bluuebunny/crossref_metadata_2025 huggingface dataset:
Tourists’ attitude affecting consumption behavior for sustainable Satoyama Tourism: A comparison between domestic and international tourists
Authors: Fithriyah A F , Shimizu N , Hoshino S , Onitsuka K
Published: June 2020

Over these decades, tourism industry has developed very rapidly. Tourism evidently improves sustainability especially in rural by prosperity enhancement. Japan is nominated as the decade’s fastest-growing major destination with a 334% rise of arrival from 2010-2017. Moreover, Japan pulls out a tourism goal, aiming 40 million arrivals with JPY 8 trillion receipts by the year 2020. Rural areas are promoted to be tourist destination as an effort for sustaining rural landscape. But, it is not the case for Kita Village. Kita Village is one of famous rural heritage destinations located in Kyoto Prefecture with excellent Satoyama landscape. Residents of Kita Village agreed to preserve the Satoyama landscape through tourism. Maintaining a heritage site is not easy nor cheap. Economic needs couldn’t be denied to sustain the area. Tourists’ visitation is increasing each year, yet the tourism income is low. Therefore, increasing tourism income became an important issue in Miyama to sustain the Satoyama landscape. Literature have shown domestic and international tourists are different. With the increasing international tourists in Kita Village, this study aimed to explore each group and compare their consumption behavior. Tourists’ consumption behavior is studied to understand the tourism demands to increase tourism income in Kita Village, aiming for local revitalization and Satoyama landscape preservation. Data collected through a questionnaire survey in Spring. Results showed that expenditure between domestic and international tourists in Kita Village is not significantly different, JPY1954 for domestic tourists and JPY1994 for international tourists, yet the tourism attitudes between the two groups were different. Domestic and international tourists are significantly different in age, companion, transportation, times visited Miyama, duration, motivation, activity preference, and price preference. Expenditure is affected by marital status, age, duration, satisfaction, motivation, product preference, and price preference. This study managed to discover that the low tourism receipt from international tourists is mainly due to the incompatibility of the type of program. While for domestic tourists, the low tourism receipt is mainly due to the high price offered. It is suggested to make tourism program development as priority for tourism development.
Land Cover Change Impacts on Land Surface Temperature in Jakarta and Its Satellite Cities
Authors: Danniswari D , Honjo T , Furuya K
Published: June 2020

Indonesia’s capital city, Jakarta, is surrounded by several satellite cities and has grown spatially into a larger region called Jabodetabek. The development in Jabodetabek has resulted in changes in the landscape. The increase of impervious surface and decrease of green space has led to the formation of an urban heat island (UHI). UHI could be detected through land surface temperature (LST) monitoring. Therefore, the objectives of this study were to analyze the land cover changes in Jakarta and its satellite cities and to analyze the impact of these changes on LST using GIS-based analysis. We analyzed Jakarta and its three satellite cities, Depok, Tangerang, and Bekasi, through a satellite image time-series analysis in 1989/1990 and 2015/2018. It is found that, among the four cities we analyzed, Tangerang has the highest built-up area expansion proportion, followed by Bekasi with a slight difference, then Depok and Jakarta. As for the LST, the city that has the most significant difference between mean LST in the initial and recent year is Bekasi with 12.66°C, then followed by Tangerang (11.05°C), Jakarta (8.34°C), and Depok (6.43°C). These orders’ inconsistency might be caused by higher proportion of built-up area combined with higher loss of vegetated area. This shows that the land cover change played a big role in the temperature increase.
Transport Management for Sustainable Urban Development at Tambun Market Area
Authors: Sari N , Hidayat B
Published: June 2020

Tambun market is a commercial area located at T-Junction, an area with mixed land uses. Land use in this area consists of settlement, commuter line stations, offices, factories, and a historic building (Gedung Juang) which is a tourist destination. Trade activities, loading goods, unloading goods, public transport passengers, on-street parking, and traffic conflict between vehicles and pedestrian in this area influence the road traffic. It causes the bottleneck up to congestion at Tambun Market area. The level-crossing at the commuter line station become one of the causes of congestion. To solve from 2014 to 2017 that problem, the government of Bekasi districts built the underpasses to overcome congestion and improve road safety. In fact, the construction of underpasses does not solve the problems. The purpose of this research is to propose transportation management in the Tambun market area. The problem is analyzed based on the principles of traffic engineering. There are include some points such as accessibility planning, movement of people, goods and vehicles, pedestrian facilities, and parking areas. The analysis is using the principle of connectivity, accessibility, comfort, and safety. The results are the improvement of pedestrian facilities, design of public parking area, loading and unloading management, improvement road performance for Volume and Capacity Ratio (v/c ratio), traffic flow and accessibility planning, where it could be improvement of connectivity, accessibility, and traffic safety.
Accessibility and Connectivity Concept Between Motorcycles and Pedestrians at Education District
Authors: Hidayat B , Sari N
Published: June 2020

