bluuebunny/crossref_metadata_2025 huggingface dataset:
The perspectives for the development and the conceptual and organizational framework of health tourism in Croatia
Authors: Skupnjak Berilav
Published: April 2021

In the historical part of the review, the author notes that the overall tourism in Croatia did in fact begin as a form of health tourism by the inauguration of the Hygiene Promotion Society in the last century on the island of Hvar. The author is strongly convinced that in the present day, and especially in the near future, health tourism has excellent chances for growth. This claim is based upon two major propositions. Firstly, because the hole in the ozone layer shows no signs of diminishing and thus reducing the adverse effects of the ultra-violet radiation on skin, eyes, and the immune system, the tourists are compelled to refrain from direct exposure to the sun, and are drawn towards the alternative specialized tourist activities, such as those found in the cultural, farming, recreational, ecological and health tourism. Secondly, and this is particularly applicable to the situation in Croatia, health tourism represents the most growth-oriented specialized branch of tourist economy, especially since it is geared towards the extension of the tourist season by its natural orientation towards the non-peak months of the tourist year. In this respect, it is completely complementary to the more usual forms of tourist economy. Since, by definition, health tourism falls into the area bordering both health and tourism, the respective authorities from both areas are expected to put forward the necessary regulations, standards, and norms; the Ministry of Health has already done that. The experts are expected to provide the necessary professional conceptualizations from the viewpoint of medical doctrines, such as algorithms (eg. the compulsory initial consultations, medical supervision of treatment dosage, etc.).
Health food and health tourism
Authors: Šimundić Borislav
Published: April 2021

Healthy food is made up of separate components in everyday nourishment. Under the term "to feed onself healthy" we understand well balanced daily meals which contain the necessary amount of protein, carbohydrates, fat, vitamins and minerals. Well balanced nutrition should not contain harmful substances which can cause a disorder of good physical and psychological health of men. The latest news on nutrition tells us that time is over, when "healthy" diet meant consuming as much food as possible. Now, the attention is focused upon a well balanced diet with previously established, exact quantities of fat, sugar, cholesterol and salt. Hotel business nowadays along with the standards in menus should add energetic and nutritional value of each meal, so as the customer could choose the food which will suit his sec, age, physical endurance, recreation and his health condition.
Prediction of COVID 19 and Its Economic Impact in Africa
Authors: Likassa Habte Tadesse
Published: April 2021

This paper presents a two-way factor design incorporating both spatial and temporal variation in the prediction of COVID 19 in Africa. In line with this, the impact of COVID-19on the GDP in Africa is well scrutinized. In contrast to the existing works [1–3], this work also extends the two-factor design into the one-way factor design through incorporating covariates into spatial effects. The data rely on the spatial and temporal obtained from WHO datasets [4, 5]. The one-factor design with more covariates is taken into consideration to identify the major potential predictor variables responsible for the deaths and confirmed cases due to COVID 19 in Africa. The MANCOVA considered population density, temperature, humidity; perception, and wind are all considered as co-variates. Simulations show that the two-way analysis of variance has shown that there is a statistically significant difference between the spatial (Fcal= 8.2704, Pvalue= 3.099∗10−6)and temporal (Fcal= 48.7964, Pvalue= 9.147∗10−16) effects. South Africa and Nigeria are highly influencing due to the pandemic where their GDP also relatively mostly declined. A significant economic change is observed before the pandemic and after the outbreak of the pandemic(tcal= 2.9548, Pvalue= 0.01805). COVID 19 negatively influenced the economy of1 most of the African countries. The population density, temperature, and wind are found to be statistically significantly associated with COVID 19 cases and deaths.
Модель автомобильного трафика с несколькими лидерами
Authors: Курц Валентина Валерьевна , Kurts Vaventina Valer'evna , Ануфриев Игорь Евгеньевич , Anufriev Igor Evgen'evich , Труфанов Данила Олегович , Trufanov Danila Olegovich
Published: April 2021

Предложена новая микроскопическая модель автомобильного трафика, которая в явном виде учитывает время реакции водителя, а при вычислении ускорения принимаются во внимание сразу несколько впереди идущих транспортных средств. Данная модель основана на модели оптимальной скорости. Учeт времени запаздывания и взаимодействий сразу с несколькими лидерами позволяет воспроизвести динамику автомобилей с большей степенью правдоподобности. Выполнен анализ потоковой устойчивости стационарных решений. Ряд численных экспериментов подтверждает корректность полученных условий устойчивости. Исследован вопрос о влиянии количества лидеров на степень устойчивости транспортного потока, а также на пространственно-временные характеристики stop-and-go волн.
Гибридный численный поток для решения задач сверхзвукового обтекания твердых тел
Authors: Ладонкина Марина Евгеньевна , Ladonkina Marina Eugenievna , Неклюдова Ольга Александровна , Neklyudova Olga Aleksandrovna , Тишкин Владимир Федорович , Tishkin Vladimir Fedorovich
Published: April 2021

Численное моделирование сверхзвукового обтекания твердых тел является сложной задачей из-за возможности возникновения нефизичных неустойчивостей, которые могут повлиять на решение. В настоящей работе предлагается новый гибридный численный поток для вычисления потоков Эйлеровой части системы уравнений Навье-Стокса, который позволяет избежать возникновения неустойчивости и сохраняет высокую точность на ударных волнах и пограничных слоях. Данный поток представляет собой комбинацию между численным потоком Годунова и численным потоком Русанова-Лакса-Фридрихса. Проведено численное моделирование сверхзвукового обтекания крылатой ракеты Tomahawk.
Multilayered Democracy in Papua: A Comparison of “Noken” System and Electoral College System in the United States
Authors: Yunus Ahsan
Published: April 2021

