bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidencia acumulada de anomalías fetales incompatibles con la vida en Perú
Authors: Taype-Rondán Alvaro , Zafra-Tanaka Jessica Hanae , Guevara-Rios Enrique , Chávez-Alvarado Susana
Published: April 2020

Introducción. Las anomalías fetales incompatibles con la vida (AFIV) son aquellas que se asocian con la muerte temprana del feto o del recién nacido. En la actualidad, se desconoce la magnitud de este problema en Perú.Objetivos. Estimar la incidencia acumulada de AFIV en Perú, en el departamento de Lima y en seis hospitales de la ciudad de Lima, y describir las características de este tipo de anomalías reportadas entre 2012 y 2016 en el Instituto Nacional Materno Perinatal (INMP) de Lima, Perú.Materiales y métodos. Se determinó la incidencia acumulada de las AFIV reportadas en un período de cinco años en Perú, el cual varió dependiendo de la disponibilidad de los datos (2011-2015 y 2012-2016). Además, se revisaron las historias clínicas de los neonatos con AFIV registradas en el INMP para obtener sus características.Resultados. La incidencia acumulada de AFIV en todo el Perú fue de 0.89 por cada 10 000 recién nacidos y en el INMP fue 7.19. De los 48 recién nacidos con AFIV atendidos en el INMP, 54.2% nacieron con depresión neonatal y 83.3% fallecieron en el hospital.Conclusión. Las incidencias acumuladas de AFIV encontradas fueron menores a las reportadas por los sistemas internacionales de vigilancia epidemiológica, lo que podría deberse a falencias en su registro en las instituciones de salud y registros analizados.
Dynamic responses of bridge substructures subjected to high-speed trains
Authors: Pugasap Kongsak
Published: April 2020

The substructures of high-speed rail (HSR) structures are typically rigid, as they are designed to meet stringent longitudinal displacement limits specified in most HSR design standards. For site conditions such as deep valleys and soft soils, tall columns or low foundation stiffness can lead to a flexible substructure system. Flexible substructures are preferred for bridges in seismic areas because their lower horizontal frequencies yield smaller seismic forces. This cost-effective design strategy is recognised in the California HSR design criteria manual, which specifies larger relative longitudinal displacement limits. In this work, the influences of substructure flexibility on relative displacements were investigated through dynamic analyses of 36 different numerical models representing a 20-span viaduct supported by substructures with first horizontal frequencies of 0.566–3.706 Hz. Four key parameters were investigated: column height, span length, bearing plan layout and ratio of depth to span length. Train models from BS EN 1991-2:2003 were used as dynamic moving loads. The results of this study show that the chances of dynamic responses larger than design limits do exist as the stiffness of substructures departs from being rigid, where resonance effects on substructures are the main contributor to response amplification.
Termal indirgenmiş grafen oksit ile elektrokimyasal olarak askorbik asit tayini
Authors: OKUTAN Merve
Published: April 2020

Bu çalışmada termal olarak indirgenmiş grafen oksit (T-rGO) ve Nafion çözeltisi (N117) ile kaplanmış camsı karbon elektrotun (GCE), fosfat tampon çözeltisindeki (PBS) askorbik asitin (AA) varlığına göre elektrokimyasal davranışı dönüşümlü voltametri (CV), diferansiyel puls voltametri (DPV) ve amperometrik tekniklerle incelenmiştir. Bu amaçla T-rGO, başlangıç malzemesi olan sentetik grafitten modifiye Hummers yöntemi ile grafen oksite (GO), ardından da GO’nun inert gaz ortamında termal işlem uygulanarak indirgenmesi ile sentezlenmiştir. Yapının karakterize edilmesi amacıyla SEM, XRD, Raman, FTIR ve elementel analiz gibi çeşitli teknikler kullanılmıştır. XRD analiz verileri kullanılarak yaklaşık 3,32 tabaka sayısına sahip T-rGO elde edildiği tespit edilmiştir. 5,0 mM AA içeren farklı pH değerlerine sahip (6, 7 ve 8) PBS arasından, pH 8 çözeltisindeki GCE/T-rGO elektrotu için en belirgin anodik yükseltgenme piki elektrot üzerinden geçen en yüksek akım miktarıyla elde edilmiştir. GCE/T-rGO elektrotu ile elde edilen sonuçlara göre, AA, derişim ve anodik pik akımı arasındaki geniş doğrusal tayin aralığında (4,0-100,0 mM, R2=0,9978) yüksek hassasiyet (0,3 μA mM-1), tayin limiti (0,61 μM), yeniden üretilebilirlik (RSD=%6,25, n=3) ve tekrarlanabilirlikle (RSD=%2,14, n=3) belirlenebilmektedir. Ayrıca, GCE/T-rGO elektrot ürik asit, NaCl ve CaCl2’e karşı yüksek seçicilik sergilemiştir. Bu nedenlerle, hazırlanan GCE/T-rGO elektrotların AA molekülünün elektrokimyasal tayininde kullanılabileceği düşünülmektedir.
Cristalización y disolución, estatismo y perpetuum mobile en la pintura de Maya Kulenovic
Authors: Aguirre Martínez Guillermo
Published: April 2020

