bluuebunny/crossref_metadata_2025 huggingface dataset:
Bladder perforation during transurethral resection of bladder tumour is not a result of deficient structure of the bladder wall
Authors: Poletajew Sławomir , Ilczuk Tomasz , Krajewski Wojciech , Niemczyk Grzegorz , Cyran Agata , Białek Łukasz , Radziszewski Piotr , Górnicka Barbara , Kryst Piotr
Published: May 2020

Background Transurethral resection of the bladder tumour (TUR) is associated with a risk of bladder perforation. The underlying mechanisms and risk factors are unknown. The aim of this study was to describe the quality and architecture of urothelium and bladder submucosa in patients undergoing TUR complicated by bladder perforation. Methods Fifteen patients who underwent TUR complicated by a bladder perforation were retrospectively enrolled into this morphological analysis (group 1). As a control group, 15 patients, who had undergone uncomplicated TUR, were matched (group 2). Surgical specimens were collected from all participating patients. Immunohistochemical studies were performed with primary mouse anti-human E-cadherin, beta-catenin, type IV collagen, cytokeratin 20 and epithelial membrane antigen antibodies. The intensity of the immunohistochemical reaction was assessed using an immunoreactive score (IRS). Ultrastructural examinations were performed in transmission electron microscopy. The microscopic assessment was focused on the intensity of fibrosis in bladder submucosa and the presence of degenerative changes in the urothelium. Results Patients’ age, sex distribution, tumour diameters, surgeon experience or cancer stage did not differ between study groups. Immunohistochemical analysis did not reveal statistically significant differences between group 1 and group 2. From clinical point of view, ultrastructural analysis by electron microscopy showed higher rate of severe fibrosis in group 1 (63.6% vs. 38.5%), with no differences in the rate and degree of urothelial changes. However, these differences were not statistically significant (p = 0.32). Conclusions Bladder perforation during transurethral resection of bladder tumour is not a result of deficient structure of the bladder wall and surgical technique seems to play the most important role in its prevention.
Adjuvant instant pre-operative renal artery embolization facilitates the radical nephrectomy and thrombectomy in locally advanced renal cancer with venous thrombus: A retrospective study of 54 cases
Authors: Tang Guangxin , chen xiaoxu , Wang Jianwei , He Wei , Niu Zhihong
Published: May 2020

Background: The role of renal artery embolization (RAE) in the therapeutic armamentarium is always controversial. The present study aimed to assess the safety and the surgical outcomes of the instant renal artery embolization (I-RAE) prior to nephrectomy and thrombectomy in locally advanced renal cell carcinoma patients with venous thrombus.Methods: We performed a retrospective analysis of 54 patients treated with nephrectomy and thrombectomy between Jan 2012 and Jan 2019. Twenty-four patients were treated by I-RAE before surgery. Thirty patients were performed surgery alone (Non-RAE). The patient demographics, operation time, blood loss, transfusion requirements, complications and other surgical parameters were analyzed between the two groups.Results: The mean tumor size in I-RAE group was significantly larger than that in the Non-RAE group (11.1cm versus 7.9cm; p = .001). The mean estimated blood loss was significantly lower in I-RAE group compared to Non-RAE group (596ml versus 827ml; p = .015), and the patients in the Non-RAE group were more likely to receive blood transfusion (RBC units, 4U versus 6U, p = .025; plasma volume, 200ml versus 400ml, p = .01). No differences were found in operative duration, ICU stay, perioperative complications and length of postoperative hospitalization. Conclusions: The adjuvant instant pre-operative renal artery embolization (I-RAE) is a safe technique. It facilitates the nephrectomy and thrombectomy by reduction of blood loss, transfusion requirements and complication of delayed operation, providing the urologists with a reliable option for locally advanced RCC with tumor thrombus.
Sensitivity of Radio-Photoluminescence Glass Dosimeters to Accumulated Doses
Authors: Kim Dong Wook , Sung Jiwon , Son Jaeman , Kim Min-Joo , Shin Han-Back , Noh Yu-Yun , Kim Hojae , Han Min Cheol , Kim Jihun , Han Su Chul , Chang Kyung Hwan , Kim Hojin , Park Kwangwoo , Yoon Myonggeun , Kim Jinsung , Shin Dongho
Published: May 2020

Background This study investigated the effect of accumulated doses on radio-photoluminescence glass dosimeters (RPLGDs) from measurements involving mega-voltage photons. Methods Forty-five commercially available RPLGDs were irradiated to estimate their dose responses. Photon beams of 6, 10, and 15 MV were irradiated onto the RPLGDs inside a phantom, which were divided into five groups with different doses and energies. Groups 1 and 2 were irradiated at 1, 5, 10, 50, and 100 Gy in a sequential manner; Group 3 was irradiated 10 times with a dose of 10 Gy; and Groups 4 and 5 followed the same method as that of Group 3, but with doses of 50 Gy and 100 Gy, respectively. Results For the annealed Group 1, RPLGD exhibited a linearity response with variance within 5%. For the non-annealed Group 2, readings demonstrated hyperlinearity at 6 MV and 10 MV, and linearity at 15 MV. Following the 100 Gy irradiation, the readings for Group 2 were 118.7 ± 1.9%, 112.2 ± 2.7%, and 101.5 ± 2.3% at 6, 10, and 15 MV, respectively. For Groups 3, 4, and 5, the responsiveness of the RPLGDs gradually decreased as the number of repeated irradiations increased. The percentage readings for the 10th beam irradiation with respect to the readings for the primary beam irradiation were 84.6 ± 1.9%, 87.5 ± 2.4%, and 93.0 ± 3.0% at 6 MV, 10 MV, and 15 MV, respectively. Conclusions The non-annealed RPLGD response to dose was hyperlinear for the 6 MV and 10 MV photon beams but not for the 15 MV photon beam. Additionally, the annealed RPLGD exhibited a fading phenomenon when the measurement was repeated several times and demonstrated a relatively large fading effect at low energies than at high energies.
Prostate cancer tumour control probability modelling for external beam radiotherapy based on multi-parametric MRI-GTV definition
Authors: Sachpazidis Ilias , Mavroidis Panayiotis , Zamboglou Constantinos , Klein Christina Marie , Grosu Anca-Ligia , Baltas Dimos
Published: May 2020