Land Transport Academy is one district of the education on Bekasi. Vehicle and pedestrian are the main traffic movement in the education district especially pedestrian and motorcycle. The condition of pedestrian facilities is not yet enough and not optimum, that be causing conflict between motorcycle and pedestrian. The conflict could to decrease level of road safety and to increase in road accident. Recently, the government has issued the Regulation of Safe and Safety Route for Schools (RASS) is focus for pedestrian safety at education district. This paper aims to propose the concept of accessibility and connectivity at education district, which could decrease road accident with develop safety routes for pedestrian. Basic concept of design was protected the pedestrian and decrease conflict between motorcycle and pedestrians. Research methodology includes observation of pedestrian and motorcycles movement, traffic counting, land use inventory of education district and pedestrian facilities. Data is analyzed by using qualitative description. The result is used to show separate pathway of pedestrians with traffic lane will be increasing of pedestrian safety. The separate pathway of pedestrians with traffic lane is to decrease conflict. The concepts of a school safety zone (Zoss) and pedestrian safety are very important for students in the education district.
Study of Phasing Plan of Kalimati Water Treatment Plant Installation in Sidoarjo
Authors: Firdaus S , Purnomo A
Published: June 2020

One of the programs to increase clean water supply services in Sidoarjo district is maximizing water sources to serve 5 sub-districts in Western Sidoarjo, including Prambon, Tarik, Tulangan, Krembung and Balongbendo sub-districts, by planning a Water Treatment Plant (WTP) with total capacity of 1,000 LPS. The planning stages begin with calculation of projected water demands in 5 sub-districts for 10 years ahead. The results of projected water demands will be compared with the installation’s capacity to obtain the actual and initial staging plan for Water Treatment Plan’s constructions. Therefore, the construction and investment of Kalimati Water Treatment Plan could be arranged efficiently.
Impacts Assessment of Crude Oil Exploration Using Life Cycle Assessment (LCA)
Authors: Sulistyawati S , Iswara A P , Boedisantoso R
Published: June 2020

Oil and gas are strategic, non-renewable natural resources and are vital commodities. It is explained that upstream business activities are business activities that are cored or rely on exploration and exploitation. While downstream business activities are business activities whose core are in processing, transportation, storage and/or commercial business activities. At present, 68% of the world’s energy needs are derived from fossil fuels. Fossil fuels that are often used include coal, petroleum and natural gas. The results of the 2007 Intergovernmental Panel on Climate Change (IPCC) study showed that the concentration of CO2 gas in the pre-industrial period amounted to 278 ppm, while in 2005 it was 379 ppm. The consequences of this change are rising global temperatures by 0.74°C, and there has also been a sea-level rise of 0.17 m, then there has also been a 7% reduction in snow cover in the northern hemisphere and rivers experience slower freeze. The contribution of greenhouse gas emissions from the oil and gas sector is expected to increase from 122 metric tons (Mt) of CO2 in 2005 to 137 metric tons (Mt) of CO2 in 2030. Emissions produced by crude oil exploration in 2015 amounted to 48,947.35 tonnes of CO2e and increased in 2016 amounting to 232,950.30 CO2e. Therefore, an LCA study is needed as a solution to reduce the emissions of greenhouse gases CO2, CH4, N2O, NOx and SOx at a company in East Java. The purpose of this study is to determine the environmental impacts generated by crude oil exploration. The emission data of CO2, CH4, N2O, NOx and SOx, mass balance, the amount of raw materials, fuels used and emissions produced in each of the main process units and supporting units, as well as data on the amount of products produced from petroleum production activities in one company in East Java, are used to determine the impact on the environment that would arise through the stages of LCA analysis using the Eco Indicator 99 method in the SimaPro 8.5.2 software. The results obtained from this study revealed that the process which has the highest impact value on the environment is the process of producing oil in the PV-9900 separator unit, with an impact value of 12620 MPt and the value of each category of damage was 4,76 × 1011 MJ surplus for the “resources” category, 0,00118 DALY for the “human health” category and 0,0847 PDF⋅m2⋅year for “ecosystem quality” category.
Rehabilitation Planning of Gedangkeret Landfill in Jombang Region
Authors: Mujaddid G R A , Pandebesie E S
Published: June 2020

The Region of Jombang in East Java has Gedangkeret Landfill as its final solid waste management system. There are 50 transfer stations that are mostly located in the district of Jombang. The other transfer stations are located in the districts of Diwek, Peterongan, Mojowarno, Mojoagung, Ploso, Ngoro, Gudo, Perak, Sumobito. These transfer stations produce at least 76.11 tonnes/day of solid waste. The composition of the solid wastes dumped in this landfill is mostly food waste and plastic. The presence of biodegradable wastes will produce plenty of greenhouse gasses. The leachate produced is processed in stabilization ponds, but the value of BOD and COD is still below the quality standard. The Index Score of Gedangkeret Landfill is 538.48, indicating that the landfill needs to be rehabilitated. The rehabilitation plans comprise of dumping zone stabilization, drainage system, leachate processing, landfill gasses management, and greenbelt plan. The dumping zone planning is based on population projection. The drainage system planning is based on the Jombang climate condition. The leachate processes planning is based on the leachate flow rate on each dumping zone and its characteristics. The greenbelt planning is based on the CO2 production and the conversion of the methane gasses.
Effect of Flow Rate on Electrochemical Oxidation of Landfill Leachate Using DSA and BDD Anode
Authors: Nurhayati E , Bagastyo A Y , Hartatik D D
Published: June 2020

