bluuebunny/crossref_metadata_2025 huggingface dataset:
Hedychium gardnerianum Sheph. ex Ker Gawl. from its discovery to its invasive status: a review
Authors: Pereira Maria João , Eleutério Telmo , Meirelles Maria Gabriela , Vasconcelos Helena Cristina
Published: July 2021

Hedychium gardnerianumSheph. ex Ker Gawl. is one of the 100 world's worst invasive alien species and the research target in areas as diverse as biological control, natural fibres uses, taxonomy or the biological activity of its compounds. This review aimed to clarify the taxonomic status and the native range ofH. gardnerianumand bring accuracy to the history of its introduction and escape from cultivation through the analysis of the increasing number of accessible digitalized dry specimens and grey literature. The analysis of the available information allowed to conclude that: (a)Hedychium gardnerianumis a validly published name, the authority of the name is Sheph. ex Ker Gawl., the species holotype is the illustration published along with the species name, and the Natural History Museum BM000574691 specimen collected in 1815 is the first dried specimen ofH. gardnerianum; (b) This species is native to the Central and Eastern Nepal, Bhutan, Northeast India and North Myanmar; (c) The species was cultivated at Cambridge Botanical Garden since 1818 and the first known herbarium specimen collected in Europe dates back to 1821; (d) Kathmandu (Nepal) and Khasi Hills (India) specimens are considered two varieties of the same species and the BM000574691 specimen is the lectotype ofH. gardnerianumvar.speciosum; (e) Specimens, references, and/or pictures support thatH. gardnerianumescaped from cultivation at Galicia (Spain), Azores archipelago, Madeira, Tenerife, Cuba, Jamaica, Martinique, Trinidad, Ascension, Mexico, Honduras, Brazil, South Africa, Swaziland, Zimbabwe, Réunion, Mauritius, Australia, New Zealand, Fiji, Hawaii, and Vietnam; and (f)H. gardnerianumis a serious pest in Azores, Madeira, Jamaica, Réunion, New Zealand and Hawaii and continues to expand its distribution area in South and Central America, Australia and Southern Africa. This review presents linear raw information compiled with precision, allowing the world databases updating their data but also gives the most detailed information possible to each country/region identifying new regions of concern and updating the invasiveness status in each region.
Enhancing argumentation component classification using contextual language model
Authors: Hidayaturrahman  , Dave Emmanuel , Suhartono Derwin , Arymurthy Aniati Murni
Published: July 2021

Arguments facilitate humans to deliver their ideas. The outcome of the discussion heavily relies on the validity of the argument. If an argument is well-composed, it is more effective to grasp the core idea behind the argument. To grade the argument, machines can be utilized by decomposing into semantic label components. In natural language processing, multiple language models are available to perform this task. It is divided into context-free and contextual models. The majority of previous studies used hand-crafted features to perform argument component classification, while state of the art language models utilize machine learning. The majority of these language models ignore the context in an argument. This research paper aims to analyze whether by including the context in the classification process may improve the accuracy of the language model which will enhance the argumentation mining process as well. The same document corpus is fed into several language models. Word2Vec and GLoVe represent the context free models, while BERT and ELMo as context sensitive language models. Accuracy and time from each model are then compared to determine the importance of context. The result shows that contextual language models are proven to be able to boost classification accuracy by approximately 20%. However, time comes as a cost where contextual models require longer training and prediction time. The benefit from the increase in accuracy outweighs the burden of time. Thus, as a contextual task, argumentation mining is suggested to use contextual model where context must be included to achieve promising results.
Stakeholders’ perspectives on training over the counter medicine sellers and Community-based Health Planning and Services facilities to dispense antibiotics in Ghana
Authors: Afari-Asiedu Samuel , Hulscher Marlies , Abdulai Martha Ali , Boamah-Kaali Ellen , Wertheim Heiman F. L. , Asante Kwaku Poku
Published: July 2021

Background

Dispensing of antibiotics by over the counter medicine sellers (OTCMS) is a major driver of inappropriate use and resistance in low and middle income countries. Recent studies in Ghana revealed the need to consider training OTCMS and Community-based Health Planning and Services (CHPS)/health posts to dispense some antibiotics. Feasibility of training OTCMS and CHPS to dispense some antibiotics was explored in this study.

Methods

This was an explorative study involving 10 in-depth interviews (IDIs) among staff of Ghana health services (GHS), pharmacy council and the association of OTCMS at the district and regional levels. Next, findings were presented to the Ghana Antimicrobial Resistance (AMR) platform for further discussions at the national level. Five IDIs were also performed among selected members of the AMR platform as a follow-up on emerging issues. Data were thematically analysed and presented as narratives with quotes to support the findings.

Results

Two opposing views were found in our study. Leadership of OTCMS and GHS staff at the district health directorate supported the suggestion that OTCMS and CHPS should be trained to dispense specific antibiotics because they are already dispensing them. The leadership of OTCMS explained that some of their members are experienced and could be trained to improve their practices. In contrast, participants from pharmacy council, GHS in the region and national AMR platform generally alluded that OTCMS and CHPS should not be trained to dispense antibiotics because their level of education is inadequate. GHS personnel from the region further explained that training OTCMS could further compromise inappropriate antibiotic use in the context of already weak regulation enforcement. GHS and pharmacy council in the region rather suggested that OTCMS and CHPS should focus on public health education on disease prevention and appropriate antibiotic use.