El siguiente artículo profundiza en el trabajo de la pintora bosnio-canadiense Maya Kulenovic. A partir de su estética tenebrista, ambigua asimismo, con lazos remitentes tanto a El Fayum como a Caravaggio, tanto a Carrière como a Lucien Freud, indagaremos en el sentido existencial denotado en su serie Faces, poniéndola en relación con aspectos de la cosmovisión contemporánea.
STRATEJİK İTTİFAKLAR VE SÜRDÜRÜLEBİLİR REKABET AVANTAJI İLİŞKİSİ
Authors: TAŞGİT Yunus Emre , ÇİÇEK Tuğba
Published: April 2020

Bu araştırma, işletmelerin stratejik ittifak oluşturma yönlü davranışlarıyla sürdürülebilir rekabet avantajı elde etme durumları arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Bu doğrultuda oluşturulan kavramsal modelde tedarike, teknolojiye ve pazarlamaya yönelik stratejik ittifakların; temel yetenekler, yenilikçilik davranışı ve bilgi yönetimine dayalı sürdürülebilir rekabet avantajı üzerindeki etkisi test edilmiştir. Araştırmada nicel araştırma yöntemi kullanılmış, veriler anket tekniği ile elde edilmiştir. Araştırmanın örneklemini, Düzce’de faaliyet gösteren işletmelerin üst ve orta düzey yöneticileri oluşmaktadır. Araştırma sonuçlarına göre; temel yeteneğe bağlı sürdürülebilir rekabet üstünlüğü elde edilmesinde en etkili stratejik ittifak davranışı tedarike ve pazarlamaya yönelik davranışlar olarak ortaya çıkarken, bilgi yönetimine dayalı rekabet avantajı elde etme durumu üzerinde teknolojiye yönelik stratejik ittifak en etkili davranış olmuştur. Yenilikçi davranışa dayalı rekabet avantajında ise tedarike teknolojiye yönelik stratejik ittifakların en etkili davranışlar olduğu belirlenmiştir.
Is surgery the only option for unstable ankle fracture?
Authors: C. Marikannan , R. Dorai Kumar , B. Mohan Choudary , M. R. Thirunthaiyan , K. R. Tarun Prashanth
Published: April 2020

Background: Ankle fracture is one of the most common injuries in sports and daily activity. Unstable ankle fracture that are displaced fracture of the lateral malleolus and most bimalleolar or trimalleolar fractures need surgical reduction and fixation.

Methods: It is a single centre study in which all unstable ankle fracture above the age of 18 and not associated with any other injury were included in the study. Following fixation patients were followed up at 6 weeks, 3 months and 6 months and functional outcome was assessed with American Orthopaedic Foot and Ankle score (AOFAS).

Results: Supination external rotation injury was most common type. Mean AOFAS score at the end of six months was found to be best in supination adduction type. Posterior malleolus fixation with screw were found to have maximum AOFAS score.

Conclusions: Surgical outcome in unstable ankle fracture are proved to have good functional outcome.
DIVERSIFIKASI USAHA USAHA SANGGAR SENI UNTUK MENINGKATKAN KESEJAHTERAAN
Authors: Anoegrajekti Novi , Asrumi Asrumi , Macaryus Sudartomo , Maharani Hanni Miladia
Published: April 2020

Sanggar Tari “Sayu Sarinah” sebagai salah satu pengembang perajin asesoris memiliki potensi untuk berkembang namun mengalami keterbatasan ketrampilan untuk usaha mandiri. Kurangnya ketrampilan pembuatan asesoris dan cindera mata maupun kemampuan pengelolaan atau manajemen dalam proses produksi yang terbatas membuat kegiatan Sanggar belum optimal.

Kegiatan ini ditujukan untuk mengatasi permasalahan tersebut dengan cara: (1) memberikan penyuluhan dan pelatihan peningkatan ketrampilan pembuatan asesoris dan cendera mata bernuansa seni gandrung berbahan baku perak dan inovasinya; (2) penyuluhan pentingnya manajemen usaha asesoris dan cendera mata secara mandiri. Sasaran kegiatan ini adalah para pemuda yang ada di sekitar Sanggar “Sayu Sarinah”. Kegiatan ini dilaksanakan melalui  penyuluhan, pelatihan, dan pendampingan praktik. Metode pelaksanaannya adalah ceramah, tanya  jawab, demonstrasi, dan  latihan atau praktik pembuatan asesoris dan cendera mata mahkota gandrung berbahan baku perak. Dengan cendera mata motif gandrung menguatkan posisi gandrung sebagai maskot pariwisata dan identitas Banyuwangi.
Um Caso de Sépsis ao Longo de 24 Horas: Não FALHAR Escreve-se com LHAFAR.
Authors: Fernandes Manuel , Silva Isa , Organista Diana , Abreu Tiago , Santos Fernanda Paula , Froes Filipe
Published: April 2020

N/a.
NOS-2 Participates in the Behavioral Effects of Ethanol Withdrawal in Zebrafish
Authors: Chaves Suianny Nayara da Silva , Costa Bruna Patrícia Dutra , Gomes Gabriela Cristini Vidal , Lima-Maximino Monica , Rico Eduardo Pacheco , Maximino Caio
Published: April 2020

