bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting non-performing loans of commercial banks: the role of bank performance and credit growth
Authors: Kieu Oanh Dao Le , Yen Nguyen Thi , Hussain Sarfraz , Chien Nguyen Van
Published: August 2020

The recent crisis of non-performing loans in the banking system has hit the Vietnamese economy hard. The GDP has been fallen down, while the bad debt ratio in the banking system has risen dramatically to 17.2 percent, and it takes more time to restore the economy and banking system. This research aims to define aspects that impact non-performing commercial bank loans in Vietnam. It covers the period of 2008–2017 using 200 identified banks of Ho Chi Minh City Stock Exchange and Hanoi Stock Exchange, and applies methods based on the regression of pooled ordinary least squares, fixed and random effects models, in particular, generalized least squares to confirm the stability of the regression model. The results show that non-performing loans this year will positively affect those in the next year. In addition, a raise in bank performance and credit growth also leads to the reduction in non-performing loans from banks. Regarding macroeconomic factors, higher interest rates would have a major and beneficial influence on failed loans in terms of macroeconomic dynamics, and, therefore, little effect on economic activity and inflation. Therefore, Vietnamese banking system should reduce the systematic risk and improve monitoring processes, drawing on the experience of global banks with extensive experience in risk management.
Eco-friendly approach for elimination of olive mill wastewaters (OMW) toxicity using cactus prickly pears juice as a coagulant
Authors: Neffa M. , Taourirte M. , Ouazzani N. , Hanine H.
Published: August 2020

Currently, research focuses on the application of newer biocoagulant products in wastewater treatment. In this study, the performance of cactus juice to clarify Olive Mill Wastewater (OMW) was investigated by using Jar-test experimentation and assessed by physicochemical analysis of the obtained supernatant: turbidity, total suspended solids (TSS), (λ465; λ395) absorbance, polyphenols (pp), chemical oxygen demand (COD) and Fourier-Transform-Infrared spectroscopy (FTIR) on lyophilized sludge. A series of experiments were conducted to estimate the influence of various experimental parameters, such as the amounts of biocoagulants used, time, stirring speed, and pH. The study showed the optimal coagulation conditions were as follows: sample pH10; cactus juice dose, 10% (v/v); rapid mixing time, 30 s at a speed of 150 rp/min. Under these conditions, the overall removals of 74% for COD, 93% for turbidity and 51% for polyphenols were achieved. As referring to the FTIR analysis, the cactus juice of Opuntia spp. operates predominantly through an adsorption interparticle bridging coagulation mechanism. These results are encouraging in the context of developing a low-cost technology and eco-friendly approach for the effective management of OMW.
Autophagic Vacuole Secretion Triggered by Chidamide Participates in TRAIL Apoptosis Effect in Breast Cancer Cells
Authors: Zhou Weiqiang , Han Han , Xu Junnan , Sun Tao , Feng Xiuyan
Published: August 2020

Background:

Breast cancer is one of the most prevalent diseases threatening women's health today. Indepth
research on breast cancer (BC) pathogenesis and prevention and treatment methods are gradually receiving
attention. Chidamide is a novel histone deacetylase inhibitor (HDACi) that depresses the function of histone
deacetylase, consequently affecting the growth of BC cells through epigenetic modification. However, preclinical
and clinical studies show that chidamide is ineffective in long-term treatment. We demonstrated in previous experiments
that TNF-related apoptosis-inducing ligand (TRAIL) induces apoptosis in BC cells and is significantly
less non-toxic to normal cells than chidamide. Therefore, in this study, we treated BC cells with chidamide and
TRAIL to explore a novel option to reduce the clinical toxicity through augmenting the sensitivity for BC cells.

Methods and Results:

Results from the MTT and cell viability assays indicated that the combination of chidamide
and TRAIL in MCF-7 and MDA-MB-231 cells induced BC cell death, while maintaining a reduced concentration
of chidamide. Autophagy assay and annexin V analysis showed that the autophagosome microtubuleassociated
protein1light chain3-II (LC3-II) was abnormally increased and much more early and late phase of
apoptotic cells appeared during chidamide and TRAIL induction. Anti-tumor assays in a BC tumor xenograft
model displayed that the mixture of chidamide and TRAIL exhibited stronger effects on inhibiting tumor growth.
The data from real-time PCR and western blotting showed that the cytotoxic effect correlated with the expressions
of related apoptosis and autophagy factors.

Conclusion:

Our data are the first to demonstrate the synergistic effects of chidamide and TRAIL in BC cells,
specifically, the pharmacological effects on cell death induction. These results lay a solid experimental and theoretical
basis to solve the clinical resistance of chidamide.
Approach to the Patient with Subclinical Cushing’s Syndrome
Authors: Ivović Miomira , Marina Ljiljana V. , Šojat Antoan S. , Tančić-Gajić Milina , Arizanović Zorana , Kendereški Aleksandra , Vujović Svetlana
Published: August 2020