The elucidation of understanding popular sovereignty through the implementation of democratic principles when applied to a pluralistic Indonesian society requires a comprehensive study. This study is a normative-legal research by using statute, case, and conceptual approaches. This paper provides information on the latest trend in research. The results show that the characteristics of the general election by Noken system are in line with the Electoral College system to presidential elections in the United States, especially in the Noken system as represented by the chieftain (election by the big man). The Noken system is the result of the relations of political culture and the strengthening of local democracy. Hence, the constitutionality of Noken system is a translation of the constitution that pays attention to the social diversity that lives in society. Not only in the context of general elections, but in every aspect of national and State life, as more attention is given to the constitution of social diversity in society (constitutional pluralism).
Forest Data Collection by UAV Lidar-Based 3D Mapping: Segmentation of Individual Tree Information from 3D Point Clouds
Authors: Suzuki Taro , Shiozawa Shunichi , Yamaba Atsushi , Amano Yoshiharu ,   Chiba Institute of Technology 2-17-1 Tsudanuma, Narashino, Chiba 275-0016, Japan,   Terra Drone Corporation, Tokyo, Japan,   Forestry Research Center, Hiroshima Prefectural Technology Research Institute, Miyoshi, Japan,   Waseda University, Tokyo, Japan
Published: April 2021

In this study, we develop a system for efficiently measuring detailed information of trees in a forest environment using a small unmanned aerial vehicle (UAV) equipped with light detection and ranging (lidar). The main purpose of forest measurement is to predict the volume of wood for harvesting and delineating forest boundaries by tree location. Herein, we propose a method for extracting the position, number of trees, and vertical height of trees from a set of three-dimensional (3D) point clouds acquired by a UAV lidar system. The point cloud obtained from a UAV is dense in the tree’s crown, and the trunk 3D points are sparse because the crown of the tree obstructs the laser beam. Therefore, it is difficult to extract single-tree information from 3D point clouds because the characteristics of 3D point clouds differ significantly from those of conventional 3D point clouds using ground-based laser scanners. In this study, we segment the forest point cloud into three regions with different densities of point clouds, i.e., canopy, trunk, and ground, and process each region individually to extract the target information. By comparing a ground laser survey and the proposed method in an actual forest environment, it is discovered that the number of trees in an area measuring 100 m × 100 m is 94.6% of the total number of trees. The root mean square error of the tree position is 0.3 m, whereas that of the vertical height is 2.3 m, indicating that single-tree information can be measured with sufficient accuracy for forest management.
PENGARUH LABA AKUNTANSI, ARUS KAS OPERASI, RETURN ON EQUITY, DAN RETURN ON ASSET TERHADAP RETURN SAHAM
Authors: Verensiana Uhus Maria , Indah Mustikowati Rita , Wahyu Setiyowati Supami
Published: April 2021

Tujuan penelitian ini yaitu untuk menguji pengaruh LAK, AKO, ROE,dan ROA ,terhadap RS secara simultan dan secara parsial. Teknik yang digunakan peneliti dalam pengambilan sampel adalah menggunakan Purposive Sampling pada perusahaan LQ 45 yang terdaftar di Bursa Efek Indonesia (BEI) karena dalam pengambilan sampel menggunakan kriteria tertentu. Penelitian dilakukan dalam kurun waktu 2016-2018. Metode analisis menggunakan analisis regresi linear berganda yaitu  program SPSS 22. Hasil penelitian menunjukan  secara simultan LAK, AKO, ROE,dan ROA berpengaruh terhadap RS dan secara parsial LAK dan AKO memiliki pengaruh terhadap RS , sedangkan ROE dan ROA tidak memiliki prngaruh terhadap RS.
PENGARUH PENGAWASAN KEUANGAN DAN PENYAJIAN LAPORAN KEUANGAN TERHADAP KINERJA PEMERINTAH BERKONSEP VALUE FOR MONEY PADA PEMERINTAH KOTA MALANG
Authors: Elda Natalia , Sulistyo  , Dianawati Eris
Published: April 2021

Penelitian ini bertujuan untuk menguji dan menjelaskan pengaruh Pengawasan Keuangan dan Penyajian Laporan Keuangan terhadap Kinerja Pemerintah Berkonsep Value For Money Kota Malang. Model analisis data yang digunakan yaitu regresi linear berganda. Pengambilan sampel dilakukan dengan metode purposive sampling yaitu pengambilan sampel yang didasarkan atas kriteria tertentu untuk dijadikan responden dalam penelitian ini. Pengumpulan data dalam penelitian ini menggunakan kuesioner yang dibagikan kepada pegawai Badan Pengelola Keuangan dan Aset Daerah yang berjumlah 46 kuesioner atau (92%). Pengujian asumsi klasik meliputi uji multikolinearitas, uji heteroskedastisitas, uji autokorelasi dan uji normalitas. Pengujian hipotesis menggunakan uji F dan uji t. Berdasarkan hasil penelitian analisis data dengan bantuan SPSS 16.00 menunjukkan bahwa 1) Terdapat pengaruh secara signifikan antara Pengawasan Keuangan dan Penyajian Laporan Keuangan terhadap Kinerja Pemerintah Berkonsep Value For Money. 2) Terdapat pengaruh yang positif dan signifikan antara Pengawasan Keuangan terhadap Kinerja Pemerintah berkonsep Value For Money. 3) Terdapat Pengaruh yang positif dan signifikan antara Penyajian Laporan Keuangan terhadap kinerja pemerintah berkonsep value for money.
Investigation of Dehydroxylated Sodium Bentonite as a Pozzolanic Extender in Oil-Well Cement
Authors: Adjei Stephen , Elkatatny Salaheldin , Sarmah Pranjal , Chinea Gonzalo
Published: April 2021