Nitric oxide has been implicated in symptoms of ethanol withdrawal in animal models. Zebrafish have been used as models to study neurobehavioral effects of ethanol (EtOH) withdrawal, but the mechanisms associated with these effects are not yet clear. Adult zebrafish were treated with 1% EtOH for 20 min per day for 8 days, injected with the nitric oxide synthase 2 (NOS-2) inhibitor aminoguanidine (50 mg/kg), and allowed to experience withdrawal (WD) in their hometanks for 7 days. EtOH WD increased anxiety-like behavior in the novel tank test, an effect that was blocked by aminoguanidine. EtOH WD also increased brain levels of nitrite, an effect that was partially blocked by aminoguanidine. These results underline a novel mechanism by which NOS-2 controls anxiety-like responses to ethanol withdrawal, with implications for the mechanistic study of symptoms associated with chronic ethanol abuse.
The Complexity of Mathematics
Authors: Vega Frank
Published: April 2020

The strong Goldbach's conjecture states that every even integer greater than 2 can be written as the sum of two primes. The conjecture that all odd numbers greater than 7 are the sum of three odd primes is known today as the weak Goldbach conjecture. A principal complexity class is NSPACE(S(n)) for some S(n). We show if the weak Goldbach's conjecture is true, then the problem PRIMES is not in NSPACE(S(n)) for all S(n) = o(log n). However, if this happens, then the strong Goldbach's conjecture is true or this has an infinite number of counterexamples. In addition, if this happens, then the Twin prime conjecture is true. Moreover, if this happens, then the Beal's conjecture is true. Furthermore, if this happens, then the Riemann hypothesis is true. Since the weak Goldbach's conjecture was proven, then this will certainly happen.
Emergence of Drift Variants That May Affect COVID-19 Vaccine Development and Antibody Treatment
Authors: Koyama Takahiko , Weeraratne Dilhan , Snowdon Jane L. , Parida Laxmi
Published: April 2020

New coronavirus (SARS-CoV-2) treatments and vaccines are under development to combat the COVID-19 disease. Several approaches are being used by scientists for investigation including 1) various small molecule approaches targeting RNA polymerase, 3C-like protease, and RNA endonuclease and 2) exploration of antibodies obtained from convalescent plasma from patients who have recovered from COVID-19. The coronavirus genome is highly prone to mutations that lead to genetic drift and escape from immune recognition; thus, it is imperative that sub-strains with different mutations are also accounted for during vaccine development. As the disease has grown to become a pandemic, new B-cell and T-cell epitopes predicted from SARS coronavirus have been reported. Using the epitope information along with variants of the virus, we have found several variants which might cause drifts. Among such variants, 23403A>G variant (p.D614G) in spike protein B-cell epitope is observed frequently in European countries such as the Netherlands, Switzerland and France.
A Marketing Approach to a Psychological Problem: Problematic Smartphone Use on Adolescents
Authors: Ertemel Adnan Veysel
Published: April 2020

Background: Smartphones have become an indispensable part of the daily lives of adolescents in the 21st century, which is characterized by a highly digitized modern world. Besides their many advantages, smartphones might pave the way to compulsive usage and addictive experiences. To remedy this problem, this study proposes an authentic approach which integrates consumer behavior theories and techniques such as unhook and gamification. An education program has been designed based on these approaches to decrease the problematic smartphone use. Method: The participants of the education program consisted of 305 students (48.2% girls and 51.8% boys) with a mean age of 14.57 (SD = 0.74). The Demographic Form and Smartphone Addiction Scale for Adolescents (SASA) were conducted before the education program and three weeks after the education. Results: The results of the paired sample t-test analysis before and after the education program revealed that the SASA total scores decreased significantly (p < 0.01). There are significant differences in terms of gender, mothers’ education and class levels. Conclusion: This research emphasizes the role of an interdisciplinary approach to the addiction problem. The content used in the education program includes strategies that originally aimed at increasing consumption. The effectiveness of the program can be enhanced further in the future along with self-regulatory additions.
Influence of non-ferrous metals on the structural quality of the high-alloy mild steel 20X2H4A billets received by centrifugal electroslag remelting
Authors: Papkovskiy P. I. , Valko A. I. , Sandomirskii S. G.
Published: April 2020

The problem of the formation of cracks and the conditions of their origin in the cast of metal products have been widely studied in world practice, but the real mechanism of this process is not yet clear enough that it could be applied in production. Hot cracks – one of the most common and the most detrimental defects of steel castings, leading to a significant increase in the cost of products. The formation of hot cracks in steel castings depends on many factors, including the chemical composition of steel, the presence of non-metallic inclusions and gases, conditions of deoxidation and solidification of steel, etc. Therefore, special attention in the real conditions of production should be given to the metallurgical side of the issue. There is no quantitative measure of steel purity in the books of steel, which is divided into chemical, defined by the chemical analysis, and metallographic, defined by the content of non-metallic inclusions. The effect of the general purity of steel on the characteristics of destruction is studied sufficiently, but the data on the individual impact of impurities is very incomplete.

In many respects, pure steel has a clear advantage over steel with harmful impurities. This applies to all mechanical properties associated with destruction or processes occurring on the edge of grains. The cardinal way of obtaining cleaner steel, including the reduction of impurities of non-ferrous metals, is the use of pure original charge mixture.

The article discusses the topical problem of cracking formation after chemical-thermal treatment in the material of sun gears of the second row of quarry dump trucks BELAZ, obtained by the method of CESR rolled steel 20X2H4А, the possible impact of small concentrations of non-ferrous metals (Pb, Zn, Sn, Bi, As, Se) on the development of external and internal cracks in castings and on structural heterogeneity of steel after CESR.