A growing number of patients with adrenal incidentalomas and subclinical Cushing’s syndrome (SCS)
led to an increasing number of different guidelines, and diagnostic and treatment recommendations. Excess cortisol
secretion in patients with SCS is associated with several comorbidities, such as hypertension, dyslipidemia,
type 2 diabetes mellitus, and obesity, which in the long-term increase mortality of these patients. Subtle cortisol
secretion affects bone health, quality of life and causes depression, but due to the unapparent clinical features,
patients with SCS are often at risk between over and under treatment. This narrative review aimed to summarize
the latest recommendations on the approach to the patient with subclinical Cushing’s syndrome.
Thiocoumarins and Dithiocoumarins: Advances in Synthesis and Pharmacological Activity
Authors: Chaudhary Diksha , Pramanik Tanay , Santra Soumava
Published: August 2020

Thiocoumarins and dithiocoumarins are two important classes of sulphurcontaining heterocyclic compounds, which are bioisosteres of coumarins. Herein, various synthetic strategies for these two classes of heterocyclic compounds reported in the literature have been discussed. Different solvents, catalysts, reagents and reaction conditions, which were employed successfully for synthesizing thiocoumarins and dithiocoumarins have also been described concisely in this review. Mechanistic overview has been given wherever it was necessary. In addition, a comparative view of various solvents, catalysts and reagents focusing on their efficiency for synthesizing thiocoumarins and dithiocoumarins, has been discussed as well. Furthermore, pharmacological activities of these two classes of compounds have also been discussed.
The Role of Skin and Gut Microbiome and Epigenetic Modifications in Skin-Autoimmune Disorders
Authors: Murdaca Giuseppe , Greco Monica , Negrini Simone , Casciaro Marco , Gangemi Sebastiano
Published: August 2020

Human microbiota and immune system are strictly connected to each other.
Several studies demonstrated that normal skin and/or gut floral alterations may have
negative consequences on disease pathogenesis. Indeed, a strong association between
skin and gut microbiota alterations and autoimmune diseases was found. Moreover, a
significant interplay between microbiome and miRNAs expression was noticed among
several conditions. The aim of this review article is to shed new light on some of the
commonest skin disorders such as psoriasis, atopic dermatitis, allergic contact
dermatitis, with special regard to epigenetic pathogenetic mechanisms such as miRNAs
expression and skin and gut microbiome alterations. Indeed, evidence is still lacking
regarding these two factors and their possible interactions. We believe their implications
may be crucial for screening, early diagnosis and also therapeutic strategies; therefore,
this field could represent a promising challenge for further studies.
Synthesis of Novel N-(R)-2-(1-Adamantyl)-1H-Benzimidazole-5(6)- Carboxamide, Carbohydrazide and 1,3,4-Oxadiazole Derivatives
Authors: Soselia Marina , Lomidze Medea , Tabatadze Tamar , Zurabishvili Davit , Trapaidze Marina , Samsoniya Shota
Published: August 2020

A novel series of benzimidazole-5(6)-carboxamide 3a-g, carbohydrazide 5a-e and 1,3,4-
oxadiazole 6a-g derivatives bearing adamantane moiety were synthesized. The synthesis of benzimidazole
heterocycle was performed by direct condensation/cyclization reaction of 1-
adamantanecarboxylic acid with methyl 3,4-diaminobenzoate in Trimethylsilyl Polyphosphate (PPSE).
The obtained Methyl 2-(1-adamantyl)-1H-benzimidazole-5(6)-carboxylate was converted to desired
carboxamide and carbohydrazide derivatives in two different ways. In the first case, the synthesized ester
after hydrolysis was converted to an acid chloride and subsequently coupled with different aromatic
and heterocycle amines to give carboxamide derivatives. In the second case, treatment with hydrazine
hydrate gave corresponding 2-(1-adamantyl)-1H-benzimidazole-5(6)-carbohydrazide which was coupled
with some acyl chlorides to give appropriate carbohydrazide derivatives and with some aromatic
acids to give 1,3,4-oxadiazole derivatives.
Microwave Irradiation: Synthesis and Characterization of Substituted Pyranoquinolines
Authors: Abirami Maharajan , Selvi Senniappan Thamarai , Nadaraj Vetrivel
Published: August 2020

A new series of pyrano[2,3-b]quinolines were synthesized from 3-formylquinolin-2(1H)-
ones via Knoevenagel condensation followed by cyclization reaction of ethyl cyanoacetate using
DMSO as solvent. This methodology is a simple; clean, fast, efficient, eco-friendly method with less
reaction time, an improvement in the yield and purity of the product. The structures of newly synthesized
compounds were confirmed by IR, NMR, Mass and elemental analysis.
Solid Lipid Particle-loaded Ocimum Gratissimum Seed Films and Polymeric Films for Controlled Drug Delivery
Authors: Mai Hang D. , Tran Phuong H.L. , Tran Thao T.D.
Published: August 2020

Aims:

The purpose of this study was to investigate and compare the formation of polymeric
and Ocimum gratissimum seed films containing solid lipid particles for controlled drug release.

Methods:

The hot homogeneous method was selected to form solid lipid particles containing sodium
fusidate to load the drug into the film. The in vitro drug release and drug permeability of the films were
tested with dialysis tubes and the Franz diffusion cell method, respectively. The mucoadhesive time
and swelling and erosion rates were also studied.

Results:

The solid lipid particles showed the ability to form Ocimum gratissimum seed and polymeric
films for use in drug delivery. Although the polymeric matrix yielded excellent swelling and erosion
rates, leading to a faster drug release rate and drug permeation than that of the Ocimum gratissimum
seed film, the mucoadhesive time of the polymer film was worse than that of the seed film.