Fly ash, which is a pozzolan generated as a byproduct from coal-powered plants, is the most used extender in the design of lightweight cement. However, the coal-powered plants are phasing out due to global-warming concerns. There is the need to investigate other materials as substitutes to fly ash. Bentonite is a natural pozzolanic material that is abundant in nature. This pozzolanic property is enhanced upon heat treatment; however, this material has never been explored in oil-well cementing in such form. This study compares the performance of 13-ppg heated (dehydroxylated) sodium bentonite and fly-ash cement systems.

The raw (commercial) sodium bentonite was dehydroxylated at 1,526°F for 3 hours. Cement slurries were prepared at 13 ppg using the heated sodium bentonite as partial replacements of cement in concentrations of 10 to 50% by weight of blend. Various tests were done at a bottomhole static temperature of 120°F, bottomhole circulating temperature of 110°F, and pressure of 1,000 psi or atmospheric pressure.

All the dehydroxylated sodium bentonite systems exhibited high stability, thickening times in the range of 3 to 5 hours, and a minimum 24-hour compressive strength of 600 psi. At a concentration of 40 and 50%, the 24-hour compressive strength was approximately 800 and 787 psi, respectively. This was higher than a 13-ppg fly-ash-based cement designed at 40% cement replacement (580 psi).
A Generalized Empirical Expression for Collapse of Worn Tubulars Using Stress Concentration Factors
Authors: Teigland Andreas , Brechan Bjørn , Dale Stein Inge , Sangesland Sigbjørn
Published: April 2021

As wells in modern operations are getting longer and more complex, assessing the effect of casing wear becomes ever more crucial. Degradation of the tubulars through mechanical wear reduces the pressure capacity significantly. In this paper, we use the finite element method (FEM) to analyze the stress distribution in degraded geometries and to assess reduction in collapse strength. A model for the collapse strength of the casing with a crescent-shaped wear groove is developed and its performance evaluated in relation to experimental data. The model was created by using the Buckingham Pi theorem to make generalized empirical expressions for yield and elastic collapse of tubulars. Finite element analysis (FEA) of 135 geometries was used in the development of the model. The results show that the generalized expressions capture the trends observed in the FEA accurately and match the experimental data from six tubular collapse tests with an average relative difference in collapse pressure of 5.2%.
Thymosin β4 protect against LPS induced lung injury and inflammation and subsequent fibrosis in mice
Authors: Tian Zhen , Yao Naijuan , Wang Fei , Ruan Litao
Published: April 2021

Background: Inflammation plays a critical role in the progression of pulmonary fibrosis. Thymosin β4 (Tβ4) has antioxidant, anti-inflammatory and antifibrotic effects. Although the potent protective role of Tβ4 in bleomycin-induced pulmonary fibrosis has been validated, the mechanism is not clear, and its impact on lipopolysaccharide (LPS)-induced lung injury/fibrosis has not been reported. Method: Expression of Tβ4 in fibrotic lung tissues was assessed by real-time quantitative reverse transcriptase PCR (RQ-PCR), immunohistochemistry (IHC) and Western Blotting. The effects of intraperitoneal adeno-associated virus-Tβ4 (AAV-Tβ4) on LPS-induced lung injury and fibrosis were observed through the evaluation of collagen deposition and α-smooth muscle actin (SMA) expression. In vitro tests with HPAEpiC and HLF-1 cells were performed to confirm the effects of Tβ4.Results: In this study, we evaluated the role of Tβ4 in pulmonary fibrosis and explored the possible underlying mechanisms. We found that Tβ4 was markedly upregulated in human or mouse fibrotic lung tissues. AAV-Tβ4 markedly alleviated LPS-induced oxidative damage, lung injury, inflammation, and fibrosis in mice. Our in vitro experiments also showed that LPS inhibited mitophagy and promoted inflammation via oxidative stress in HPAEpiC, and usage of Tβ4 significantly attenuated LPS-induced mitophagy inhibition, inflammasome activation and transforming growth factor-β (TGF)-β1 induced epithelial-mesenchymal transition (EMT) in HPAEpiC. Moreover, we found that Tβ4 suppressed the proliferation and attenuated the TGF-β1-induced activation of HLF-1 cells. Conclusions: In conclusion, Tβ4 alleviates LPS-induced lung injury, inflammation, and subsequent fibrosis in mice, suggesting a protective role of Tβ4 in disease pathogenesis of pulmonary fibrosis (PF). Tβ4 involves in attenuating oxidative injury, promoting mitophagy, and then alleviating inflammation and fibrosis. Modulating of Tβ4 might be a novel strategy for treating PF.
Development of a Core Outcome Set for Effectiveness Studies of Breech Birth at Term (Breech-COS)- An International Multi-Stakeholder Delphi Study: Study Protocol
Authors: Walker Shawn , Dasgupta Tisha , Shennan Andrew , Sandall Jane , Bunce Catey , Roberts Phoebe
Published: April 2021