The obtained results allowed to draw conclusions about the impact of non-ferrous metals on the formation of cracks in castings and to establish their limited quantitative characteristics. Based on the results, measures have been proposed to minimize the impact of small amounts of non-ferrous metals on the formation of cracks in castings.
Why under five children are stunted in Pakistan? A Multilevel analysis of Punjab Multiple Indicator Cluster Survey (MICS-2014)
Authors: Mahmood Tahir , Abbas Faisal , Kumar Ramesh , Somrongthong Ratana
Published: April 2020

Background: Pakistan is facing an acute problem of child under-nutrition as about 38% of children in Pakistan are stunted. Punjab, the largest province by population and GDP share having a stunting prevalence of about 33.5% moderately and 13.3%severely stunted children of less than five years. Thus, this study aims at examining the determinants of stunting (moderate and severe) at different level of hierarchy empirically.Methodology: Data for this study is coming from Punjab Multiple Indicators Cluster Survey (MICS-2014). MICS uses a two-stage, stratified cluster sampling approach. MICS is sub-national level (Punjab province) data covering urban and rural areas. The data consists of 25,067 children under five, for 9 administrative divisions and 36 districts of Punjab province of Pakistan. Descriptive statistics and multilevel hierarchical models were estimated. Multilevel data analyses have an advantage because it provides robust standard error estimates and helps in finding variation in the data at various levels. Results: Punjab has a stunting prevalence of about 27% moderately and 10% severely stunted children of less than five years. The results depict that increasing the age of the child, increasing birth order, illiterate mothers and fathers, lack of sanitation facilities and being poor are associated significantly with the likelihood of moderate and severe stunting. Surprisingly, there is a gender bias in stunting in Punjab, Pakistan and being a girl child is more likely associated with moderate and severe stunting, which depicts the patriarchal nature of the society and a substantial prevalence of gender bias in household resource allocations.Conclusion: This outcome of our analysis points towards targeting not only households (focus on girls) but also their families and communities.
Problematic Internet Use in Children and Adolescents: Associations with psychiatric disorders and impairment
Authors: Author) Anita Restrepo(Former Corresponding , Scheininger Tohar , Clucas Jon , Alexander Lindsay , Salum Giovanni , Georgiades Kathy , Paksarian Diana , Merikangas Kathleen , Author) Michael Milham(New Corresponding
Published: April 2020

Background: Problematic internet use (PIU) is an increasingly worrisome issue, as youth population studies are establishing links with internalizing and externalizing problems. There is a need for a better understanding of psychiatric diagnostic profiles associated with this issue, as well as its unique contributions to impairment. Here, we leveraged the ongoing, large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5-21), to examine the associations between PIU and psychopathology, general impairment, physical health and sleep disturbances.Methods: A total sample of 564 (190 female) participants between the ages of 7-15 (mean = 10.80, SD = 2.16), along with their parents/guardians, completed diagnostic interviews with clinicians, answered a wide range of self-report (SR) and parent-report (PR) questionnaires, including the Internet Addiction Test (IAT) and underwent physical testing as part of the Healthy Brain Network protocol. Results: PIU was positively associated with depressive disorders (SR: aOR = 2.43, CI: 1.22-4.74, p = .01; PR: aOR = 2.56, CI: 1.31-5.05, p = .01), the combined presentation of ADHD (SR: aOR = 1.91, CI: 1.14-3.22, p = .01; PR: n.s.), Autism Spectrum Disorder (SR: n.s.; PR: aOR = 2.24, CI: 1.34-3.73, p < .001), greater levels of impairment (SR: Standardized Beta = 4.63, CI: 3.06-6.20, p < .001; PR: Standardized Beta = 5.05, CI: 3.67-6.42, p < .001) and increased sleep disturbances (SR: Standardized Beta = 3.15, CI: 0.71-5.59, p = .01; PR: Standardized Beta = 3.55, CI: 1.34-5.75, p < .001), even when accounting for demographic covariates and psychiatric comorbidity.Conclusions: The association between PIU and psychopathology, as well as its impact on impairment and sleep disturbances, highlight the urgent need to gain an understanding of mechanisms in order to inform public health recommendations on internet use in U.S. youth.
Laparoscopic based renal denervation in a canine neurogenic hypertension model
Authors: Shao Chunlai , Zhou Yan , You Tao , Xue Boxin , Stella Pieter R , Jiang TingBo , Miao Zhigang , Xu Longjiang , Yin Yin , Lan Longsheng , Rong Guang
Published: April 2020

