE CERTAINTY FACTOR BERBASIS ANDROID
Authors: N Gesa Rizky , Setyaningsih Sri , Saepulrohman Asep
Published: January 2020

Rice is a staple food in several countries of Southeast Asia including Indonesia, rice is the main commodity that acts as the fulfillment of basic needs of carbohydrate and protein. As one of the big rice producer and consumer countries, the increase of rice production is very influential to the state economic condition, effective and efficient national rice production will be achieved if cultivation technology is applied in specific location, in accordance with environmental conditions and farmers. However, the number and ability and extension agents are very limited to serve farmers whose land is diverse. The existence of tools to determine the proper way of cultivating rice-specific locations, easy to use and disseminated will help solve many problems above, The tool used in this study is artificial intelligence is the expert system to help solve the problem due to the limited number of experts or extension workers, many methods used in expert system one of them is certainty factor method which is a method that defines the size of certainty of a fact or rule, to describe the level of expert belief to a problem encountered, by using certainty factor this can level of expert beliefs with android based.
Институциональные режимы психиатрической помощи после оптимизации
Authors: Лебедева Наталья
Published: January 2020

В статье на примере Московского региона описаны основные характеристики, сходства и различия институциональных режимов психонервологических диспансеров (ПНД). Рассмотрены вопросы о соотношении формальных и неформальных правил, профессиональных и институциональных норм, а также взаимосвязи между характером отношений (властные / коллегиальные) внутри организации и опосредованностью взаимодействия за ее пределами. Исследование локальных порядков ПНД проведено на материалах глубинных интервью с медперсоналом высшего и среднего звена. Представленный анализ институциональных режимов учитывает различие как между учреждениями Москвы и Московской области, так и между ПНД Москвы при нескольких психиатрических больницах.
Лечебные травы шаманов современных майя: практики применения
Authors: Роот Татьяна
Published: January 2020

В статье освещаются некоторые аспекты шаманизма различных групп майя Мексики и Гватемалы, в частности, практика применения лекарственных растений. Раскрывается исторический контекст майяского шаманизма, преемственность целительских методов и традиционного использования лекарственных средств. Указаны основные причины болезней, какими их видят шаманы майя. Приводится краткий обзор исследований на тему сохранения и применения лекарственных растений в культуре майя. Кроме того, затронут вопрос о взаимодействии медицинских систем, описаны проблемы, возникающие при соприкосновении традиционной медицины и биомедицины. В статье перечислены некоторые наиболее часто используемые в общинах майя целебные растения с их оригинальными майяскими названиями, научными названиями и полезными свойствами. Шаманское траволечение рассматривается в его связи с сохранением культурной самобытности и языкового богатства коренных народов, а также в качестве одной их практик по сохранению биологического разнообразия влажных тропических лесов высокогорья Мексики и Гватемалы.
Prostatic Neoplasia in the Intact and Castrated Dog: How Dangerous is Castration?
Authors: Schrank Magdalena , Romagnoli Stefano
Published: January 2020

Elective gonadectomy in the dog is a topic of interest for clinicians, pet-owners, and society. Although canine prostatic neoplasia (CPN) has a low incidence (0.35%), reports of an increased risk for castrated dogs attract attention and cause concern in pet-owners. Our aim is to provide professionals and non-professionals with a detailed description of this possible side effect of gonadectomy in the dog. The mean age at diagnosis of CPN ranges from 8.5 to 11.2 years. Medium to large size breeds are more frequently affected. Symptoms and findings of non-invasive examinations are not pathognomonic, therefore, cytological or histological examinations are needed for diagnosis. Overall, the incidence of metastasis reaches up to 80%, yet lung metastasis reportedly has no negative impact on median survival time (MST). It has been reported that castrated males have a significantly higher MST than intact males. Differences in inclusion criteria for studied populations make a comparison of studies difficult. Citation of odds ratios without consideration of the context of the reference may result in premature conclusions. We conclude that elective gonadectomy of adult male dogs under six years of age cannot be excluded from the veterinary practice due to concern of causing CPN until clear and strong evidence is available.
Targeting Non-Oncogene Addiction: Focus on Thyroid Cancer
Authors: Anania Maria Chiara , Di Marco Tiziana , Mazzoni Mara , Greco Angela
Published: January 2020

Thyroid carcinoma (TC) is the most common malignancy of endocrine organs with an increasing incidence in industrialized countries. The majority of TC are characterized by a good prognosis, even though cases with aggressive forms not cured by standard therapies are also present. Moreover, target therapies have led to low rates of partial response and prompted the emergence of resistance, indicating that new therapies are needed. In this review, we summarize current literature about the non-oncogene addiction (NOA) concept, which indicates that cancer cells, at variance with normal cells, rely on the activity of genes, usually not mutated or aberrantly expressed, essential for coping with the transformed phenotype. We highlight the potential of non-oncogenes as a point of intervention for cancer therapy in general, and present evidence for new putative non-oncogenes that are essential for TC survival and that may constitute attractive new therapeutic targets.
A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer
Authors: De Bleser Elise , Willems Ruben , Decaestecker Karel , Annemans Lieven , De Bruycker Aurélie , Fonteyne Valérie , Lumen Nicolaas , Ameye Filip , Billiet Ignace , Joniau Steven , De Meerleer Gert , Ost Piet , Bultijnck Renée
Published: January 2020