Background: Women pregnant with a breech-presenting foetus at term are at increased risk of adverse pregnancy outcomes. The most common intervention used to improve neonatal outcomes is planned delivery by caesarean section. But this is not always possible, and some women prefer to plan a vaginal birth. A number of providers have proposed alternative interventions, such as delivery protocols or specialist teams, but heterogeneity in reported outcomes and their measurements prevents meaningful comparisons. The aim of this paper is to present a protocol for a study to develop a Breech Core Outcome Set (Breech-COS) for studies evaluating the effectiveness of interventions to improve outcomes associated with term breech birth.Methods: The development of a Breech-COS includes three phases. First, a systematic literature review will be conducted to identify outcomes previously used in effectiveness studies of breech birth at term. A focus group discussion will be conducted with the study’s pre-established Patient and Public Involvement (PPI) group, to enable service user perspectives on the results of literature review to influence the design of Delphi survey instrument. Second, an international Delphi survey will be conducted to prioritize outcomes for inclusion in the Breech-COS from the point of view of key stakeholders, including perinatal care providers and families who have experienced a term breech pregnancy. Finally, a consensus meeting will be held with stakeholders to ratify the Breech-COS and disseminate findings for application in future effectiveness studies.Discussion: The expectation is that the Breech-COS will always be collected in all clinical trials, audits of practice and other forms of observation research that concern breech birth at term, along with other outcomes of interest. This will facilitate comparing, contrasting and combining studies with the ultimate goal of improved maternal and neonatal outcomes. Trial registration: Core Outcome Measures in Effectiveness Trials (COMET): #1749; Core Outcomes in Women’s and Newborn Health (CROWN) Initiative.
Photodetectors for Weak Signal Conditions from Au/Cu co-doped ZnO
Authors: Elkamel Imen Ben , Hamdaoui Nejeh , Mezni Amine , Ajjel Ridha , Beji Lotfi
Published: April 2021

Here, we have used a simple method for polyol synthesis, analysis, and testing of Au/Cu-doped ZnO Ultraviolet (UV) photodetectors (PD). Our results are reported and discussed by X-ray diffraction (XRD) to ensure that the manufactured samples show a hexagonal wurtzite ZnO structure. Transmission electron microscopy (TEM) confirmed the nanoparticle growth in the hexagonal sample on the surface, which is the key to improving the light response. Our prepared UV PD Au/Cu codoped ZnO showed a rapid time at a power density of 7.6 mW. the highest responsivity of R = 575 mA/W and sensitivity 103 obtained at 7.6 mW with an applied voltage of 1V. Our results demonstrate the obvious substitution of Au and Cu in ZnO, thereby improving the UV-sensing light response.
Design of Linear Variable Optical Filter for Hyperspectral Imaging
Authors: Mahendra Rouchin , Chandra Ramesh
Published: April 2021

In this paper, the design and simulation of a Linear Variable Optical Filter (LVOF) for the visible and near-infrared (VNIR) 450-900nm region is reported. The design and simulation of LVOF are made based on all-dielectric [1–4] and metal-dielectric based induced transmission filter. In the given paper, we have compared the design approach based on all-dielectric and metal-dielectric filters. The LVOF filter based on the metal-dielectric method reduces the design and fabrication complexities and is also cost-effective as it doesn’t require any band rejection filters. The minimum spectral transmission of the metal-dielectric filter reported in the paper is 70% with a FWHM of 2–3% of central maxima.
Randomized clinical trial to assess the protective efficacy of a Plasmodium vivax CS synthetic vaccine
Authors: Arevalo-Herrera Myriam , Larmart-Delgado Michelle , Caicedo Maria Alejandra , Henao-Geraldo Juliana , Castellanos Angelica , Gaitan Xiomara , Devaud Jean-Christophe , Pannatier André , Herrera Sonia , Oñate Jose , Corradin Giampietro , Herrera Socrates
Published: April 2021

A randomized, double-blind, controlled clinical trial was conducted to assess the safety and protective efficacy of the Plasmodium vivax circumsporozoite (CS) protein. A total of 35 healthy adults, either malaria-naïve (n = 17) or P.vivax semi-immune (n = 18), were enrolled and immunized intramuscularly (i.m.) at months 0, 2, and 6, with the PvCS (150 µg) formulated in Montanide ISA-51 adjuvant. Most volunteers developed PvCS specific antibody and T-cell responses and were subjected to a P. vivax sporozoite controlled human malaria infection (CHMI) 30 days after the last immunization. Sterile protection was observed in five of 11 naïve (42%) and four of 11 semi-immune (36%) volunteers by showing no parasitemia during the 60 days follow-up, as did a semi-immune control (1/5) volunteer. All non-protected volunteers developed malaria symptoms 10–19 days after CHMI and were immediately treated with antimalarial drugs. This is the first study of a P. vivax sub-unit vaccine demonstrating sterile protection against P. vivax infection.
Can investors’ collective decision-making evolve? Evidence from Peer-to-Peer lending markets
Authors: Kim Dongwoo
Published: April 2021

This study tries to identify the accuracy of individual investors' capability to predict a borrower’s creditworthiness in peer-to-peer lending markets and examine whether their ability is likely to evolve over time. The results of this study show that there is no significant difference between the predictive power of investors' ex-ante funding decision model and that of the ex-post repayment model over a borrower’s repayment performance. Furthermore, the predictive power of investors' ex-ante funding decision over a borrower’s repayment performance is shown to improve over time . It is also found that the main reason why investors’ predictive power improve over time is because investors can assess more accurately the information provided by the platform operator and describe the borrower's characteristics. The results of this study are important as they confirm the possibility of optimizing and streamlining the P2P lending market, through the evolution of investors’ decision making.
Proteins Expression Profiling of Rat Uteruses with Primary Dysmenorrhea Syndrome
Authors: Xie Yazhen , Qian Jianqiang , Wu Mingmei
Published: April 2021