The leachate produced in municipal mixed waste landfill contains mostly organic pollutants in various forms. Biological treatment that popularly applied for the treatment only capable of removing biodegradable portion of the organics whilst the recalcitrant parts will leave the system untreated. Therefore, a pretreatment prior to biological process to increase biodegradability of leachate is essential. The physicochemical method such as electrochemical oxidation is an appropriate pretreatment alternative because it has high efficiency in degrading such pollutants. The purpose of this study was to examine the effect of flow rate (1.5 and 5 mL s−1) and anodes (boron-doped diamond (BDD) and dimensionally stable anode (DSA)) on the efficiency of electrochemical oxidation process to degrade leachate. The parameters analyzed were COD, BOD, ratio of BOD5/COD (biodegradability index, BI), TDS and pH. The results showed that the increase in BI when BDD and DSA used were 0.386 and 0.179, respectively. The best COD removal was achieved by BDD and DSA at current density of 30 mA cm−2 with the flow rate of 5 mL s−1. BDD could remove 83 % COD (1.56 g) while DSA 68 % (1.08 g) with specific energy consumption of 0.00268 kWh g−1 and 0.00186 kWh g−1, respectively.
Enhancing the Ductility of a Reinforced Concrete Beam using Engineered Cementitious Composite
Authors: Bastian M A , Tambusay A , Komara I , Sutrisno W , Irawan D , Suprobo P.
Published: June 2020

A series of small-scale rectangular reinforced concrete beams made with different mix proportions were presented. The beams were fabricated using normal concrete designated as specimen control (NC), normal concrete blended with supplementary material using Class F fly ash (SMFA), and engineered cementitious composite (ECC). The beams comprised of similar reinforcement where the ratio of compression, tension, and transverse bars were 1.0%, 1.5%, and 1.0% respectively. To this end, the beams were tested under four-point bending and they were intended to fail in flexure mode. The tests also aimed to provide direct evidence regarding the improvement of beam ductility due to the use of ECC. Furthermore, the performance of test beams on the overall strength, crack pattern, and damage state was also assessed. To corroborate the experimental work, an analytical work employing nonlinear finite element analysis using Abaqus was also included. From this study, it was found that each beam demonstrated a discernible ductile plateau upon the post-cracking region with Beam ECC showing the largest ductility compared to the other two thereby suggesting that the use of ECC could enhance the beam ductility. It was also shown that the flexural cracks manifested in Beam ECC were less critical, signifying that ECC is a damage-tolerant composite. Furthermore, the overall results of predicted load-deflection and damage state obtained from Abaqus were also in a good agreement with the experimental results.
Estimation of Shear Wave Velocity Using Horizontal to Vertical Spectrum Ratio (HVSR) Inversion to Identify Faults in Pacitan
Authors: Haryono A , Sungkono  , Caesardi M A , Santosa B J , Syaifuddin F , Widodo A
Published: June 2020

Pacitan is one of the cities in Indonesia which is located around a subduction zone with many faults. Grindulu Fault is one of the active faults in Pacitan. In order to mitigate hazard in the area, detailed information about the existence and characteristic of the fault is needed. Thus, imaging of Grindulu Fault using shear wave velocity (Vs) was carried out. 1-D of Vs was revealed by inversion of HVSR from microtremor data using the Monte Carlo algorithm. Furthermore, several Vs were processed using interpolation approach to determine two-dimensional (2-D) cross-section of Vs. Based on the contrast of Vs and considering the geological conditions in Pacitan area, the existence of Grindulu Fault and other faults were identified.
National French Survey of Coronavirus Disease (COVID-19) Symptoms in People Aged 70 and Over
Authors: Annweiler Cédric , Sacco Guillaume , Salles Nathalie , Aquino Jean-Pierre , Gautier Jennifer , Berrut Gilles , Guérin Olivier , Gavazzi Gaetan
Published: June 2020

The objective of this national French survey was to determine the coronavirus disease 2019 (COVID-19) semiology in seniors (n = 353; mean, 84.7 ± 7.0 years). A total of 57.8% of patients exhibited ≤3 symptoms, including thermal dysregulation (83.6%), cough (58.9%), asthenia (52.7%), polypnea (39.9%), and gastrointestinal signs (24.4%). Patients ≥80 years exhibited falls (P = .002) and asthenia (P = .002). Patients with neurocognitive disorders exhibited delirium (P < .001) and altered consciousness (P = .001). Clinical peculiarities of COVID-19 were reported in seniors.

Clinical Trials Registration

NCT04343781.
Sex differences in the vascular access of hemodialysis patients: a cohort study
Authors: MacRae Jennifer M , Clarke Alix , Ahmed Sofia B , Elliott Meghan , Quinn Rob R , James Matthew , King-Shier Kathryn , Hiremath Swapnil , Oliver Matthew J , Hemmelgarn Brenda , Scott-Douglas Nairne , Ravani Pietro ,   Alberta Kidney Disease Network
Published: June 2020

Background

We describe differences for probability of receiving a fistula attempt, achieving fistula use, remaining catheter-free and the rate of access-related procedures as a function of sex.