The optimal management of patients with oligorecurrent prostate cancer (PCa) is unknown. There is growing interest in metastasis-directed therapy (MDT) for this population. The objective was to assess cost-utility from a Belgian healthcare payer’s perspective of MDT and delayed androgen deprivation therapy (ADT) in comparison with surveillance and delayed ADT, and with immediate ADT. A Markov decision-analytic trial-based model was developed, projecting the results over a 5-year time horizon with one-month cycles. Clinical data were derived from the STOMP trial and literature. Treatment costs were derived from official government documents. Probabilistic sensitivity analyses showed that MDT is cost-effective compared to surveillance (ICER: €8393/quality adjusted life year (QALY)) and immediate ADT (dominant strategy). The ICER is most sensitive to utilities in the different health states and the first month MDT cost. At a willingness-to-pay threshold of €40,000 per QALY, the cost of the first month MDT should not exceed €8136 to be cost-effective compared to surveillance. The Markov-model suggests that MDT for oligorecurrent PCa is potentially cost-effective in comparison with surveillance and delayed ADT, and in comparison with immediate ADT.
Predictive Nomogram for Early Recurrence after Pancreatectomy in Resectable Pancreatic Cancer: Risk Classification Using Preoperative Clinicopathologic Factors
Authors: Kim Naru , Han In Woong , Ryu Youngju , Hwang Dae Wook , Heo Jin Seok , Choi Dong Wook , Shin Sang Hyun
Published: January 2020

The survival of patients with pancreatic ductal adenocarcinoma (PDAC) is closely related to recurrence. It is necessary to classify the risk factors for early recurrence and to develop a tool for predicting the initial outcome after surgery. Among patients with resected resectable PDAC at Samsung Medical Center (Seoul, Korea) between January 2007 and December 2016, 631 patients were classified as the training set. Analyses identifying preoperative factors affecting early recurrence after surgery were performed. When the p-value estimated from univariable Cox’s proportional hazard regression analysis was <0.05, the variables were included in multivariable analysis and used for establishing the nomogram. The established nomogram predicted the probability of early recurrence within 12 months after surgery in resectable PDAC. One thousand bootstrap resamplings were used to validate the nomogram. The concordance index was 0.665 (95% confidence interval [CI], 0.637–0.695), and the incremental area under the curve was 0.655 (95% CI, 0.631–0.682). We developed a web-based calculator, and the nomogram is freely available at http://pdac.smchbp.org/. This is the first nomogram to predict early recurrence after surgery for resectable PDAC in the preoperative setting, providing a method to allow proceeding to treatment customized according to the risk of individual patients.
Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer Who Are Genetic Carriers, Have a Strong Family History or Are just Young at Presentation
Authors: Teoh Victoria , Tasoulis Marios-Konstantinos , Gui Gerald
Published: January 2020

The uptake of contralateral prophylactic mastectomy is rising with increasing trends that are possibly highest in the USA. Whilst its role is generally accepted in carriers of recognized high-risk predisposition genes such as BRCA1 and BRCA2 when the affected individual is premenopausal, controversy surrounds the benefit in less understood risk-profile clinical scenarios. This comprehensive review explores the current evidence underpinning the role of contralateral prophylactic mastectomy and its impact on contralateral breast cancer risk and survival in three distinct at-risk groups affected by unilateral breast cancer: known genetic carriers, those with strong familial risk but no demonstrable genetic mutation and women who are of young age at presentation. The review supports the role of contralateral prophylactic mastectomy in “high risk” groups where the evidence suggests a reduction in contralateral breast cancer risk. However, this benefit is less evident in women who are just young at presentation or those who have strong family history but no demonstrable genetic mutation. A multidisciplinary and personalized approach to support individuals in a shared-decision making process is recommended.
Mutant IDH1 Depletion Downregulates Integrins and Impairs Chondrosarcoma Growth
Authors: Li Luyuan , Hu Xiaoyu , Eid Josiane E. , Rosenberg Andrew E. , Wilky Breelyn A. , Ban Yuguang , Sun Xiaodian , Galoian Karina , DeSalvo Joanna , Yue Jinbo , Chen Xi Steven , Blonska Marzenna , Trent Jonathan C.
Published: January 2020