Purpose: To evaluate the applicability and estimate the radiobiological parameters of linear-quadratic Poisson tumour control probability (TCP) model for primary prostate cancer patients for two relevant target structures (prostate gland and GTV). The TCP describes the dose–response of prostate after definitive radiotherapy (RT). Also, to analyse and identify possible significant correlations between clinical and treatment factors such as planned dose to prostate gland, dose to GTV, volume of prostate and mpMRI-GTV based on multivariate logistic regression model.Methods: The study included 129 intermediate and high-risk prostate cancer patients (cN0 and cM0), who were treated with image-guided intensity modulated radiotherapy (IMRT) +/- androgen deprivation therapy with a median follow-up period of 81.4 months (range: 42.0 - 149.0) months. Tumour control was defined as biochemical relapse free survival according to the Phoenix definition (BRFS). MpMRI-GTV was delineated retrospectively based on a pre-treatment multi-parametric MR imaging (mpMRI), which was co-registered to the planning CT. The clinical treatment planning procedure was based on prostate gland, delineated on CT imaging modality.Results: Our results indicated an appropriate α/β = 1.3 Gy for prostate gland and α/β = 2.9 Gy for mpMRI-GTV. Only for prostate gland, EQD2 and gEUD 2Gy were significantly lower in the biochemical relapse (BR) group compared to the biochemical control (BC) group. Fitting results to the linear-quadratic Poisson TCP model for prostate gland and α/β = 1.3 Gy were D 50 = 66.8 Gy with 95%CI [64.6 Gy, 69.0 Gy], and γ = 3.81 with 95%CI [2.58, 5.20]. For mpMRI-GTV and α/β = 2.9 Gy, D 50 was 68.1 Gy with 95%CI [66.1 Gy, 70.0 Gy], and γ = 4.45 with 95%CI [3.00, 6.12]. The fitness of the model was better for prostate gland. For the multivariate logistic model, the gEUD 2Gy for prostate gland showed a very high significant predictive value ( p = 0.001), whereas regarding mpMRI-GTV only its volume showed a significance ( p = 0.01).Conclusion: The linear-quadratic Poisson TCP model was better fit when the prostate gland was considered as responsible target than with mpMRI-GTV. This is compatible with the results of the comparison of the dose distributions among BR and BC groups and with the results achieved with the multivariate logistic model regarding gEUD 2Gy . Probably limitations of mpMRI in defining the GTV explain these results. Another explanation could be the relatively homogeneous dose prescription and the relatively low number of recurrences.
Joint Destructive Role of Mast Cells in Rheumatoid Arthritis
Authors: Kim Kyoung-Woon , Kim Bo-Mi , Won Ji-Yeon , Min Hong-Ki , Lee Kyung-Ann , Lee Sang-Heon , KIM HAE-RIM
Published: May 2020

Background: We aimed to define the inflammatory and tissue-destructive roles of mast cells in rheumatoid arthritis (RA). Methods: Serum and synovial fluid (SF) concentration levels of tryptase, chymase, and histamine were quantified using ELISA. After activating mast cells using IL-33, the production of TNF-a, IL-1b, IL-6, IL-17, RANKL, and MMPs was determined using real-time PCR and ELISA. Osteoclastogenesis was assessed in CD14+ monocytes from peripheral blood and SF, which were cultured with IL-33-activated mast cells, by counting TRAP-positive multinucleated cells. Results: The concentration levels of serum tryptase, chymase, and histamine and SF histamine were higher in patients with RA than in controls. FceR1 and c-kit-positive mast cells were higher in RA synovium than in osteoarthritic (OA) synovium. Stimulation of mast cells by IL-33 increased the number of trypatse+chymase- and tryptase+chymase+ mast cells. IL-33 stimulation also increased the gene expression levels of TNF-a, IL-1b, IL-6, IL-17, RANKL, and MMP-9 in mast cells. Furthermore, IL-33 stimulated human CD14+ monocytes to differentiate into TRAP+ multinucleated osteoclasts. When CD14+ monocytes were co-cultured with mast cells, osteoclast differentiation was increased. Additionally, IL-33-activated mast cells stimulated osteoclast differentiation. The inhibition of intercellular contact between mast cells and monocytes using inserts reduced osteoclast differentiation. Conclusions: Mast cells and their mediators such as tryptase, chymase, and histamine were increased in RA synovial tissues and fluid. Mast cells stimulated osteoclast differentiation in monocytes. The inhibition of mast cells could be a new therapeutic option for reducing joint destruction in RA.
Reliability of Dopamine Transporter PET Measurements with [18F]FE-PE2I in patients with Parkinson's Disease
Authors: Kerstens Vera S. , Fazio Patrik , Sundgren Mathias , Matheson Granville J. , Franzén Erika , Halldin Christer , Cervenka Simon , Svenningsson Per , Varrone Andrea
Published: May 2020