Conclusions

There is general lack of consensus among stakeholders on whether OTCMS and CHPS should be trained to dispense specific antibiotics. Further stakeholder engagement is required to carefully consider this suggestion as views on feasibility differ. Ministries of health and healthcare agencies in Ghana and LMIC should improve access to approved health services to improve antibiotic use in rural settings.
Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials
Authors: Chen Xiao-Li , Zhang Bei-Lei , Meng Chang , Huang Hui-Bin , Du Bin
Published: July 2021

Objective

Conservative oxygen strategy is recommended in acute illness while its benefit in ICU patients remains controversial. Therefore, we sought to conduct a systematic review and meta-analysis to examine such oxygen strategies’ effect and safety in ICU patients.

Methods

We searched PubMed, Embase, and the Cochrane database from inception to Feb 15, 2021. Randomized controlled trials (RCTs) that compared a conservative oxygen strategy to a conventional strategy in critically ill patients were included. Results were expressed as mean difference (MD) and risk ratio (RR) with a 95% confidence interval (CI). The primary outcome was the longest follow-up mortality. Heterogeneity, sensitivity analysis, and publication bias were also investigated to test the robustness of the primary outcome.

Results

We included seven trials with a total of 5265 patients. In general, the conventional group had significantly higher SpO2 or PaO2 than that in the conservative group. No statistically significant differences were found in the longest follow-up mortality (RR, 1.03; 95% CI, 0.97–1.10; I2=18%; P=0.34) between the two oxygen strategies when pooling studies enrolling subjects with various degrees of hypoxemia. Further sensitivity analysis showed that ICU patients with mild-to-moderate hypoxemia (PaO2/FiO2 >100 mmHg) had significantly lower mortality (RR, 1.24; 95% CI, 1.05–1.46; I2=0%; P=0.01) when receiving conservative oxygen therapy. These findings were also confirmed in other study periods. Additional, secondary outcomes of the duration of mechanical ventilation, the length of stay in the ICU and hospital, change in sequential organ failure assessment score, and adverse events were comparable between the two strategies.

Conclusions

Our findings indicate that conservative oxygen therapy strategy did not improve the prognosis of the overall ICU patients. The subgroup of ICU patients with mild to moderate hypoxemia might obtain prognosis benefit from such a strategy without affecting other critical clinical results.
Active learning through flipped classroom in mechanical engineering: improving students’ perception of learning and performance
Authors: Cho Hyun Jin , Zhao Kejie , Lee Cho Rong , Runshe Debra , Krousgrill Chuck
Published: July 2021

Background

To address some challenges that the large lecture-focused courses have faced in higher education, the flipped classroom model was implemented in mechanical engineering. The purpose of the study was to investigate mechanical engineering undergraduate students’ performance in the flipped classroom. A comprehensive analysis was conducted to investigate the pedagogical benefits of active learning in the flipped classroom from a self-determination theory perspective. To evaluate the effectiveness of the flipped classroom, students’ academic achievements in the flipped classroom were compared with the ones in the traditional lecture format. Moreover, to explore in-depth students’ learning experiences and their perceptions about the flipped classroom, students’ open-ended surveys were analyzed.

Results

Results demonstrated that students in the flipped classroom performed better and favored the new model, feeling that flipped classroom was useful and helpful in preparing for the course. The qualitative findings showed that students felt that they benefited from the pre-week online lectures in the flipped classroom to prepare for the course.

Conclusions

The current study shows that the flipped classroom model has the potential to create an autonomy-supportive learning environment and provide beneficial learning experiences. This study highlights the benefits of and future direction for implementing the flipped classroom in traditional mechanical engineering courses.
Mature stand developmental stage has ceased to constitute the most suitable habitat for the capercaillie in the Augustów Forest, Poland
Authors: Drozdowski Stanisław , Zawadzka Dorota , Zawadzki Grzegorz , Studnicki Marcin , Brzeziecki Bogdan
Published: July 2021

Background

Forest management affects the habitat conditions for many forest-dwelling species. Among them, the capercaillie (Tetrao urogallus) is a rare forest grouse inhabiting old, mature forests. We compared the structure of forest habitat among 9 active and 9 abandoned leks in the Augustów Forest (North-Eastern Poland), within a radius of 1 km of the leks, defined as the Key Areas for the capercaillie in lowland temperate forest. Habitat measurements were conducted on 1779 circular plots. Assessments made on all plots related to 13 habitat variables measured or noted in the field, including stand structure, canopy closure, stand developmental stage, percentage of Scots pine (Pinus sylvestris), soil fertility and soil moisture, the share of undergrowth, the cover of shrubs, the cover of bilberry (Vacciniumsp.), and the presence of certain habitat elements important to the capercaillie.

Results

To compare the still-occupied and the abandoned KAs for the capercaillie, a logistic regression model was developed. The variables best explaining differences between these two categories were: the occurrence of undergrowth layers, canopy closure in the second canopy layer, and stand age. According to the model, with the increase of the shrub-layer cover as well as the density of trees, the probability of the presence of the capercaillie decreased. The capercaillie in the area of the Augustów Forest occupy mainly dry and poor, middle-aged, pine-dominated forests, with a moderate extent of stand canopy closure and only weakly-developed layers of undergrowth.

