bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Prior Authorization Requirements on Provider Clinical Decision Making
Authors: Salzbrenner Stephen G. , Lydiatt Maxwell , Heldin Brandon , Scheier Lawrence M. , Hill Trish Wonch , Greene Harrison , McAdam-Marx Carrie
Published: August 2021

Background: Prior authorization (PA) of medications is widely used by payers in the United States as a way to promote safe and effective use of medications and to control costs. However, PA-related tasks such as completing forms, submitting forms, researching medical history and submitting required documentation can all contribute to burden on healthcare providers. This study examines how such tasks and affect provider burden and treatment decisions. Methods: We developed and administered a nationwide, cross-sectional online survey of medical providers in the United States in 2020 based on a convenience sample of 100,000 providers (physicians, nurse practitioners, and physician assistants). Path analysis was used to test the associations between provider practice characteristics, step therapy and other health plan requirements, perceived burdens of PA, and communication issues with insurers on prescribing behaviors, which included prescribing a different medication, avoiding prescribing of newer medications, and modifying a diagnosis. Weighted analyses were also conducted to account for sample bias due to non-response. Results: A total of 1173 providers (1.2% response rate) provided 1147 usable surveys. The sample was 49.6% female, and a majority were MD/DO providers (85%). Step therapy requirements had the largest influence on prescribing a different medication than planned (b = .22, 95% CI = .160-.285) and avoiding prescribing a newer medication despite meeting evidence-based guidelines (b = .24, 95% CI = .181-.309). A unit-weighted index of perceived PA burden risk was associated with prescribing a different medication (b = .09, 95% CI = .012-.128) and modifying a diagnosis to obtain PA approval (b = .14, 95% CI = .065-.195). Communication issues were associated with prescribing a different medication (b = .11, 95% CI = .029-.186), while health plan requirements (e.g., clinical documentation) was significantly associated with all three prescribing outcomes. Weighted analyses showed that the study conclusions were unlikely to have been biased by nonresponse. Conclusions: Providers report altering prescribing and modifying diagnoses to avoid PA requirements and related burdens. Processes that reduce the administrative burden of PA through improved communication and transparency as well as standardized documentation may help ensure that PA more seamlessly achieves its goals of safe and effective use of medications. Trial Registration: NA Keywords: clinical decision making, health plan, prior authorization, provider burden, specialty types, workaroundsTrial Registration: NA
Modelling Hydrometeorological Extremes Associated to the Moisture Transport Driven by the Great Plains Low-Level Jet
Authors: Gimeno-Sotelo Luis , Bermudez Patricia de Zea , Algarra Iago , Gimeno Luis
Published: August 2021

The Great Plains Low-Level Jet system consists of very strong winds in the lower troposphere that transport a huge amount of moisture from the Gulf of Mexico to the American Great Plains. This paper aims to study the extremes of the Transported Moisture (TM) from the GPLLJ source region to the jet domain; and, for low and high TM, to analyze the extremal dependence between the upper tail of the precipitation in the GPLLJ sink region and the lower tail of the tropospheric stability in that region (omega).
The declustered extremes of TM were analyzed using Peaks Over Threshold (POT). A non-stationary Exponential model was fitted to the cluster maxima. Estimated return levels show that the extremes of TM are expected to decrease in the future. This is meteorologically congruent with the known displacement of the western edge of the North Atlantic Subtropical High, which controls atmospheric circulation in the North Atlantic, and to a higher scale with the change of phase from negative to positive of the Atlantic Multidecadal Oscillation.
Bilogistic and Logistic models were fitted to the extremes of (-omega, precipitation) for low and high TM, respectively. The extremal dependence between "-omega" and precipitation proves to be stronger in the case of high TM. This confirms that dynamical instability represented by “-omega” is the most important parameter for achieving high values of precipitation once there is a mechanism that allows the continuous supply of large amounts of moisture, such as the derived from a low-level jet system.
Integrated Weighted Gene Co-expression Network Analysis Reveals ALB Associated With Prognosis of High-grade Serous Ovarian Cancer
Authors: Wang Bo , Chao Shan , Guo Bo
Published: August 2021

Background: Ovarian cancer is the gynecologic tumor with the highest fatality rate, and high-grade serous ovarian cancer (HGSOC) is the most common and malignant type of ovarian cancer. One important reason for the poor prognosis of HGSOC is the lack of effective diagnostic and prognostic biomarkers. New biomarkers are necessary for improvement of treatment strategies and to ensure appropriate healthcare decisions.Methods: To construct the co-expression network of HGSOC samples, we applied weighted gene co-expression network analysis (WGCNA) to assess the proteomic data downloaded from Clinical Proteomic Tumor Analysis Consortium (CPTAC), and module-trait relationship was then analyzed and plotted in a heat map to choose key module associated with HGSOC. Enrichment analysis was performed on the genes in the key modules to explore the functional information in which these genes participate. Hub genes with high connectivity in key module were identified by Cytoscape software. Furthermore, the true hub gene was selected through survival analysis, followed by expression verification with transcriptome dataset from TCGA and GTEx. Finally, the potential biological functions of hub gene were analyzed via single-gene Gene Set Enrichment Analysis (GSEA).Results: After merging similar modules, a total of 9 modules were identified. Module-trait analysis revealed that the brown module (cor = 0.7) was significantly associated with HGSOC. The results of enrichment analysis of the genes in the brown module show that these genes were related to the functions of the extracellular matrix, the complement system and the blood system. Ten hub genes with the highest connectivity were selected by protein-protein interaction analysis. After survival analysis and expression verification of hub genes, only ALB was confirmed to be the true hub gene and positively correlated with HGSOC prognosis. Single gene GSEA revealed that ALB was associated with cell material degradation.Conclusion: We conducted the first gene co-expression analysis based on proteomic data from HGSOC samples, and found that ALB had prognostic value, which could be applied in the treatment of HGSOC in the future.
Content validation of observer-reported sickle cell pain diaries (SCPD-CS and SCPD-CN): results from interviews with caregivers
Authors: White Michelle , Foster April , Bailey Miranda , D'Alessio Denise , Rizio Avery , Stebbins Patricia , Pierre Danielle St. , Saucier Cory
Published: August 2021

