bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Antiepileptic Drug Treatment in Glioma Patients: Lamotrigine Versus Lacosamide
Authors: Opijnen Mark van , Meer Pim van der , Dirven Linda , Fiocco Marta , Kouwenhoven Mathilde , Bent Martin van den , Taphoorn Martin , Koekkoek Johan
Published: May 2021

Purpose: Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.Methods: In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2-4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.Results: We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI: 26-51%) versus 30% (95%CI: 20-41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI: 0.46-1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide. Conclusion: Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy.
Validity and risk factor analysis for helicopter emergency medical services (HEMS): The emergency call dispatch of Japanese air ambulances (Doctor-HeliTM️)
Authors: YAMADA Noriaki , KITAGAWA Yuichiro , YOSHIDA Takahiro , NACHI Sho , OKADA Hideshi , OGURA Shinji
Published: May 2021

Background:Some emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and the JUST, to detect the status of life-threatening situations. However, these triage systems have not been used for aeromedical services in Japan. Therefore, we investigated these profiles and conducted a pilot study.Method:We retrospectively evaluated the helicopter emergency medical service cases from 1 April 2015 to 31 March 2020 at Gifu University Hospital using our mission record. In this study, we only evaluated cases that dealt with internal medicine. We excluded cases that were influenced by external factors such as trauma or cases that included hospital-to-hospital transportation, focusing only on prehospital care. We evaluated the validity of medical emergencies such as emergency interventions and the necessity of hospital admission. In addition, we evaluated the validity of the suggested diagnoses and the associated risk factors.Result:A total of 451 cases were suitable for inclusion in the study. In the analysis for all emergency calls, 235 (52.11%) needed emergency intervention and 300 (64.4%) required hospital admission. The suggested diagnosis was valid for 261 (57.87%) cases. After the first assessment by emergency medical technicians (EMTs), 75 cases were removed from the analysis.Therefore, the results of the analysis for all emergency calls requiring emergency intervention were: 52.31%, need admission: 70.26%, and the suggested diagnosis was valid for 69.41% of cases. Results of a multivariate analysis of some key variables identified risk factors for emergency intervention, namely, age, under sports, and gasping. Hospital admission risk factors are being years old only. The suggested diagnosis was only valid in under sports situations.In the first analysis, the risk factors for emergency intervention are years old, being male, under sports, and gasping, and for hospital admission they are years old, being male, detecting stroke symptoms, and disturbance of consciousness. The suggested diagnosis was only valid in under sports situations.Conclusion:There are some “second” keywords/phrases that predict medical emergencies. Therefore, the dispatch commander should gather these keyword/phrases to assess.
Emergence of SARS-CoV-2 Spike Escape Mutation Q493r After Bamlanivimab/Etesevimab Treatment for COVID-19
Authors: Focosi Daniele , Novazzi Federica , Genoni Angelo , Dentali Francesco , gasperina Daniela Dalla , Baj Andreina , Maggi Fabrizio
Published: May 2021

SARS-CoV-2 variants are usually a consequence of random mutations in humans or other hosts, but accelerated evolution can also occur under selective pressure from therapeutic interventions with neutralizing antibodies1. Bamlanivimab has been recently withdrawn from the vendor as a monotherapy because of failure against E484K-positive SARS-CoV-2 variants, but emergency use authorization remains in place for the bamlanivimab/etesevimab cocktail2, for which no completely resistant variant has been reported to date. We report here the first in vivo case of a Spike escape mutation conferring combined resistance to both bamlanivimab and etesevimab.
RF and microwave variable waveform generator based on photonics with an integrated 49GHz FSR Kerr micro-comb source
Authors: Moss David
Published: May 2021

We report a photonic-based radio frequency (RF) arbitrary waveform generator (AWG) using a soliton crystal micro-comb source with a free spectral range (FSR) of 48.9 GHz. The comb source provides over 80 wavelengths, or channels, that we use to successfully achieve arbitrary waveform shapes including square waveforms with a tunable duty ratio ranging from 10–90%, sawtooth waveforms with a tunable slope ratio of 0.2 to 1, and a symmetric concave quadratic chirp waveform with an instantaneous frequency of sub GHz. We achieve good agreement between theory and experiment, validating the effectiveness of this approach towards realizing high-performance, broad bandwidth, nearly user-defined RF waveform generation.
The Role of Renewable Energy and Ecological Footprint on Economic Growth in Francophone African Countries in presence of Institutions
Authors: Nulambeh* Ndzembanteh Aboubakary , Eryiğit Kadir Yasin
Published: May 2021