Purpose The aim of this study was to investigate differentially expressed proteins (DEPs) and their functions in the uteruses of primary dysmenorrhea (PD) rats by using label-free quantitative proteomics analysis.Methods The PD rat model was induced by injecting both estradiol benzoate and oxytocin. Twenty rats were equally divided into two groups: a control group (normal rats), a PD model group (PD rats). Writhing scores and serum levels of Prostaglandin E2 (PGE2) and Prostaglandin F2α (PGF2α) were used to evaluate the success of the rat PD model. The DEPs were identified and analyzed by label-free quantitative proteomics and bioinformatics analyses.Results A total of 276 DEPs were identified, including 119 up-regulated DEPs and 157 down-regulated DEPs. Bioinformatics revealed that the DEPs were mainly associated with ‘protein binding’, ‘metabolism’, ‘signal conduction’ and ‘focal adhesion’. The proteomic findings were verified by western blot analysis, which confirmed that myosin light chain kinase (MLCK), heat shock protein 90 AB1 (HSP90AB1), apolipoprotein A1 (Apoa1), p38 MAP kinase, c-Jun N-terminal kinase (JNK), and extracellular signal-related kinase 1/2 (ERK1/2) were significantly differentially expressed in between the control and PD samples.Conclusions These results provide a deeper understanding the molecular pathogenesis of PD. The DEPs found in the present study may provide new ideas for further study of the mechanism of PD and aid the search for biomarkers for early diagnosis and treatment.
Dementia Management Act and Death Toll by Dementia Drug
Authors: Lee Jong-hoon
Published: April 2021

The Dementia Management Act (DMA) came into effect on August 4, 2011, in South Korea. Medical data on the correlation between Alzheimer's disease (AD) and anti-AD drug (AAD) groups were observed from 2010 to 2019. This study investigated the increase and decrease in deaths and AAD used to treat AD. It is known that psychotropic medicines should not be administered for dementia patients because they increase all-cause mortality. This study demonstrated that acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists increase the death toll when used to treat dementia.
Infalling Streamer-Disk-Outflow System in a Nearby High-mass Star Formation Region
Authors: Chen Xi , Ren Zhiyuan , Li Da-Lei , Liu Tie , Wang Ke , Shen Zhi-Qiang , Ellingsen Simon , Sobolev Andrey , Mei Ying , Li JingJing , Wu Yue-Fang , Kim Kee-Tae
Published: April 2021

Theoretical models and numerical simulations suggest that high mass star (with mass > 8 solar mass) can be formed either via monolithic collapse of a massive core or competitive accretion, but the dominant mechanism is currently unclear. Although recent high resolution observations with the Atacama Large Millimeter/submillimeter Array (ALMA) have detected physical and kinematic features, such as disks, outflows and filamentary structures surrounding the high mass young stellar objects (HMYSO), direct detection of the infalling gas towards the HMYSO is still the key to distinguish the different scenarios. Chemically fresh gas inflows have been detected towards low-mass stars being formed, which are consistent with the accretion-disk-outflow process. In this work we report the detection of a chemically fresh inflow which is feeding HMYSO growth in the nearby high mass star-forming region G352.63-1.07. High quality images of the dust and molecular lines from both ALMA and the Submillimeter Array (SMA) have consistently revealed a gravitationally-controlled gas inflow towards a rotating structure (disk or torus) around the HMYSO. The HMYSO is also observed to have an outflow, but it can be clearly separated from the inflow. These kinematic features provide observational evidence to support the conjecture that high-mass stars can be formed in a similar process to that observed in the low-mass counterparts. The chemically fresh infalling streamers could also be related with the disk configuration, fragmentation and accretion bursts that occur in both simulations and observations.
Superinfections in a Cohort of Patients with COVID-19 Admitted to Intensive Care: Impact of Gram Negative Resistance.
Authors: Costa Rafael Lessa da , Lamas Cristiane da Cruz , Simvoulidis Luiz Fernando Nogueira , Espanha Claudia Adelino , Monteiro Lorena , Bonancim Renan , Weber João Victor , Ramos Max Rogerio Freitas , Silva Eduardo Costa Freitas , Oliveira Liszt Palmeira
Published: April 2021

Background: some studies have shown that superinfection during pandemics may have contributed to high mortality. Our objective is to identify the frequency, types and aetiology of superinfections in patients with Covid-19 admitted to the intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and hospital mortality.Methods: retrospective cohort of adult patients admitted to the ICU for more than 48 hours between March to May 2020. Comparisons of groups with and without ICU- acquired infection were established.Results: a total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. Most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% Acinetobacter and in 57% K.pneumoniae. The most prevalent infection was ventilator-associated pneumonia (VAP) in 57.9% of patients with bacterial superinfection, or 17.3% of all COVID-19 patients admitted to ICU, followed by tracheobronchitis, in 26.3%. Patients with superinfection had a longer ICU stay (40.0 vs. 17; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0; p = 0.003). There were 35.6% deaths overall, of which 39.7% of the patients had superinfection; in those who survived, 24.4% had a superinfection (OR 2.041; 95% CI 1.080–3.859).Conclusion: a high incidence of superinfections was seen, mostly caused by Gram-negative bacteria. The most common infection was VAP. Superinfections were associated with longer ICU stay and MV use and higher mortality.
Automatic Phase Identification of Earthquake Based on the UBDN Deep Network
Authors: Cai Jianxian , Dai Xun , zhitao Gao , Shi Yan
Published: April 2021