Background
Patients with sickle cell disease (SCD) experience daily pain and acute episodes known as sickle cell pain crises (SCPCs). The Sickle Cell Pain Diary - Caregiver Report (SCPD-C) is an observer-reported diary for use by caregivers of children ages < 12 years with SCD. This study reports on the content validity of the SCPD-C.
Methods
The SCPD-C was developed based on a literature review, measurement expert input, and a patient advisory board including clinicians. Three rounds of interviews (including both concept elicitation and cognitive debriefing methodologies) were conducted with caregivers of children with SCD aged < 12 to evaluate the content validity of the SCPD-C.
Results
Across three rounds of interviews, caregivers confirmed concepts in the SCPD-C and described observed impacts that were important and were added. Overall, caregivers evaluated the SCPD-C as easy to understand, with some minor adaptations for clarity. Additionally, the diary was split into two versions based on the child’s age and school enrollment status (SCPD-CS for school-aged and SCPD-CN for non-school age children).
Conclusions
Caregivers provided valuable input that led to important additions and changes to the measures. The SCPD-CS and SCPD-CN are appropriate and fit-for-purpose observer-reported outcome measures of SCPC-related pain frequency and severity, and the impacts on health-related quality of life.
Prenatal Prognostic Factors for Isolated Right Congenital Diaphragmatic Hernia: A Single Center’s Experience
Authors: Jeong Jiyoon , Lee Byong Sop , Cha Teahyen , Jung Euiseok , Kim Ellen Ai-Rhan , Kim Ki-Soo , Kim Dae Yeon , Namgoong Jung-Man , Kim Seong-Chul , Lee Mi-Young , Won Hye-Sung
Published: August 2021

Background: Right-sided congenital diaphragmatic hernia (RCDH) is relatively rare. Clinical data of RCDH, especially with respect to antenatal prediction of neonatal outcome, are lacking. This study aimed to report the treatment outcome of newborn infants with RCDH and to identify prenatal prognostic indicators. Methods: We retrospectively reviewed the medical records of newborn infants with isolated RCDH who were born at a gestational age of ≥35 weeks. We analyzed and compared the clinical and prenatal characteristics including the fetal lung volume, which was measured as the observed-to-expected lung area-to-head circumference ratio (O/E LHR), between the survivors and non-survivors. Results: A total of 24 (70.6%) of 34 patients with isolated RCDH survived to discharge. The O/E LHR was significantly greater in survivors (67.0 ± 19.9) than in non-survivors (42.4 ± 25.0) (P < .05). In multivariate analysis, the O/E LHR was found to be a good predictor of mortality or requirement for extracorporeal membrane oxygenation (ECMO) support (area under the curve [AUC], 0.870; P < .01) and mortality (AUC, 0.789; P < .05). The best O/E LHR cut-off value for predicting mortality and mortality or requirement for ECMO support in isolated RCDH was 47. Conclusions: The survival rate of patients with isolated RCDH was comparable to that of patients with left-sided CDH. The O/E LHR of the contralateral lung was a reliable predictor of short-term postnatal outcome in RCDH.
Development of Improved Cellulase Variants for the Conversion of Spent Mushroom Substrate Supplemented with Wheat Straw by Directed Evolution
Authors: Mauriello Valentina , Pennacchio Anna , Dallo Irantzu Alegria , Saez Laura Garcia , Ihalainen Petri , Mialon Antoine , Ventorino Valeria , Faraco Vincenza
Published: August 2021

To improve the Spent mushroom substrate (SMS) saccharification, cloning, recombinant expression in Escherichia coli and characterization of two new GH5 family cellulases (Cel1 and Cel2) were performed. Based on enzymes properties, Cel2 was selected for the generation of 30,000 random mutants by directed evolution in order to develop improved biocatalysts. Error-prone Polymerase Chain Reaction was used for diversity generation in cel2 gene and the screening for activity of mutants allowed selection of 63 improved variants that were subjected to a scale up production. Among these, 13 clones exhibited two-fold higher activity than Cel2 and a higher thermoresistance after 72h. The performances of these mutants in the hydrolysis of pretreated SMS/ wheat straw (40/60) were compared to the wild type Cel2 in conjunction with a commercial enzymatic mixture (MetZyme® SUNO™ BOOSTER 144). All the mutants exhibited a glucose yield two-fold or four fold higher than wild-type Cel2 after 72h of incubation.
Effect of Ligninolytic Axenic and Coculture White-Rot Fungi on Rice Straw Chemical and In Vitro Fermentation Characteristics.
Authors: Datsomor Osmond , Gou-qi Zhao , Miao Lin
Published: August 2021