Conclusion:

Therefore, the characteristics of the individual systems may be further studied in a combined
system to take full advantage of both in the desired film.
The Use of Natural Products Against Fusarium oxysporum: A Review
Authors: Belhi Zeyneb , Boulenouar Noureddine , Cheriti Abdelkrim
Published: August 2020

:

Currently, numerous researchers have focused their attention on the use of natural products from plants and
microorganisms, or compounds derived from these organisms to protect crops from various diseases, thus reduce the
negative effects on human health and environmental safety.
Fungal diseases cause a considerable loss of crop yields in agricultural industries worldwide. Fusarium oxysporum
comprises a multitude of formae speciales that cause vascular wilt diseases of economically important crops.
This review presents an overview of researches realized on natural products tested against Fusarium oxysporum formae
speciales phytopathogens for the period (2017-2020).
This review aims to collect major research works of the antifungal compounds against these fungi and up-dates information
on their developments and approaches that have been rapidly taking place in recent years so that further novel researches
can be envisaged.
Discussion of these studies by analyzing different sources for antifusariosis treatment, evaluation of testing methods, and
information on their advantages and limitations and to determine those with real efficacy. Despite the important number of
natural products with remarkable in vitro efficiency, the limiting point is their in vivo application for soil microorganisms
(in this case: Fusarium oxysporum). Therefore, more advanced researches are needed to solve this problem.
Predicting the Cumulative Number of Cases of the COVID-19 Epidemic in India from Early Data
Authors: Thakur Amit Kumar , Singh Rajesh , Gehlot Anita , Das Prabin Kumar , Roy Bishwajyoti
Published: August 2020

Aim:

The present study aims at explaining the epidemic situation in India for
COVID-19 and forecasting the expected rise in the positive cases in India.

Objective:

This study will be useful for Government authorities and Medical Practitioners in assessing
the trends for India and preparing a combat plan with stringent measures. This research would
also be useful in predicting outbreak numbers with greater precision for people involved in exploring
this deadly disease.

Methods:

We used the Support Vector Machine (SVM) to forecast and analyze the COVID-19 situations
to predict future trends. On definite trail and model training, it was observed that the number
of COVID cases will increase for the next four days.

Results:

The SVM model predicted accurate results. The prediction accuracy seems to best fit and
indicates the cases to rise in the next coming days. Confirmed cases and the SVM predictions are
close to each other, thus proving the accuracy of the SVM predictions. It was inferred that the numbers
of COVID-19 instances will rise if the same trend is followed.

Conclusion:

The COVID-19 outbreak is exacerbated by secondary hospital transmission. Testing,
particularly of those coming in with respiratory symptoms, is essential to isolate those in hospitals.
A two-stage, pre-emptive testing is recommended in symptomatic older people immediately to reduce
mortality. Immediate and on-going serological surveys are required to track the epidemic level.
We are flying blind at the moment. The demand for the ventilators would be 1 million. The current
supply in India is projected to range from 30 K to 50 K (the US has 160 K and is still running
short). Health staff involved in treating COVID-19 patients also have to shield themselves using
personal protection (i.e., masks and gowns) to save themselves from being infected. Thus, SVM
model predictions will give a better insight into the growth of COVID-19 cases and, therefore, will
allow the government of India to take adequate measures to restrain the issue at the earliest.
Analysis of Relay Node Failure in Heterogeneous Wireless Sensor Networks
Authors: Kakamanshadi Gholamreza , Gupta Savita , Singh Sukhwinder
Published: August 2020

Introduction:

Fault tolerance is an important issue for assuring data reliability, energy saving and prolonging
the lifetime of wireless sensor networks. Since, sensor node, relay node, etc. are prone to failure, there is a need an effective fault tolerance mechanism.

Methods:

Relay nodes are used as cluster heads and the concept of two disjoint paths is employed
for proving fault tolerance against link failure. To evaluate the fault tolerance level, mean time to
failure and subsequently, failure rate are calculated, that reflect the reliability of the network.

Results:

The results show that as the area size of the network increases, the average fault tolerance
level of the network becomes constant. Furthermore, when the mean time to failure of the network
decreases, then the failure rate increases. It means the overall reliability of the network with a
smaller network size is more than the larger network size.

Discussion:

This paper presents a detailed analysis of relay nodes failure under distinct network
configurations in heterogeneous wireless sensor networks.

Conclusion:

This analysis helps the network designers to decide the quantity of deployment of relay
nodes with respect to fault tolerance level. It may also help to prevent relay nodes failure by
taking appropriate actions so as to increase the fault tolerance level of the network as well as network
reliability.
Growth and quality of Pinus nigra (Arn.), Pinus sylvestris (L.) and Pinus pinaster (Aiton) seedlings in two container types
Authors: Dina Kolevska Dana , Dimitrova Anastazija , Cokoski Kristijan , Basova Mare
Published: August 2020