Background: Previous renal denervation (RDN) studies showed controversial results in reducing blood pressure. The aim of this study was to provide evidence supporting the effectiveness of laparoscopic-based renal denervation (L-RDN) in treating hypertension.
Methods: Sixteen Beagle dogs were randomly divided into RDN group (n = 12) and sham group (n = 4). Neurogenic hypertension was generated in all dogs via carotid artery route. L-RDN was performed in the RDN group, with sham operation performed as a control. Blood pressure (BP) changes were recorded at 2, 4, 6, and 8 weeks after the procedure. Changes in serum creatinine (sCr), blood urea nitrogen (BUN) and level of norepinephrine (NE) were analyzed. Histological changes of kidney and renal arteries were also evaluated.
Results: BP and NE levels were significantly elevated after hypertension induction (p < 0.01). Systolic and diastolic BP of RDN group were decreased by 15.5 mmHg and 7.3 mmHg (p < 0.0001 and p = 0.0021, respectively) at the eighth week after L-RDN. Invasive systolic and diastolic BP of RDN group were significantly decreased by 14.5 mmHg and 15.3 mmHg (p < 0.0001). In contrast, there was no significant decrease in blood pressure in the sham group. In addition, RDN group but not the sham group showed a significant decrease in NE levels (p < 0.001), while no significant changes in sCr and BUN were observed in both groups. Pathological examinations showed no discernible damage, tear, or dissection to the renal arteries in RND group.
Conclusions: L-RDN lowered BP and NE levels in hypertensive dogs without affecting renal artery morphology and kidney function.
A practice improvement package at scale to improve management of birth asphyxia in Rwanda: A before-after mixed methods evaluation
Authors: Umunyana Jacqueline , Sayinzoga Felix , Ricca Jim , FAVERO RACHEL , Manariyo Marcel , Kayinamura Assumpta , Tayebwa Edwin , Khadka Neena , Molla Yordanos , Kim Young-Mi
Published: April 2020

Background: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence-based protocol to manage birth asphyxia in low resource settings. HBB has been shown to improve health worker skills and neonatal outcomes, but studies have documented problems with skills retention and little evidence of effectiveness at large scale in routine practice. This study examined the effect of complementing provider training with clinical mentorship and quality improvement as outlined in the second edition HBB materials. This “system-oriented” approach was implemented in all public health facilities (n=172) in ten districts in Rwanda from 2015 to 2018.
Methods: A before-after mixed methods study assessed changes in provider skills and neonatal outcomes related to birth asphyxia. Mentee knowledge and skills were assessed with HBB objective structured clinical exam (OSCE) B pre and post training and during mentorship visits up to one year afterward. The study team extracted health outcome data across the entirety of intervention districts and conducted interviews to gather perspectives of providers and managers on the approach.
Results: Nearly forty percent (n= 772) of health workers in maternity units directly received mentorship. Of the mentees who received two or more visits (n=456), sixty percent demonstrated competence (received > 80% score on OSCE B) on the first mentorship visit, and 100% by the sixth. In a subset of 220 health workers followed for an average of five months after demonstrating competence, 98% maintained or improved their score. Three of the tracked neonatal health outcomes improved across the ten districts and the fourth just missed statistical significance: neonatal admissions due to asphyxia (37% reduction); fresh stillbirths (27% reduction); neonatal deaths due to asphyxia (13% reduction); and death within 30 minutes of birth (19% reduction, p=0.06). Health workers expressed satisfaction with the clinical mentorship approach, noting improvements in confidence, patient flow within the maternity, and data use for decision-making.
Conclusions: Framing management of birth asphyxia within a larger quality improvement approach appears to contribute to success at scale. Clinical mentorship emerged as a critical element. The specific effect of individual components of the approach on provider skills and health outcomes requires further investigation.
Cone beam computed tomographic analysis of the spatial limitation during mandibular arch distalization
Authors: Chen Chia-Ling , Chen Chia-Hui , Pan Chin-Yun , Chang Hong-Po , Chen Ping-Ho , Tseng Yu-Chuan
Published: April 2020

Background: In the literature, attempts are seldom made to quantify spatial limitation during mandibular arch distalization. This study aimed to investigate the spatial limitations associated with cortical contact with the mandibular second molar during mandibular arch distalization.
Methods: The study population included 67 individuals who had undergone cone beam computed tomography (CBCT) (34 male and 33 female; mean age: 23.9 ± 2.72 years). The total ridge width, alveolar housing width, and root width were measured to evaluate the buccolingual limit. The space distal to the molar root represented the mesiodistal limit. The influence of sex, right versus left side, root-contact condition, malocclusion category, and presence of wisdom teeth were evaluated.
Results: The rate of cortical contact was 49.3% before any orthodontic movement. No significant differences were observed in the alveolar width according to sex (male vs female), side assessed (right vs left), wisdom teeth (present vs absent), or malocclusion category. The ridge width and the alveolar width were smaller in the contact group than in the non-contact group ( P < 0.01). The group with wisdom teeth showed a larger available distalization distance, but a significant difference was observed only near the alveolar crest.
Conclusions: Both ridge width and available distalization distance were limiting factors for mandibular teeth distalization. For cases in which whole-arch distalization is planned, CBCT is recommended before treatment, especially for non-extraction treatment. This approach ensures safe and predictable tooth movement.
Amaryllidaceae alkaloids with anti-Trypanosoma cruzi activity
Authors: Martinez-Peinado Nieves , Cortes-Serra Nuria , Torras-Claveria Laura , Pinazo Maria-Jesus , Gascon Joaquim , Bastida Jaume , Alonso-Padilla Julio
Published: April 2020