Background. Reliable quantification of dopamine transporter (DAT), a biomarker for Parkinson’s disease (PD), is essential for diagnostic purposes as well as for evaluation of potential disease-modifying treatment. Due to degeneration of dopaminergic neurons and thus lower expected radioligand binding to DAT, higher measurement variability in PD patients might be expected than earlier reproducibility results in healthy controls. Therefore, we aimed to examine the test-retest properties of [18F]FE-PE2I-PET in PD patients. Methods. Nine patients with PD (Hoehn & Yahr stage < 3) were included (men/women: 6/3; mean age 65.2±6.8y). Each patient underwent two [18F]FE-PE2I-PET measurements within 7–28 days. The outcome measure was non-displaceable binding potential generated using wavelet-aided parametric imaging with cerebellum as reference region. We assessed test-retest performance using estimates of reliability and repeatability. Regions for primary analysis were caudate, putamen, ventral striatum, and substantia nigra. Exploratory analysis was performed for functional subdivisions of the striatum. We also compared the more vs. less-affected side. Results. [18F]FE-PE2I showed absolute variability estimates of 5.3–7.6% in striatal regions and 11% in substantia nigra, and ICCs of 0.74—0.97 (median: 0.91). The absolute variability for functional striatal subdivisions was 6.0–9.6% and ICCs of 0.76–0.91 (median: 0.91). The less affected substantia nigra exhibited greater consistency than the more affected side. According to power calculations based on the current sample size, DAT changes of 5–11% in the striatum and 28% in the substantia nigra can be detected with a power of 0.8 (p<0.0125).Conclusion. DAT-PET measurements with [18F]FE-PE2I in PD patients showed good repeatability and reliability. The slightly lower reliability in the substantia nigra in patients may be explained by lower DAT density and smaller anatomical size. Power calculations suggest that [18F]FE-PE2I PET of DAT is a suitable disease progression marker in PD. Trial registration number: EudraCT 2017-003327-29 Keywords: reliability, test-retest, [18F]FE-PE2I, dopamine transporter, Parkinson’s disease
Pleiotropic Effects of RsmA and RsmE Proteins in Pseudomonas Fluorescens 2P24
Authors: Zhang Yang , Zhang Bo , Wu Haiyan , Wu Xiaogang , Yan Qing , Zhang Li-qun
Published: May 2020

Background: Pseudomonas fluorescens 2P24 is a rhizosphere bacterium that produces 2,4-diacetyphloroglucinol (2,4-DAPG) as the decisive secondary metabolite to suppress soilborne plant diseases. The biosynthesis of 2,4-DAPG is strictly regulated by the RsmA family proteins RsmA and RsmE. However, mutation of both of rsmA and rsmE genes results in reduced bacterial growth.Results: In this study, we showed that overproduction of 2,4-DAPG in the rsmA rsmE double mutant influenced the growth of strain 2P24. This delay of growth could be partially reversal when the phlD gene was deleted or overexpression of the phlG gene encoding the 2,4-DAPG hydrolase in the rsmA rsmE double mutant. RNA-seq analysis of the rsmA rsmE double mutant revealed that a substantial portion of the P. fluorescens genome was regulated by RsmA family proteins. These genes are involved in the regulation of 2,4-DAPG production, cell motility, carbon metabolism, and type six secretion system.Conclusions: These results suggest that RsmA and RsmE are the important regulators of genes involved in the plant-associated strain 2P24 ecologic fitness and operate a sophisticated mechanism for fine-tuning the concentration of 2,4-DAPG in the cells.
Age-Related Decrease of Expression of GDF9 and BMP15 Genes in Follicle Fluid and Granulosa Cells from Poor Ovarian Responders
Authors: Gong Yan , Li-Ling Jesse , Xiong Dongsheng , Wei Jiajing , Zhong Taiqing , Tan Hao
Published: May 2020

Background: Growth differentiation factor 9 ( GDF9 ) and bone morphogenetic protein 15 ( BMP15 ) genes play important roles in folliculogenesis. Altered expression of the GDF9 and BMP15 genes have been found among patients with poor ovarian response (POR). In this prospective cohort study, we determined the expression of the GDF9 and BMP15 genes in follicle fluid (FF) and granulosa cells (GCs) from poor ovarian responders grouped by age, and explored its correlation with the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods: A total of 196 patients with POR were enrolled from a tertiary teaching hospital. The patients were diagnosed based on the Bologna criteria and sub-divided into different age groups: group A (< 35 year old), group B (35 ~ 40 year old) and group C (> 40 year old). A GnRH antagonist protocol was conducted for all patients, and FF and GCs were collected after oocyte retrieval. Expression of GDF9 and BMP15 in the FF and GCs was determined with enzyme linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR), and Western blotting. Results: Compared with group C, groups A and B had significantly more transplantable embryos and higher rates of implantation and clinical pregnancy ( P < 0.05). Group A also had significantly more two pronuclei (2PN) oocytes ( P < 0.05). The expression level of GDF9 and BMP15 in the FF and GCs differed significantly among the three groups ( P < 0.05), showing a trend of decline with age. Conclusion: For poor ovarian responders, the expression of GDF9 and BMP15 is declined with increased age in accompany with poorer oocyte quality and IVF outcome, particularly for those over 40.
Vascular Function and Cardiovascular Risk in a HIV Infected and HIV Free Cohort of African Ancestry: Baseline Profile, Rationale and Methods of the Longitudinal EndoAfrica-NWU Study
Authors: Fourie Carla Maria Theresia , Roux Shani Botha-Le , Smith Wayne , Schutte Aletta E , Breet Yolandi , Mels Carina MC , Gafane-Matemane Lebo F , Lammertyn Leandi , Uys Lisa , Burger Adele , Joseph Jitcy S , Goswami Nandu , De Boever Patrick , Strijdom Hans
Published: May 2020