This paper targets to examine the impact of renewable energy and ecological footprint on economic growth in 14 selected French-speaking countries in Africa. The study contributes to the ongoing debate in the literature on environment growth-nexus by providing evidence that economic growth emerges with environmental degradations and can be improved when there is a robust institutional framework. The present research used the generalized method of moments (GMM) to assess a dynamic growth model with data from 2007 to 2015. The results demonstrate that renewable energy is significant and negatively related to economic growth, which implies that renewable energy sources lower the per capita income growth in these countries. Meanwhile, the ecological footprint is positive and statistically significant in impacting economic growth in the long run. For institutions, we find that voice and accountability, political stability, and the rule of law are positive and statistically significant in influencing economic growth. Consequently, it is recommended that policymakers in this region develop dual policies that raise institutions' quality with minimal emissions of greenhouse gases.
Psychological impact of COVID-19 pandemic on medical students in Sudan, 2020
Authors: Omer Mohammed Eltahier Abdalla , Shareef Ahd Alaaeldin Hussain , Al-lahawi Ala'a Mirghani Babiker , Alhaj Hassan Hamed Mohammed , Ali Khalid Mohammed
Published: May 2021

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-2019 pandemic is prompting fear of falling sick, dying, helplessness and stigma so urgent and timely understanding of mental health status is needed to help the community. The aim of our study is to assess the psychological impact of COVID19 pandemic on medical students in Sudan. Methods and Materials: A cross-sectional descriptive research was done among medical student in Sudan during COVID 19 pandemic in August 2020. DASS-21 scales were used to determine the level of depression, anxiety and stress among medical students through an online questionnaire, their responses were taken relatable to 21 items of DASS scale. The data was analyzed by means of SPPS version 25.0. Results: The mean (SD) age of our study participants was 21.8 (2.4) with female to male ratio of 2.1. Most of the participants were residing during the time the of the study in middle stats of Sudan (50.8%) and 83% were staying with their families. Interestingly, more than 40.5% of the study participants were free of depression while more than 13% had extremely severe depression. On the other hand, only 4.4% had extremely severe stress. However, anxiety ranked the higher numbers with 23% had extremely severe anxiety. Adjusted linear regression model revealed that lower levels in the medical school and open colleges during the lock down period were associated with more anxiety (p value 0.01,0.006 respectively), while having a family member working in the medical field is associated with less stress (p value 0.02). Conclusion : Our study provides good idea about the magnitude of the psychological burden upon medical students during the COVID- 19 pandemic and showed many factors that can inﬂuence mental health so as to emphasize the need to adopt new strategies to improve psychological services. In addition, it's important to support high-risk groups especially those with preexisting mental illness to offer advanced psychological interventions. So our study can be used to construct and formulate a psychological intervention and implement mental health strategies directed toward vulnerable groups during the COVID-19 epidemic.
Depth distribution of belowground net primary production across global biomes
Authors: Luo Zhongkui , Xiao Liujun , Wang Guocheng , Chang Jinfeng , Chen Yaoyao , Guo Xiaowei , Mao Xiali , Wang Mingming , Zhang Shuai , Shi Zhou , Luo Yiqi , Cheng Lei , Yu Kailiang , Mo Fei , Jia Shengyao
Published: May 2021

The depth distribution of belowground net primary production (BNPP) has been unquantified globally, hindering our understanding of belowground carbon dynamics. We synthesize global observational data sets to infer the depth allocation of BNPP down to 2 m, and map depth-specific BNPP globally at 1 km resolution. We estimate that global average BNPP in the 0–20 soil layer is 1.1 Mg C ha–1 yr–1, accounting for >50% of total BNPP. Across the globe, the depth distribution of BNPP shows large variability, and more BNPP is allocated to deeper layers in hotter and drier regions. Edaphic, climatic and topographic properties (in the order of importance) can explain >80% of such variability in different soil depths; and the direction and magnitude of the influence of individual properties (e.g., precipitation and soil nutrient) are soil depth- and biome-dependent. Our results provide global benchmarks for predictions of whole-soil carbon profiles across global biomes.
Floral traits and flowering behaviors of Malaysian rice cytoplasmic male sterile and maintainer lines and its relationship with out-crossing performance
Authors: Hashim Shahida , Ding Phebe , Ismail Mohd Firdaus , Ramli Asfaliza
Published: May 2021

Rice is a strictly self-pollinating crop. However, in hybrid rice seed production, an effective male sterility system is used to produce hybrid seed in bulk. In hybrid rice system, the pollen grains of cytoplasmic male sterile (CMS) are sterile and the female organ of the CMS depends on the fertile pollen released by the maintainer or restorer lines via out-crossing or cross-pollination in order to produce seed. Floral trait and flowering behavior of CMS and its corresponding maintainer or restorer lines are essential factors in hybrid rice seed production because they influenced the out-crossing or cross-pollination between parental lines. Two local CMSs and their corresponding maintainer lines were developed through breeding program in Malaysian Agricultural Research and Development Institute (MARDI) namely 0025A/0025B and 0047A/0047B. This study was carried out on floral traits and flowering behavior of these two hybrid line. Present studies have shown that there were variations between the CMS and its maintainer lines whether on floral trait or flowering behavior for both hybrid rice combinations. The results showed that stigma characters for both 0025A and 0047 were superior than their respective maintainers. Therefore, it is expected that the out-crossing rate would be high. Seeding date intervals need to be done on 0025A/0025B during nursery stage because the on-set of flowering between parental lines was significantly different. Panicle of both CMS was also classified as just exserted and partially-exserted and application of exogenous hormones such as gibberellic acid was useful to improve panicle elongation and consequently increase the seed set and yield. Correlation study indicates that the stigma area of both 0025A and 0047A has significant positive correlation with out-crossing rate.
Economic feasibility of abscisic acid application to uniform ‘Rubi’ grapes coloration
Authors: Neto Francisco José Domingues , Nachiluk Katia , Fagundes Priscilla Rocha Silva , Tecchio Marco Antonio
Published: May 2021