Abstract
In this study we investigated the dynamics of growth and quality features of 1+0 Austrian Pine (AP; Pinus nigra Arn.), Scots Pine (SP; Pinus sylvestris L.)  and Maritime Pine (MP; Pinus pinaster Aiton) seedlings in containers Yukosad (YS; hard plastic, 75cm3, 610 seedlings m-2) and Siset (SS; gray cardboard with white coating, 128 cm3, 589 seedlings m-2). The experiment, for all Pine species, was conducted in randomized blocks in four replications. Each replication contained 10 multipots of each container type. After the seed germination, every 15 days, i.e. 10 times during the vegetation season, 10 seedlings of each of 4 replications, i.e. 40 seedlings of each container and Pine species, were analyzed. The following morphological characteristics were measured: shoot height (SH), root collar diameter (RCD), shoot dry weight (SDW), number, length and dry weight (RDW) of I, II and III order lateral roots (FOLR, SOLR and TOLR) and of the central root. Quality ratios and indexes were calculated. The dynamics of growth of selected features during the vegetation season was expressed as trend lines. AP and SP seedlings, grown in containers YS had higher values of almost all measured traits (SH, RCD, SDW, number, length and dry weight of FOLR, SOLR and TOLR). However, in AP, the SS seedlings had better values of quality indexes and ratios (SQ, DQI, SDW/RDW and RDW/SDW ratio), than YS seedlings. SP seedlings, except for SQ, had better quality indexes in YS container. MP seedlings, with some exceptions, have better above ground quality features in SS containers, while root systems don’t differ significantly in both containers. Root quality indicators (root intensity and root bound indexes) are more favorable in SS containers in all Pine species. The polynomial trend lines in AP and SP grow in similar way and intensity in both containers, gradually increasing during the vegetation season. MP seedlings differ in much more intensive growth of above ground features, especially in the half of the vegetative period in both containers, while during this period root quantity and length stagnates. Generally, the quality of AP and SP seedlings is more or less equal and satisfactory in both containers, while MP seedlings show slightly better results in SS container.
Effect of using harvesting residues as a nursery media on seedling weight in Brutian pine (Pinus brutia Ten.)
Authors: Çetinkaya Durmuş , Bilir Nebi
Published: August 2020

Effects of harvesting residues (needle, bark and branch) on fresh and dry weights of two-year bare root seedlings originated from a seed stand and a seed orchard were examined in Brutian pine (Pinus brutia Ten.) to contribute nursery practices of the species and to estimate utilization possibility of the residues. Averages of seedling fresh and dry weights were 9.24 g and 3.36 g, respectively in polled treatments and origins. Results of analysis of variance showed significant differences (p≤0.05) among the treatments and between seed sources for the fresh and dry weights. Total averages of water content were 61.20% in root, 64.69% in stem and 63.75% in fresh weight of full seedling. Seed orchard seedlings had higher water content in root, stem and full seedling than seed stand seedlings opposite to fresh and dry weights. Averages of water content ranged from 60.39% (control treatment) to 65.94% (bark treatment) in full seedling of polled treatments and seed sources.
Evaluación de la calidad de vida como predictor de supervivencia en el cáncer
Authors: Viada Carmen , Bouza Carlos , Ballesteros Javier , Fors Martha , Alvarez Mabel , Frias Aliuska , Garcia Lazara , Santiesteban Yanela , Santiesteban Yuliannis , Ramos Mayra
Published: August 2020

La calidad de vida y la supervivencia son variables a tener en cuenta en ensayos clínicos de pacientes oncológicos. Es importante investigar la relación que existe entre ellas para los distintos tipos de cáncer. Se unieron las bases de datos de todos los pacientes oncológicos incluidos en los ensayos clínicos que se ejecutaron en el país, en el período 2000-2020. La calidad de vida se evaluó a través de las encuestas utilizadas en cada protocolo de investigación. Se realizó un análisis del tiempo transcurrido entre la inclusión del paciente y el fallecimiento para determinar el tiempo de supervivencia. Se comprobó que las variables de supervivencia de los pacientes incluidos en ensayos clínicos, mostraron valores superiores a los reportados para los pacientes con similares localizaciones del tumor no incluidos en estas investigaciones. Las localizaciones de mayor supervivencia fueron: pulmón (14.03 meses), cabeza y cuello (19.63 meses) y esófago (16.85 meses). En el caso de la calidad de vida se obtuvo que, globalmente, los pacientes mantuvieron un excelente estado general y la mayoría se incorporó a las actividades domésticas y laborales. Los pacientes incluidos en ensayos clínicos mostraron un incremento de la supervivencia y calidad de vida.
Tamizaje fitoquímico de extractos obtenidos de la planta Sapindus saponaria L que crece en Cuba
Authors: Pujol Garcia Anairis , Tamargo Beatriz , Salas Eva , Acevedo Reinaldo , Sierra Gustavo
Published: August 2020