Conclusions

The filling-in of mature stands with sub-canopy trees and shrubs (the process which is stimulated by climate change and site eutrophication) causes structural changes, which are unfavourable to the capercaillie. This might explain why in the course of the recent decades the capercaillie has abandoned the oldest stands, distinguished by the presence of bigger shares of undergrowth. The capercaillie has shifted to younger stands, which reveal a lesser extent of canopy closure and a more limited development of understorey vegetation.
Immediate Bystander Cardiopulmonary Resuscitation to Sudden Cardiac Arrest During Sports is Associated with Improved Survival—a Video Analysis
Authors: Panhuyzen-Goedkoop Nicole M. , Wellens Hein J. , Verbeek André L. M. , Piek Jan J. , Peters Ron J. G.
Published: July 2021

Background

Sudden cardiac arrest (SCA) during sports can be the first symptom of yet undetected cardiovascular conditions. Immediate chest compressions and early defibrillation offer SCA victims the best chance of survival, which requires prompt bystander cardiopulmonary resuscitation (CPR).

Aims

To determine the effect of rapid bystander CPR to SCA during sports by searching for and analyzing videos of these SCA/SCD events from the internet.

Methods

We searched images.google.com, video.google.com, and YouTube.com, and included any camera-witnessed non-traumatic SCA during sports. The rapidity of starting bystander chest compressions and defibrillation was classified as < 3, 3–5, or > 5 min.

Results

We identified and included 29 victims of average age 27.6 ± 8.5 years. Twenty-eight were males, 23 performed at an elite level, and 18 participated in soccer. Bystander CPR < 3 min (7/29) or 3–5 min (1/29) and defibrillation < 3 min was associated with 100% survival. Not performing chest compressions and defibrillation was associated with death (14/29), and > 5 min delay of intervention with worse outcome (death 4/29, severe neurologic dysfunction 1/29).

Conclusions

Analysis of internet videos showed that immediate bystander CPR to non-traumatic SCA during sports was associated with improved survival. This suggests that immediate chest compressions and early defibrillation are crucially important in SCA during sport, as they are in other settings. Optimal use of both will most likely result in survival. Most videos showing recent events did not show an improvement in the proportion of athletes who received early resuscitation, suggesting that the problem of cardiac arrest during sports activity is poorly recognized.
Urgent surgery for COVID-19–positive pediatric patient
Authors: Rivera-Calonje Franchesca , Chen Shiu-Yi Emily , Lo Carl , Le Sang , Nagoshi Makoto
Published: July 2021

Background

We present a case of COVID-19–positive pediatric patient for urgent urological surgery by spinal anesthesia to avoid aerosolizing procedure.

Case presentation

A 12-year-old, COVID-19–positive boy presented for urgent wound incision and drainage at the circumcision site. Our anesthetic plan consisted of spinal anesthesia with sedation. He was transported from the COVID-19 isolation floor to the negative pressure operating room. He was placed in lateral decubitus position and oxygen was delivered through facemask. Under sedation, spinal anesthesia was achieved at first attempt. The patient maintained spontaneous ventilation without airway intervention. Patient was recovered in the operation room then transported back to the floor.

Conclusion

Spinal anesthesia is a safe alternative to general endotracheal anesthesia for many pediatric urology procedures. Effective team communication and preparation are keys when caring COVID-19–positive patient in perioperative setting to avoid minimize the risk to healthcare providers.
Sustainability in dialysis therapy: Japanese local and global challenge
Authors: Nagai Kei , Barraclough Katherine , Ueda Atsushi , Itsubo Norihiro
Published: July 2021

Human-induced climate change is considered the greatest health threat of the 21st century. The health effects of climate change are becoming increasingly apparent, and there is substantial evidence indicating increased risk of kidney injury due to heat illness and other climate change-related meteorological abnormalities. On the other hand, healthcare itself is responsible for environmental burdens and has been estimated to generate between 3 and 10% of total national CO2 equivalent emissions. Dialysis has been estimated as one of the major contributors to healthcare’s carbon footprint. Especially in Australia and the UK, nations that have high awareness regarding environmental research, “Green Nephrology” has emerged as a new discipline. From both of these countries, a series of papers have been produced outlining the carbon footprint of hemodialysis, the results of surveys of specialists’ awareness of environmental issues, and proposals for how to save resources in dialysis therapy. Following on from this, several national and international nephrology societies have committed themselves to a range of initiatives aiming at “greening” the kidney sector. In Japan, where water and electricity supplies currently are stable, we occasionally are reminded of the potential for shortages of water and energy and of waste disposal problems. These issues particularly come to the fore in times of disasters, when hemodialysis patients need to be evacuated to distant dialysis facilities. Irrespective of the current state of resource availability, however, continuous efforts and the establishment of resource-saving procedures as a part of Japanese culture are highly desirable and would contribute to environmentally friendly healthcare. Japan needs to build awareness of these issues before the country faces a catastrophic situation of resource shortages. This review is intended as a call to action regarding environmental sustainability in kidney healthcare in Japan and the world.
Plant of the Millennium, Caper (Capparis spinosa L.), chemical composition and medicinal uses
Authors: Shahrajabian Mohamad Hesam , Sun Wenli , Cheng Qi
Published: July 2021

Background

Caper (Capparis spinosa L.) is a common member of the genus Capparis, which is a perennial shrub and thorny, and a common aromatic plant in many parts of the world, especially the Mediterranean regions.