São Miguel Arcanjo municipality (23º 31 ’S, 47º 35’ O and average altitude of 660 m) is part of one of the three main grape productive regions of São Paulo state, Brazil. The ‘Rubi’ grapes (Vitis vinifera) production constraint in that region is to achieve the variety characteristic coloration, which affects commercialization. The color of the berry grapes is due to the existence of anthocyanins and their accumulation seems to be at least in part regulated by abscisic acid. Therefore, exogenous applications of this regulator may increase the anthocyanins concentration in the grapes' skin. The aim of this paper is to evaluate the economic feasibility of abscisic acid application for treatment of the ‘Rubi’ grapes color uniformization and the impact of this application in the production cost. Production costs were calculated for the abscisic acid treated grapes and the non-treated grapes for a ‘Rubi’ grapes variety in the sixth year of production and recommended abscisic acid concentration for the region (400 mg L-1 at the beginning of the maturation + 200 mg L-1 at 25 days after first application). The abscisic acid was applied on the berry bunches in the morning using a backpack sprayer that provided full and uniform coverage. Economic feasibility was determined by the increment in the sale price of the final product due to the berries’ quality achieved with the treatment. The cost components measured were: production cost, variable and fixed cost quota, effective operational cost, total operational cost, operational profit and profitability index. Technical coefficients input prices, machinery and implements compose the production cost and were surveyed at the property where the experiment was performed. The cost structure is the Total Operating Cost to which social charges, machinery depreciation, interest rate and depreciation of a one-hectare area with a lifespan of 20 years were added. Prices paid to producers in the same period were collected from CEAGESP database for the profitability analysis. The Total Operating Cost for grape’s production with abscisic acid treatment was 26.12 % superior to the one of the grapes produced without the treatment, thus adding a US$ 0.15 increment in the paid price per kilogram of the final product. Therefore, this experiment has shown that abscisic acid application is a profitable investment that adds value to the final product cultivated in low thermal amplitude regions where the grapes cannot achieve the variety’s characteristic coloration
Stability and adaptability of elite upland rice lines using Bayesian-AMMI model
Authors: Nuvunga Joel Jorge , Silva Alessandra Querino da , Mendes Cristian Tiago Erazo , Cossa Gabriel , Oliveira Luciano Antonio de , Silva Carlos Pereira da , Cândido Nelio , Inácio Hermínio Bento , Filho Júlio Sílvio de Sousa Bueno
Published: May 2021

Rice is one of the world’s most important crops. The search for genotypes that are more productive and have wide adaptation to different environments is paramount. One of the major breeder’s obstacles faced is identification of superior strains is the presence of Genotype × Environment Interaction (GEI), which motivated the development of countless statistical procedures aiming to offer more efficient studies. In this work we analysed adaptability and stability of 13 upland rice lineages as part of a genetic improvement program in nine different environments, resulting from local combination and years of agriculture. The experiment was conducted in a completely randomized block design, with three replicates. The main variable is the grain storage in kg/ha. The model applied is the Bayesian Main Additive Effects and Multiplicative Interaction (Bayesian-AMMI). Our implementation implies an extra assumption of random effects from genotypes coming from a single population as opposed to previous works in the literature. Credibility regions with maximum posteriori density allowed identification of cultivars with higher average yield. Stable genotypes showed an initial evidence of adaptation to an environment in this rice breeding program. Bayesian-AMMI is flexible, and starts to be more widely used, but our suggestion is promising in making it a more powerful tool
Temporal and spatial progress of Cowpea aphid-borne mosaic virus (CABMV) in passion fruit (Passiflora edulis Sims)
Authors: Kotsubo Roger Yochiharu , Santos Karina Silva dos , Fantin Lucas Henrique , Chaves Vitória Carolina Antunes , Filho João Valdecir Casaroto , Tissiano Vinicius Ferrari , Molina Rúbia de Oliveira
Published: May 2021