Chondrosarcomas are a heterogeneous group of malignant bone tumors that produce hyaline cartilaginous matrix. Mutations in isocitrate dehydrogenase enzymes (IDH1/2) were recently described in several cancers, including conventional and dedifferentiated chondrosarcomas. These mutations lead to the inability of IDH to convert isocitrate into α-ketoglutarate (α-KG). Instead, α-KG is reduced into D-2-hydroxyglutarate (D-2HG), an oncometabolite. IDH mutations and D-2HG are thought to contribute to tumorigenesis due to the role of D-2HG as a competitive inhibitor of α-KG-dependent dioxygenases. However, the function of IDH mutations in chondrosarcomas has not been clearly defined. In this study, we knocked out mutant IDH1 (IDH1mut) in two chondrosarcoma cell lines using the CRISPR/Cas9 system. We observed that D-2HG production, anchorage-independent growth, and cell migration were significantly suppressed in the IDH1mut knockout cells. Loss of IDH1mut also led to a marked attenuation of chondrosarcoma formation and D-2HG production in a xenograft model. In addition, RNA-Seq analysis of IDH1mut knockout cells revealed downregulation of several integrin genes, including those of integrin alpha 5 (ITGA5) and integrin beta 5 (ITGB5). We further demonstrated that deregulation of integrin-mediated processes contributed to the tumorigenicity of IDH1-mutant chondrosarcoma cells. Our findings showed that IDH1mut knockout abrogates chondrosarcoma genesis through modulation of integrins. This suggests that integrin molecules are appealing candidates for combinatorial regimens with IDH1mut inhibitors for chondrosarcomas that harbor this mutation.
SMYD3: An Oncogenic Driver Targeting Epigenetic Regulation and Signaling Pathways
Authors: Bottino Cinzia , Peserico Alessia , Simone Cristiano , Caretti Giuseppina
Published: January 2020

SMYD3 is a member of the SMYD lysine methylase family and plays an important role in the methylation of various histone and non-histone targets. Aberrant SMYD3 expression contributes to carcinogenesis and SMYD3 upregulation was proposed as a prognostic marker in various solid cancers. Here we summarize SMYD3-mediated regulatory mechanisms, which are implicated in the pathophysiology of cancer, as drivers of distinct oncogenic pathways. We describe SMYD3-dependent mechanisms affecting cancer progression, highlighting SMYD3 interplay with proteins and RNAs involved in the regulation of cancer cell proliferation, migration and invasion. We also address the effectiveness and mechanisms of action for the currently available SMYD3 inhibitors. The findings analyzed herein demonstrate that a complex network of SMYD3-mediated cytoplasmic and nuclear interactions promote oncogenesis across different cancer types. These evidences depict SMYD3 as a modulator of the transcriptional response and of key signaling pathways, orchestrating multiple oncogenic inputs and ultimately, promoting transcriptional reprogramming and tumor transformation. Further insights into the oncogenic role of SMYD3 and its targeting of different synergistic oncogenic signals may be beneficial for effective cancer treatment.
Complex Correntropy with Variable Center: Definition, Properties, and Application to Adaptive Filtering
Authors: Dong Fei , Qian Guobing , Wang Shiyuan
Published: January 2020

The complex correntropy has been successfully applied to complex domain adaptive filtering, and the corresponding maximum complex correntropy criterion (MCCC) algorithm has been proved to be robust to non-Gaussian noises. However, the kernel function of the complex correntropy is usually limited to a Gaussian function whose center is zero. In order to improve the performance of MCCC in a non-zero mean noise environment, we firstly define a complex correntropy with variable center and provide its probability explanation. Then, we propose a maximum complex correntropy criterion with variable center (MCCC-VC), and apply it to the complex domain adaptive filtering. Next, we use the gradient descent approach to search the minimum of the cost function. We also propose a feasible method to optimize the center and the kernel width of MCCC-VC. It is very important that we further provide the bound for the learning rate and derive the theoretical value of the steady-state excess mean square error (EMSE). Finally, we perform some simulations to show the validity of the theoretical steady-state EMSE and the better performance of MCCC-VC.
Dynamic Analysis and Intelligent Control Strategy for the Internal Thermal Control Fluid Loop of Scientific Experimental Racks in Space Stations
Authors: Cai Ben-Yuan , Wei Hui-Yi , Li Yun-Ze , Lou Yuan-Yuan , Li Tong
Published: January 2020

Scientific experimental racks are an indispensable supporter in space stations for experiments with regard to meeting different temperature and humidity requirements. The diversity of experiments brings enormous challenges to the thermal control system of racks. This paper presents an indirect coupling thermal control single-phase fluid loop system for scientific experimental racks, along with fuzzy incremental control strategies. A dynamic model of the thermal control system is built, and three control strategies for it, with different inputs and outputs, are simulated. A comparison of the calculated results showed that pump speed and outlet temperature of the cold plate branch are, respectively, the best choice for the control variable and controlled variable in the controller. It showed that an indirect coupling thermal control fluid loop system with a fuzzy incremental controller is feasible for the thermal control of scientific experimental racks in space stations.
Complexity Changes in the US and China’s Stock Markets: Differences, Causes, and Wider Social Implications
Authors: Gao Jianbo , Hou Yunfei , Fan Fangli , Liu Feiyan
Published: January 2020