Las plantas medicinales son consideradas una fuente importante de componentes biológicamente activos, que pueden ser usados en el tratamiento de disímiles enfermedades. En particular el potencial medicinal del género Sapindus L. ha sido estudiado por autores de varios países y dentro de este género, la especie Sapindus saponaria L se ha aplicado en el tratamiento de diversas enfermedades. Para la especie S. saponaria L se refieren 32 usos y 14 efectos biológicos comprobados. Dentro de los efectos biológicos más referenciados están acaricida, antihemorrágico, anti protozoario, antiulceroso, citotóxico, molusquicida y nematicida. Además, el pericarpio del fruto es la parte más empleada, aunque también se han empleado las hojas, ramas, corteza y semillas. Los principales efectos biológicos se encuentran relacionados con elevados contenidos de saponinas y flavonoides en los extractos obtenidos de diferentes partes de la planta. El objetivo de este trabajo es determinar los principales componentes de la planta Sapindus saponaria L que crece en Cuba mediante el tamizaje fitoquímico de las diferentes partes de la planta. Para ello, se realizó una marcha experimental con extracciones alcohólicas y acuosas del pericarpio del fruto, la corteza del tallo y hojas de la planta. Los resultados del tamizaje en ambas extracciones y análisis de componentes revelaron que el pericarpio del fruto y hojas son ricas en flavonoides mientras que el pericarpio del fruto posee un alto contenido de saponinas. La composición de Sapindus saponaria L que crece en Cuba es similar a la composición de S. saponarias que crecen en otras regiones de Latinoamérica.
Pruebas rápidas para COVID-19, la mejor alternativa para Ecuador
Authors: Valencia Portillo Ruth T. , Amorín Uscata Bernardina , Gonzales-Zubiate Fernando Alexis , Juscamaita Medina Katia , Sevillano Orlando R. , Ramos-Sanchez Eduardo Milton
Published: August 2020

La enfermedad respiratoria COVID-19 causada por el virus SARS-Cov-2 cuenta con más de 18 millones de personas infectadas y más de 600 mil muertes en el mundo, en Ecuador se tienen ya más de 88 mil infectados. Siendo el cuarto país con menos pruebas de diagnóstico realizadas, Ecuador podría afrontar un retraso en la investigación epidemiología y una ausencia de datos reales de la población afectada. Se cuenta con dos tipos de pruebas para el diagnóstico de SARS-CoV-2: las pruebas moleculares que son el Gold estándar y que se basan en la detección del virus (qRT-PCR y RT-LAMP) y las pruebas rápidas que detectan anticuerpos generados por la respuesta inmunológica del paciente. Ambas pruebas presentan pros y contras que las hacen complementarias y aumentan su alcance, ya que el foco poblacional es distinto. Las pruebas moleculares pueden detectar la presencia del virus en media, una semana antes y hasta una semana después de la aparición de los síntomas. Sin embargo, qué ocurre con los individuos asintomáticos que no fueron sometidos a ningún tipo de prueba diagnóstica y que ignoran si fueron infectados o no, y en qué momento fueron infectados. Para este grupo existen las pruebas rápidas, pruebas que detectan la respuesta inmunológica del individuo. Es así como las pruebas de diagnóstico se convierten en herramientas de vital importancia, complementando los estudios de los cuadros clínicos y la búsqueda activa de personas asintomáticas que ya pasaron del pico de carga viral. Inicialmente, la cuarentena controló el número de infectados pero la dinámica económica ha obligado a la población a salir de su hogar y es por esto que en este momento se necesitan nuevas estrategias para minimizar los efectos del SARS-CoV-2. En conclusión, las pruebas rápidas serían una solución que aceleraría la identificación y aislamiento de los individuos infectados, estimando con mayor exactitud el número de contagios, lo que permitiría una mejor toma de decisiones y el desarrollo de políticas públicas para contrarrestar la presente pandemia.
Microwave Breast Imaging Using Rotational Bistatic Impulse Radar for the Detection of Breast Cancer: Protocol for a Prospective Diagnostic Study
Authors: Sasada Shinsuke , Masumoto Norio , Song Hang , Emi Akiko , Kadoya Takayuki , Arihiro Koji , Kikkawa Takamaro , Okada Morihito
Published: August 2020

Background

Mammography is the standard examination for breast cancer screening; however, it is associated with pain and exposure to ionizing radiation. Microwave breast imaging is a less invasive method for breast cancer surveillance. A bistatic impulse radar–based breast cancer detector has recently been developed.

Objective

This study aims to present a protocol for evaluating the diagnostic accuracy of the novel microwave breast imaging device.

Methods

This is a prospective diagnostic study. A total of 120 participants were recruited before treatment administration and divided into 2 cohorts: 100 patients diagnosed with breast cancer and 20 participants with benign breast tumors. The detector will be directly placed on each breast, while the participant is in supine position, without a coupling medium. Confocal images will be created based on the analyzed data, and the presence of breast tumors will be assessed. The primary endpoint will be the diagnostic accuracy, sensitivity, and specificity of the detector for breast cancer and benign tumors. The secondary endpoint will be the safety and detectability of each molecular subtype of breast cancer. For an exploratory endpoint, the influence of breast density and tumor size on tumor detection will be investigated.

Results

Recruitment began in November 2018 and was completed by March 2020. We anticipate the preliminary results to be available by summer 2021.

Conclusions

This study will provide insights on the diagnostic accuracy of microwave breast imaging using a rotational bistatic impulse radar. The collected data will improve the diagnostic algorithm of microwave imaging and lead to enhanced device performance.

Trial Registration

Japan Registry of Clinical Trials jRCTs062180005; https://jrct.niph.go.jp/en-latest-detail/jRCTs062180005

International Registered Report Identifier (IRRID)

DERR1-10.2196/17524
Weight Reduction Through a Digital Nutrition and Food Purchasing Platform Among Users With Obesity: Longitudinal Study
Authors: Hu Emily A , Nguyen Viet , Langheier Jason , Shurney Dexter
Published: August 2020

Background

Digital nutrition apps that monitor or provide recommendations on diet have been found to be effective in behavior change and weight reduction among individuals with obesity. However, there is less evidence on how integration of personalized nutrition recommendations and changing the food purchasing environment through online meal planning and grocery delivery, meal kits, and grocery incentives impacts weight loss among individuals with obesity.