Among the diseases that affect passion fruit, those causing fruit woodiness is considered the most important. Cowpea aphid-borne mosaic virus (CABMV) is an important vírus that is transmitted by several aphid species during the bite, making the use of insecticides infeasible to control these vectors. In order to understand the epidemiological behavior of the disease, this study aimed to study the temporal progress and spatial pattern of CABMV in the field. Healthy seedlings of passion fruit with 2.0 meters height were implanted in the field condition at the experimental station of the IDR-Paraná, Brazil. The evaluations were performed weekly observing the symptoms of blister, mosaic, chlorosis and crinkled leaves. For the analyses, the logistic, gompertz and monomolecular models were adjusted to CABMV incidence data in passion fruit. The spatial pattern of the disease was characterized by the dispersion index and Taylor's Power Law. The logistic model was the one that best described the progress in the incidence of the disease. The incidence progress rate of CABMV was 0.037, 0.077 and 0.060 % day-1. At the beginning of the epidemic, the pattern was random. The initial dispersion mechanism was occured through aphid vectors, como Aphis gossypii Glover, Aphis fabae Scopoli, Aphis solanella Theobald, Toxoptera citricida Kilkaldy, Uroleucon ambrosiae Thomas and Uroleucon sonchi L. infected with CABMV that starts its test bite randomly. The pattern of disease dispersion began to be added when the incidence of plants reached 10 and 7%, in the 2015/16 and 2017/18 harvests, respectively. The random spatial pattern suggested that infected aphids enter several points of the orchard and infected plants become a source for secondary infections, characterizing aggregate pattern. Thus, the eradication of alternative hosts abroad can be adopted as management strategies of CABMV
The mediating effect of job satisfaction on health and safety policy management and employee productivity in manufacturing firms
Authors: Morgan O. Morgan , Emu Winifred , Amadi Christian , E. Okon Emmanuel , Njama Paul
Published: May 2021

The study investigated the mediating effect of job satisfaction on health and safety policy management and employee productivity in manufacturing firms in Nigeria. For the study, a quantitative analytical method was adopted, including a descriptive survey. To obtain data for the study, a questionnaire instrument was constructed and distributed among 950 sampled respondents in selected manufacturing firms in Nigeria. The descriptive statistics was deployed in the data analysis, while the multiple regression analysis was used to test the study hypotheses at the 0.05 level of significance. The mediating effect of job satisfaction on health and safety policy management and employee productivity relationship was confirmed using the Sobel test with the aid of MedGraph. The results showed that hazard prevention and control policy have a significant positive effect on employee productivity. Risk assessment policy have a significant positive effect on employee productivity. Also, job satisfaction has a significant positive mediating effect on the health and safety policy management and employee productivity relationship. Therefore, manufacturing firms should take appropriate measures to prevent and control hazards and provide effective risk assessments to improve health and safety policy management. AcknowledgmentsThe authors express gratitude to anonymous reviewers, the journal editor and all the authors whose work were used in this study. The authors are grateful to the management of manufacturing firms included in the study for having given approval for the administration of the questionnaire instrument, and the survey respondents for providing their views on the issues raised in the questionnaire instrument on health and safety policy management (hazard prevention and control policy and risk assessment policy), employee productivity and job satisfaction.
Assessment of temporal change in the tails of probability distribution of daily precipitation over India due to climatic shift in the 1970s
Authors: Gupta Neha , Chavan Sagar Rohidas
Published: May 2021

Daily precipitation extremes are crucial in the hydrological design of major water control structures and are expected to show a changing tendency over time due to climate change. The magnitude and frequency of extreme precipitation can be assessed by studying the upper tail behavior of probability distributions of daily precipitation. Depending on the tail behavior, the distributions can be classified into two categories: heavy-tailed and light-tailed distributions. Heavier tails indicate more frequent occurrences of extreme precipitation events. In this paper, we have analyzed the temporal change in the tail behavior of daily precipitation over India from pre- to post-1970 time periods as per the global climatic shift. A modified Probability Ratio Mean Square Error norm is used to identify the best-fit distribution to the tails of daily precipitation among four theoretical distributions (e.g., Pareto-type II, Lognormal, Weibull, and Gamma distributions). The results indicate that the Lognormal distribution, which is a heavy-tailed distribution, fits the tails of daily precipitation for the majority of the grids. It is inferred from the study that there is an increase in the heaviness of tails of daily precipitation data over India from pre- to post-1970 time periods.
Significance of Carbohydrate Antigen 19-9 as a biomarker in Hepatocellular Carcinoma and Cholangiocarcinoma
Authors: Abdulaziz Badawy A. , El Agawy Waleed , Ibrahim Mohamed El-Tantawy , Khalil Medhat A. , Abdel Halim Walid A.
Published: May 2021

Background & Aims:

Combined hepatocellular - cholangiocarcinomas (cHCC-CCs) are rare malignancies representing less than 1% of all primary liver cancers. Correct preoperative diagnosis is desirable because the frequency of lymph node metastasis in ICC and cHCC-CC, making lymph node dissection a necessity if curative resection to be attempted. This study aimed to investigate the significance of elevated CA19-9 in suspecting a diagnosis of Intrahepatic Cholangiocarcinoma (ICC) “non-invasively” in patients with typical radiological features of HCC.

Methods

This cross-sectional study was conducted on 54 patients with typical radiological criteria of HCC and elevated CA19-9 level. And were classified into two groups I included 22 patients (40.74%) who were diagnosed as HCC, group II included 30 patients (55.56%) were diagnosed as ICC, and there were 2 patients (3.7%) were diagnosed as cHCC-CC.