Background: Chagas disease, caused by the protozoan Trypanosoma cruzi, is a neglected disease that affects ~7 million people worldwide. Development of new drugs to treat the infection remains a priority since those currently available have frequent side effects and limited efficacy at the chronic stage. Natural products provide a pool of diversity structures to lead the chemical synthesis of novel molecules for this purpose. Herein we analyzed the anti- T. cruzi activity of 9 alkaloids derived from plants of the Amaryllidaceae family.
Methods: the activity of each alkaloid was assessed by means of an anti- T. cruzi phenotypic assay. We further evaluated the compounds that inhibited the parasite growth on two distinct cytotoxicity assays to discard those that were toxic to host cells and assure parasite selectivity.
Results: we identified a single compound (hippeastrine 2 ) that was selectively active against the parasite yielding selectivity indexes of 12.7 and 35.2 against Vero and HepG2 cells, respectively. Moreover, it showed specific activity against the amastigote stage (IC 50 = 3.31 μM).
Conclusions: results reported here suggest that natural products are an interesting source of new compounds for the development of drugs against Chagas disease.
Comparative Outcome of Loop Suspensory Reconstruction and Hook Plate Fixation for Acute Type III-V Acromioclavicular Joint Dislocation
Authors: Chang Yu-Jui , Chou Wen-Yi , Ko Jih-Yang , Liu Hao-Chen , Yang Ya-Ju , Siu Ka-Kit
Published: April 2020

Background Treatment options of acromioclavicular (AC) joint dislocation depend on the injury severity and the functional demand of the patient. Common surgical options include fixation across the AC joint, coracoclavicular (CC) fixation, and AC joint or CC reconstruction. However, the clinical superiority of these various procedures is controversial. This study aimed to compare the clinical and radiological outcomes of loop suspensory reconstruction and hook plate fixation for acute unstable AC joint dislocation.Methods We retrospectively included patients with acute unstable AC joint dislocation who were treated with loop suspensory reconstruction (group I, 23 cases) or hook plate fixation (group II, 14 cases) in our hospital from January 2010 to December 2016 with a minimum follow-up period of 1 year after surgery. We assessed the clinical outcomes of blood loss during surgery, surgical duration, duration of medication required for pain relief after the primary operation, occurrence of complications, and the Constant-Murley score; radiological analysis included postoperative arthritic change and the CC distance discrepancy ratio (CCDR) on preoperative and final follow-up plain films.Results The average follow-up duration was17.0±6.1 months. The mean duration of pain-control medication usage was 121.7±174.1 and 235.4±251.8 days in groups I and II, respectively, significantly lower in the CC reconstruction group (p=0.031). Group I revealed a superior Constant-Murley score at the final outpatient follow-up as compared with group II (71.7±15.8 vs 61.1±6.7, p=0.009). Regarding radiographic analysis, the hook plate group had a superior residual CCDR (group I vs II = 30% vs 80±40%, p<0.001). In addition, there were 9 cases of subluxation noted in group I and 2 cases in group II; however, 4 cases of acromion osteolysis were observed in group II.Conclusions The principle finding of the present study was that hook plate fixation was superior to loop suspensory reconstruction in terms of CC distance maintenance. However, the loop suspensory reconstruction group demonstrated superior clinical functional outcomes and less painkiller usage. A further randomized controlled trial with a long-term follow-up period is required.
Chronic Exposure to Ambient Particulate Matter Induces Gut Microbial Dysbiosis in a Rat COPD Model
Authors: Li Naijian , Yang Zhaowei , Liao Baoling , Pan Tianhui , Pu Jinding , Hao Binwei , Fu Zhenli , Cao Weitao , Zhou Yuming , He Fang , Li Bing , Ran Pixin
Published: April 2020

Background The role of the gut microbiota in the pathogenesis of chronic obstructive pulmonary disease following exposure to ambient particulate matter is largely unknown. We hypothesized that exposure alters gut microbial composition and metabolites and is involved in the pathogenesis of chronic obstructive pulmonary disease. Methods Fifty-four male Sprague-Dawley rats were exposed to clean air, biomass fuel, or motor vehicle exhaust for 4, 12, and 24 weeks. Lung tissue was assessed histologically and gut microbial composition was assessed by 16S rRNA pyrosequencing. Serum lipopolysaccharide levels were measured and short-chain fatty acids in colon contents were quantified. Results After a 24-week exposure to particulate matter, rats exhibited pulmonary inflammation and pathological changes characteristic of chronic obstructive pulmonary disease. The gut microbiome was characterized by decreased microbial richness and diversity, distinct overall microbial composition, lower levels of short-chain fatty acids, and higher serum lipopolysaccharide. Conclusion Chronic exposure to ambient particulate matter induces gut microbial dysbiosis and metabolite shifts in a rat model of chronic obstructive pulmonary disease.
Effects of alkaline water intake on gastritis and miRNA expression (miR-7, miR-155, miR-135b and miR-29c)
Authors: Chaves Juliana Ramos , Souza Carolina Rosal Teixeira de , Modesto Antonio André Conde , Moreira Fabiano Cordeiro , Teixeira Eliel Barbosa , Sarraf Jonathan Souza , Allen Thaís Suellen Ramos , Araújo Taíssa Maíra Thomaz , Khayat André Salim
Published: April 2020