How different are the emerging and the well-developed stock markets in terms of efficiency? To gain insights into this question, we compared an important emerging market, the Chinese stock market, and the largest and the most developed market, the US stock market. Specifically, we computed the Lempel–Ziv complexity (LZ) and the permutation entropy (PE) from two composite stock indices, the Shanghai stock exchange composite index (SSE) and the Dow Jones industrial average (DJIA), for both low-frequency (daily) and high-frequency (minute-to-minute)stock index data. We found that the US market is basically fully random and consistent with efficient market hypothesis (EMH), irrespective of whether low- or high-frequency stock index data are used. The Chinese market is also largely consistent with the EMH when low-frequency data are used. However, a completely different picture emerges when the high-frequency stock index data are used, irrespective of whether the LZ or PE is computed. In particular, the PE decreases substantially in two significant time windows, each encompassing a rapid market rise and then a few gigantic stock crashes. To gain further insights into the causes of the difference in the complexity changes in the two markets, we computed the Hurst parameter H from the high-frequency stock index data of the two markets and examined their temporal variations. We found that in stark contrast with the US market, whose H is always close to 1/2, which indicates fully random behavior, for the Chinese market, H deviates from 1/2 significantly for time scales up to about 10 min within a day, and varies systemically similar to the PE for time scales from about 10 min to a day. This opens the door for large-scale collective behavior to occur in the Chinese market, including herding behavior and large-scale manipulation as a result of inside information.
Image Parallel Encryption Technology Based on Sequence Generator and Chaotic Measurement Matrix
Authors: Yu Jiayin , Guo Shiyu , Song Xiaomeng , Xie Yaqin , Wang Erfu
Published: January 2020

In this paper, a new image encryption transmission algorithm based on the parallel mode is proposed. This algorithm aims to improve information transmission efficiency and security based on existing hardware conditions. To improve efficiency, this paper adopts the method of parallel compressed sensing to realize image transmission. Compressed sensing can perform data sampling and compression at a rate much lower than the Nyquist sampling rate. To enhance security, this algorithm combines a sequence signal generator with chaotic cryptography. The initial sensitivity of chaos, used in a measurement matrix, makes it possible to improve the security of an encryption algorithm. The cryptographic characteristics of chaotic signals can be fully utilized by the flexible digital logic circuit. Simulation experiments and analyses show that the algorithm achieves the goal of improving transmission efficiency and has the capacity to resist illegal attacks.
Belgian Energy Transition: What Are the Options?
Authors: Limpens Gauthier , Jeanmart Hervé , Maréchal Francois
Published: January 2020

Different scenarios at different scales must be studied to help define long term policies to decarbonate our societies. In this work, we analyse the Belgian energy system in 2035 for different carbon emission targets, and accounting for electricity, heat, and mobility. To achieve this objective, we applied the EnergyScope Typical Days open source model, which optimises both the investment and the operation strategy of a complete energy system for a target year. The model includes 96 technologies and 24 resources that have to supply, hourly, the heat, electricity, mobility, and non-energy demands. In line with other research, we identify and quantify, with a merit order, different technological steps of the energy transition. The lack of endogenous resources in Belgium is highlighted and estimated at 275.6 TWh/y. It becomes obvious that additional potentials shall be obtained by importing renewable fuels and/or electricity, deploying geothermal energy, etc. Aside from a reduction of the energy demand, a mix of solutions is shown to be, by far, the most cost effective to reach low carbon emissions.
Analysis and Experiment for Wireless Power Transfer Systems with Two Kinds Shielding Coils in EVs
Authors: Wang Yushan , Song Baowei , Mao Zhaoyong
Published: January 2020

Electric vehicles (EVs) with wireless power transfer (WPT) systems are convenient, but WPT technology will produce a strong stray electromagnetic field (EMF) in the surrounding space when the system works with high power. Shielding coils can reduce stray EMF efficiently without additional control, and they have advantages of being simple, light, and cheap. In this paper, the series-opposing structure is compared systematically with the inductive structure based on circuit theory and electromagnetic field theory. Simplified circuit models are proposed to give an intuitive and comprehensive analysis of transfer efficiency. Electric field analysis and finite element analysis (FEA) is used to explain the functional principles of shielding coils and to compare the EMF distribution excited by two structures. The simulation results show that both structures decrease the mutual inductance and perform better than the system without shielding coils when they have the same transfer efficiency. Further, the inductive structure system performs best. The most important between two structures is that the shielding effects is independent of turns of shielding coils for inductive structure, while it can be adjusted by changing turns of shielding coils for the series-opposing structure. The experimental results show that the EMF is reduced by 65% for the inductive structure and 40% for the series-opposing structure. The theoretical analysis is confirmed by experimental results.
Spatial Perception of Urban Forests by Citizens Based on Semantic Differences and Cognitive Maps
Authors: Zhao Zheng , Ren Jie , Wen Yali
Published: January 2020