Main body

The aim of this mini-review was to outline the most significant health benefits of caper in both traditional and modern pharmaceutical medicine. Scientific databases such as PubMed, Science Direct, Scopus, Research Gate, and Google Scholar with emphasis on Science Direct and Scopus have been used. A review of literature was carried out using the keywords caper, Capparis spinosa, health benefits, pharmaceutical benefits, natural products, and caper bush. During the writing of the review, the time period in which the papers were published had not been selected since the focus was on significant researched selected for the areas covered in this mini-review. The main components of its aerial parts are cappariloside A, stachydrin, hypoxanthine, uracil, capparine A, capparine B, flazin, guanosine, 1H-indole-3-carboxaldehyde, 4-hydroxy-1H-indole-3-carboxaldehyde, kaempferol, thevetiaflavone, tetrahydroquinoline, rutin, kaempferol-3-glucoside, kaempferol-3-rutinoside, kaempferol-3-rhamnorutinoside, isorhamnetin 3-O-rutinoside, quercetin 3-O-glucoside, ginkgetin, isoginkgetin, sakuranetin and glucocapparin in aerial parts. The main components of root are capparispine, cadabicine 26-O-β-D-glucoside, capparispine 26-O-β-D-glucoside, and stachydrine, seeds contain glucocapparin. Traditional application of caper is for treatment of headache, fever, convulsions, diabetes, toothache, menstruation, skin disease, kidney disease, liver disease, rheumatism, ulcers, hemorrhoids and sciatica. Fruit and leaves have anti-diabetic effects, fruits have anti-obesity, cholesterol-lowering and anti-hypertensive effects, roots, fruits, stem barks and shoots have antimicrobial effects, leaves, roots and fruits contain anti-inflammatory activity, and aerial parts have antihepatotoxic effects.

Conclusion

On the basis of phytochemical advantages and pharmacological benefits, caper shows its importance as one of the most notable medicinal plant for prevention and treatment of various diseases, however, more researches are need on the usage of caper, especially in modern pharmaceutical science.
Techniques for postmortem tenderisation in meat processing: effectiveness, application and possible mechanisms
Authors: Shi Haibo , Shahidi Fereidoon , Wang Jiankang , Huang Yan , Zou Ye , Xu Weimin , Wang Daoying
Published: July 2021

Developing efficient and promising tenderising techniques for postmortem meat is a heavily researched topic among meat scientists as consumers are willing to pay more for guaranteed tender meat. However, emerging tenderising techniques are not broadly used in the meat industry and, to some degree, are controversial due to lack of theoretical support. Thus, understanding the mechanisms involved in postmortem tenderisation is essential. This article first provides an overview of the relationship of ageing tenderisation and calpain system, as well as proteomics applied to identify protein biomarkers characterizing tenderness. In general, the ageing tenderisation is mediated by multiple biochemical activities, and it can exhibit better palatability and commercial benefit by combining other interventions. The calpain system plays a key role in ageing tenderisation functions by rupturing myofibrils and regulating proteolysis, glycolysis, apoptosis and metabolic modification. Additionally, tenderising techniques from different aspects including exogenous enzymes, chemistry, physics and the combined methods are discussed in depth. Particularly, innovation of home cooking could be recommended to prepare relatively tender meat due to its convenience and ease of operation by consumers. Furthermore, the combined interventions provide better performance in controlled tenderness. Finally, future trends in developing new tenderising techniques, and applied consideration in the meat processing industry are proposed in order to improve meat quality with higher economical value.

Graphical abstract
Herniation of ureter: a rare cause of hydroureteronephrosis
Authors: Gupta Preeti , Sharma Pankaj , Maurya Vinay , Bhatia Mukul
Published: July 2021

Background

Omentum and bowel loops are commonly seen in inguinal hernia. An unusual case of extraperitoneal herniation of ureter was detected in hernial sac with other contents, on computed tomography (CT) urography.

Case presentation

A 54-year-old male presented with inguinal hernia, with no previous history of surgery or trauma. Pre-operative screening showed a unilateral hydroureteronephrosis involving the pelvicalyceal system and entire ureter. No calculus was visualized in the ureter on ultrasound. On non-contrast CT (NCCT) followed by CT urography, the ureter was seen descending into the hernia sac causing hydroureteronephrosis. The patient subsequently underwent mesh repair surgery of the inguinal hernia with meticulous reduction of the herniated contents including the ureter, resulting in complete resolution of the hydroureteronephrosis.

Conclusion

An isolated extraperitoneal inguinal herniation of the ureter without concomitant urinary bladder involvement is extremely rare, especially with no prior history of trauma or surgery, as seen in our case. The case also exemplifies the role of pre-operative imaging as a protocol in cases of inguinal hernia to prevent per-operative complications.
Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study
Authors: Rosic Tea , Au Vivian Y. O. , Worster Andrew , Marsh David C. , Thabane Lehana , Samaan Zainab
Published: July 2021

Background

Exposure to traumatic events is both a risk factor for substance use and an adverse outcome of substance use disorders. Identifying and managing post-traumatic stress disorder (PTSD) in patients with addiction requires attention.