Methods

Prospectively collected vascular access data on incident dialysis patients from five Canadian programs using the Dialysis Measurement Analysis and Reporting System to determine differences in fistula-related outcomes between women and men. The probability of receiving a fistula attempt and the probability of fistula use were determined using binary logistic regression. Catheter and fistula procedure rates were described using Poisson regression. We studied time to fistula attempt and time to fistula use, accounting for competing risks.

Results

We included 1446 (61%) men and 929 (39%) women. Men had a lower body mass index (P < 0.001) and were more likely to have coronary artery disease (P < 0.001) and peripheral vascular disease (p < 0.001). A total of 688 (48%) men and 403 (43%) women received a fistula attempt. Women were less likely to receive a fistula attempt by 6 months {odds ratio [OR] 0.64 [95% confidence interval (CI) 0.52–0.79]} and to achieve catheter-free use of their fistula by 1 year [OR 0.38 (95% CI 0.27–0.53)]. At an average of 2.30 access procedures per person-year, there is no difference between women and men [incidence rate ratio (IRR) 0.97 (95% CI 0.87–1.07)]. Restricting to those with a fistula attempt, women received more procedures [IRR 1.16 (95% CI 1.04–1.30)] attributed to increased catheter procedures [IRR 1.50 (95% CI 1.27–1.78)]. There was no difference in fistula procedures [IRR women versus men 0.96 (95% CI 0.85–1.07)].

Conclusion

Compared with men, fewer women undergo a fistula attempt. This disparity increases after adjusting for comorbidities. Women have the same number of fistula procedures as men but are less likely to successfully use their fistula.
Exploring primary care physician experiences conducting practice-based research on adult vaccination: a qualitative evaluation study in Greece
Authors: Tsiligianni Ioanna , Oikonomou Nikolaos , Papaioannou Anastasia , Tatsioni Athina , Gougourelas Dimitrios , Birka Sofia , Domeyer Philippe-Richard J , Tsimtsiou Zoi
Published: June 2020

Background

Research in primary care is necessary to empower its role in health systems and improve population health.

Objective

The aim of this evaluation study was to assess the experiences of primary care physicians who participated as researchers in a multi-centre, mixed-methodology study on adult vaccination supported by a newly established practice-based research network.

Methods

Twenty-three physicians participated as researchers, operating in their own practices in 10 different prefectures of Greece. After the completion of the study, they were asked to reflect on their experiences in the research by providing written responses to the questions on the evaluation tool of the study. The open-ended questions were analyzed using thematic content analysis.

Results

Mean age of the researchers was 42.9 years old (±3.9, min 35, max 49) and 11 (47.8%) were male. Six themes emerged as beneficial for the participating researchers: (i) raised awareness of patients’ needs, (ii) enhancement of clinical practice and services offered, (iii) positive impact on the doctor–patient relationship, (iv) personal satisfaction, (v) enrichment of their curriculum vitae and (vi) improvement of research skills. All researchers were interested in participating in future studies.

Conclusion

The experience of conducting clinical research on adult vaccination in their own practices within a network was reported to be very rewarding. The benefits gained from their participation could be a valuable tool in promoting research and enhancing the quality of primary health care.
Effect of salbutamol on neuromuscular junction function and structure in a mouse model of DOK7 congenital myasthenia
Authors: Webster Richard G , Vanhaesebrouck An E , Maxwell Susan E , Cossins Judith A , Liu Weiwei , Ueta Ryo , Yamanashi Yuji , Beeson David M W
Published: June 2020

Congenital myasthenic syndromes (CMS) are characterized by fatigable muscle weakness resulting from impaired neuromuscular transmission. β2-adrenergic agonists are an effective treatment for DOK7-CMS. DOK7 is a component within the AGRN-LRP4-MUSK-DOK7 signalling pathway that is key for the formation and maintenance of the synaptic structure of the neuromuscular junction (NMJ). The precise mechanism of action of β2-adrenergic agonists at the NMJ is not fully understood. In this study, we investigated whether β2-adrenergic agonists improve both neurotransmission and structural integrity of the NMJ in a mouse model of DOK7-CMS. Ex-vivo electrophysiological techniques and microscopy of the NMJ were used to study the effect of salbutamol, a β2-adrenergic agonist, on synaptic structure and function. DOK7-CMS model mice displayed a severe phenotype with reduced weight gain and perinatal lethality. Salbutamol treatment improved weight gain and survival in DOK7 myasthenic mice. Model animals had fewer active NMJs, detectable by endplate recordings, compared with age-matched wild-type littermates. Salbutamol treatment increased the number of detectable NMJs during endplate recording. Correspondingly, model mice had fewer acetylcholine receptor-stained NMJs detected by fluorescent labelling, but following salbutamol treatment an increased number were detectable. The data demonstrate that salbutamol can prolong survival and increase NMJ number in a severe model of DOK7-CMS.
Comprehensive Drug Screening of Whole Blood by LC–HRMS–MS in a Forensic Laboratory
Authors: Stephenson Jon B , Flater Melanie L , Austin Joseph , Bain Lisa T , Holt Lisa A , Mehan Jessica M
Published: June 2020