The objective of this study was to investigate the axenic culture of Pleurotus ostreatus, Phanerochaete chrysosporium, and the coculture (P. chrysosporium and P. ostreatus) for their potential to break down lignin and to enhance the rumen fermentability of rice straw. Rice straw was fermented by two lignin-degrading fungi, namely, P. ostreatus, P. chrysosporium, and coculture (P. ostreatus and P. chrysosporium) under solid-state fermentation (SSF). The coculture exhibited a mutual intermingling plus inhibition interaction. Coculture treated straw had a lower lignin content (5.26%) compared to P. chrysosporium axenic treated straw (6.18%), although P. ostreatus axenic treated straw was the lowest (3.27%). The polysaccharide content of coculture treated straw was higher than P. chrysosporium axenic treated straw, although smaller than P. ostreatus. P. ostreatus and coculture suitably delignified rice straw without adversely affecting cellulose. Treatment of rice straw with coculture improved in vitro dry matter digestibility (68.08%), total volatile fatty acids (35.27%), and total gas (57.4 ml/200 mg) compared to P. chrysosporium (45.09%, 32.24%, 44.39 ml/200 mg) but was second to P. ostreatus (75.34%, 38.31%, 65.60 ml/200 mg). The coculture via synergistic interaction has the potential to decompose lignin and improve the nutritive value of rice straw than P. chrysosporium.
Synthesis of 1-Hydroxy-3-O-Substituted Xanthone Derivatives and their Structure-activity Relationship on Acetylcholinesterase Inhibitory Effect
Authors: Vanessa Vincentsia Vienna , Teh Soek Sin , Lam Kok Wai , Mah Siau Hui
Published: August 2021

Xanthones are valuable compounds in drug design and development, attributed to their multi-dimensional pharmacological properties, including anti-cancer, anti-bacterial, anti-malarial, anti-inflammatory and anti-cholinesterase. This study focused on the synthesis of 1,3-dihydroxyxanthone (1) and its new 1-hydroxy-3-O-substituted derivatives with alkyl (2a-2f), alkenyl (2g-2k), alkynyl (2l-2n) and alkylated phenyl (2o-2r) groups and were synthesised in a high percentage yield of >70%, except for 2l and 2p. Their structures were confirmed by MS, NMR and FTIR spectroscopic techniques. The evaluation of acetylcholinesterase (AChE) inhibitory activities showed that all the substituted xanthones (2a-2r) are more potent than 1. Compounds 2g and 2j are the strongest AChE inhibitors with the IC50 values of 20.8 and 21.5 μM and their enzyme kinetic analyses indicated that these derivatives possess a mixed-mode inhibition, where they targeted both the active sites and allosteric sites of AChE. Molecular docking study revealed that 2g binds favourably to the active site of AChE via π–π stacking and hydrogen bonding, in addition to π-alkyl interaction and alkyl interaction from the substituent group. The xanthone derivatives are identified as potential lead compounds for further development of Alzheimer’s disease treatments.
The Hemoglobin, Albumin, Lymphocytes and Platelets (HALP) Predicts Long-term Survival in Posterior Circulation Ischemic Stroke
Authors: Li Fengjuan , Wei Zheng zachory , Xie Dan , Han Yanfei , Liu Beibei , Zhao Fangfang , Luo Yumin , Zhang Yongbo
Published: August 2021

The survival of posterior circulation ischemic stroke (PCIS) patients is worse. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel combined index reflecting nutritional and inflammation status. We aimed to evaluate the impact of the HALP score on the prognosis of PCIS. The Kaplan-Meier method with log-rank test was used to draw the survival curves. Cox proportional hazard regression model were performed to determine the independent prognostic factors. The predictive power was evaluated by assessing the area under the receiver operating characteristic (ROC) curve. A total of 238 PCIS patients were retrospectively enrolled, and the median follow-up time was 4.3 years. Based on the Kaplan–Meier curve analysis, it was noticed that a low HALP value was significantly associated with a worse overall survival (P < 0.001). Multivariate Cox analysis showed that age, National Institutes of Health Stroke Scale (NIHSS), and HALP score were independent risk factors for overall survival (HR 1.059, 1.26 and 0.354). Furthermore, the combination of the HALP and NIHSS score improved the prediction performance (AUC 0.888) and appeared to has the ability to accurately identify high-risk patients with poor prognosis.
Heavy Metal Removal by Magnetospirillum Strains and its Possible Use in the Treatment of Tannery Effluents
Authors: Sannigrahi Sumana , K. Suthindhiran
Published: August 2021