Tumor markers (AFP and CA19-9), dynamic study (Triphasic CT or Dynamic MRI) were done for all patients. Target liver biopsy was done for histopathology and immuno-histochemistry using specific monoclonal antibodies against Glypican-3, Hep-par1, CK-7, CK-19 and CK-20 were done.

Results:

There was a statistically significant difference between HCC and ICC as regard CA19-9 and Alpha-fetoprotein (AFP). CA19-9 and AFP cut-offs were ˃ 58.9 U/mL and ˂ 25.8 ng/mL, respectively favoring the diagnosis of ICC, with very high sensitivity and specificity. CA19-9 level was 176.3 and 156.7 U/mL while AFP level was 460 and 170 ng/mL in cHCC-CC cases, respectively.

Conclusion:

CA19-9 could be a diagnostic marker of ICC in cases of typical radiological criteria of HCC with elevated CA19-9.
Superheroines and superstereotypes? Queer postfeminism, intersectionality and female superheroes in Supergirl
Authors: De Wulf Helskens Maxine , Dhaenens Frederik , Van Leuven Sarah
Published: May 2021

Since the new millennium, there has been a remarkable increase in audio-visual adaptations of superhero comic books (Garcia-Escriva, 2018). Whereas these adaptations used to include predominantly male superheroes, they have started to feature more female superheroes (Curtis & Cardo, 2018). An increase, however, does not imply diverse and rounded representations, since women in superhero movies tend to be depicted in stereotypical and sexualized ways (Kaplan, Miller & Rauch, 2016). Even though previous research has addressed the genre's politics of gender representation, there is a need for research that looks at televised female superheroes from a queer postfeminist lens. Therefore, this study conducted a textual analysis, informed by queer postfeminism and intersectionality theory, to explore how leading female superheroes in the series Supergirl are represented. We concluded that the superhero series Supergirl subverts hegemonic gendered identities through its depiction of both traditional and queer femininities.
COVID-19 Roundtable
Authors: Beeckmans Luce , D'Aoust Anne-Marie , De Craene Valerie , DiCenzo Maria , Hens Kristien , Kenis Anneleen , McRuer Robert , Zeiter Anne-Christel
Published: May 2021

DiGeSt 8(1) General Issue - COVID-19 Roundtable
Title Page & Table of Contents
Authors: Vanlee Florian
Published: May 2021

DiGeSt 8(1) General Issue - Title Page & Table of Contents
Uso de aguas residuales de porcicultura y faenamiento para el crecimiento y obtención de biomasa algal de Chlorella vulgaris
Authors: Medrano-Barboza Johanna , Aguirre-Bravo Alberto Alejandro , Encalada-Rosales Paula , Yerovi Roberto , Ramírez-Iglesias José Rubén
Published: May 2021

Diversas investigaciones respaldan el uso de microalgas como fuente de productos de interés biotecnológico, pero aún existen limitaciones para su implementación; como el uso de aguas residuales como medio de cultivo y la generación de biomasa en presencia de otros microorganismos que compiten por los nutrientes. En este estudio se compararon 3 métodos de desinfección para aguas residuales de porcicultura y faenamiento, y se evaluó su aplicabilidad para el cultivo de Chlorella vulgaris. Se probaron tres métodos de pretratamientos: irradiación UV, hipoclorito de sodio (NaClO) y ácido peracético (CH3CO3H) y se compararon los resultados con agua no tratada. Se determinó la generación de biomasa (g/L) y el consumo de nitratos, ortofosfatos y demanda química de oxígeno, durante 13 días de cultivo con pretratamiento y en agua sin tratar. La desinfección por UV durante 30 minutos eliminó completamente las bacterias, mientras que los tratamientos químicos con las concentraciones empleadas en este estudio lograron reducir parcialmente la carga bacteriana. El agua residual con pretratamiento por UV generó una biomasa de C. vulgaris de 0,2 g/L con elevados porcentajes de remoción de nutrientes del medio (97 y 89 % para nitratos y ortofosfatos), valores de remoción superiores a los presentados por la condición sin pretratamientos. Estos resultados sugieren la necesidad de desinfectar las aguas residuales para su implementación como medio de cultivo, además de indicar la factibilidad de su uso como medio de crecimiento complejo, con el objetivo de generar biomasa.
Effect of Plasmodium berghei infection on fetuses in pregnant BALB/c mice at two periods of pregnancy
Authors: Gómez Andreina , Pernía Beatriz , Zamora Lizbeth , Spencer Lilian M.
Published: May 2021

Malaria is a disease caused by a protozoan of the genus Plasmodium in humans and vertebrates. It has a high morbidity and mortality rate, especially in pregnant women living in countries with high transmission rates. Murine models have been an excellent tool to evaluate the effects of malarial infection in the mother-fetus relationship. For this reason, we evaluated the effect of malarial infection on fetal development at the beginning and middle of the gestational period in BALB/c mice infected with Plasmodium berghei ANKA. Our results show that malarial infection at the beginning of pregnancy markedly affects the development of the fetus in size, weight, and development of its limbs so that the control of the pregnant mother is relevant at the beginning of gestation
Adaptation in Metapopulation: Book Review
Authors: Cevallos-Chávez Jordy José
Published: May 2021