Aims

To examine the lifetime prevalence of traumatic events and past-month prevalence of PSTD in patients treated for opioid use disorder, and explore the association between trauma, PTSD and treatment outcomes.

Method

Participants (n = 674) receiving methadone treatment in 20 community clinics across Ontario, Canada, were administered the Mini-International Neuropsychiatric Interview to identify self-reported traumatic events and PTSD. Drug use was measured for 12 months by urine drug screens.

Results

Eleven per cent of participants met past-month criteria for PTSD (n = 72), and 48% reported history of traumatic events with no current PTSD (n = 323). Participants with PTSD were more likely to be female (odds ratio 2.13, 95% CI 1.20–3.76) and less likely to be employed (odds ratio 0.31, 95% CI 0.16–0.61) or married (odds ratio 0.51, 95% CI 0.26–0.90) than those with no trauma history. Antidepressants (39 v. 24%) and benzodiazepines (36 v. 18%) were differentially prescribed to patients with and without PTSD. Length of time in treatment and opioid use were not associated with trauma; however, suicidal ideation was more common in PTSD (odds ratio 2.29, 95% CI 1.04–5.01).

Conclusions

Trauma and PTSD are prevalent among patients with opioid use disorder, and consideration of trauma symptoms and associated characteristics is warranted. Patients with and without comorbid PTSD differ clinically and psychosocially, highlighting the relevance of integrating addiction and mental health services for this population.
Toward the Cure of Acute Lymphoblastic Leukemia in Children in China
Authors: Chen Si-Liang , Zhang Hui , Gale Robert Peter , Tang Jing-Yan , Pui Ching-Hon , Chen Sai-Juan , Liang Yang
Published: July 2021

This study explored results of therapy of children with acute lymphoblastic leukemia (ALL) in China, recent progress, and challenges. Included are a survey of therapy outcomes of ALL in Chinese children nationwide, comparison of these data with global ALL therapy outcomes, analyses of obstacles to improving outcomes, and suggestions of how progress can be achieved. Therapy outcomes at many Chinese pediatric cancer centers are approaching those of resource-rich countries. However, nationwide outcomes still need improvement. Obstacles include suboptimal clinical trials participation, children without adequate health care funding, human resource shortages, especially physicians expert in pediatric hematology and oncology, and social-economic disparities. We suggest how these obstacles have been and continue to be remedied including expanded access to protocol-based therapy, improved supportive care, health care reforms, recruitment of trained personnel, and international collaborations. China has made substantial progress treating children with ALL. We envision even better outcomes in the near future.
Spectrum of BCR-ABL Mutations and Treatment Outcomes in Ethiopian Imatinib-Resistant Patients With Chronic Myeloid Leukemia
Authors: Tadesse Fisihatsion , Asres Getahun , Abubeker Abdulaziz , Gebremedhin Amha , Radich Jerald
Published: July 2021

PURPOSE

Despite the successes achieved in chronic myeloid leukemia (CML) with tyrosine kinase inhibitor (TKI) therapy, resistance remains an obstacle. The most common mechanism of resistance is the acquisition of a point mutation in the BCR-ABL kinase domain. Few studies have reported African patients with CML in regard to such mutations. We here report the types of BCR-ABL mutations in Ethiopian imatinib-resistant patients with CML and their outcome.

PATIENTS AND METHODS

Patients with CML with a diagnosis of imatinib resistance who were tested for BCR-ABL mutation between 2014 and September 2019 were included.

RESULTS

A total of 962 cases of CML on imatinib therapy were reviewed and 164 cases of failure were found. Of these, only 31 cases (19%) had mutation analysis performed. Most cases (94%) were secondary failures. At the time of CML diagnosis, the median age was 33 years and the majority presented with features of advanced-phase disease. Of the 31 patients, 22 mutations were found (65%). The types of mutations detected were as follows: non–P-loop mutations 36% (11), P-loop mutations 13% (four), and alternatively spliced BCR-ABL variants 23% (seven). The splice variant frequently detected was BCR-ABL35INS (20%). Twenty-six of the 31 patients (84%) were switched to second-line TKIs, whereas in four patients (13%), imatinib dose escalation was done. Overall, the outcome revealed that 16 patients (52%) were alive with complete hematologic response, whereas 12 patients (39%) had died. All patients who expressed BCR-ABL135INS were treated with second-line TKIs, and two of them (33%) had died because of disease progression.

CONCLUSION

In Ethiopia, CML affects the young and point mutations were frequently detected in imatinib-resistant patients. BCR-ABL1 35INS was also prevalent and associated with disease progression.
US Trends in Opioid Access Among Patients With Poor Prognosis Cancer Near the End-of-Life
Authors: Enzinger Andrea C. , Ghosh Kaushik , Keating Nancy L. , Cutler David M. , Landrum Mary Beth , Wright Alexi A.
Published: July 2021

PURPOSE

Heightened regulations have decreased opioid prescribing across the United States, yet little is known about trends in opioid access among patients dying of cancer.