Background: People living with the Human Immunodeficiency Virus (PLHIV) have an increased susceptibility to develop non-communicable diseases such as cardiovascular disease (CVD). Infection with HIV contributes to the development of CVD independent of traditional risk factors, with endothelial dysfunction being the central physiological mechanism. While HIV-related mortality is declining due to antiretroviral treatment (ART), the number of deaths due to CVD is rising in South Africa - the country with the highest number of PLHIV and the world’s largest ART programme. The EndoAfrica study was developed to determine whether HIV infection and ART are associated with cardiovascular risk markers and changes in vascular structure and function over 18 months in adults from different provinces of South Africa. This paper describes the rationale, methodology and baseline cohort profile of the EndoAfrica study conducted in the North West Province, South Africa. Methods: In this case-control study, conducted between August 2017 and June 2018, 382 volunteers of African descent (276 women; 106 men), comprising of 278 HIV infected and 104 HIV free individuals were included. We measured health behaviours, a detailed cardiovascular profile, and performed biomarker analyses. We compared baseline characteristics, blood pressure, vascular function and biochemical markers between those infected and HIV free. Results: At baseline, the HIV infected participants were older (43 vs 39 years), less were employed (21% vs 40%), less had a tertiary education (7% vs 16%) and their body mass index was lower (26 vs 29 kg/m 2 ) than that of the HIV free participants. While the cardiovascular profile, flow-mediated dilation and pulse wave velocity did not differ, glycated haemoglobin was lower (p=0.017) and total cholesterol, high density lipoprotein cholesterol, triglycerides, gamma-glutamyltransferase and tobacco use were higher (all p<0.047) in PLHIV. Conclusion: Despite PLHIV being older, preliminary cross-sectional analysis suggests that PLHIV being treated with ART do not have poorer endothelial or vascular function compared to the HIV free participants. More detailed analyses on the baseline and follow-up data will provide further clarity regarding the cardiovascular profile of South Africans living with HIV.
Structural and functional modelling of SARS-CoV-2 entry in animal models
Authors: Brooke Greg N. , Prischi Filippo
Published: May 2020

SARS-CoV-2 is the novel coronavirus responsible for the outbreak of COVID-19, a disease that has spread to over 100 countries and, as of the 13 May 2020, has infected over 4 million people. Despite the urgent need to find effective therapeutics, research on SARS-CoV-2 has been affected by a lack of suitable animal models. To facilitate the development of medical approaches and novel treatments, we compared the ACE2 receptor and TMPRSS2 protease usage of the SARS-CoV-2 Spike glycoprotein in human and in a panel of animal models, i.e. guinea pig, dog, cat, rat, rabbit, ferret and mouse. Here we showed that ACE2, but not TMPRSS2, has a higher level of sequence variability in the Spike protein interaction surface, which greatly influences Spike protein binding mode. Comparison of SARS-CoV and SARS-CoV-2 S proteins bound the ACE2 receptors showed that the SARS-CoV-2 Spike glycoprotein has adapted to bind the human, but not rodents, ACE2 with high affinity. In contrast, we did not detect species-specific adaptation for TMPRSS2. Analysis of binding modes and protein contacts indicates that ferrets are the most suitable model for the study of inhibitory antibodies and small molecules targeting the SARS-CoV-2 Spike protein interaction with ACE2. Since TMPRSS2 is similar across species, our data also suggest that transgenic animal models expressing human ACE2, such as the K18-hACE2 mouse, are also likely to be useful models for studies investigating viral entry.
Sewage Pooling Test for SARS-CoV-2
Authors: Guha Ritam , Sengupta Anik , Dutta Ankan
Published: May 2020

CoVID-19 is currently one of the biggest threats to mankind. To date, it is the reason for infections of over 35 lakhs and death of over 2 lakh human beings. We propose a procedure to detect CoVID-19 affected localities using a sewage mass testing and pooling mechanism which has gained ground in recent times. The proposed method named Sewage Pooling Algorithm tests wastewater samples from sewage systems to pinpoint the regions which are affected by maximum chances of the virus spread. The algorithm also uses a priority-based backtracking procedure to perform testing in sewage links depending on the probability of infection in the sub-areas. For places with very rare CoVID cases, we present a gradient-based search method to prune those areas. The proposed method has less human intervention and increases the effective tests/million people overcurrent in-place methods.
Early Oral Protein-Containing Diets Following Elective Lower Gastrointestinal Tract Surgery in Adults: A Meta-Analysis of Randomized Clinical Trials.
Authors: PU Hong , Heighes Philippa T. , Simpson Fiona , WANG Yaoli , LIANG Zeping , Wischmeyer Paul , Hugh Thomas J. , Doig Gordon S.
Published: May 2020