Heavy metals pose a serious threat to the environment and their continuous accumulation cause ecological imbalance. Biosorption of heavy metals by bacteria is a conventional process. However, the meagre performance of bacterial biomass in situ limits their applications. Magnetotactic bacteria are microaerophilic organism that possesses an active metal transport system for the biomineralization of iron oxide particles. On this basis, this work investigates the ability of chosen Magnetospirillum strains, viz, MSR-1 RJS2, RJS5, RJS6, and RJS7 to uptake the heavy metals through biomineralization. Metals such as cadmium, lead, zinc, manganese, nickel, chromium, and cobalt were supplemented independently (1 ppm and 10 ppm) in previously optimized MS1 media as a sole electron donor and its utilization by the bacteria were determined by Atomic Absorption Spectroscopy (AAS). Further, the optimal time/days and metal concentration for efficient biosorption were optimized. All the strains were grown in presence of metals and the growth pattern was found to be unaltered due to metal concentration. The AAS analysis revealed metal biosorption (1 ppm) by all five strains. RJS5 strain utilized all the metals viz, cadmium (95.8%), manganese (39.3%), lead (58%), nickel (57%), zinc (55%), chromium (27.5%) and cobalt (78%). Similarly, RJS2 strain showed metal biosorption in cadmium (26.4%), manganese (28%), lead (96%), nickel (30%), zinc (9.2%), chromium (51%) and cobalt (48%). The strain MSR-1 displayed biosorption of five metals- chromium (100%), cadmium (55%), manganese (12%), cobalt (40%) and nickel (4%). Both RJS6 and RJS7 displayed significant biosorption of six metals˗ cadmium (52%), manganese (17.2%), nickel (10%), zinc (34%), chromium (100%) and cobalt (59%) and cadmium (24%), manganese (22%), nickel (7.8%), zinc (40%), chromium (69%) and cobalt (28%) respectively. Metal biosorption in MSR-1 was higher in 10 ppm than 1 ppm concentration. Moreover, metals – lead and nickel biosorption was more evident in 10 ppm concentration by MTBs. RJS5 being the effective strain was exposed to a high concentration of lead, cadmium, and zinc. AAS analysis revealed the biosorption of lead (93.42%) at a 50 ppm concentration. The strains were further exposed for metal biosorption from tannery effluents. RJS6 showed higher biosorption of metals compared to other strains with nickel (88%) and zinc (81%). RJS2 displayed significant biosorption of manganese (82%) and cobalt (96%). The other three strains MSR-1, RJS5, and RJS7 showed moderate biosorption of metals from tannery effluent. The MTB strains showed biosorption against all the metals from tannery effluent. The ability of these strains to remove heavy metals from industrial waste can be further explored for a clean environment.
Echocardiographic Assessment of Diastolic Dysfunction in Elderly Patients with Severe Aortic Stenosis Before and After Aortic Valve Replacement
Authors: Caglayan Hatice Akay , Kjønås Didrik , Malm Siri , Schirmer Henrik , Rösner Assami
Published: August 2021

Background: The 2016 guidelines of the American Society of Echocardiography (ASE) and European Association of Cardiovascular Imaging (EACVI) for evaluation of left ventricular (LV) diastolic dysfunction by Doppler flow and tissue Doppler- echocardiography do not adjust assessment of high filling pressures for patients with aortic stenosis (AS). However, most of the studies on this patient group indicate age independent specific diastolic features in AS. The aim of this study is to identify disease-specific range and distribution of diastolic functional parameters and their ability to identify high N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels as a marker for high filling pressures.Methods: In this study, 169 patients who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) were prospectively enrolled. Resting echocardiography was performed including Doppler of the mitral inflow, pulmonary venous flow, tricuspid regurgitant flow and tissue Doppler in the mitral ring and indexed volume-estimates of the left atrium (LAVI). Echocardiography, and NT-proBNP levels were assessed before TAVR/SAVR and at two postoperative visits at 6 and 12 months. Results: Pre- and postoperative values were septal e´; 5.1±3.9, 5.2±1.6 cm/s; lateral e´ 6.3±2.1; 7.7±2.7 cm/s; E/e´19±8; 16±7 cm/s; E velocity 96±32; 95±32 cm/s; LAVI 39±8; 36±8 ml/m2, pulmonary artery pressure (PAP) 39±8; 36±8 mmHg, respectively. The scoring recommended by ASE/EACVI detected elevated NT pro-BNP with a specificity of 25%. Adjusting thresholds towards PAP ≥ 40 mmHg, E velocity ≥ 100 cm/s, E deceleration time < 220 ms, and E/septal e´ ≥ 20 or septal e´< 5.0 cm/s increased prediction of NT-proBNP levels ≥ 500 ng/L with substantially increased specificity (>85%).Conclusion: Diastolic echocardiographic parameters in AS indicate persistent impaired relaxation and NT-proBNP indicate elevated filling pressures in most of the patients, improving only modestly 6-12 months after TAVR and SAVR. Applying the 2016 ASE/EACVI recommendations for detection of elevated filling pressures to patients with AS, elevated NT pro-BNP levels could not be reliably detected. However, adjusting thresholds of the echocardiographic parameters increased specificities to useful diagnostic levels. Trial registration: The study was prospectively approved by the regional ethical committee, REK North with the registration number: REK 2010/397-10
Full-length MAVS Inhibits Hepatitis E Virus Replication Dependent of JAK Signaling
Authors: Qu Changbo , Li Yang , Li Yunlong , Pan Yihang
Published: August 2021