Urban forests are more about people than trees. The positivist approach faces many obstacles in analyzing current urban forest-related issues; thus, this study adopted semantic differences and cognitive map approaches to evaluate the subjective preferences of citizens based on their spatial behavior. From December 2015 to November 2017, a three-year continuous public questionnaire was administered to a total of 450 citizens. Typical forest parks, suburban parks, and urban parks in Beijing were selected as research sites, and were analyzed respectively. This study comprehensively evaluated the perception characteristics and differences in the spatial images of urban forests by citizens in relation to different location conditions. Because these characteristics varied across individuals, the spatial cognition and familiarity of citizens with different types of urban forests were analyzed and compared. The perception of spatial images by citizens of different types of urban forests noticeably varied with respect to color and psychology. The perception of spatial images significantly varied with respect to gender, educational background, and income level, with individual characteristics being most closely related to the perception elements of urban forests in terms of space, color, style, and environment. Comparison of cognitive maps demonstrated clear differences in how citizens selected different types of urban forests. These differences were reflected in six types of cognitive maps and six familiar elements in the cognitive maps drawn by citizens.
Adaptation of the System for Observing Play and Recreation in Communities (SOPARC) for the Measurement of Physical Activity in Jail Settings
Authors: Camplain Ricky , Pinn Travis A. , Williamson Heather J. , Pro George , Becenti Lyle , Bret James , Luna Crystal , Baldwin Julie A.
Published: January 2020

Over 9 million people are incarcerated in jail each year, but physical activity has not been assessed among incarcerated populations. Measuring physical activity in the jail setting is complicated as current physical activity measurement tools are not designed for use inside jail facilities. Therefore, we adapted an evidence-based physical activity measurement tool, the System for Observing Play and Recreation in Communities (SOPARC), to assess physical activity within a jail facility. SOPARC was designed to obtain observational information on physical activity of individuals. The study team created a protocol for SOPARC for use in jail facilities. Unlike the original SOPARC, access to recreation time in jail required prior scheduling. Target areas were unnecessary as recreation spaces were enclosed. The adapted SOPARC protocol for jails included start and end times, the number of individuals that attended, and recreation time users’ physical activity levels, footwear, outerwear, uniform color, and use of mobility assistive devices. The use of SOPARC in the jail setting requires adaptation to adequately capture physical activity data among incarcerated individuals. Accurately measuring physical activity among incarcerated individuals and the environment in which they are active may allow for future development and testing of physical activity interventions in jail facilities.
Symptom Burden and Profiles in Concussed Children with and without Prolonged Recovery
Authors: Schilling Samantha , Mansour Adam , Sullivan Lindsay , Ding Kele , Pommering Thomas , Yang Jingzhen
Published: January 2020

Although symptom burden and symptom profile severity are independent predictors of post-concussion symptom duration, few studies have examined their effects on prolonged recovery simultaneously. This study examined differences in symptom burden and symptom profile scores between concussed children with prolonged recovery and those with typical recovery. We conducted a retrospective case-control study of concussed children aged 10–18 years. Prolonged recovery was defined as symptom duration beyond 28 days post-injury. Symptom burden was measured as total symptom score (TSS) at injury. Symptom profiles included: (1) vestibular, (2) ocular, (3) cognitive/fatigue, (4) migraine, and (5) anxiety. A total of 4380 unique concussions sustained by 3777 patients were included; 80.3% white, 60.0% male, and 44.0% aged 13–15 years. The prolonged recovery group had a significantly higher TSS and greater number of symptoms than the typical recovery group (p < 0.001 and p < 0.001, respectively). The prolonged recovery group had significantly higher scores on all five symptom profiles, including vestibular (p < 0.001), ocular (p < 0.001), cognitive/fatigue (p < 0.001), migraine (p < 0.001) and anxiety (p < 0.001), than the typical recovery group, even after adjusting for number of symptoms and other covariates. Further studies using prospective cohort designs are needed to better understand the influence of symptom burden and profiles on pediatric concussion recovery.
Sickness Presence among Health Care Professionals: A Cross Sectional Study of Health Care Professionals in Slovenia
Authors: Skerjanc Alenka , Fikfak Metoda Dodic
Published: January 2020