Background : It is known that abnormal expression of miRNAs in the gastric cancer (GC) contributes to its carcinogenesis. Therefore, ingestion of commercial (usual) water on a daily basis may be a contributing factor for the occurrence of alterations in the gastric mucosal. In this study, it was evaluated the expression of the miRNAs miR-29c, miR-7, miR-155, and miR-135b in the gastric tissue of patients with gastritis before and after the consumption of alkaline water (pH range from 8.0 to 10.0), as well as the clinic pathological characteristics. Methods : 50 subjects from the Amazon region, diagnosed with gastritis that routinely used commercial (usual) water with a pH lower than 5.0, were enrolled to change the consume water to a pH of 8.5 to 10.0 for 5 months. Results : Endoscopic findings of gastritis were such different (less severe disease), p = 0.024; in 43% diagnosed with moderate gastritis upfront esophagogastroduodenoscopy (EGD) presented mild gastritis after the consumption of alkaline water, according to study methods; there were no worsening gastritis and there were a significant increase in the expression of miR-135b (p = 0.039) and miR-29c (p = 0.039). Conclusions : Modified pH range water (from 8.0 to 10.0) ingested for 5 months was able lead to a less severe gastritis according to the Sidney classification system, suggesting that this lifestyle change represented a clinical benefit in patients with gastritis on the Amazon region. In addition, higher expression of miR-135b and miR-29c was observed after the consumption of alkaline water for 5 months.
The Molecular Pathogenesis of Trichilemmal Carcinoma
Authors: Ha Jeong Hyun , Lee Cheol , Lee Kyu Sang , Pak Chang-sik , Sun Choong-Hyun , Chang Hak , Koh Youngil
Published: April 2020

Background : Trichilemmal carcinoma (TC) is an extremely rare hair follicle tumor. We aimed to explore the genetic abnormalities involved in TC to gain insight into its molecular pathogenesis. Methods : Data from patients diagnosed with TC within a 12-year period were retrospectively reviewed. Genomic DNA isolated from a formalin-fixed paraffin-embedded (FFPE) tumor tissue block was sequenced and explored for a panel of cancer genes. Results : DNA was extracted from the FFPE tissue of four patients (50% female; mean age, 51.5 years) diagnosed with TC for analysis. The tumor was located in the head and neck of three patients and in the shoulder of one patient. TP53 mutations (p.Arg213*, p.Arg249Trp, and p.Arg248Gln) were found in three patients. Fusions previously identified in melanoma were detected in two patients ( TACC3-FGFR3 and ROS1-GOPC fusions). Other mutations found included NF1-truncating mutation (Arg1362*), NRAS mutation (p.Gln61Lys), TOP1 amplification, and PTEN deletion. Overall, genetic changes found in TC resemble that of other skin cancers, suggesting similar pathogenesis. All patients with TP53 mutations had aggressive clinical course, two who died (OS 93 and 36 months), and one who experienced recurrent relapse. Conclusions : We reported the genomic variations found in TC, which may give insight into the molecular pathogenesis. Overall, genetic changes found in TC resembled that of other skin cancers, suggesting similar pathogenesis. TP53 mutations was were identified in patients who had an aggressive clinical course. Genetic alterations identified may further suggest the potential treatment options of TC.
Nurses’ Knowledge, Attitude, and Fall Prevention Practices at South Korean Hospitals: A Cross-Sectional Survey
Authors: Cho Mi-young , Jang Sun Joo
Published: April 2020

Background: Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study examined fall-prevention activities in small and medium-sized hospitals and assessed knowledge and attitudes regarding falls of nurses working in these hospitals. Methods: Participants were 162 nurses from seven small and medium-sized hospitals. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results: Nurses’ experience with patients falling was positively correlated with knowledge. Length of nursing experience and attendance at education sessions influenced attitudes regarding patient falls. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. To ensure engagement in fall-prevention activities, hospitals should develop incentive programs tailored to each hospital’s specific circumstances and create attitude improvement programs based on nurses’ subjective norms. Conclusion: In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small and medium-sized hospitals can be enhanced by creating an environment which encourages voluntary and self-directed participation in fall-prevention activities using motivation and rewards.
A new method for evaluating packing efficiency of particle size distribution during coal water slurry preparation
Authors: Li Heping , Chen Xiaoyan , Liu Wanyi , Wu Zhiqiang , Wang Gang
Published: April 2020

Particle size distribution is a key problem in preparation of coal water slurry . Due to the large number of particles and irregular accumulation of particles, how to evaluate and calculate CWS particles has become an urgent need. In this paper, the volume accumulation of particles is simplified as plane accumulation, and the particle packing gradation model based on the three-particle packing gradation and the four-particle packing gradation is constructed. Based on the classical mathematical principle, the packing voids and packing probability of 5 typical CWS particle sizes were calculated. The packing styles of N 1 N 2 N 3 , N 2 N 3 N 4 and N 3 N 4 N 5 were evaluated and analyzed. The evaluation method of packing index based on ΣP×S min andΣP×S max was established. The results show that the packing efficiency of particles can be quantitatively evaluated by using of cumulative calculation of voids areas and packing probabilities under different packing modes. The evaluation results are consistent to the tendency of CWS concentration. By this method, the particle size distribution of CWS can be controlled and adjusted during both wet milling processes and experimental investigations. Furthermore, the method may be used to other particle packing cases.
The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.
Authors: Vossius Corinna , Ersdal Hege , Kvaløy Jan Terje , M Paschal , Md Estomih , Moshiro Robert , Kidanto Hussein , Lynaga Sara
Published: April 2020

Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams and an increase in newborns weighing more than 4000 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.
Runx1 Gene in Acute Myeloid Leukemia: Expression Level Significance and Impact on Clinical Features
Authors: Mohamed Fadwa Said Abdelazim , Shafik Roxan E , Hassan Naglaa M.
Published: April 2020

Background

Acute myeloid leukemia represents the highest percentage of all adult acute leukemia variants. Runt-related transcription factor1 (RUNX1), a transcription factor with a known tumor suppressor function was recently reported as a tumor promotor in AML. We investigated the role of RUNX1 geneexpression levelin Egyptian AML patients and delineateits clinical significance.