Background: Although current guidelines make consensus recommendations for the early resumption of oral intake after surgery, a recent comprehensive meta-analysis failed to identify any patient-centred benefits. We hypothesized this finding was attributable to pooling studies providing effective protein-containing diets with ineffective non-protein liquid diets. Therefore, the aim of this paper was to investigate the safety and efficacy of early oral protein-containing diets versus later (traditional) feeding after elective lower gastrointestinal tract surgery in adults. Methods: PubMed, Embase and the China National Knowledge Infrastructure databases were searched from inception until 1 August 2019. Reference lists of retrieved studies were hand searched to identify randomized clinical trials reporting mortality. No language restrictions were applied. Study selection, risk of bias appraisal and data abstraction were undertaken independently by two authors. Disagreements were settled by obtaining an opinion of a third author. Majority decisions prevailed. After assessment of underlying assumptions, a fixed-effects method was used for analysis. The primary outcome was mortality. Secondary outcomes included surgical site infections, postoperative nausea and vomiting, serious postoperative complications and other key measures of safety and efficacy . Results: Eight randomized clinical trials recruiting 657 patients were included. Compared with later (traditional) feeding, commencing an early oral protein-containing diet resulted in a statistically significant reduction in mortality (Odds Ratio [OR] 0.31, P =0.02, I 2 =0%). An early oral protein-containing diet also significantly reduced surgical site infections (OR 0.39, P =0.002, I 2 =32%), postoperative nausea and vomiting (OR 0.62, P =0.04, I 2 =37%), serious postoperative complications (OR 0.60, P =0.01, I 2 =25%) and significantly improved other major outcomes. No harms attributable to an early oral protein-containing diet were identified. Conclusions: The results of this systematic review can be used to upgrade current guideline statements to a Grade A recommendation supporting an oral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults.
Knowledge and Utilization of Family Planning Methods Among People Living With Hiv In Kathmandu Valley
Authors: Bhoosal Anshu , Karki Namrata , Parajuli Riya
Published: May 2020

Background HIV is a major global health issue, targeting the immune system and making the body prone to diseases. People living with HIV mostly face societal stigma and fear of disclosure resulting in discrimination of accessing health facilities leading to multiple sex partners, increased sexual activity and less use of condoms. HIV positive women are at risk of transmitting HIV to their infants and their partners. Thus, the family planning services if provided to PLHIV can help to improve their and families health. In addition to, it reduces the risk of mother-to-child transmission (PMTCT). The facts related to PLHIV with respect to pregnancy and childbearing are not available. The purpose of this study is to focus on the status of the use of family planning methods and explore factors affecting the utilization among people living with HIV and AIDS in Kathmandu valley of Nepal. The study is expected to contribute in enhancing the present understanding of PLHIV towards family planning.Methods The cross sectional descriptive method was used for the research. The study followed Population proportion to size method for the calculation of the respondents from four ART sites of Kathmandu Valley. Structured questionnaire used previously in similar research has been adopted with necessary question related to dual contraceptive use.Results The mean age group of the respondents was (39.16 ± 6.969) years. More than two third respondents (69.5%) were Hindu. 34.8% respondents were married at the less than 20 years of age. Almost three- fourth of the PLHIV (74.4%) were literate where more than three fourth (79.3%) their spouses were literate and educated. About half of the respondents (43.9%) were found to be involved in professional/ technical/ managerial. More than half of the respondent’s spouses (63.4%) were HIV positive. All the respondents (100%) respondents had disclosed their status to their partners. Neither the respondents nor their partner had fertility desire. 28% of neither respondents nor their partners had used the family planning methods before HIV diagnosis. More than half (60.4%) of the respondents had sexual intercourse prior to last 6 months. 15.9% of the respondents positively responded to use of dual protection. Only 11% either respondents or their partners had used the emergency contraceptive pill. 17.7% respondents did not use any family planning. This study revealed that almost half of the respondents (48.8%) had the good knowledge on the use of contraception.Conclusion The use of dual protection is much less than the half of the respondents. Therefore, counseling and health education towards motivating PLHIV on using dual FP methods to avoid the risk of HIV, STIs and unplanned pregnancy is encouraged.
Trends and Prevalence of Obesity in the Arab-American Population of Southeast Michigan and Comparison with their Counterparts
Authors: Kamatham Saivaishnavi , Trak Joseph , Alzouhayli Suma , Fehmi Ziad , Rahoui Nabil , Sulieman Noor , Khoury Zaina , Fehmi Omar , Rakine Hanan , El-Masri Dana , Ujayli Deema , Elhagehassan Hanin , Naaman James , Almsaddi Firas , Salloum Michael , Farooquee Iqra , Syed Nadia , Kim Seongho , Lattouf Omar , Cote Michele , Ali-Fehmi Rouba
Published: May 2020

Background Arab-Americans constitute ~ 5% of Michigan’s population. Estimates of obesity in Arab-Americans are not up-to-date. Here we describe the distribution of, and factors associated with obesity in an Arab-American population.Methods Arab-American patients, ages 18–98 years, from Arab Community Center for Economic and Social Services (ACCESS) clinic located in Dearborn, Michigan were identified from medical records. Retrospective chart review abstracted age, sex, marital status, employment, body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), employment status, tobacco use and alcohol consumption. This cohort was compared to Michigan’s Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 and to a cohort seeking care between 2013–2019 from a free clinic in Ferndale, Michigan.Results Of the 2,363 Arab-American patients from the ACCESS clinic, 67% (n = 1591) were female and 33% (n = 772) were male. Among Arab-Americans, patients who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value < 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% 95% CI: 2.41–3.93; p < 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92–3.16; p < 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75–2.83; p < 0.001). 9,589 individuals from Michigan’s BRFSS data were included in the study and no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%) was noted. Compared to Arab-Americans, patients seen at the free clinic (n = 1,033) had a higher obesity rate (52.6%; p < 0.001) as well as significantly higher rates of HTN, DM and HLD (all p < 0.001). In Arab-Americans, a trend was observed in which obesity increased with age upto 44 years and declined thereafter. This was not the case in BRFSS and FCFC patients, where consistent increase in obesity was seen with increasing age.Conclusion Obesity rates in Arab-Americans were comparable to their BRFSS counterparts, and lower than their FCFC counterparts. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans residing in the US.
Primary Care Population Management for COVID-19 Patients
Authors: Blazey-Martin MD Deborah , Barnhart FNP Elizabeth , Gillis Joseph , Vazquez Gabriela Andujar
Published: May 2020