Background and objectives: Presenteeism is a relatively new phenomenon that people, despite complaints and ill health that should prompt them to rest and take sick leave, go to work in any case. The highest sickness presence is largely to be found in the care and welfare and educational sectors. The aim of the study is to investigate the relations between different factors and sickness presence among health care professionals. Materials and Methods: A cross-sectional study was conducted at the largest hospital in Slovenia involving 5865 health care professionals employed at the University Medical Centre Ljubljana in the period between 1 January 2010 and 31 December 2010. Logistic regression methods were used to assess the associations between risk factors and their interactions and sickness presence. Results: Besides high odds for sickness presence in multivariate modelling for acute (OR = 359.7; 95%CI = 89.1–1452.8) and chronic disease (OR = 722.5; 95%CI = 178.5–2924.5) the highest odds were calculated for poor self-related health (OR = 3.0; 95%CI = 1.9–4.8), no possibility of replacement (OR = 1.9; 95%CI = 1.5–2.3), sickness absence > two times a year (OR = 1.6; 95%CI = 1.2–2.1), disabled workers (OR = 1.6; 95%CI = 1.0–2.5), and lower salary when on sick leave (OR = 1.5; 95%CI = 120–1.9). Risk factors interactions were not found to be associated with sickness presence among health care workers. Conclusions: The pre-requisite for higher sickness presence is workers’ bad health. The results indicate that sickness presence was associated with psycho social risk factors at work and their economic consequences. Continued sickness presence might have negative rather than positive consequences on work and health care professionals’ health in the future. Sickness presence needs to be taken into account for health care organizers.
The Willingness for Downward Referral and Its Influencing Factors: A Cross-Sectional Study among Older Adults in Shandong, China
Authors: Jing Xiang , Xu Lingzhong , Qin Wenzhe , Zhang Jiao , Lu Lu , Wang Yali , Xia Yu , Jiao An’an , Li Yaozu
Published: January 2020

Objectives: The aim of this study was to understand the willingness for downward referral among older adults who were hospitalized in the year before the survey and to explore its influencing factors. Methods: The sample was randomly selected by the multi-stage sampling method. A structural questionnaire was used to collect data from participants age 60 and above in Shandong, China, during August 2017. Data were analyzed by using descriptive statistics, one-way ANOVA, chi-square test, and multinomial logistic regression. Results: Of 1198 participants who were hospitalized in the year before the survey, 28.7% self-initiated downward referral, and 33.9% were willing to accept downward referral after a doctor’s advice. Multinomial logistic regression results showed that self-rated health, treatment effect in primary medical institutions, preference for outpatient service, choice of inpatient service, general understanding of essential medicines, the cost of essential medicines after zero-markup policy, and satisfaction with essential medicines’ reimbursement policy significantly correlated with older adults’ willingness for downward referral. Conclusions: The proportion of older adults who self-initiated downward referral was less than one-third. Doctors’ advice plays an important role in willingness for downward referral. More attention should be paid to improving the treatment effect of primary medical institutions, increasing the benefits of zero-markup policy, and ensuring a high reimbursement for the downward referral to work alongside doctors’ advice.
Tripartite Data Analysis for Optimizing Telemedicine Operations: Evidence from Guizhou Province in China
Authors: Yu Jinna , Zhang Tingting , Liu Zhen , Hatab Assem Abu , Lan Jing
Published: January 2020

Telemedicine is an innovative approach that helps alleviate the health disparity in developing countries and improve health service accessibility, affordability, and quality. Few studies have focused on the social and organizational issues involved in telemedicine, despite in-depth studies of and significant improvements in these technologies. This paper used evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the implementation and operation of telemedicine. Further, numerical simulation was carried out to develop management strategies for promoting telemedicine as a new way of delivering health services. The results showed that: (1) When the benefits are greater than the costs, the higher medical institutions (HMIs), primary medical institutions (PMIs), and patients positively promote telemedicine with benign interactions; (2) when the costs are greater than the benefits, the stability strategy of HMIs, PMIs, and patients is, respectively, ‘no efforts’, ‘no efforts’, and ‘non-acceptance’; and (3) promotion of telemedicine is influenced by the initial probability of the ‘HMI efforts’, ‘PMI efforts’, and ‘patients’ acceptance’ strategy chosen by the three stakeholders, telemedicine costs, and the reimbursement ratio of such costs. Based on theoretical analysis, in order to verify the theoretical model, this paper introduces the case study of a telemedicine system integrated with health resources at provincial, municipal, county, and township level in Guizhou. The findings of the case study were consistent with the theoretical analysis. Therefore, the central Chinese government and local governments should pay attention to the running cost of MIs and provide financial support when the costs are greater than the benefits. At the same time, the government should raise awareness of telemedicine and increase participation by all three stakeholders. Lastly, in order to promote telemedicine effectively, it is recommended that telemedicine services are incorporated within the scope of medical insurance and the optimal reimbursement ratio is used.
Improving the UNAIDS 90-90-90 Treatment Targets: Solutions Suggested from a Qualitative Study of HIV Patients, Community Advocates, Health Workers and Program Managers in Jimma, Southwest Ethiopia
Authors: Gesesew Hailay , Ward Paul , Woldemichael Kifle , Mwanri Lillian
Published: January 2020