As the number of prescriptions, over-the-counter medications and drugs of abuse continue to increase, forensic laboratories are faced with the challenge of developing more comprehensive screening methods in order to detect them in whole blood samples. Another challenge faced by forensic laboratories is detecting and identifying novel synthetic compounds as they emerge and change. Traditional drug screening methods include enzyme immunoassay (EIA) and either gas or liquid chromatography paired with mass spectrometry (GC–MS or LC–MS-MS, respectively). While these methods are good, they have their disadvantages. For example, EIA requires special reagents for each drug class, GC–MS requires extensive sample preparation, and LC–MS-MS only detects drugs on a known inclusion lists of compounds of interest. Described here is the development of a robust and comprehensive screening method for drugs in whole blood samples that eliminates the aforementioned disadvantages of the traditional methods. Using a Q Exactive Focus™ liquid chromatography–high-resolution accurate mass spectrometer (LC–HRMS-MS), a method was developed that is capable of detecting ~200 drugs at a concentration of 2 μg/L for most analytes. This method also employs a more automated data processing feature which reduces processing time. Finally, it has the added benefit of retroactive data analysis, which allows it to be used for unknown drug analysis as well. Used as an initial screening method, the comprehensive drug screen using LC–HRMS-MS has the potential to take on two of the most important challenges faced by forensic laboratories today.
Genetic Melting Pot in Blacklegged Ticks at the Northern Edge of their Expansion Front
Authors: Talbot Benoit , Leighton Patrick A , Kulkarni Manisha A
Published: June 2020

Blacklegged ticks (Ixodes scapularis) are considered to be the main vector of Lyme disease in eastern North America. They may parasitize a wide range of bird and mammal hosts. Northward dispersal of blacklegged ticks has been attributed largely to movement of hosts to areas outside of the current range of the tick, in conjunction with climate change. To better understand the drivers of range expansion in the blacklegged tick, we need investigations of the genetic connectivity and differentiation of tick populations at a fine spatial scale using appropriate markers. In this study, we investigated genetic connectivity and differentiation in blacklegged ticks, in an area of putatively recent advance in Ontario and Quebec, Canada, using microsatellite markers. Our findings suggest patchy differentiation of alleles, no spatial pattern of genetic structure, and genetic subdivision within sites, which are consistent with the very limited evidence available near the leading edge of range expansion of blacklegged ticks into Canada. These findings are consistent with the prevailing hypothesis, drawn from a variety of fields of study, suggesting that migratory birds from a variety of regions may be bringing hitchhiking ticks northward into Canada.
The Potential of Domestic and International Courts to Protect Women’s Right to Family Life in the North Caucasus
Authors: Kogan Vanessa
Published: June 2020

The North Caucasus region of Russia is known for spawning the highest number of adverse judgments from the European Court of Human Rights compared to any other Russian region—over 500 as of mid-2020. Since 2005, the Court has found Russia responsible for enforced disappearances, extrajudicial killings and torture carried out on a mass scale during the second Chechen war and in its aftermath. The Head of the Chechen Republic, Ramzan Kadyrov, has become internationally infamous for the brutal repression of even his mildest critics, ensuring that most Chechens will be too afraid to claim their rights in any forum. Domestically, the Russian federal authorities have either ignored or tacitly condoned the increasing subversion of state law in the region in favour of de facto customary norms—adat—and elements of sharia law that have had a devastating effect mainly on women’s and girls’ rights. Harmful traditional practices such as ‘honour killings’, child marriage, bride-kidnapping, and—in certain remote mountain regions of Dagestan—female genital mutilation take place on a regular basis. Yet such violations, however grave, do not easily lend themselves to litigation. This practice note focuses on one of the few areas in the region in which systematic focused litigation is being carried out in domestic courts, often against enormous odds: the systematic denial of women’s right to family life after divorce or the death of their children’s biological father.
Cuticular waxes of nectarines during fruit development in relation to surface conductance and susceptibility to Monilinia laxa
Authors: Oliveira Lino Leandro , Quilot-Turion Bénédicte , Dufour Claire , Corre Marie-Noëlle , Lessire René , Génard Michel , Poëssel Jean-Luc
Published: June 2020