Objective

The objective of this observational longitudinal study was to examine weight loss and predictors of weight loss among individuals with obesity who are users of a digital nutrition platform that integrates tools to provide nutrition recommendations and changes in the food purchasing environment grounded in behavioral theory.

Methods

We included 8977 adults with obesity who used the digital Foodsmart platform, created by Zipongo, Inc, DBA Foodsmart between January 2013 and April 2020. We retrospectively analyzed user characteristics and their associations with weight loss. Participants reported age, gender, height, at least 2 measures of weight, and usual dietary intake. Healthy Diet Score, a score to measure overall diet quality, was calculated based on responses to a food frequency questionnaire. We used paired t tests to compare differences in baseline and final weights and baseline and final Healthy Diet Scores. We used univariate and multivariate logistic regression models to estimate odds ratios and 95% CI of achieving 5% weight loss by gender, age, baseline BMI, Healthy Diet Score, change in Healthy Diet Score, and duration of enrollment. We conducted stratified analyses to examine mean percent weight change by enrollment duration and gender, age, baseline BMI, and change in Healthy Diet Score.

Results

Over a median (IQR) of 9.9 (0.03-54.7) months of enrollment, 59% of participants lost weight. Of the participants who used the Foodsmart platform for at least 24 months, 33.3% achieved 5% weight loss. In the fully adjusted logistic regression model, we found that baseline BMI (OR 1.02, 95% CI 1.02-1.03; P<.001), baseline Healthy Diet Score (OR 1.06, 95% CI 1.05-1.08; P<.001), greater change in Healthy Diet Score (OR 1.12, 95% CI 1.11-1.14; P<.001), and enrollment length (OR 1.28, 95% CI 1.23-1.32; P<.001) were all significantly associated with higher odds of achieving at least 5% weight loss.

Conclusions

This study found that a digital app that provides personalized nutrition recommendations and change in one’s food purchasing environment appears to be successful in meaningfully reducing weight among individuals with obesity.
Digital Micro Interventions for Behavioral and Mental Health Gains: Core Components and Conceptualization of Digital Micro Intervention Care
Authors: Baumel Amit , Fleming Theresa , Schueller Stephen M
Published: August 2020

Although many people access publicly available digital behavioral and mental health interventions, most do not invest as much effort in these interventions as hoped or intended by intervention developers, and ongoing engagement is often low. Thus, the impact of such interventions is minimized by a misalignment between intervention design and user behavior. Digital micro interventions are highly focused interventions delivered in the context of a person’s daily life with little burden on the individual. We propose that these interventions have the potential to disruptively expand the reach of beneficial therapeutics by lowering the bar for entry to an intervention and the effort needed for purposeful engagement. This paper provides a conceptualization of digital micro interventions, their component parts, and principles guiding their use as building blocks of a larger therapeutic process (ie, digital micro intervention care). The model represented provides a structure that could improve the design, delivery, and research on digital micro interventions and ultimately improve behavioral and mental health care and care delivery.
Consumer Reported Care Deferrals Due to the COVID-19 Pandemic, and the Role and Potential of Telemedicine: Cross-Sectional Analysis
Authors: Atherly Adam , Van Den Broek-Altenburg Eline , Hart Victoria , Gleason Kelsey , Carney Jan
Published: August 2020

Background

The COVID-19 pandemic forced many health systems to proactively reduce care delivery to prepare for an expected surge in hospitalizations. There have been concerns that care deferral may have negative health effects, but it is hoped that telemedicine can provide a viable alternative.

Objective

This study aimed to understand what type of health care services were being deferred during the COVID-19 pandemic lockdown, the role played by telemedicine to fill in care gaps, and changes in attitudes toward telemedicine.

Methods

We conducted a cross-sectional analysis of survey responses from 1694 primary care patients in a mid-sized northeastern city. Our main outcomes were use of telemedicine and reports of care deferral during the shutdown.

Results

Deferred care was widespread—48% (n=812) of respondents deferred care—but it was largely for preventive services, particularly dental and primary care, and did not cause concerns about negative health effects. In total, 30.2% (n=242) of those who delayed care were concerned about health effects, with needs centered around orthopedics and surgery. Telemedicine was viewed more positively than prior to the pandemic; it was seen as a viable option to deliver deferred care, particularly by respondents who were over 65 years of age, female, and college educated. Mental health services stood out for having high levels of deferred care.

Conclusions

Temporary health system shutdowns will give rise to deferred care. However, much of the deferrals will be for preventive services. The effect of this on patient health can be moderated by prioritizing surgical and orthopedic services and delivering other services through telemedicine. Having telemedicine as an option is particularly crucial for mental health services.
An Electronic Data Capture Framework (ConnEDCt) for Global and Public Health Research: Design and Implementation (Preprint)
Authors: Ruth Caleb J , Huey Samantha Lee , Krisher Jesse T , Fothergill Amy , Gannon Bryan M , Jones Camille Elyse , Centeno-Tablante Elizabeth , Hackl Laura S , Colt Susannah , Finkelstein Julia Leigh , Mehta Saurabh
Published: August 2020

BACKGROUND

When we were unable to identify an electronic data capture (EDC) package that supported our requirements for clinical research in resource-limited regions, we set out to build our own reusable EDC framework. We needed to capture data when offline, synchronize data on demand, and enforce strict eligibility requirements and complex longitudinal protocols. Based on previous experience, the geographical areas in which we conduct our research often have unreliable, slow internet access that would make web-based EDC platforms impractical. We were unwilling to fall back on paper-based data capture as we wanted other benefits of EDC. Therefore, we decided to build our own reusable software platform. In this paper, we describe our customizable EDC framework and highlight how we have used it in our ongoing surveillance programs, clinic-based cross-sectional studies, and randomized controlled trials (RCTs) in various settings in India and Ecuador.