Ethiopia’s performance toward the UNAIDS 90-90-90 targets is low. The present study explored interventions to improve delayed HIV care presentation (first 90), poor retention (second 90) and clinical and immunological failure (third 90). We employed a qualitative approach using in-depth interviews with 10 HIV patients, nine health workers, 11 community advocates and five HIV program managers. Ethical approvals were obtained from Australia and Ethiopia. The following were suggested solutions to improve HIV care and treatment to meet the three 90s: (i) strengthening existing programs including collaboration with religious leaders; (ii) implementing new programs such as self-HIV testing, house-to-house HIV testing, community antiretroviral therapy (ART) distribution and teach-test-treat-link strategy; (iii) decentralizing and integrating services such as ART in health post and in private clinics, and integrating HIV care services with mental illness and other non-communicable diseases; and (iv) filling gaps in legislation in issues related with HIV status disclosure and traditional healing practices. In conclusion, the study suggested important solutions for improving delayed HIV care presentation, attrition, and clinical and immunological failure. A program such as the teach-test-treat-link strategy was found to be a cross-cutting intervention to enhance the three 90s. We recommend further nationwide research before implementing the interventions.
The Microarchitecture of Pancreatic Cancer as Measured by Diffusion-Weighted Magnetic Resonance Imaging Is Altered by T Cells with a Tumor Promoting Th17 Phenotype
Authors: Mayer Philipp , Linnebacher Alica , Glennemeier-Marke Hannah , Marnet Nicole , Bergmann Frank , Hackert Thilo , Klauss Miriam , Poth Tanja , Gaida Matthias M.
Published: January 2020

Diffusion-weighted magnetic resonance imaging (DW-MRI) is a diagnostic tool that is increasingly used for the detection and characterization of focal masses in the abdomen, among these, pancreatic ductal adenocarcinoma (PDAC). DW-MRI reflects the microarchitecture of the tissue, and changes in diffusion, which are reflected by changes in the apparent diffusion coefficient (ADC), are mainly attributed to variations in cellular density, glandular formation, and fibrosis. When analyzing the T cell infiltrates, we found an association of a tumor-promoting subpopulation, characterized by the expression of interleukin (IL) 21 and IL26, with high ADC values. Moreover, the presence of IL21+ and IL26+ positive T cells was associated with poor prognosis. Pancreatic cancers—but not healthy pancreatic tissue—expressed receptors for IL21 and IL26, a finding that could be confirmed in pancreatic cell lines. The functionality of these receptors was demonstrated in pancreatic tumor cell lines, which showed phosphorylation of ERK1/2 and STAT3 pathways in response to the respective recombinant interleukins. Moreover, in vitro data showed an increased colony formation of tumor cells. In summary, our data showed an association of IL21+ and IL26+ immune cell infiltration, increased ADC, and aggressive tumor disease, most likely due to the activation of the key cancer signaling pathways ERK1/2 and STAT3 and formation of tumor colonies.
Senile Osteoporosis: The Involvement of Differentiation and Senescence of Bone Marrow Stromal Cells
Authors: Qadir Abdul , Liang Shujing , Wu Zixiang , Chen Zhihao , Hu Lifang , Qian Airong
Published: January 2020

Senile osteoporosis has become a worldwide bone disease with the aging of the world population. It increases the risk of bone fracture and seriously affects human health. Unlike postmenopausal osteoporosis which is linked to menopause in women, senile osteoporosis is due to aging, hence, affecting both men and women. It is commonly found in people with more than their 70s. Evidence has shown that with age increase, bone marrow stromal cells (BMSCs) differentiate into more adipocytes rather than osteoblasts and undergo senescence, which leads to decreased bone formation and contributes to senile osteoporosis. Therefore, it is necessary to uncover the molecular mechanisms underlying the functional changes of BMSCs. It will benefit not only for understanding the senile osteoporosis development, but also for finding new therapies to treat senile osteoporosis. Here, we review the recent advances of the functional alterations of BMSCs and the related mechanisms during senile osteoporosis development. Moreover, the treatment of senile osteoporosis by aiming at BMSCs is introduced.
Global Gene Expression Analysis Identifies Age-Related Differences in Knee Joint Transcriptome during the Development of Post-Traumatic Osteoarthritis in Mice
Authors: Sebastian Aimy , Murugesh Deepa K. , Mendez Melanie E. , Hum Nicholas R. , Rios-Arce Naiomy D. , McCool Jillian L. , Christiansen Blaine A. , Loots Gabriela G.
Published: January 2020