Seismic data obtained from seismic stations are the major source of the information used to forecast earthquakes. With the growth in the number of seismic stations, the size of the dataset has also increased. Traditionally, STA/LTA and AIC method have been applied to process seismic data. However, the enormous size of the dataset reduces accuracy and increases the rate of missed detection of the P and S wave phase when using these traditional methods. To tackle these issues, we introduce the novel U-net-Bidirectional Long-Term Memory Deep Network (UBDN) which can automatically and accurately identify the P and S wave phases from seismic data. The U-net based UBDN strongly maintains the U-net’s high accuracy in edge detection for extracting seismic phase features. Meanwhile, it also reduces the missed detection rate by applying the Bidirectional Long Short-Term Memory (Bi-LSTM) mode that processes timing signals to establish the relationship between seismic phase features. Experimental results using the Stanford University seismic dataset and data from the 2008 Wenchuan earthquake aftershock confirm that the proposed UBDN method is very accurate and has a lower rate of missed phase detection, outperforming solutions that adapt traditional methods by an order of magnitude in terms of error percentage.
Non-Parametric Estimation of Reference Adjusted, Standardised Probabilities of All-Cause Death and Death Due to Cancer for Population Group Comparisons
Authors: Rutherford Mark J , Andersson Therese M-L , Myklebust Tor Åge , Møller Bjørn , Lambert Paul C
Published: April 2021

Background: Ensuring fair comparisons of cancer survival statistics across population groups requires careful consideration of differential competing mortality due to other causes, and adjusting for imbalances over groups in other prognostic covariates (e.g. age). This has typically been achieved using comparisons of age-standardised net survival, with age standardisation addressing covariate imbalance, and the net estimates removing differences in competing mortality from other causes. However, these estimates lack ease of interpretability. In this paper, we motivate an alternative non-parametric approach that uses a common rate of other cause mortality across groups to give reference-adjusted all-cause and cancer-specific estimates rather than reporting net estimates.Methods: We develop the methodology for a non-parametric equivalent of standardised and reference adjusted crude probabilities of death, building on the estimation of non-parametric crude probabilities of death. We illustrate the approach using regional comparisons of survival following a diagnosis of rectal cancer for men in England. We standardise to the covariate distribution and other cause mortality of England as a whole to offer comparability, but with close approximation to the observed all-cause region-specific mortality.Results: The approach gives comparable estimates to observed crude probabilities of death, but allows direct comparison across population groups with different covariate profiles and competing mortality patterns. In our illustrative example, we show that regional variations in survival following a diagnosis of rectal cancer persist even after accounting for the variation in deprivation, age at diagnosis and other cause mortality. Conclusions: The methodological approach of using standardised and reference adjusted metrics offers an appealing approach for future cancer survival comparison studies and routinely published cancer statistics. Our non-parametric estimation approach through the use of weighting offers the ability to estimate comparable survival estimates without the need for statistical modelling.
Novel SCNN1A Gene Splicing-site Mutation Causing Autosomal Recessive Pseudohypoaldosteronism type 1 (PHA1) in two Italian Patients Belonging to the Same Small Town
Authors: Serra Gregorio , Antona Vincenzo , D’Alessandro Maria Michela , Maggio Maria Cristina , Verde Vincenzo , Corsello Giovanni
Published: April 2021

IntroductionPseudohypoaldosteronism type 1 (PHA1) is a rare genetic disease due to the peripheral resistance to aldosterone. Its clinical spectrum includes neonatal salt loss syndrome with hyponatremia and hypochloraemia, hyperkalemia, metabolic acidosis and increased plasmatic levels of aldosterone. Two genetically distinct forms of disease, renal and systemic, have been described, showing a wide clinical expressivity. Mutations in the genes encoding for the subunits of the epithelial sodium channels (ENaC) are responsible for generalized PHA1. Patients’ presentationWe hereby report on two Italian patients with generalized PHA1, coming from the same small town in the center of Sicily. The first patient is a male child, born from the first pregnancy of healthy consanguineous Sicilian parents. A novel SCNN1A (sodium channel epithelial subunit alpha) gene mutation, inherited from both heterozygous parents, was identified by next generation sequencing (NGS) in the homozygous child (and later, also in the heterozygous maternal aunt). A more detailed family history disclosed a possible related twenty-year-old girl, belonging to the same Sicilian small town, with referred neonatal salt loss syndrome associated to hyperkalemia, and subsequent normal growth and neurodevelopment. This second patient had a PHA1 clinical diagnosis when she was about one year old. The genetic investigation was, then, extended to her and to her family, revealing the same mutation in the homozygous girl and in the heterozygous parents.ConclusionsThe neonatologist should consider PHA1 diagnosis in newborns showing hyponatremia, hyperkalemia and metabolic acidosis, after the exclusion of a salting-loss form of adrenogenital syndrome. The increased plasmatic levels of aldosterone and aldosterone/renin ratio, associated to a poor response to steroid administration, confirmed the diagnosis in the first present patient. An accurate family history may be decisive to identify the clinical picture. A multidisciplinary approach and close follow-up evaluations are requested, in view of optimal management, adequate growth and development of patients. Next generation sequencing (NGS) techniques allowed the identification of the SCNN1A gene mutation either in both patients or in other heterozygous family members, enabling also primary prevention of disease. Our report may broaden the knowledge of the genetic and molecular bases of PHA1, improving its clinical characterization and providing useful indications for the treatment of patients. Clinical approach must be personalized, also in relation to long-term survival and potential multiorgan complications.
Forensic facial reconstruction using CBCT – A systematic review
Authors: JAYAKRISHNAN JIJIN MEKKADATH
Published: April 2021