METHODS

Among 270,632 Medicare fee-for-service decedents with poor prognosis cancers, we used part D data to examine trends from 2007 to 2017 in opioid prescription fills and opioid potency (morphine milligram equivalents per day [MMED]) near the end-of-life (EOL), defined as the 30 days before death or hospice enrollment. We used administrative claims to evaluate trends in pain-related emergency department (ED) visits near EOL.

RESULTS

Between 2007 and 2017, the proportion of decedents with poor prognosis cancers receiving ≥ 1 opioid prescription near EOL declined 15.5% (relative percent difference [RPD]), from 42.0% (95% CI, 41.4 to 42.7) to 35.5% (95% CI, 34.9 to 36.0) and the proportion receiving ≥ 1 long-acting opioid prescription declined 36.5% (RPD), from 18.1% (95% CI, 17.6 to 18.6) to 11.5% (95% CI, 11.1 to 11.9). Among decedents receiving opioids near EOL, the mean daily dose fell 24.5%, from 85.6 MMED (95% CI, 82.9 to 88.3) to 64.6 (95% CI, 62.7 to 66.6) MMED. Overall, the total amount of opioids prescribed per decedent near EOL (averaged across those who did and did not receive an opioid) fell 38.0%, from 1,075 morphine milligram equivalents per decedent (95% CI, 1,042 to 1,109) to 666 morphine milligram equivalents per decedent (95% CI, 646 to 686). Simultaneously, the proportion of patients with pain-related ED visits increased 50.8% (RPD), from 13.2% (95% CI, 12.7 to 13.6) to 19.9% (95% CI, 19.4 to 20.4). Sensitivity analyses demonstrated similar declines in opioid utilization in the 60 and 90 days before death or hospice, and suggested that trends in opioid access were not confounded by secular trends in hospice utilization.

CONCLUSION

Opioid use among patients dying of cancer has declined substantially from 2007 to 2017. Rising pain-related ED visits suggests that EOL cancer pain management may be worsening.
The wing scales of the mother-of-pearl butterfly, Protogoniomorpha parhassus, are thin film reflectors causing strong iridescence and polarization
Authors: Stavenga Doekele G.
Published: July 2021

The dorsal wings of the mother-of-pearl butterfly, Protogoniomorpha parhassus, display an angle-dependent pink, structural color. This effect is created by light interference in the lower lamina of the wing scales, which acts as an optical thin film. The scales feature extremely large windows that enhance the scale reflectance, because the upper lamina of ridges and cross-ribs is very sparse. Characteristic for thin film reflectors, the spectral shape of the reflected light strongly depends on the angle of light incidence, shifting from pink to yellow when changing the angles of illumination and observation from normal to skew, and also the degree of polarization strongly varies. The simultaneous spectral and polarization changes serve a possibly widespread, highly effective system among butterflies for intraspecific communication during flight.
Prognostic Impact of Resection Margin Status in Distal Pancreatectomy for Ductal Adenocarcinoma
Authors: Sahakyan Mushegh A. , Verbeke Caroline S. , Tholfsen Tore , Ignjatovic Dejan , Kleive Dyre , Buanes Trond , Lassen Kristoffer , Røsok Bård I. , Labori Knut Jørgen , Edwin Bjørn
Published: July 2021

Background

Resection margin status is considered one of the few surgeon-controlled parameters affecting prognosis in pancreatic ductal adenocarcinoma (PDAC). While studies mostly focus on resection margins in pancreatoduodenectomy, little is known about their role in distal pancreatectomy (DP). This study aimed to investigate resection margins in DP for PDAC.

Methods

Patients who underwent DP for PDAC between October 2004 and February 2020 were included (n = 124). Resection margins and associated parameters were studied in two consecutive time periods during which different pathology examination protocols were used: non-standardized (period 1: 2004–2014) and standardized (period 2: 2015–2020). Microscopic margin involvement (R1) was defined as ≤1 mm clearance.

Results

Laparoscopic and open resections were performed in 117 (94.4%) and 7 (5.6%) patients, respectively. The R1 rate for the entire cohort was 73.4%, increasing from 60.4% in period 1 to 83.1% in period 2 (p = 0.005). A significantly higher R1 rate was observed for the posterior margin (35.8 vs. 70.4%, p < 0.001) and anterior pancreatic surface (based on a 0 mm clearance; 18.9 vs. 35.4%, p = 0.045). Pathology examination period, poorly differentiated PDAC, and vascular invasion were associated with R1 in the multivariable model. Extended DP, positive anterior pancreatic surface, lymph node ratio, perineural invasion, and adjuvant chemotherapy, but not R1, were significant prognostic factors for overall survival in the entire cohort.

Conclusions

Pathology examination is a key determinant of resection margin status following DP for PDAC. A high R1 rate is to be expected when pathology examination is meticulous and standardized. Involvement of the anterior pancreatic surface affects prognosis.
Comparison of mobile health education messages verses face-to-face consultation for weight reduction among overweight female adolescents in Thailand
Authors: Wongtongtair Supim , Iamsupasit Sompoch , Somrongthong Ratana , Kumar Ramesh , Yamarat Khemika
Published: July 2021

Background: Obesity is considered a significant public health problem in Thailand. This study was conducted to compare the impact of mobile health education messages verses face-to-face consultation on weight reduction among overweight female university students.