BACKGROUND: Most patients infected with SARS-CoV-2 have mild to moderate symptoms manageable at home; however up to 20% develop severe illness requiring additional support. Primary care practices performing population management can use these tools to remotely assess and manage COVID-19 patients and identify those needing additional medical support before becoming critically ill.AIM: We developed an innovative population management approach for managing COVID-19 patients remotely.SETTING: Development, implementation, and evaluation took place in April 2020 within a large urban academic medical center primary care practice.PARTICIPANTS: Our panel consists of 40,000 patients. By April 27, 2020, 305 had tested positive for SARS-CoV-2 by RT-qPCR. Outreach was performed by teams of doctors, nurse practitioners, physician assistants, and nurses.PROGRAM DESCRIPTION: Our innovation includes an algorithm, an EMR component, and a twice daily population report for managing COVID-19 patients remotely.PROGRAM EVALUATION: Of the 305 patients with COVID-19 in our practice at time of submission, 196 had returned to baseline; 54 were admitted to hospitals, six of these died, and 40 were discharged.DISCUSSION: Our population management strategy helped us optimize at-home care for our COVID-19 patients and enabled us to identify those who require inpatient medical care in a timely fashion.
ANÁLISE DE CUSTOS HOSPITALARES
Authors: Pedrosa Antonio José Gomes , Nascimento Jorge Messias Leal do
Published: May 2020

Em vista da relevância conferida à adoção de sistemas de custos nas entidades públicas, em especial nas organizações públicas hospitalares de ensino, a presente pesquisa tem por objetivo aplicar a sistemática do método de custeio por absorção, utilizando o centro de custos, tendo como objeto de análise os serviços ofertados pela Unidade de Nutrição do HU-Univasf. A pesquisa é do tipo exploratória, realizada por meio de estudo de caso, com abordagem mista (qualitativa-quantitativa). Por meio da pesquisa, foi possível encontrar os custos unitários dos serviços de nutrição e dietética, desjejum (R$4,88), lanche da manhã (R$3,76), almoço (R$9,79), lanche da tarde (R$4,31), jantar (R$9,58), ceia (R$3,76) e dietas enterais (R$10,58), ofertadas pelo hospital aos funcionários, acompanhantes e pacientes internados, no ano de 2018. Os resultados do estudo, entre outras finalidades, poderão servir como modelo para implantação do sistema de custos aos demais setores do HU-Univasf.

Palavras-chave: Custeio por Absorção; Setor Público; Hospital Universitário.
ACREDITAÇÃO HOSPITALAR NA ÓTICA DOS FUNCIONÁRIOS DO HOSPITAL UNIVERSITÁRIO PROFESSOR ALBERTO ANTUNES
Authors: De Oliveira Santos Jennifer Stéfany , Alves Correia Barbosa Milka
Published: May 2020

É um papel da gestão da qualidade adotar práticas cada vez mais precisas dentro de um hospital, a fim de contribuir para os índices de diminuição da precariedade das organizações hospitalares no mundo. Cada vez mais mecanismos são criados para certificar-se de que os protocolos hospitalares sejam feitos de forma eficaz. A acreditação hospitalar surge como ferramenta de avaliação desses processos. Contudo, nem todas as organizações hospitalares são certificadas nem sequer possuem conhecimento a respeito da temática. Diante disso, a questão que se coloca entre o problema e o campo de investigação é: qual a compreensão dos funcionários do Hospital Universitário Professor Alberto Antunes (HUPAA) a respeito da acreditação hospitalar?. Para responder à pergunta proposta foi realizada uma pesquisa qualitativa. Os dados foram coletados por meio de aplicação de uma entrevista estruturada. Assim, como lócus para a realização do estudo de caso qualitativo optou-se pelo Hospital Universitário Professor Alberto Antunes (HUPAA). O estudo pode concluir que a percepção dos funcionários do Hospital Universitário sobre a acreditação ainda é muito limitada, fruto de uma cultura organizacional burocrática e que a temática precisa ser mais disseminada entre seus funcionários e suas equipes de trabalho.