The members of any family are not always living in the same region. Either for work, study or other reasons they are separated by distance. Although they live separately, they are related by blood and still interact with another family member to some extent. This phenomenon not only happens with humans. In the same way, we can see this pattern with any living organism in nature. For instance, we can see individuals of a forest bird species distributed among several separate forest patches, within which more or fewer stable populations are established, but that maintain migratory movements from one patch to another. At present, nature is increasingly fragmenting due to natural causes as well as a human activity. Therefore, since nature is patchy and becoming more so, biologists have become more interested in metapopulations1. Specifically, they have a particular interest in understanding how metapopulations adapt. Adaptation in Metapopulations addresses this topic, providing a varied, profoundly considered discussion of the current condition of the understanding of it.
Effect of Adherence to Smartphone App Use on the Long-term Effectiveness of Weight Loss in Developing and OECD Countries: Retrospective Cohort Study
Authors: Han Myeunghee , Rhee Sang Youl
Published: May 2021

Background

Globally, 71% of deaths occur due to noncommunicable diseases (NCDs). Poor diet quality and physical activity have a significant impact on NCDs. At present, behavior change interventions using smartphone apps have rapidly increased worldwide to prevent NCDs. However, most previous studies on the use and effectiveness of apps have been conducted in Organization for Economic Co-operation and Development (OECD) countries. As such, relevant research in low-income countries is scarce.

Objective

This retrospective cohort study aims to investigate the characteristics of adherence to the use of the Noom app. We also aim to compare the effects of using the app on body weight changes over time according to adherence to the use of the app between users in low-income and OECD countries. In addition, the differences in weight loss are compared among users who use the free and paid versions of the app.

Methods

A secondary data analysis was conducted using repeated measures. The data were collected from users in low-income countries (n=312) and OECD countries (n=8041) who used the app for 12 months. The app provided programs for the self-monitoring of physical activity, dietary intake, and body weight. Descriptive statistics, independent two-tailed t tests, chi-square tests, and linear mixed models were used for the analysis.

Results

During the first 3 months of using the Noom app, users from OECD countries entered data into the app more frequently; however, users in low-income countries entered data more frequently from 3 months to 12 months. Users in OECD countries consumed significantly more calories than those in low-income countries for 12 months. The body weight of all users significantly decreased over time (−1.8 kg; P<.001); however, no statistically significant differences in the change in body weight for 12 months were observed between users from low-income and OECD countries (β=−.2; P=.19). The users who frequently monitored their lunch (β=−.1; P<.001), dinner (β=−.1; P<.001), body weight (β=−.1; P<.001), evening snack (β=−.1; P<.001), and exercise (β=−.03; P<.001) exhibited significant weight loss over time. We found no significant differences in the body weight changes between users who used the free and paid versions of the app (β=−.2; P=.19).

Conclusions

This study found that using the app has a significant effect on weight loss regardless of users’ country of residence. The results of this study suggest that the frequency of monitoring health-related behaviors by entering data into the app plays a pivotal role in losing weight. In conclusion, regardless of where users live and what versions of the app they use, it is important to monitor health-related behaviors by frequently entering data into the app to efficiently lose weight.
A Typology of Existing Machine Learning–Based Predictive Analytic Tools Focused on Reducing Costs and Improving Quality in Health Care: Systematic Search and Content Analysis
Authors: Nichol Ariadne A , Batten Jason N , Halley Meghan C , Axelrod Julia K , Sankar Pamela L , Cho Mildred K
Published: May 2021

Background

Considerable effort has been devoted to the development of artificial intelligence, including machine learning–based predictive analytics (MLPA) for use in health care settings. The growth of MLPA could be fueled by payment reforms that hold health care organizations responsible for providing high-quality, cost-effective care. Policy analysts, ethicists, and computer scientists have identified unique ethical and regulatory challenges from the use of MLPA in health care. However, little is known about the types of MLPA health care products available on the market today or their stated goals.

Objective

This study aims to better characterize available MLPA health care products, identifying and characterizing claims about products recently or currently in use in US health care settings that are marketed as tools to improve health care efficiency by improving quality of care while reducing costs.

Methods

We conducted systematic database searches of relevant business news and academic research to identify MLPA products for health care efficiency meeting our inclusion and exclusion criteria. We used content analysis to generate MLPA product categories and characterize the organizations marketing the products.

Results

We identified 106 products and characterized them based on publicly available information in terms of the types of predictions made and the size, type, and clinical training of the leadership of the companies marketing them. We identified 5 categories of predictions made by MLPA products based on publicly available product marketing materials: disease onset and progression, treatment, cost and utilization, admissions and readmissions, and decompensation and adverse events.