ObjectivesThis systematic review evaluated whether CBCT is a better diagnostic tool in facial forensic reconstruction. Forensic facial reconstruction is a technique to reconstruct human face from unidentified face from skull remains for human identification and facial recognition.Materials and methodsArticle selection and data extraction was done based on the inclusion and exclusion criteria devised for the study. The articles were screened from PubMed, ProQuest, Google scholar, Science direct and Scopus.ResultThree hundred and thirty-nine articles were initially identified from which seven articles were full text reviewed and included in the review. All the articles included in this study suggest that the facial reconstruction done using CBCT are reliable. ConclusionThe computerized 3D modeling method produces reliable facial reconstructions which involves the images scanned from CBCT and the combination method. The computerized 3D modeling method produces facial reconstruction which almost mimics the original resemblance.
Adjuvant Chemotherapy for Gastric Cancer Patients with Mismatch Repair Deficiency or Microsatellite Instability: Systematic Review and Meta-Analysis
Authors: Nie Runcong , Yuan Shuqiang , Kim Jin Won , Wang Yun , Chen Guoming , Zhou Jie , Chen Yingbo , Chen Shi , Zhou Zhiwei , Cai Muyan , Li Yuanfang
Published: April 2021

Background: Mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) serves as a predictor poor response to adjuvant chemotherapy in stage II colon cancer patients. Our objective was to investigate the efficacy of adjuvant chemotherapy in dMMR/MSI-H gastric cancer (GC). Methods: We searched literatures through December, 2020 to identify clinical studies that reported survival comparing adjuvant chemotherapy with surgery alone in dMMR/MSI-H GCs. Two approaches were used to pool the hazard ratio (HR) of survival: (1) If Kaplan-Meier curves and number at risk were provided, individual patient data were extracted. Cox models were used to calculate the HR with 95% confidence interval (CI); (2) for study-level data, pooled HR was estimated using fixed/random-effects models. Results: Six clinical studies were identified. For dMMR/MSI-H versus mismatch repair proficient (pMMR)/microsatellite stable (MSS)/microsatellite instability-low (MSI-L), the estimated 5-years DFS were 74.2% versus 51.5% (HR, 0.44; 95% CI, 0.32-0.62; P < 0.001); the estimated 5-years OS were 60.8% versus 50.1% (HR, 0.72; 95% CI, 0.60-0.88; P = 0.001). At study-level data, the pooled HRs were 0.42 for DFS (95% CI, 0.31-0.57; P < 0.001) and 0.66 for OS (95% CI, 0.32-1.38; P = 0.268). For adjuvant chemotherapy versus observation in dMMR/MSI-H, the estimated 5-years DFS were 76.1% versus 73.3% (HR, 0.72; 95% CI, 0.45-1.15; P = 0.171); the estimated 5-years OS were 74.9% versus 60.2% (HR, 0.60; 95% CI, 0.44-0.83; P = 0.001). Significant survival differences were also observed at study-level. Conclusions: This study further suggested adjuvant chemotherapy could be beneficial even in dMMR/MSI-H GC patients.
Air Pollution Impacts During 2020 COVID-19 Pandemic: Emphasis on Urban, Suburban and Rural Zones
Authors: Slezakova Klara , Pereira Maria
Published: April 2021

Air quality improvements pollution changes due to COVID-19 restrictions have been reported for many urban developments and large metropolitan areas, but the respective impacts at rural and remote zones are less frequently analysed. This study evaluated air pollution changes across all Portugal (68 stations) considering all urban, suburban and rural zones. PM10, PM2.5, NO2, SO2, ozone was analysed in pre-, during, and post-lockdown period (January-May 2020) and for a comparison also in 2019. NO2 was the most reduced pollutant in 2020, which coincided with decreased traffic. Significant drop (15– 240%) of traffic related NO2 was observed specifically during lockdown period, being 55% for the largest and most populated region in country. PM was affected to a lesser degree (with substantial differences found for largely populated areas (Lisbon region 30–40%; North region: up to 95%); during lockdown traffic-related PM dropped 10–70%. PM10 daily limit was exceeded 50% less in 2020, with 80% of exceedances before lockdown period. SO2 decreased by 35%, due to suspended industrial productions, whereas ozone concentrations slightly (though not significantly) increased (83 vs. 80 µg m− 3).
Population genetic structure of European wildcats inhabiting the area between the Dinaric Alps and the Scardo-Pindic mountains
Authors: Urzi Felicita , Šprem Nikica , Potočnik Hubert , Sindičić Magda , Konjević Dean , Ćirović Duško , Rezić Andrea , Duniš Luka , Melovski Dime , Buzan Elena
Published: April 2021