Palavras-chave: acreditação; gestão hospitalar; hospital universitário.
Effect of defined, seasonally variable exercise on oxidative status markers (TOS, TAS) in jumping horses
Authors: BIS-WENCEL HANNA , ROWICKA AGNIESZKA , KUBIK-KOMAR AGNIESZKA , KRUKOWSKI HENRYK , NOWAKOWICZ-DĘBEK BOŻENA , WLAZŁO ŁUKASZ
Published: May 2020

The present study aimed to determine the adaptation capacity of horses subjected to defined, seasonally variable exercise on the basis of selected indicators of their oxidative status. The research was carried out over a two-year period on 25 Polish Noble Half-bred horses (PKSP). All horses came from stables in south-eastern Poland (51°15’00”N, 22°34’00”E) and competed in show jumping. According to the intensity of exercise, two experimental periods were distinguished, characterized by moderate intensity of exercise (D1) and high intensity of exercise (D2). The test material consisted of blood taken from the external jugular vein into dry tubes in a closed system. Samples were collected four times. The oxidative status was determined by means of PerOx reagents (TOS/TOC) and ImAnOx reagents (TAS/TAC) from Immundiagnostik. The results were analyzed statistically with the Statistica 10 software (StatSoft Inc.). Changes were found in all parameters studied. The average level of total antioxidant status (TAS) in our research was low, and the average level of total oxidant status (TOS) obtained in the experiment corresponds to a low level of oxidative stress. The oxidant status and the antioxidant status did not correlate with each other. The values were balanced regardless of sex or age, which suggests that training did not result in oxidative stress. Our results also suggest that evaluation of blood oxidative markers can help in assessing the welfare of training horses.
Physicochemical properties and lipid oxidation parameters of selected muscles of Puławska breed fatteners during 14-day ageing in vacuum packaging
Authors: DOMARADZKI PIOTR , SKAŁECKI PIOTR , PRASOW MICHAŁ , BABICZ* MAREK , FLOREK MARIUSZ
Published: May 2020

The aim of this study was to determine the influence of the ageing period on the physicochemical properties and lipid quality indicators of pig meat from the native Puławska breed. The experiment was carried out on samples of skeletal muscles (adjacent part of M. longissimus thoracis and M. longissimus lumborum – LTL, and M. semimembranosus – SM) collected 24 h after slaughter from 30 carcasses of Puławska castrated male pigs. Following collection, samples were packaged in vacuum and stored for up to 14 day at a temperature of 4°C (± 1°C). The meat pH, colour (CIE L*a*b*), water-holding capacity (drip loss – DL and cooking loss – CL), shear force (WBSF), energy force, and lipid quality indicators (free fatty acids – FFA, peroxide value – PV, and thiobarbituric acid reactive substances expressed as malondialdehyde MDA – TBARS) were measured. A typical course of postmortem glycogenolysis for normal meat was demonstrated. The pH of muscles 45 min after slaughter was 6.55 for LTL and 6.61 for SM, and after 24 h it was 5.62 and 5.66, respectively. As ageing progressed, the DL of the meat increased significantly (on average 2.4 times), while CL were not significantly changed, being 24.83% on average. WBSF decreased by approximately 40% for LTL, and by 18% for SM. The WBSF value adopted for tender meat (< 45 N/cm2) was obtained on day 14 of the experiment. The progressive oxidative changes in intramuscular fat were not advanced, averaging from 2.06% for FFA, 0.62 meq O2/kg for PV and 0.24 MDA/kg for TBARS on day 4 post mortem to 3.71%, 1.82 meq O2/kg and 0.48 mg MDA/kg, respectively, on day 14 post mortem. Ageing of pork under vacuum positively influenced the quality characteristics of the meat, with relatively minor oxidative changes. An extended ageing period of up to 14 days can measurably improve the quality characteristics of fresh meat obtained from Puławska breed pigs, especially for culinary purposes.
Modified cryopreservation of semen of young bulls with reduced freezability
Authors: SZCZĘŚNIAK-FABIAŃCZYK BARBARA , BOCHENEK MICHAŁ , GOGOL PIOTR , SMORĄG ZDZISŁAW
Published: May 2020

The aim of the study was to improve cryopreservation of young bulls’ semen. Bioxcell and Tris extenders were modified by adding α-linoleic acid (ALA) or linoleic acid albumin (LAA). Non-modified Bioxcell extender was used as control. Semen diluted in modified, glycerol-free Tris extender was subjected to a longer equilibration (26-28 hours at +4°C). Thirty-one ejaculates collected from 12 bulls aged 12-17 months were used in this research. After collection, fresh semen was divided into 7 portions, and each portion was diluted in one of experimental diluents, as well as in the control diluent. After equilibration, semen was frozen in a freezer. Subsequently, the semen was thawed and its motility was assessed (approximately and by CSA) along with cell membrane integrity (SYBR-14 and PI). The highest motility was observed in Bioxcell diluent supplemented with α-linoleic acid (ALA), and it was significantly higher (p ≤ 0.5) than in Bioxcell diluent (control). No significant differences in cell membrane integrity were observed between experimental groups that were subjected to a 2.5 hour equilibration. The extension of the equilibration time to 26-28 hours caused a significant (p ≤ 0.01) decrease in both the motility and the cell membrane integrity of spermatozoa compared to semen frozen in Bioxcell diluent (control) as well as to all other experimental diluents. In the case of semen that did not meet qualitative standards (motility below 50%) when frozen in the control diluent, significantly better results (p ≤ 0.01 and p ≤ 0.05) in terms of motility (assessed approximately and by SCA) were observed when the semen was diluted in Bioxcell diluent supplemented with α-linoleic acid (ALA) as well as in Bioxcell diluent supplemented with linoleic acid albumin (LAA) (p ≤ 0.05). No significant differences in cell membrane integrity were observed. The extension of equilibration time caused a significant (p ≤ 0.01) decrease in both the motility and the cell membrane integrity of spermatozoa. The study confirmed the possibility of improving cryopreservation of young bulls’ semen by modification of freezing diluents.
Convergencia con Europa y cambio en la universidad
Authors: Casado Ortiz Rafael
Published: May 2020