Hepatitis E virus (HEV) infection is the leading cause of acute hepatitis worldwide. Mitochondrial antiviral signaling protein (MAVS)-mediated interferon (IFN) response plays a pivotal role in the hepatic antiviral immunity. However, little is known about the effects of overexpression of MAVS on HEV infection. Here, we studied the effects of FL-MAVS on HEV. We found that overexpression of FL-MAVS profoundly inhibited HEV replication. The overexpression of FL-MAVS is accompanied by the secretion of functional IFNs and transcriptional induction of interferon stimulated genes (ISGs). Furthermore, we showed that the anti-HEV effect of FL-MAVS is largely dependent of the JAK signaling activation.
Detection of Human Papillomavirus Infection in Oral Cancers reported at Dental Facility: Assessing the Utility of FFPE tissues
Authors: Verma Gaurav , Aggarwal Nikita , Tyagi Abhishek , Vishnoi Kanchan , Jadli Mohit , Singh Tejveer , Goel Ankit , Pandey Durgatosh , Sharma Ankita , Agarwal Kiran , Sarkar Urmi , Doval Dinesh Chandra , Sharma Shashi , Mehrotra Ravi , Singh Sukh Mahendra , Bharti Alok Chandra
Published: August 2021

Incidence of human papillomavirus (HPV)–associated oral cancers is on the rise. However, epidemiological data of this subset of cancers is limited. Dental hospital pose a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed, paraffin-embedded (FFPE) tissues, which are readily available, for evaluation of high-risk HPV infection in oral cancer. For protocol standardization, we used 20 prospectively-collected, paired FFPE and fresh tissues of histopathologically-confirmed oral cancer cases reported in Oral Medicine department of a dental hospital for comparative study. Only short-PCRs (~200bp) of DNA isolated using a modified xylene-free method displayed a concordant HPV result. For HPV analysis, we used additional 30 retrospectively-collected FFPE tissues. DNA isolated from these specimens showed an overall 23.4% (11/47) HPV positivity with detection of HPV18. Comparison of HPV positivity from dental hospital FFPE-specimens with overall HPV positivity of freshly-collected oral cancer specimens (n-55) from three cancer care hospitals of the same region showed notable difference (12.7%; 7/55). Further, cancer hospital specimens showed HPV16 positivity and displayed a characteristic difference in reported sub-sites and patient spectrum. Overall, using a xylene-free FFPE-DNA isolation method clubbed with short amplicon PCR, we showed detection of HPV-positive oral cancer in dental hospitals.
Health Systems’ Preparedness to Provide Post-abortion Care: Assessment of Health Facilities in Burkina Faso, Kenya and Nigeria
Authors: Juma Kenneth Okoth , Ouedraogo Ramatou , Adjei Joshua-Amo , Sie Ali , Ouattara Mamadou , Emma-Echiegu Nkechi , Eton Joseph , Mutua Michael , Bangha Martin
Published: August 2021

Background: In many parts of sub-Saharan Africa (SSA), access to abortion is legally restricted, which partly contributes to high incidence of unsafe abortion. This may result in unsafe abortion-related complications that demand long hospital stays, treatment and attendance by skilled health providers. There is however, limited evidence on the capacity of public health facilities to deliver post-abortion care (PAC) in these settings. We describe and discuss the preparedness and capacity of public health facilities to deliver complete and quality PAC services in Burkina Faso, Kenya and Nigeria. Methods: A cross-sectional survey of primary, secondary and tertiary-level public health facilities was conducted between November 2018 and February 2019 in the three countries. Data on signal functions for measuring the ability of health facilities to provide post-abortion services were collected and analyzed. These data included information on essential PAC equipment and supplies, PAC staffing and training among others. Results: Across the three countries, fewer primary health facilities (ranging from 4.3%–12.2% in Kenya and Burkina Faso) had the capacity to deliver on all components of basic PAC services. Only one in three (30–33%) of referral facilities across Burkina Faso, Kenya and Nigeria could provide comprehensive PAC services. Lack of trained staff, absence of necessary equipment and lack of PAC commodities and supplies were a main reason for inability to deliver specific PAC services (such as surgical procedures for abortion complications, blood transfusion and post-PAC contraceptive counselling). Further, the lack of capacity to refer acute PAC cases to higher-level facilities was identified as a key weakness in provision of post-abortion care services. Conclusions: Our findings reveal considerable gaps and weaknesses in the delivery of basic and comprehensive PAC within the three countries. There is need for increased investments by governments to strengthen capacity of primary, secondary and tertiary public health facilities to deliver quality PAC services.
Changes in Positive Airway Pressure Use in Adults with Sleep-Related Breathing Disorder during the COVID-19 Pandemic: A Cross-Sectional National Community-Based Survey
Authors: Kendzerska Tetyana , Saad Mysa , Ayas Najib , Robillard Rebecca
Published: August 2021