Aging and injury are two major risk factors for osteoarthritis (OA). Yet, very little is known about how aging and injury interact and contribute to OA pathogenesis. In the present study, we examined age- and injury-related molecular changes in mouse knee joints that could contribute to OA. Using RNA-seq, first we profiled the knee joint transcriptome of 10-week-old, 62-week-old, and 95-week-old mice and found that the expression of several inflammatory-response related genes increased as a result of aging, whereas the expression of several genes involved in cartilage metabolism decreased with age. To determine how aging impacts post-traumatic arthritis (PTOA) development, the right knee joints of 10-week-old and 62-week-old mice were injured using a non-invasive tibial compression injury model and injury-induced structural and molecular changes were assessed. At six-week post-injury, 62-week-old mice displayed significantly more cartilage degeneration and osteophyte formation compared with young mice. Although both age groups elicited similar transcriptional responses to injury, 62-week-old mice had higher activation of inflammatory cytokines than 10-week-old mice, whereas cartilage/bone metabolism genes had higher expression in 10-week-old mice, suggesting that the differential expression of these genes might contribute to the differences in PTOA severity observed between these age groups.
Pistachio Consumption Alleviates Inflammation and Improves Gut Microbiota Composition in Mice Fed a High-Fat Diet
Authors: Terzo Simona , Mulè Flavia , Caldara Gaetano Felice , Baldassano Sara , Puleio Roberto , Vitale Maria , Cassata Giovanni , Ferrantelli Vincenzo , Amato Antonella
Published: January 2020

High-fat diet (HFD) induces inflammation and microbial dysbiosis, which are components of the metabolic syndrome. Nutritional strategies can be a valid tool to prevent metabolic and inflammatory diseases. The aim of the present study was to evaluate if the chronic intake of pistachio prevents obesity-associated inflammation and dysbiosis in HFD-fed mice. Three groups of male mice (four weeks old; n = 8 per group) were fed for 16 weeks with a standard diet (STD), HFD, or HFD supplemented with pistachios (HFD-P; 180 g/kg of HFD). Serum, hepatic and adipose tissue inflammation markers were analyzed in HFD-P animals and compared to HFD and STD groups. Measures of inflammation, obesity, and intestinal integrity were assessed. Fecal samples were collected for gut microbiota analysis. Serum TNF-α and IL-1β levels were significantly reduced in HFD-P compared to HFD. Number and area of adipocytes, crown-like structure density, IL-1β, TNF-α, F4-80, and CCL-2 mRNA expression levels were significantly reduced in HFD-P subcutaneous and visceral adipose tissues, compared to HFD. A significant reduction in the number of inflammatory foci and IL-1β and CCL-2 gene expression was observed in the liver of HFD-P mice compared with HFD. Firmicutes/Bacteroidetes ratio was reduced in HFD-P mice in comparison to the HFD group. A pistachio diet significantly increased abundance of healthy bacteria genera such as Parabacteroides, Dorea, Allobaculum, Turicibacter, Lactobacillus, and Anaeroplasma, and greatly reduced bacteria associated with inflammation, such as Oscillospira, Desulfovibrio, Coprobacillus, and Bilophila. The intestinal conductance was lower in HFD-P mice than in the HFD mice, suggesting an improvement in the gut barrier function. The results of the present study showed that regular pistachio consumption improved inflammation in obese mice. The positive effects could be related to positive modulation of the microbiota composition.
Nephrocalcinosis: A Review of Monogenic Causes and Insights They Provide into This Heterogeneous Condition
Authors: Dickson Fay J. , Sayer John A.
Published: January 2020

The abnormal deposition of calcium within renal parenchyma, termed nephrocalcinosis, frequently occurs as a result of impaired renal calcium handling. It is closely associated with renal stone formation (nephrolithiasis) as elevated urinary calcium levels (hypercalciuria) are a key common pathological feature underlying these clinical presentations. Although monogenic causes of nephrocalcinosis and nephrolithiasis are rare, they account for a significant disease burden with many patients developing chronic or end-stage renal disease. Identifying underlying genetic mutations in hereditary cases of nephrocalcinosis has provided valuable insights into renal tubulopathies that include hypercalciuria within their varied phenotypes. Genotypes affecting other enzyme pathways, including vitamin D metabolism and hepatic glyoxylate metabolism, are also associated with nephrocalcinosis. As the availability of genetic testing becomes widespread, we cannot be imprecise in our approach to nephrocalcinosis. Monogenic causes of nephrocalcinosis account for a broad range of phenotypes. In cases such as Dent disease, supportive therapies are limited, and early renal replacement therapies are necessitated. In cases such as renal tubular acidosis, a good renal prognosis can be expected providing effective treatment is implemented. It is imperative we adopt a precision-medicine approach to ensure patients and their families receive prompt diagnosis, effective, tailored treatment and accurate prognostic information.