The cuticle is composed of cutin and cuticular waxes, and it is the first protective barrier to abiotic and biotic stresses in fruit. In this study, we analysed the composition of and changes in cuticular waxes during fruit development in nectarine (Prunus persica L. Batsch) cultivars, in parallel with their conductance and their susceptibility to Monilinia laxa. The nectarine waxes were composed of triterpenoids, mostly ursolic and oleanolic acids, phytosterols, and very-long-chain aliphatics. In addition, we detected phenolic compounds that were esterified with sugars or with triterpenoids, which are newly described in cuticular waxes. We quantified 42 compounds and found that they changed markedly during fruit development, with an intense accumulation of triterpenoids during initial fruit growth followed by their decrease at the end of endocarp lignification and a final increase in very-long-chain alkanes and hydroxylated triterpenoids until maturity. The surface conductance and susceptibility to Monilinia decreased sharply at the beginning of endocarp lignification, suggesting that triterpenoid deposition could play a major role in regulating fruit permeability and susceptibility to brown rot. Our results provide new insights into the composition of cuticular waxes of nectarines and their changes during fruit development, opening new avenues of research to explore brown rot resistance factors in stone fruit.
Impact of first-wave COronaVIrus disease 2019 infection in patients on haemoDIALysis in Alsace: the observational COVIDIAL study
Authors: Keller Nicolas , Chantrel François , Krummel Thierry , Bazin-Kara Dorothée , Faller Anne Laure , Muller Clotilde , Nussbaumer Thimothée , Ismer Manfred , Benmoussa Abdellatif , Brahim-Bouna Mohamed , Beier Stéphanie , Perrin Peggy , Hannedouche Theirry
Published: June 2020

Background

There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death.

Methods

All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes.

Results

Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66–83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0–5), 7 (4–11) and 32 (26.5–35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25–106) and 690 Ly/µL (IQR 450–960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11–3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005–1.017); P < 0.0001].

Conclusions

HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.
DISTORTION OF SPHERES AND SURFACES IN SPACE
Authors: Baader Sebastian , Studer Luca , Züst Roger
Published: June 2020

It is known that the surface of a cone over the unit disc with large height has smaller distortion than the standard embedding of the 2-sphere in $\mathbb{R}^3$. In this note we show that distortion minimizers exist among convex embedded 2-spheres and have uniformly bounded eccentricity. Moreover, we prove that $\pi /2$ is a sharp lower bound on the distortion of embedded closed surfaces of positive genus.
Gut Microbiome Critically Impacts PCB-induced Changes in Metabolic Fingerprints and the Hepatic Transcriptome in Mice
Authors: Lim Joe Jongpyo , Li Xueshu , Lehmler Hans-Joachim , Wang Dongfang , Gu Haiwei , Cui Julia Yue
Published: June 2020

Polychlorinated biphenyls (PCBs) are ubiquitously detected and have been linked to metabolic diseases. Gut microbiome is recognized as a critical regulator of disease susceptibility; however, little is known how PCBs and gut microbiome interact to modulate hepatic xenobiotic and intermediary metabolism. We hypothesized the gut microbiome regulates PCB-mediated changes in the metabolic fingerprints and hepatic transcriptome. Ninety-day-old female conventional and germ-free mice were orally exposed to the Fox River Mixture (synthetic PCB mixture, 6 or 30 mg/kg) or corn oil (vehicle control, 10 ml/kg), once daily for 3 consecutive days. RNA-seq was conducted in liver, and endogenous metabolites were measured in liver and serum by LC-MS. Prototypical target genes of aryl hydrocarbon receptor, pregnane X receptor, and constitutive androstane receptor were more readily upregulated by PCBs in conventional conditions, indicating PCBs, to the hepatic transcriptome, act partly through the gut microbiome. In a gut microbiome-dependent manner, xenobiotic, and steroid metabolism pathways were upregulated, whereas response to misfolded proteins-related pathways was downregulated by PCBs. At the high PCB dose, NADP, and arginine appear to interact with drug-metabolizing enzymes (ie, Cyp1–3 family), which are highly correlated with Ruminiclostridium and Roseburia, providing a novel explanation of gut-liver interaction from PCB-exposure. Utilizing the Library of Integrated Network-based Cellular Signatures L1000 database, therapeutics targeting anti-inflammatory and endoplasmic reticulum stress pathways are predicted to be remedies that can mitigate PCB toxicity. Our findings demonstrate that habitation of the gut microbiota drives PCB-mediated hepatic responses. Our study adds knowledge of physiological response differences from PCB exposure and considerations for further investigations for gut microbiome-dependent therapeutics.
Telemedicine and the COVID-19 Pandemic: Are We Ready to Go Live?
Authors: Mills Emily C. , Savage Elizabeth , Lieder Jessica , Chiu Ernest S.
Published: June 2020

Telemedicine use in the field of wound care had been increasing in popularity when the novel coronavirus 2019 paralyzed the globe in early 2020. To combat the constraints of healthcare delivery during this time, the use of telemedicine has been further expanded. Although many limitations of telemedicine are still being untangled, the benefits of virtual care are being realized in both inpatient and outpatient settings. In this article, the advantages and disadvantages of telemedicine are discussed through two case examples that highlight the promise of implementation during and beyond the pandemic.
Opioid free anesthesia: feasible?
Authors: Chia Pamela A. , Cannesson Maxime , Bui Christine C. Myo
Published: June 2020

Purpose of review

The present review aims to address the feasibility of opioid free anesthesia (OFA). The use of opioids to provide adequate perioperative pain management has been a central practice of anesthesia, and only recently has been challenged. Understanding the goals and challenges of OFA is essential as the approach to intraoperative analgesia and postsurgical management of pain has shifted in response to the opioid epidemic in the United States.

Recent findings

OFA is an opioid sparing technique, which focuses on multimodal or balanced analgesia, relying on nonopioid adjuncts and regional anesthesia. Enhanced recovery after surgery protocols, often under the auspices of a perioperative pain service, can help guide and promote opioid reduced and OFA, without negatively impacting perioperative pain management or recovery.