OBJECTIVE

This paper describes the creation of a mobile framework to support complex clinical research protocols in a variety of settings including clinical, surveillance, and RCTs.

METHODS

We developed ConnEDCt, a mobile EDC framework for iOS devices and personal computers, using Claris FileMaker software for electronic data capture and data storage.

RESULTS

ConnEDCt was tested in the field in our clinical, surveillance, and clinical trial research contexts in India and Ecuador and continuously refined for ease of use and optimization, including specific user roles; simultaneous synchronization across multiple locations; complex randomization schemes and informed consent processes; and collecting diverse types of data (laboratory, growth measurements, sociodemographic, health history, dietary recall and feeding practices, environmental exposures, and biological specimen collection).

CONCLUSIONS

ConnEDCt is customizable, with regulatory-compliant security, data synchronization, and other useful features for data collection in a variety of settings and study designs. Furthermore, ConnEDCt is user friendly and lowers the risks for errors in data entry because of real time error checking and protocol enforcement.
Augmented Reality System for Digital Rectal Examination Training and Assessment: System Validation (Preprint)
Authors: Muangpoon Theerapat , Haghighi Osgouei Reza , Escobar-Castillejos David , Kontovounisios Christos , Bello Fernando
Published: August 2020

BACKGROUND

Digital rectal examination is a difficult examination to learn and teach because of limited opportunities for practice; however, the main challenge is that students and tutors cannot see the finger when it is palpating the anal canal and prostate gland inside the patients.

OBJECTIVE

This paper presents an augmented reality system to be used with benchtop models commonly available in medical schools with the aim of addressing the problem of lack of visualization. The system enables visualization of the examining finger, as well as of the internal organs when performing digital rectal examinations. Magnetic tracking sensors are used to track the movement of the finger, and a pressure sensor is used to monitor the applied pressure. By overlaying a virtual finger on the real finger and a virtual model on the benchtop model, students can see through the examination and finger maneuvers.

METHODS

The system was implemented in the Unity game engine (Unity Technologies) and uses a first-generation HoloLens (Microsoft Inc) as an augmented reality device. To evaluate the system, 19 participants (9 clinicians who routinely performed digital rectal examinations and 10 medical students) were asked to use the system and answer 12 questions regarding the usefulness of the system.

RESULTS

The system showed the movement of an examining finger in real time with a frame rate of 60 fps on the HoloLens and accurately aligned the virtual and real models with a mean error of 3.9 mm. Users found the movement of the finger was realistic (mean 3.9, SD 1.2); moreover, they found the visualization of the finger and internal organs were useful for teaching, learning, and assessment of digital rectal examinations (finger: mean 4.1, SD 1.1; organs: mean 4.6, SD 0.8), mainly targeting a novice group.

CONCLUSIONS

The proposed augmented reality system was designed to improve teaching and learning of digital rectal examination skills by providing visualization of the finger and internal organs. The initial user study proved its applicability and usefulness.
Use of Telemedicine for Emergency Triage in an Independent Senior Living Community: Mixed Methods Study (Preprint)
Authors: Carolan Kelsi , Grabowski David C , Mehrotra Ateev , Hatfield Laura A
Published: August 2020

BACKGROUND

Older, chronically ill individuals in independent living communities are frequently transferred to the emergency department (ED) for acute issues that could be managed in lower-acuity settings. Triage via telemedicine could deter unnecessary ED transfers.

OBJECTIVE

We examined the effectiveness of a telemedicine intervention for emergency triage in an independent living community.

METHODS

In the intervention community, a 950-resident independent senior living community, when a resident called for help, emergency medical technician–trained staff could engage an emergency medicine physician via telemedicine to assist with management and triage. We compared trends in the proportion of calls resulting in transport to the ED (ie, primary outcome) in the intervention community to two control communities. Secondary outcomes were telemedicine use and posttransport disposition. Semistructured focus groups of residents and staff were conducted to examine attitudes toward the intervention. Qualitative data analysis used thematic analysis.

RESULTS

Although the service was offered at no cost to residents, use was low and we found no evidence of fewer ED transfers. The key barrier to program use was resistance from frontline staff members, who did not view telemedicine triage as a valuable tool for emergency response, instead perceiving it as time-consuming and as undermining their independent judgment.

CONCLUSIONS

Engagement of, and acceptance by, frontline providers is a key consideration in using telemedicine triage to reduce unnecessary ED transfers.
Development and Evaluation of Acceptability and Feasibility of a Web-Based Intervention for Patients With Bipolar Disorder in Iran: Implementation Study (Preprint)
Authors: Ashrafi Agaah , Tabatabaee Maryam , Sharifi Vandad
Published: August 2020

BACKGROUND

Psychoeducation for bipolar disorder has a significant impact on symptoms and treatment adherence. In Iran, as a low-resource setting, infrastructural barriers, such as inadequate mental health professionals, difficulties in transportation, and costs of care, may hinder optimum delivery of this evidence-based intervention to patients.