Methods

This study recruited 91 AML patients that were recently diagnosed at our hospital with 14 healthy age- and sex-matched donors of bone marrow transplantation unit. We measured RUNX1 gene expression level using reverse transcription–quantitative polymerase chain reaction.

Results

We found that RUNX1 gene expression level was significantly higher compared to the control group (p < 0.001). Patients with FLT3 mutations had the higher expression level of RUNX1 (p=0.023). The male patients expressed significantly higher level of RUNX1 (p=0.046).

Conclusion

The RUNX1 gene expression may serve as a diagnostic marker in Egyptian AML patients. Its relation to FLT3 may give clue that patients carrying this mutation may benefit fromnew treatments that target RUNX1 in the future. Further studies on a larger number of patients and different ethnic groupsmay give a clearer vision about this new molecular therapeutic target.
Intravenous lidocaine to prevent endothelial dysfunction after major abdominal surgery: A randomised controlled pilot trial
Authors: Pustetto Marco , GOLDSZTEJN Nicolas , TOUIHRI Karim , ENGELMAN Edgard , ICKX Brigitte , Obbergh Luc Van
Published: April 2020

Background Major abdominal surgery is associated with endothelial glycocalyx disruption. The anti-inflammatory effects of lidocaine were recently associated with endothelial barrier protection.Methods This was a single-centre, parallel group, randomised, controlled, double blind, pilot trial. Forty adult patients scheduled for major abdominal surgery were included between December 2016 and March 2017 in the setting of a University Hospital in Brussels (Belgium); reasons for non-inclusion were planned liver resection and conditions associated to increased risk of local anesthetics systemic toxicity. Patients were randomized to receive either lidocaine by continuous intravenous administration or an equivalent volume of 0.9% saline. The primary endpoint was the postoperative syndecan-1 concentration (difference between groups). Near-infrared spectroscopy of the thenar eminence in association with the vascular occlusion test, and contemporary analysis of flow-mediated dilation of the brachial artery were the secondary outcomes, along with hemodynamic data. Blood samples and data were collected before surgery (T0), and at 1–3 h (T1) and 24 h (T2) post-surgery. Results Syndecan-1 concentration increased significantly post-surgery ( P <0.001), but without any difference between groups. The near-infrared spectroscopy-derived and flow-mediated dilation-derived variables showed minor changes unrelated to group assignment. Compared with the placebo group, the intervention group had a significantly lower peri-operative mean arterial pressure and cardiac index, despite equally conducted goal-directed haemodynamic management. Postoperative lactate concentrations were similar between groups. Conclusions Lidocaine failed to have any effect on endothelial function. Endothelial dysfunction in major abdominal surgery may be overestimated.
‘Too old to test?’: A life course approach to HIV-related risk and self-testing among midlife-older adults in Malawi
Authors: Johnson Cheryl , Kumwenda Moses , Meghji Jamilah , Choko Augustine , Phiri Mackwellings , Hatzold Karin , Baggaley Rachel , Taegtmeyer Miriam , Terris-Prestholt Fern , Desmond Nicola , Corbett Elizabeth L
Published: April 2020

Background Despite the aging HIV epidemic, increasing age can be associated with hesitancy to test. Addressing this gap is a critical policy concern and highlights the urgent need to identify the underlying factors, to improve knowledge of HIV-related risks as well as uptake of HIV testing and prevention services, in midlife-older adults.Methods We conducted five focus group discussions and 12 in-depth interviews between April 2013 and November 2016 among rural and urban Malawian midlife-older ( ≥ 30 years) men and women. Using a life-course theoretical framework we explored how social age is enacted and the implications for HIV testing and sexual risk behaviours. We also explore the potential for HIVST to be part of a broader strategy for engaging midlife-older adults in HIV testing, prevention and care. Thematic analysis was used to identify recurrent themes and variations.Results Life course and aging among midlife-older adults was associated with respectability and participants identified HIV as “a disease of youth” that would not affect them, with age protecting them against high sexual activity, infidelity and sexual risk-taking. HIV testing was felt to be stigmatizing, challenging age norms, threatening social status, and implying “lack of wisdom”. These norms drove self-testing preferences at home or other locations deemed age-gender appropriate. Awareness of the potential for long-standing undiagnosed HIV to be carried forward from past relationships was minimal, as was understanding of treatment-as-prevention. These norms led to HIV testing being perceived as a threat to status by older-adults, contributing to low levels of recent HIV testing in midlife-older adults compared to younger adults.Conclusions Characteristics associated with age-gender norms and social position encourage self-testing but drive poor HIV-risk perception and unacceptability of conventional HIV testing in midlife-older adults. There is an urgent need to provide targeted messages and services more appropriate to midlife-older adults in sub-Saharan Africa. HIVST which has often been highlighted as a tool for reaching young people, may be a valuable tool for engaging midlife-older age groups who may not otherwise test.