Conclusions

Our findings provide a foundational reference to inform the analysis of specific ethical and regulatory challenges arising from the use of MLPA to improve health care efficiency.
The Development of a Digital Patient-Reported Outcome Measurement for Adults With Chronic Disease (The Parsley Symptom Index): Prospective Cohort Study
Authors: Williams Hants , Steinberg Sarah , Berzin Robin
Published: May 2021

Background

The monitoring and management of chronic illness has always been a challenge. Patient-reported outcome measures (PROMs) can be powerful tools for monitoring symptoms and guiding treatment of chronic diseases, but the available PROM tools are either too broad or too disease specific for the needs of a primary care practice focused on longitudinal care.

Objective

In this study we describe the development and preliminary validation of the Parsley Symptom Index (PSI).

Methods

This prospective cohort study took place from January 5, 2018, to June 05, 2020, among a sample of 4621 adult patients at Parsley Health. After a review of literature, followed by binning and winnowing of potential items, a 45-item PROM that also served as a review of systems (ROS) was developed. The PSI was deployed and completed by patients via an online portal. Construct and face validity was performed by clinicians, tested on patients, and feasibility was measured by response rate, completion rate, and percentage of missing data.

Results

The response rate for 12,175 collected PSIs was 93.72% (4331/4621) with a 100% item completion rate. A confirmatory factor analysis confirmed the model structure was satisfactory by a Comparative Fit Index of 0.943, Tucker–Lewis index of 0.938, and root mean square error of approximation of 0.028.

Conclusions

A 45-item ROS-style PROM designed to capture chronic disease symptoms was developed, and preliminary validation suggests that the PSI can be deployed, completed, and helpful to both patients and clinicians.
Olfactory Training and Visual Stimulation Assisted by a Web Application for Patients With Persistent Olfactory Dysfunction After SARS-CoV-2 Infection: Observational Study
Authors: Denis Fabrice , Septans Anne-Lise , Periers Lea , Maillard Jean-Michel , Legoff Florian , Gurden Hirac , Moriniere Sylvain
Published: May 2021

Background

Persistent olfactory dysfunction is a significant complication of SARS-CoV-2 infection. Olfactory training involving aromatic oils has been recommended to improve olfactory recovery, but quantitative data are missing.

Objective

We aimed to quantify the benefit of olfactory training and visual stimulation assisted by a dedicated web application for patients who experienced olfactory dysfunction for ≥1 month.

Methods

We performed an observational, real-life, data-based study on a cohort of patients who experienced at least 1 month of persistent olfactory dysfunction between January 30 and March 26, 2021. An analysis was performed after a mean olfactory training time of 4 weeks, and at least 500 patients were assessable for primary outcome assessment. Participants exposed themselves twice daily to odors from 4 high-concentration oils and visual stimulation assisted by a dedicated web application. Improvement was defined as a 2-point increase on a 10-point, self-assessed olfactory visual analogue scale.

Results

In total, 548 patients were assessable for primary outcome assessment. The mean baseline, self-assessed olfactory score was 1.9 (SD 1.7), and this increased to 4.6 (SD 2.8) after a mean olfactory training time of 27.7 days (SD 17.2). Olfactory training was associated with at least a 2-point increase in 64.2% (352/548) of patients. The rate of patients’ olfactory improvement was higher for patients who trained for more than 28 days than that rate for patients who trained for less than 28 days (73.3% vs 59%; P=.002). The time to olfactory improvement was 8 days faster for patients with hyposmia compared to the time to improvement for patients with anosmia (P<.001). This benefit was observed regardless of the duration of the olfactory dysfunction.

Conclusions

Olfactory training and visual stimulation assisted by a dedicated web application was associated with significant improvement in olfaction, especially after 28 days of olfactory training.
A Machine Learning Algorithm to Predict Hyperglycemic Cases Induced by PD-1/PD-L1 Inhibitors in the Real World (Preprint)
Authors: Yang Jincheng
Published: May 2021

BACKGROUND

Diabetes mellitus and cancer are amongst the leading causes of deaths worldwide; hyperglycemia plays a major contributory role in neoplastic transformation risk. Support Vector Machine (SVM) is a type of supervised learning method which analyzes data and recognizes patterns, mainly used for statistical classification and regression.

OBJECTIVE

From reported adverse events of PD-1 or PD-L1 (programmed death 1 or ligand 1) inhibitors in post-marketing monitoring, we aimed to construct an effective machine learning algorithm to predict the probability of hyperglycemic adverse reaction from PD-1/PD-L1 inhibitors treated patients efficiently and rapidly.

METHODS

Raw data was downloaded from US Food and Drug Administration Adverse Event Reporting System (FDA FAERS). Signal of relationship between drug and adverse reaction based on disproportionality analysis and Bayesian analysis. A multivariate pattern classification of SVM was used to construct classifier to separate adverse hyperglycemic reaction patients. A 10-fold-3-time cross validation for model setup within training data (80% data) output best parameter values in SVM within R software. The model was validated in each testing data (20% data) and two total drug data, with exactly predictor parameter variables: gamma and nu.