OBJECTIVE

This study sought to explore the acceptability and feasibility of a web-based intervention for bipolar patients in Iran.

METHODS

A website has been developed as a platform for providing psychoeducational content about bipolar disorder. Patients were chosen via a convenient sampling method in 2018-2019. The main component of the intervention included streaming 7 weekly video clips after attending a single in-person meeting, as well as a medication self-monitoring application. Information was collected about the feasibility and acceptability of the intervention.

RESULTS

We invited 45 patients from the day center and the outpatient clinic of Roozbeh psychiatric hospital and some private clinics in Tehran. Of the 23 patients (51%) who attended the first in-person session and provided informed consent, 14 patients dropped out during the study. While 9 patients completed the course (attended 4 or more online sessions), only 5 watched all the video sessions. The rate of adherence to the intervention and frequency of exposure to the website were much higher for those recruited from the private and outpatient clinics.

CONCLUSIONS

This web-based intervention can be feasible and acceptable only for a subgroup of patients with specific educational status and socioeconomic level.
Enhancing Healthcare Access–Smartphone Apps in Arrhythmia Screening: Viewpoint (Preprint)
Authors: Książczyk Marcin , Dębska-Kozłowska Agnieszka , Warchoł Izabela , Lubiński Andrzej
Published: August 2020

UNSTRUCTURED

Atrial fibrillation is the most commonly reported arrhythmia and, if undiagnosed or untreated, may lead to thromboembolic events. It is therefore desirable to provide screening to patients in order to detect atrial arrhythmias. Specific mobile apps and accessory devices, such as smartphones and smartwatches, may play a significant role in monitoring heart rhythm in populations at high risk of arrhythmia. These apps are becoming increasingly common among patients and professionals as a part of mobile health. The rapid development of mobile health solutions may revolutionize approaches to arrhythmia screening. In this viewpoint paper, we assess the availability of smartphone and smartwatch apps and evaluate their efficacy for monitoring heart rhythm and arrhythmia detection. The findings obtained so far suggest they are on the right track to improving the efficacy of early detection of atrial fibrillation, thus lowering the risk of stroke and reducing the economic burden placed on public health.
Challenges in prevention & control of COVID - 19 pandemic in dentistry: A review. (Preprint)
Authors: Begum Sameera , Abdulla Riaz , Hussain Akhter
Published: August 2020

UNSTRUCTURED

The menace of COVID 19 pandemic has become a major public health concern all over the world. It is a pandemic outbreak that originated from Wuhan, Hubei province of China in December 2019. All healthcare professionals including dental surgeons are in the front line and a high chance of constantly getting infected. Droplet and aerosol transmissions are the utmost concern in dental clinics and dental college hospitals. Hence, COVID 19 has a high risk of spread through droplets and aerosols generated during dental procedures from infected patients. This review article highlights the dental perspective and discusses the various preventive measures undertaken to control the spread of infection in dental clinics and dental college hospital setups.
Phonological Perversion as Detriment to Effective Use of Spoken English among Secondary School English Teachers in Non-Native Context
Authors: Comfort Adebola OYINLOYE, , Foluke FATIMAYIN, , Mojisola Olufunke OSIKOMAIYA, , Lasisi FATOLA, Olugbenga
Published: August 2020

This study investigates the effect of phonological perversion in the use of spoken English among secondary school English Teachers in Ogun State, Nigeria. The population of the study comprised all English Language teachers in the selected schools with the sample size of 120. The validated instruments used for collecting data were pronunciation test and questionnaire. A reliability index of 0.84 was achieved using Cronbach’s alpha. The data collected were statistically analyzed using frequency, percentages and t-test at 0.05 level of significant. The findings revealed that the English Language teachers in Ogun State whose language background is Yoruba had problems in pronouncing some English sounds, e.g., /v/ and /f/, /z/ and /s/, /ei/ and /e/, /i?/ and /ea/, /i:/ and /i/ and h-dropping (hard as add). It is recommended that Nigerian teachers of English Language be professionally developed in the rudiments of English sounds for intelligent communication.
A Critical Analysis of the Quad -Segments in “Train to Pakistan,” an Epoch-making Novel by Khushwant Singh
Authors: Ilame Dr. Veena Radheshyam
Published: August 2020

This research paper aims to explore “Dacoity”, “Kalyuga” (the Age of Downfall), “ManoMaira” (Dirty-Mind) and “Karma” (Deeds) in “Train to Pakistan”, an epoch-making novel inscribed by Khushawant Singh and critically analyse those four phases in the fiction. The Partition of India is the gloomiest occurrence in British India, which attracted the attention of several writers, poets, and novelists who portrayed it in their respective works. Khushwant Singh expresses his anger over the violation of the long-cherished Indian values over the communal riots that occurred over the process of the Partition of United British India into India and Pakistan. It can be argued that “Train to Pakistan”, a tragedy inscribed in a mock-comic form, heaps up pieces of criticism over the celebration of the freedom attained with mass murder, bestiality and ingeniously, delineating the pity and horror of the two-nation theory, and it is a nightmare with a thrilling texture which one closes the novel with a sigh of relief.