Methods: This comparative cross-sectional study comprised three groups: a control group, a group receiving mobile health education, and a group receiving face-to-face consultation. Each group contained 26 participants taking part over a period of 12 weeks, with a 12-week follow-up thereafter. The data analysis used two-way repeated measures ANOVA with least significant difference testing. The study was ethically approved at Chulalongkorn University, Thailand.

Results: The results revealed that the group receiving mobile health education had the lowest average body mass index and waist–hip ratio after intervention (p < 0.05). In addition, both intervention groups significantly improved their health belief, social support, and health behavior scores in comparison to the control group (p < 0.001). The results show that the average scores for social support for eating and exercise at baseline were significantly lower than at post-intervention or follow-up (p < 0.001). In addition, the results of both aspects of social support showed that the average social support score at post-intervention was significantly higher than at follow-up. Furthermore, the health behavior score measured post-intervention was higher than at follow-up. There was a statistically significant difference in average metabolism during physical activity (p < 0.001) but no statistical difference in average eating behavior score.

Conclusion: The study found that the use of mobile health education to deliver health programs facilitates communication between the healthcare provider and individual, and can empower adolescent females in their pursuit of weight loss by improving their attitudes and knowledge, leading to better health behavior.
Accounting for complexity – Intervention design in the context of studying social accountability for reproductive health
Authors: McMullen Heather , Boydell Victoria , Cordero Joanna Paula , Steyn Petrus S. , Kiarie James , Kinemo Patrick , Monyo Alice , Addah Mary Awelana , Ahuno Jacob Tetteh , Gyamfi Osei-Bonsu
Published: July 2021

Background: Social accountability interventions aim to propel change by raising community voices and holding duty bearers accountable for delivering on rights and entitlements. Evidence on the role of such interventions for improving community health outcomes is steadily emerging, including for sexual and reproductive health and rights (SRHR). However, these interventions are complex social processes with numerous actors, multiple components, and a highly influential local context. Unsurprisingly, determining the mechanisms of change and what outcomes may be transferable to other similar settings can be a challenge. We report our methodological considerations to account for complexity in a social accountability intervention exploring contraceptive uptake and use in Ghana and Tanzania.

Main Body: The Community and Provider driven Social Accountability Intervention (CaPSAI) study explores the relationship between a health facility-focused social accountability intervention and contraceptive service provision in two countries. This 24-month mixed-method quasi-experimental study, using an interrupted time series with a parallel control group, is being undertaken in 16 sites across Ghana and Tanzania in collaboration with local research and implementation partners. The primary outcomes include changes in contraceptive uptake and use. We also measure outcomes related to current social accountability theories of change and undertake a process evaluation.

We present three design features: co-design, ‘conceptual’ fidelity, and how we aim to track the intervention as ‘intended vs. implemented’ to explore how the intervention could be responsive to the embedded routines, local contextual realities, and the processual nature of the social accountability intervention.

Conclusions: Through a discussion of these design features and their rationale, we conclude by suggesting approaches to intervention design that may go some way in responding to recent challenges in accounting for social accountability interventions, bearing relevance for evaluating health system interventions.
Content analysis of behaviour change techniques in government physical distancing communications for the reopening of schools during the COVID-19 pandemic in Ireland
Authors: Durand Hannah , Mc Sharry Jenny , Meade Oonagh , Byrne Molly , Kenny Eanna , Lavoie Kim L. , Molloy Gerard J.
Published: July 2021

Background:Effective government communications and leadership are central to the management of pandemics. Behavioural science can offer important insight into the development of such communications strategies. The extent to which established behaviour-change science is reflected in current government messaging campaigns to promote adherence to physical distancing measures in the context of the coronavirus disease 2019 (COVID-19) pandemic is unclear. The current study aimed to describe the behaviour-change content of a set of government-issued poster communications for the reopening of schools in Ireland during the COVID-19 pandemic in September 2020.

Methods:Posters targeting physical distancing behaviours in school settings were retrieved from the Government of Ireland website for analysis. Posters were independently coded for behaviour change techniques (BCTs) using the BCT Taxonomy Version 1, a hierarchically clustered taxonomy of 93 distinct BCTs across 16 groups. The Theories and Techniques tool was used to identify mechanisms of action (MoAs) linked to each of the identified BCTs. Eight posters were independently content-analysed by two members of the research team for BCTs and linked MoAs.

Results:Eight unique BCTs from six unique groups were identified in at least one poster. These BCTs were linked with 11 unique MoAs through which behaviour change is theorised to occur. Several theoretically important groups of BCTs, such as Natural Consequences, Social Support, Shaping Knowledge, and Comparison of Behaviour, were underutilised or not included in any of the posters.