RESULTS

Total 95918 case files were downloaded from 7 relevant drugs (cemiplimab, avelumab, durvalumab, atezolizumab, pembrolizumab, ipilimumab, nivolumab). The number-type/number-optimization method was selected to optimize model. Both gamma and nu values correlated with case number showed high adjusted r2 in curve regressions (both r2 >0.95). Indexes of accuracy, F1 score, kappa and sensitivity were greatly improved from the prediction model in training data and two total drug data.

CONCLUSIONS

The SVM prediction model established here can non-invasively and precisely predict occurrence of hyperglycemic adverse drug reaction (ADR) in PD-1/PD-L1 inhibitors treated patients. Such information is vital to overcome ADR and to improve outcomes by distinguish high hyperglycemia-risk patients, and this machine learning algorithm can eventually add value onto clinical decision making.

CLINICALTRIAL

N/A
Are Online Synchronous Team-Based-Learning (TBL) pedagogy effective? Perspectives from study on a group of medical students in Oman (Preprint)
Authors: B Sannathimmappa Mohan
Published: May 2021

BACKGROUND

Team-based learning (TBL) is highly structured, instructive, and student-focused pedagogy used by medical educators to foster students’ learning.

OBJECTIVE

The purpose of our study was to qualitatively explore students’ perception on effectiveness of online synchronous TBL pedagogical strategy in promoting learning outcomes.

METHODS

A cross-over study was conducted on MD4 year medical students, using four modified TBL sessions on common immunological diseases. The means and standard deviations of the pretest and posttest scores were compared using unpaired T-test. ANOVA for cross-over design was used to find out confounding by sequence of interventions with a p-value of < 0.05 signifying significance. Students’ feedback on the effectiveness of online TBL sessions was collected through predesigned questionnaire on a 3-point Likert scale. The data was analyzed using SPSS version 22 and was expressed as number and percentage.

RESULTS

In total, 139 MD4 year medical students participated in the activity. The overall response of our students toward the effectiveness of online TBL pedagogy was overwhelmingly positive. Majority (>80%) perceived TBL as an enjoyable active session that promoted their active participation and engagement in the learning process through student-led discussions. Also, many opined that TBL enhanced their critical thinking, problem solving ability, communication skills, and thus improved their knowledge. The posttest scores of the students who participated in TBL session was significantly higher when compared to self-study group, suggesting the session improved their knowledge.

CONCLUSIONS

TBL is an instructive and highly structured teaching-learning strategy, welcomed by majority of our participants. The pre-class preparation, readiness assurance tests, instructor’s feedback, and knowledge application exercises encourage students to engage in active and collaborative learning and thus aids in better knowledge acquisition. From our study results, it is concluded that online TBL sessions are effective in fostering students’ learning and can be used confidently when situation demands.

CLINICALTRIAL

NU/COMHS/EBC0001/2021
Prostate Cancer Risk Calculators for Healthy Populations: Systematic Review (Preprint)
Authors: Bandala-Jacques Antonio , Castellanos Esquivel Kevin Daniel , Pérez-Hurtado Fernanda , Hernández-Silva Cristobal , Reynoso-Noverón Nancy
Published: May 2021

BACKGROUND

Screening for prostate cancer has long been a debated, complex topic. The use of risk calculators for prostate cancer is recommended for determining patients’ individual risk of cancer and the subsequent need for a prostate biopsy. These tools could lead to better discrimination of patients in need of invasive diagnostic procedures and optimized allocation of health care resources

OBJECTIVE

The goal of the research was to systematically review available literature on the performance of current prostate cancer risk calculators in healthy populations by comparing the relative impact of individual items on different cohorts and on the models’ overall performance.

METHODS

We performed a systematic review of available prostate cancer risk calculators targeted at healthy populations. We included studies published from January 2000 to March 2021 in English, Spanish, French, Portuguese, or German. Two reviewers independently decided for or against inclusion based on abstracts. A third reviewer intervened in case of disagreements. From the selected titles, we extracted information regarding the purpose of the manuscript, analyzed calculators, population for which it was calibrated, included risk factors, and the model’s overall accuracy.

RESULTS

We included a total of 18 calculators from 53 different manuscripts. The most commonly analyzed ones were the Prostate Cancer Prevention Trial (PCPT) and European Randomized Study on Prostate Cancer (ERSPC) risk calculators developed from North American and European cohorts, respectively. Both calculators provided high diagnostic ability of aggressive prostate cancer (AUC as high as 0.798 for PCPT and 0.91 for ERSPC). We found 9 calculators developed from scratch for specific populations that reached a diagnostic ability as high as 0.938. The most commonly included risk factors in the calculators were age, prostate specific antigen levels, and digital rectal examination findings. Additional calculators included race and detailed personal and family history.

CONCLUSIONS

Both the PCPR and ERSPC risk calculators have been successfully adapted for cohorts other than the ones they were originally created for with no loss of diagnostic ability. Furthermore, designing calculators from scratch considering each population’s sociocultural differences has resulted in risk tools that can be well adapted to be valid in more patients. The best risk calculator for prostate cancer will be that which has been calibrated for its intended population and can be easily reproduced and implemented.

CLINICALTRIAL

PROSPERO CRD42021242110; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242110