The feasibility of OFA is evident. However, there are limitations of this approach that warrant discussion including the potential for adverse drug interactions with multimodal analgesics, the need for providers trained in regional anesthesia, and the management of pain expectations. Additionally, minimizing opioid use perioperatively also requires a change in current prescribing practices. Monitors that can reliably quantify nociception would be helpful in the titration of these analgesics and enable anesthesiologists to achieve the goal in providing personalized perioperative medicine.
“Like Yin and Yang”: Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities
Authors: Baker Robin , Leichtling Gillian , Hildebran Christi , Pinela Cristi , Waddell Elizabeth Needham , Sidlow Claire , Leahy Judith M. , Korthuis P. Todd
Published: June 2020

Objectives:

The objective of this study was to investigate methamphetamine use among people who use opioids in rural Oregon communities to explore reasons for use and perceptions of methamphetamine consequences.

Methods:

We conducted interviews and surveys with participants who inject drugs or misuse prescription opioids in 2 rural Oregon counties with high opioid overdose rates. Survey participants were identified through participant-driven sampling initiated in syringe service programs and field outreach (n = 144). Semi-structured interviews with participants were recruited from the same locations (n = 52).

Results:

Of 144 surveys completed, 112 reported using opioids in the past 30 days; 96% of the 112 also report methamphetamine use. Among the 124 reporting injection drug use, 50% indicated they injected both methamphetamine and heroin in the past 30 days. Interview participants reported early exposure to methamphetamine and indicated that methamphetamine was more widely available, less expensive, and less stigmatized compared to heroin. Participants reported using methamphetamine to improve work-life functioning and because they enjoy the high produced from simultaneous use. Several participants reported a conscious effort to shift to methamphetamine from heroin as a harm reduction strategy.

Some participants reported being involuntarily discharged from treatment for opioid use disorder due to methamphetamine use. Several participants perceived methamphetamine as conveying overdose prevention or reversal benefits, while fentanyl contamination in methamphetamine was reported or suspected.

Conclusion:

As rural communities respond to evolving drug supply and demand, there is increasing need for public health efforts to address the emerging issue of concurrent methamphetamine and opioid use.
Female Sexual Dysfunction
Authors: Wheeler Lindsay J. , Guntupalli Saketh R.
Published: June 2020

Female sexual dysfunction is associated with personal distress and includes female sexual interest and arousal disorder (including former hypoactive sexual desire disorder), female orgasmic disorder, genitopelvic pain and penetration disorder, and substance- or medication-induced sexual dysfunction. These disorders are remarkably common among women, with an estimated prevalence of 20–40%. It is our responsibility as obstetrician–gynecologists to identify risk factors and screen for female sexual dysfunction. Appropriate screening allows for further exploration into sexual function and dysfunction and, ultimately, determination of associated distress. Treatment often involves addressing the underlying issue through therapy or medical management. For female sexual interest and arousal disorder, treatment generally includes cognitive behavioral therapy, often with a mindfulness focus, and consideration of pharmaceutical management. Female orgasmic disorder is treated with education and awareness, as well as therapy. Evaluation for underlying etiology is particularly critical for genitopelvic pain and penetration disorder to allow treatment of an underlying condition. Finally, substance- or medication-induced sexual dysfunction is best managed by cessation of the implicated substance and consideration of adjunctive therapy if dysfunction is related to antidepressants. Female sexual dysfunction is often overlooked in clinical practice; however, there are effective medical and psychological options for management.
Loop-on-suture-guided insertion for easier capsular tension ring insertion and residual cortex removal
Authors: Cendelin Jiri , Rusnak Stepan
Published: June 2020

The capsular tension ring (CTR) is a useful aid in cataract surgery involving zonular impairment. In standard implantation with tweezers or injectors, there is limited control of the leading eyelet, and this can cause excessive stress on the zonular fibers and lead to damage of the capsular bag. Several techniques have been investigated with the aim of reducing these risks. In this study, a simple new modification of the suture-guided CTR technique is described. Adding a loop to the suture can facilitate manipulation during implantation and removal of cortex residues at the end of cataract extraction.
Surgical treatment of acute calculous cholecystitis complicated with hepatic dysfunction
Authors: Tian Yuanhu , Suo Xiaopeng
Published: June 2020

To evaluate the timing, feasibility, and necessity of early laparoscopic cholecystectomy (LC) in the management of patients with acute calculous cholecystitis complicated with hepatic dysfunction.

The clinical data of 60 patients with acute calculous cholecystitis complicated with hepatic dysfunction treated from January 2016 to January 2018 were analyzed retrospectively. A total of 32 patients underwent LC within 72 hours of the cholecystitis attack, 28 patients after 72 hours. The results were compared with those from 28 patients with delayed LC.

All the patients were operated by experienced surgeons, and no LC transfer to open operation. No significant differences were detected in the operation time, postoperative complications, intraoperative blood loss, white TBIL, ALT, GGT before and after the operation between the 2 groups (P > .05). Patients who underwent early LC had a short hospital stay and fewer hospital costs (P < .05). All the patients were cured.