Conclusion:Future poster communications could benefit from including additional BCTs from key groups, particularly Natural Consequences. This article provides proof-of-concept evidence for future evaluations of government public health communications for behaviour-change content using existing taxonomies and tools.
Formation of Indicators in the Management Accounting System for Assessing the Sustainable Development of Companies (for Example, the Automotive Industry)
Authors: Grishkina Svyetlana , Chestnova K.
Published: July 2021

The article shows the role of an effi ciently organized management accounting system in achieving sustainable development of companies in the automotive industry, substantiates the feasibility of forming fi nancial and non-financial indicators in the management accounting system for assessing sustainable development, and also updates the system of indicators corresponding to the specifi cs of the industry and modern trends in its development.
UK Revenue Service Best Practices for Fighting Tax Evasion
Authors: Gribina E. , Savchenko E.
Published: July 2021

Th e authors analyze the UK experience of the tax service, the tools used to combat tax evasion, and some of the trends that have been identifi ed. In particular, the role of specialized computer systems and social networks is noted as one of the main sources for fi nding the necessary information. Attention is also drawn to the tightening of the policy of the tax department and legislation in the fi eld of combating tax crimes.
Internet and Social Networks As a Tool for Cleaning Business Development
Authors: Dorotov Pavel
Published: July 2021

In this article, using the example of cleaning companies, the features of positioning and methods of fi nding clients for micro and small enterprises and companies through various Internet resources are considered, the features of working on electronic trading platforms, the role of social networks in promoting the product of such companies, as well as ways of interaction between the seller and the buyer on the platforms of such networks.
Problems of Using Artifi cial Intelligence in Accounting
Authors: Mislavskaya N.
Published: July 2021

The article is devoted to the problems that await the national accounting system in the future in connection with the development of digital technologies and the corresponding use of artificial intelligence. The complexity of accounting tasks to reflect economic reality in the context of increasing the significance of probabilistic expert assessments is analyzed from the point of view of the utilitarian capabilities of modern computer systems. As a result, the author comes to the conclusion that it is impossible and unacceptable to eliminate accounting employees from their professional duties. Otherwise, the magnitude of the accumulated errors will affect the financial statements and the declared data will become risky and unsuitable for making management decisions.
Approximation of Physical Spline with Large Deflections
Authors: Korotkiy Viktor , Vitovtov Igor'
Published: July 2021

Physical spline is a resilient element whose cross-sectional dimensions are very small compared to its axis’s length and radius of curvature. Such a resilient element, passing through given points, acquires a "nature-like" form, having a minimum energy of internal stresses, and, as a consequence, a minimum of average curvature. For example, a flexible metal ruler, previously used to construct smooth curves passing through given coplanar points, can be considered as a physical spline. The theoretical search for the equation of physical spline’s axis is a complex mathematical problem with no elementary solution. However, the form of a physical spline passing through given points can be obtained experimentally without much difficulty. In this paper polynomial and parametric methods for approximation of experimentally produced physical spline with large deflections are considered. As known, in the case of small deflections it is possible to obtain a good approximation to a real elastic line by a set of cubic polynomials ("cubic spline"). But as deflections increase, the polynomial model begins to differ markedly from the experimental physical spline, that limits the application of polynomial approximation. High precision approximation of an elastic line with large deflections is achieved by using a parameterized description based on Ferguson or Bézier curves. At the same time, not only the basic points, but also the tangents to the elastic line of the real physical spline should be given as boundary conditions. In such a case it has been shown that standard cubic Bézier curves have a significant computational advantage over Ferguson ones. Examples for modelling of physical splines with free and clamped ends have been considered. For a free spline an error of parametric approximation is equal to 0.4 %. For a spline with clamped ends an error of less than 1.5 % has been obtained. The calculations have been performed with SMath Studio computer graphics system.
Atividade física para adultos: Guia de Atividade Física para a População Brasileira
Authors: Ritti-Dias Raphael , Trape Átila Alexandre , Farah Breno Quitella , Petreça Daniel Rogério , Lemos Emmanuelly Correia de , Carvalho Fábio Fortunato Brasil de , Magalhães Lorena Lima , Maciel Marcos Gonçalves , Gomes Paulo Sergio Chagas , Manta Sofia Wolker , Hallal Pedro Curi , Andrade Douglas Roque
Published: July 2021

Em 2020, o Ministério da Saúde, em parceria com a Universidade Federal de Pelotas, Rio Grande do Sul, selecionou pesquisadores e pesquisadoras para a elaboração do Guia de Atividade Física para a População Brasileira. O objetivo deste artigo foi apresentar os métodos utilizados, bem como os resultados do Guia de Atividade Física para a População Brasileira (Guia) para adultos de 18 a 59 anos de idade. A base para construção do Guia se deu a partir de quatro perguntas norteadoras: O quê, quando, por que e como praticar atividade física (AF)? Para responder essas questões, duas estratégias principais foram adotadas: revisão das evidências científicas e a “escuta” de diferentes grupos estratégicos. A partir dos procedimentos realizados, recomenda-se que os adultos acumulem entre 150 e 300 minutos de AF por semana com intensidade moderada e/ou entre 75 e 150 minutos por semana de intensidade vigorosa. Dentre os benefícios identificados, destaca-se a redução de mortalidade por doenças crônicas, melhoria na saúde mental, nos aspectos sociais (e.g. interação com outras pessoas, contato com a cultura local etc.) e emocionais (e.g. autoestima, sensação de bem-estar etc.). Além disso, as recomendações não ficaram restritas aos desfechos supracitados, buscou-se considerar as especificidades e singularidades da população adulta nas diferentes regiões do Brasil, destacando que a AF está envolvida em movimentos populares, sociais e culturais. No Guia também são apresentadas mensagens para superar as principais barreiras da AF, e as redes de apoio existentes para auxiliar a população adulta a ter uma vida fisicamente mais ativa.