Purpose: To better understand: i) a positive airway pressure (PAP) therapy use during the pandemic, ii) how PAP use may relate to sleep, health, and COVID-19-related outcomes, and iii) factors associated with PAP use during the pandemic. Methods: This study is based on data collected between Apr 2020 and Jan 2021 as part of the online cross-sectional national community-based survey. The included participants were located in North America, 18 years and older, with self-reported sleep-related breathing disorder (SBD) and usage of a PAP device in the last month before and during the COVID-19 pandemic (“in the past 7 days”). Results: Of all respondents, 7.2% (41/570) stopped using PAP during the pandemic. There were no significant differences between individuals who continued and stopped using PAP in the time elapsed since the pandemic declaration, age, sex, education level, occupational status, family income, or the proportions of individuals endorsing symptoms that could be related to COVID-19. Compared to individuals who continued using PAP, those who stopped had significantly shorter sleep time, lower sleep efficiency, and poorer sleep quality. Higher stress levels and living with someone who experienced symptoms that could be attributable to COVID-19 were independently associated with stopping using PAP.Conclusions: In this survey study, we found that most individuals with SBD continued PAP therapy during the pandemic. However, even 7% of participants who stopped using PAP cannot be ignored. Identifying individuals at risk of discontinuing PAP treatment would help design targeted interventions for patients and health professionals to improve PAP use.
The Differences in Cognitive Deficits Among Older Adult Patients with Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder: The Results of a Chart Review Study From 1997 to 2017
Authors: Lee Kun-Hua
Published: August 2021

1. Background: literature indicated the patient with schizophrenia showed worse cognitive deficit than those with BD, however, little study was to examine the differences of cognitive deficits from clinical data and alternative measurement instruments. Moreover, the report of Cognitive Ability Screening Inventory and chart review were applied in this study. 2. Methods: This study reviewed the charts of 354 patients seen between 1997 and 2017, and each chart included diagnosis, sex, educational level, age, and two copies of Cognitive Ability Screening Inventory (CASI) reports. Each chart contained a diagnosis of SZ, SAD, or BD, and each patient was 55 years old or older. Descriptive analysis, one-way ANOVA, and the Chi-square test were used to analyze differences in demographic information and measurement variables at the first visit. A Generalized Estimation Equation (GEE) was used to examine the effects of time, group, and interactions. The significance level was set at 0.05. 3. Results: Overall CASI scores did not have any significant differences by group, time, or interaction, but the attention subscale, orientation subscale, and fluency subscale had interaction effects. Through GEE analysis, our results partially support the idea that patients with SZ have stable cognitive deficits in all cognitive domains, whereas patients with SAD and BD show fluctuations in cognitive deficits in several cognitive domains, including CASI total scores, orientation, fluency, long-term memory, and abstract thinking.4. Conclusions: Based on the implications of our findings, more time-efficient cognitive assessments could be provided, and specific cognitive rehabilitation programs could be developed for older adults experiencing psychosis.
Social media utilisation and sexual health education. What are the issues? A systematic review
Authors: Nyaaba Albert Apotele , Ayamga Matthew , Seidu Abdul-aziz
Published: August 2021

BackgroundYoung people are at a greater risk of poor sexual health and hence, require comprehensive, effective sexual health education. These cohort are constant users of social media which presents many innovative possibilities for sexual health education.MethodsA guided search was conducted on scientific and medical databases. Selected publications within the last five years on sexual health education were classified according to their study designs, sexual health promotion/education as the main subject, target audience age, and social media use. In all, 25 publications met the inclusion criteria out of which 60% were observational studies, 12% randomised controls and 28% non-randomised. About 96% publications reporting on the main subject sexual health promotion or education. Sixty (60%) of the included publications reported specifically on young people between the ages of 12-30 years.ResultsAbout 72% of the studies found that social media has positive effects on knowledge, behaviour, and attitudes of young people and 20% reported on its negative effects on young people.ConclusionSocial media is promising in promoting knowledge, behavioural and attitudinal change in young people. However, further research is required to improve sexual health program implementation and audience reach as well as determine the effectiveness of social media in changing knowledge, attitudes, and behaviours.
Prevalence and factors associated to depression among Debrebirhan University students: a cross-sectional study
Authors: (MD
Published: August 2021

Background:

Undiagnosed depression among university students has an adverse effect on the wellbeing and academic performance of students. This study aimed to assess the prevalence of depression and associated factors among Debre Birhan university students.
Methodology:

Institutional based cross-sectional study design is conducted in Debre Birhan University from April to June 2013 E.C. Three hundred sixty nine students participated in this study which was selected by simple random sampling technique. Data were collected by using a self-administered PHQ-9 standard depression questionnaire. First the data was entered into in Epidata 3.1 and then was exported to SPSS version 20 for analysis. Associated factors were identified using binary logistic regression and variables with a p-value < 0.05 were declared as statistically significant factors with the outcome variables.
Result:

All of the study subjects were between ages 18 and 33 with a mean age of 22.65 9 ± 2.78. The overall prevalence of depression is 17.1%. Among this according to PHQ-9 scores cut scores, 161(43.6 %) scored as normal (0–4), 145(39.3%) scored as mild (5–9), 53(14.4%) scored as moderate (10–14), 4(1.1%) scored as moderately severe (15–19) and 6(1.6%) students scored as sever (> 20). In multivariate analysis being female AOR = 9.28[3.47–24.81], academic year AOR = 0.236[0.059–0.936], smoking 26.3[9.33–74.1] and alcohol use AOR of 2.62[0.95–7.21] are significantly associated with depression.
Conclusion and recommendation:

This study found a considerable proportion of undergraduate students with depression. Higher institutions need to pay special attention to students especially those who are female, junior students, smokers and alcohol users.
Metabolite trafficking enables programmed terpene secretion by yeast
Authors: Lee Ju Young , Son So-Hee , Kim Jae-Eung , Park Gyuri , Ko Young-Joon , Sung Bong Hyun , Oh Seung Soo
Published: August 2021

Metabolites are often unable to permeate cell membranes and are thus accumulated inside cells 1. We investigated whether engineered microbes could exclusively secrete intracellular metabolites because sustainable metabolite secretion holds a great potential for mass-production of high-value chemicals in an efficient and continuous manner 2,3. In this study, we demonstrated a synthetic pathway for a metabolite trafficking system that enables lipophilic terpene secretion by yeast cells. When metabolite-binding proteins are tagged with signal peptides, metabolite trafficking becomes programmable; loaded metabolites can be precisely delivered to a desired location within or outside the cell. As a proof of concept, we systematically coupled a terpene-specific protein with an export signal peptide and subsequently demonstrated exceptionally efficient, yet selective terpene secretion by yeast (~225 mg/L for squalene and ~1.6 mg/L for β-carotene). Other carrier proteins could also be readily fused with desired signal peptides, thereby tailoring different metabolite trafficking pathways in different microbes. To the best of our knowledge, this is the first and most efficient cognate pathway for metabolite secretion by microorganisms.
Complex issues of the administrative and legal regulation of counteracting the shadowing of the economy in Ukraine
Authors: Harust Y.V. , Potapenko N.I.
Published: August 2021

The Law of Ukraine “On the Fundamentals of National Security of Ukraine” currently defines “shadowing” of the national economy as one of the major, real and potential threats to Ukraine's national security, stability in society, and the economic sphere. Therefore, a process of reforming the administrative and legal support is now being implemented and run simultaneously with deploying of legislative framework (which aim is to improve the investment and business climate in Ukraine). The whole scope of actions and tools is applied within fight against the "shadow" economy. International experience shows that all developing countries join each other in fight against "dirty" cash flows, which is not the only contribute to the deterioration of economic performance, but also fund international terrorism. This article analyzes the most significant sources of "shadow" cash flows. According to the research, its major part consists of offshore and smuggling operations, which amount is over 70% of the total shadow economy. Taking into account this dependency and analysis of economic indicators, it is established that the current legislation contains shortcomings that contribute towards existence and prosperity of a "shadow" sector of the economy. In particular: – imperfection of the current tax legislation: Article 39 of the Tax Code of Ukraine minimizes the results of the state's struggle to withdraw capital from official circulation in offshore zones; – low efficiency of legislation on the regulation of foreign exchange transactions, as well as providing legislation responsibility of management and founders of business entities for non-return of foreign exchange earnings and deliberate bringing of enterprises into bankruptcy due to the increase in amounts of non-refundable foreign exchange earnings; – lack of accessible monetary policy of the National Bank of Ukraine, including the Government of Ukraine at all, which is understandable to the general population due to the increase in the volume of foreign currency purchased by the population, which is stored outside financial institutions. The article highlights the main legal loopholes of the state system in deregulation of the "shadow" economy and identifies the ways of overcoming them.
Rights and obligations of prisoners of war in the World War I and their observance in Lebedyn District of Kharkiv Province
Authors: Lobko N.V.
Published: August 2021

History of World War I that due to its global consequences started a new stage of development of European civilization still draws attention of many researchers. One of the most interesting topics for researchers is the topic of war imprisonment during the World War I. Stay of prisoners of war in the territory of Ukraine is a scantily studied issue. The objects of this study are prisoners of war who were in Lebedyn district of Kharkiv province during the World War I (1914–1918). The subject of the research is the legal status of prisoners of war, the protection of their rights and the observance of their duties. The author analyzed norms of international law and Russian legislation for regulation conditions of war imprisonment during the period of war. Using materials of Lebedyn District of Kharkiv Province, being deposited in the archives of Sumy Region, the author examines the legal status of prisoners of war, the protection of their rights and the observance of their duties. The position of prisoners of war during the World War I on Ukrainian lands as part of the Russian Empire was determined by the norms of international law and Russian legislation for regulation conditions of war imprisonment during the period of war. Using the archival sources kept in funds of the State Archives of Sumy Region, it was found that the rights of prisoners of war were generally ensured on the territory of the Lebedyn District of Kharkiv Province. However, there were not a few cases when Austrian and German prisoners suffered from hunger, domestic inconvenience and abuse by employers. There were also repeated violations of their duties by prisoners of war. The most common violations were refusal to work, leaving the workplace.
Legal status of local governments as subjects of administrative and legal relations
Authors: Melnyk V.I. , Pavlenko B.O. , Kiiashko Yu.M. , Snizhko V.V.
Published: August 2021