Habitat fragmentation and loss have contributed significantly to the demographic decline of European wildcat populations and hybridization with domestic cats poses a threat to the loss of genetic purity of the species. In this study we used microsatellite markers to analyse genetic variation and structure of the wildcat populations from the area between the Dinaric Alps and the Scardo-Pindic mountains in Slovenia, Croatia, Serbia and North Macedonia. We also investigated hybridisation between populations of wildcats and domestic cats in the area. One hundred and thirteen samples from free-leaving European wildcats and thirty-two samples from domestic cats were analysed. Allelic richness across populations ranged from 3.61 to 3.98. The observed Ho values ranged between 0.57 and 0.71. The global FST value for the four populations was 0.080 (95% CI 0.056–0.109) and differed significantly from zero (P < 0.001). The highest FST value was observed between the populations North Macedonia and Slovenia and the lowest between Slovenia and Croatia. We also found a signal for the existence of isolation by distance between populations. Our results showed that wildcats are divided in two genetic clusters largely consistent with a geographic division into a genetically diverse northern group (Slovenia, Croatia) and genetically eroded south-eastern group (Serbia, N. Macedonia). Hybridisation rate between wildcats and domestic cats varied between 13% and 52% across the regions.
Hepatocellular Carcinoma in Hepatitis C-Associated Cirrhotic Patients Treated With Different Combinations of Direct-Acting Antiviral Agents Available in Pakistan: A Prospective Observational Study
Authors: Abro Irshad Batool , Bhatti Jamil Muqtadir , Siddiqui Ali Akbar
Published: April 2021

BackgroundHepatitis C virus (HCV) is a significant cause of chronic liver disease, which can result in cirrhosis and hepatocellular carcinoma (HCC). Direct-acting antiviral agents (DAAs) are associated with a significant rise in sustained virologic response and reduced treatment duration. We performed this study to assess the incidence of HCC in patients with HCV-associated cirrhosis following therapy with DAAs available in Pakistan.MethodsWe conducted a prospective observational study at Isra University Hospital Hyderabad from July 2019 to August 2020. Three hundred fourteen patients met the inclusion criteria and were included. We recorded baseline demographic characteristics, Child-Pugh class, model for end-stage liver disease (MELD) score, alpha-fetoprotein level, and abdominal ultrasound/computed tomography (CT) scan before and after treatment. We also noted the duration of DAA treatment and the types of DAA used. HCC was considered present according to characteristic imaging findings on abdominal ultrasound/CT scans. ResultsA total of 314 patients were enrolled in the study. The mean age of patients who developed HCC was 46.7 years ± 10.3 years. Of the patients who developed HCC, 20 (69%) were male, and nine (31%) were female (p=0.221). Five patients who developed HCC also had diabetes (17.2%; p=0.174) and 17 (58.6%) were smokers (p=0.001). Among patients treated with a combination of sofosbuvir/daclatasvir, 20 (69%) developed HCC. Nine patients (31%) treated with a combination of sofosbuvir/velpatasvir developed HCC (p=0.1). Eight patients younger than 40 years (27.6%) developed HCC, and 21 patients aged 40 years or older (72.6%) developed HCC (p=0.55). HCC was common in Child-Pugh class A patients (n=19; 65.6%). Twenty-three patients (79.3%) with a MELD score <9 developed HCC. Eight percent of patients treated with sofosbuvir/daclatasvir for 12 weeks developed HCC, and 15% developed HCC after 24 weeks of treatment with sofosbuvir/daclatasvir. When treated with sofosbuvir/velpatasvir for 12 and 24 weeks, 4% and 9% developed HCC, respectively. Alpha-fetoprotein was elevated in all patients diagnosed with HCC, while only 14.7% of those with no HCC had elevated alpha-fetoprotein levels. ConclusionDAAs were associated with an increased risk of HCC. HCC was more commonly seen in patients treated with a combination of sofosbuvir/daclatasvir than sofosbuvir/daclatasvir.
Effect of CD146 on Bone Regeneration by Transplantation of Stem Cells from Human Exfoliated Deciduous Teeth into Mouse Skull Defect
Authors: Rikitake Kodai , Kunimatsu Ryo , Yoshimi Yuki , Nakajima Kengo , Hiraki Tomoka , Putranti Nurul Aisyah Rizky , Tsuka Yuji , Abe Takaharu , Ando Kazuyo , Hayashi Yoko , Nikawa Hiroki , Tanimoto Kotaro
Published: April 2021

Stem cells from human exfoliated deciduous teeth (SHED) possess bone regeneration ability and may have therapeutic applications. CD146, a cell adhesion protein expressed by vascular endothelial cells, is involved in the osteoblastic differentiation of stem cells. However, the effect of CD146 on SHED-mediated bone regeneration in vivo remains unknown. Hence, in this study we aimed to establish efficient conditions for SHED transplantation. SHED were isolated from the pulp of an extracted deciduous tooth and cultured, and CD146-positive (CD146+) and CD146-negative (CD146−) populations were sorted. Heterogeneous populations of SHED and CD146+ and CD146– cells were transplanted into bone defects generated in the skulls of individual immunodeficient mice. Micro-computed tomography was performed immediately post-transplantation and at 4- and 8-weeks thereafter to evaluate bone regeneration. Histological and immunohistochemical assessments were also performed at 8 weeks after transplantation. Micro-computed tomography revealed bone regeneration upon transplantation with CD146+ and heterogeneous populations of SHED, particularly at 8 weeks after transplantation, with significantly higher bone regeneration observed following transplantation with CD146+ cells. Furthermore, histological and immunohistochemical assessments revealed that CD146+ cells promoted bone regeneration and angiogenesis. Therefore, transplantation of CD146+ SHED into bone defects may serve as a useful strategy for bone regeneration.