It is safe, feasible, and necessary to perform LC within 72 hours in patients with acute calculous cholecystitis complicated with hepatic dysfunction. Such patients show a high positive correlation between the inflammation of acute calculous cholecystitis and the damage of hepatic function.
A comprehensive assessment of single nucleotide polymorphisms associated with pancreatic cancer risk
Authors: Ye Zhuo-Miao , Li Li-Juan , Zheng Jing-Hui , Zhang Chi , Lu Yun-Xin , Tang Youming
Published: June 2020

Background:

Single nucleotide polymorphisms (SNPs) have been inconsistently associated with pancreatic cancer (PC) risk. This meta-analysis aimed to synthesize relevant data on SNPs associated with PC.

Methods:

Databases were searched to identify association studies of SNPs and PC published through January 2020 from the databases of PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database (VIP) and Wanfang databases. Network meta-analysis and Thakkinstian algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. The methodological quality of data was assessed based on the STREGA statement Stata 14.0 will be used for systematic review and meta-analysis.

Results:

This study will provide a high-quality evidence to find the SNP most associated with pancreatic cancer susceptibility and the best genetic model.

Conclusions:

This study will explore which SNP is most associated with pancreatic cancer susceptibility.

Registration: INPLASY202040023.
Protrusion of a ceramic femoral head through the acetabular metallic cup in total-hip arthroplasty
Authors: Zhao Ding , Zhang De-Bao , Han Dong-Feng , Gu Gui-Shan
Published: June 2020

Rationale:

Dislocation, wear, metallosis, and implant loosening are well-known complications of a failed total-hip arthroplasty (THA), and acetabular liner dissociation is an uncommon but catastrophic complication. To our knowledge, this is the first description of metallosis due to acetabular liner dissociation, but not presenting as a result of wear of a metal-on-metal articulation and a polyethylene liner of other articulation.

Patient concerns:

We described a 61-year-old man who had a 2-year history of pain in the right groin region after THA. Postoperative period of primary THA was uneventful. However, he did not undergo postoperative follow-up, and often participated in strenuous sports activities including mountain climbing and long-distance running.

Diagnosis:

Radiographs demonstrated superior subluxation of the femoral head and direct articulation and abrasion wear of the ceramic femoral head on the cup. Preoperative laboratory data revealed no signs of infection.

Interventions:

We performed revision THA using a direct lateral approach with ceramic-on-ceramic hip prosthesis.

Outcomes:

Postoperatively, the patient wore a hip orthosis for 6 weeks to prevent dislocation but was allowed full weight bearing. At 1-year follow-up, there was no recurrence of hip pain.

Lessons:

Wear of THA components can result in catastrophic failure of the implants and significant soft-tissue metallosis. Therefore, regular postoperative follow-up is necessary for early intervention, even in those with asymptomatic hips.
Clinicopathologic characteristics of resectable colorectal cancer with mismatch repair protein defects in Chinese population
Authors: Li Jingjing , Xu Qi , Luo Cong , Chen Lei , Ying Jieer
Published: June 2020

Colorectal cancer (CRC) represents a major malignancy globally, with microsatellite instability as its second top molecular mechanism of carcinogenesis. Immunohistochemical (IHC), whose sensitivity and specificity exceed 90%, is used routinely to detect 4 MMR proteins (MLH1, PMS2, MSH2, and MSH6) for screening mismatch repair system defects. We aimed to assess associations of clinicopathologic characteristics with MMR status in resectable CRC patients.

Stage I-III CRC cases administered surgical resection in Zhejiang Cancer Hospital in 2013 to 2015 were retrospectively analyzed. MLH1, MSH2, MSH6, and PMS2 protein amounts were evaluated immunohistochemically. Clinicopathological information, including age, sex, tumor location, histological subclass, disease stage, regional lymph node (LN) metastasis, American Joint Committee on Cancer (AJCC) 8th edition stage, and survival data were retrospectively reviewed.

A total of 133 CRC cases were assessed, including 74 (55.6%), 45 (33.8%), 55 (41.4%), and 77 (57.9%) not expressing MLH1, MSH2, MSH6, and PMS2, respectively. There were significant associations of MLH1, MSH2, MSH6, and PMS2 proteins with age and sex (P < .05). MLH1, MSH2, and MSH6 (but not PMS2) showed positive associations with primary tumor location (P < .05). Of the 133 patients, 70 and 63 cases were affected on the right and left sides, respectively; significant associations of primary site with age and sex were observed (P < .05). Regarding the MMR status, MLH1, MSH2, and MSH6 protein expression levels were positively associated with primary site (P < .05). Five-year overall survival (OS) rates were 84.2% and 79.2% in left-side and right-side cases, respectively; 5-year disease-free survival (DFS) rates were 74.0% and 69.8%, respectively. Survival had no differences between left- and right-side patients in terms of OS (P = .318) and DFS (P = .481).

These data demonstrate that 4 major dMMR proteins are expressed differently in left- and right-side CRCs, and survival is comparable in right- and left-side resectable CRC cases with dMMR.