This article is devoted to the study of the legal status of local governments, which act as subjects of administrative and legal relations. In the process of studying the legal status of local governments as subjects of administrative and legal relations, the author reveals the concepts, functions, powers and features of the legal status of local governments and ways to improve the local government as a whole, given the positive experience of the European Union. The article highlights legal framework which serves as a regulator of local government at the national level. In general, the main document on which local self-government is based is the Constitution of Ukraine, in which a separate section on local self-government reveals issues related to the specific application of the principles of local self-government in Ukraine. The next, no less important in the field of local government regulation in Ukraine, are special laws, namely the Law of Ukraine "On Local SelfGovernment in Ukraine" and the Law of Ukraine "On the Status of Deputies of Local Councils". The first law covers and characterizes the system in which local self-government operates in Ukraine, and the second covers the limits of the deputy's activity and its legal status. It is worth mentioning a number of regulations governing certain areas of local government. These include: the Law of Ukraine "About Access to Public Information"; Law of Ukraine "About the open use of public funds"; Law of Ukraine "About Regulation of Urban Development"; Law of Ukraine "About Principles of State Regulatory Policy in the Sphere of Economic Activity"; Law of Ukraine "About improvement of settlements"; Budget Code of Ukraine. According to the study, an analysis of the current state of local self-government in Ukraine was conducted. In particular, some problematic issues related to the sphere of activity of local selfgovernment bodies, which need to be resolved immediately, have been identified. Based on the study of the legal status of local governments and analysis of interaction problems between public authorities and local governments in the European Union, the author proposed ways to further improve the interaction of local governments and local governments of Ukraine.
Legal features of insurance in the agricultural sector
Authors: Sadruk O.M. , Pokalchuk M.Yu.
Published: August 2021

The scientific article Sadruk Oksana Mykolayivna on the topic "Legal features of insurance in the agricultural sector" is devoted to the analysis of the features of insurance of agricultural products. The paper examines such concepts as "agricultural insurance", "risk in agricultural production", "index insurance of agricultural products" and others. The current state of development of agricultural insurance in Ukraine is analyzed, and such characteristic features of modern agricultural insurance as insufficient legal regulation of insurance relations in the agricultural sector are identified; low popularity of insurance among agricultural producers, which is caused by distrust of agricultural producers to insurance companies; insufficient state support for agricultural insurance in the country; insufficient supply from insurance companies and others. In addition, the authors studied the law "On the features of insurance of agricultural products with state support", namely the task of uniting insurers of the Agrarian Insurance Pool and noted the problems of its operation. Finally, the authors noted the need to develop index insurance of agricultural products, referring to the successful experience in such sectors of Ukraine's economy as energy, construction, restaurant business and others. The authors highlight the significant advantages of index insurance, such as low cost, transparency, simplicity of index insurance and the need to involve appraisers at the scene of the insured event. In the conclusions, the authors drew attention to the problems that arise today during the insurance of agricultural products and ways to overcome them. In addition, the article notes a significant step by the state to address the problems that arise during the insurance of agricultural products. Such a solution could be the Law of Ukraine, which provides for the introduction from 2021 of state support for insurance of agricultural products.
Management of the Phanom-Surin Archaeological Site in Thailand: Concept, Policies and Practices
Authors: Komoot Abhirada
Published: August 2021

The Phanom-Surin (PNS) archaeological site contains the remains of a sewn-plank vessel that is dated to the 9th century CE and discovered in Thailand’s mangrove swamp. As the only accessible sewn-plank vessel archaeology in the world, it provides research opportunities and potential for collaboration between heritage stakeholders. Preservation of the site within its context is crucial. Throughout this article, I will explain the importance of the PNS site management and its context based on my experience. The fuller understanding of the PNS site relies much on the information to be extracted from the materials and contexts. This article therefore encourages the preservation and management of the site within the original context. There are several relevant international guidelines for heritage and environmental management, such as the World Heritage Operational Guidelines, the Annex of the UNESCO (United Nations Educational, Scientific and Cultural Organization) 2001 Convention and the technical Ramsar Convention, all of which can help develop domestic framework and practices. This article aims to draw public and government attention towards the PNS site, and discusses concepts, policies and practices relating to the site.
Revealing a Maritime Cultural Landscape of Hong Kong: The Sai Kung Case Study
Authors: Jeffery Bill , Kam Joyce Ho-ching
Published: August 2021

Hong Kong island is located in Southern China at the mouth of the Pearl River. Its coastal location down river from the significant port-city of Guangzhou (formerly Canton), is strategically located in the trade route known as the Maritime Silk Road, the 2,000-year-old trade between China, Southeast Asia, India and Arabia. It was because of this trade that the waters and islands at the Pearl River mouth were frequented by many nations, and where the Portuguese had their port-city, Macau from 1557, and the British were based on Hong Kong island from 1842. Over the next 60 years, the British leased further surrounding territories and the arrangement eventually led to the establishment of the Hong Kong Special Administrative Region, hereafter called the Hong Kong region. A significant maritime cultural landscape was built up, which included sites from earlier periods. An example of this maritime cultural landscape can be seen in the Sai Kung (eastern) district of the Hong Kong region. Many ships travelled along this coastline between the northern China ports and Guangzhou, and a number of coastal facilities were established. Beginning in 2009, a group of Hong Kong residents (Hong Kong Underwater Heritage Group) implemented a series of maritime archaeological projects in the Sai Kung district in collaboration with the Hong Kong Maritime Museum (HKMM). The results of this work can be seen in three maritime archaeology survey and excavation projects implemented from 2014 to 2017, including the discovery of a 1,000-year-old underwater cultural heritage (UCH) site. They complement the many coastal cultural heritage in the Sai Kung district to reveal its maritime cultural landscape.