El autor de esta comunicación hace  una reflexión sociológica basada en el análisis institucional y organizacional de la universidad española ante el reto de la construcción del nuevo Espacio Europeo de Educación Superior (EEES), poniendo el foco en los profesores y en las nuevas tecnologías como elementos clave de la transformación. Mantiene el autor que la apuesta por la construcción de unas "universidades fuertes para una Europa fuerte" y competitiva en el ámbito de la educación superior ;en un contexto de "ambivalencias" y "amenazas; como consecuencia del modelo liberal de desarrollo de la sociedad de la información y economía del conocimiento que se está construyendo─, requiere nuevas estrategias de transformación y una adecuada gestión del cambio para tener éxito, tanto en la incorporación de las nuevas tecnologías de la información y la comunicación, como en la adopción del nuevo paradigma pedagógico basado en los aprendizajes.AbstractThe author of this paper makes a sociological reflection based on the institutional and organizational analysis of the Spanish university facing up to the challenge of the new European Space for Higher Education (ESHE), focusing in professors and new technologies as key issues of transformation. The author maintains that bet on building "universities strong and competitive for Europe strong" and to be successful   ─in  an environment of "ambivalences" and  "threats" as result of the liberal information society model and knowledge economy development─, new strategies of transformation and a suitable change management are required; so in the incorporation of the new information and communication technologies, as in the adoption of the new pedagogical paradigm based on learning.
Sistemas tutoriales multiagentes con modelado del estudiante y del autor
Authors: Cataldi Zulma , Salgueiro Fernando , Lage Fernando
Published: May 2020

En esta comunicación se presenta una arquitectura para los STI (Sistemas Tutores Inteligentes) que  integra los aspectos más significativos tecnología de agentes.La arquitectura considera la incorporación de agentes en los módulos del tutor y del estudiante a fin de poder integrarlos al modelado considerando la base Teoría Uno de Perkins los estilos de aprendizaje  y las inteligencias múltiples de Gardner.  AbstractIn this communication an architecture for STI (Intelligent Tutoring Systems) is presented and considers the most significant aspects of agents technology.This architecture considers the incorporation of agents in the modules of the tutor and the student in order to be able to integrate them to the modeled one considering the Theory One of Perkins, the styles of learning and multiple intelligences of Gardner.
Brecha digital. Posibilidad de acceso a las tecnologías de la información y la comunicación (TICs), según ubicación geográfica. Análisis descriptivo preliminar.
Authors: Bombelli Enrique , Barberis Guillermo , Roitman Germán
Published: May 2020

Este trabajo pretende evaluar el acceso tecnológico que tienen, al ingreso en la Universidad, los alumnos provenientes de diferentes regiones del país. Para ello se tuvo en cuenta el análisis de la historia del acceso a la tecnología mediante una encuesta. Basándose en un análisis estadístico descriptivo, algunos de los resultados obtenidos, en donde se encontraron las mayores diferencias, fueron: 50% de conectividad a Internet y 71,43% de conexión (banda ancha) a favor de las grandes ciudades y 38,46%, 33,33% respectivamente para localidades relativamente urbanizadas o rurales. Si bien estos resultados pueden encontrarse en la bibliografía actual, los obtenidos en este trabajo los confirman. En el resto de los tópicos considerados en la mencionada encuesta no se observan diferencias o estas son muy leves. Los mencionados resultados son preliminares y se continuarán en el tiempo sobre la base de una mayor cantidad de datos, que validen la exactitud de los aquí obtenidos y complementados con untest, que permita el análisis del uso y calidad de uso de las TICs, obteniendo de esta manera una visión cabal de lo que el concepto brecha digital significa en la sociedad actual.AbstractThis work tries to evaluate the technological access that the students of different regions from the country have, to enter at the University. For it one considered the analysis of the technology access history by means of a survey. Being based on a descriptive statistical analysis, some of the obtained results, in where were the greater differences, were: 50% of connectivity to Internet and 71.43% of connection (broadband) in favor of great cities and 38.46%, 33.33% respectively for relatively urbanized or rural localities. Although these results can be in the present bibliography, the obtained ones in this work confirm them. In the rest of the considered topics, in the mentioned survey, differences are not observed or these are very slight.Mentioned results are preliminary and amount continued in time on base of greater data, which they validate the exactitude of obtained and complemented with a test that allows to the analysis of the use and quality of use of the CITs, obtaining this way an exact vision here of which the concept digital breach means in the present society.
Propuestas de colaboración en educación a distancia y tecnologías para el aprendizaje
Authors: Cabero Almenara Julio , Llorente Cejudo María del Carmen
Published: May 2020

Sobre el trabajo colaborativo en el terreno de la educación a distancia versa el presente artículo, desde diferentes perspectivas: desde las posibilidades que las TICs nos ofrecen en la actualidad para el desarrollo de la colaboración; desde diferentes ejemplos de colaboración con profesores de otras Universidades Españolas y Latinoamérica que han dado un fruto significativo, ejemplos que se situarán a diferentes niveles –investigación, producción, etc.-; por último, algunas de las líneas que consideramos que pueden abrirse para la colaboración entre personas e instituciones interesados por la utilización educativa de las TICs.AbstractAbove collaborative work on distance education it’s refer this article, from different perspectives: from the possibilities that the ITC offers us at present time for the development of collaboration; from different examples of collaboration with professors of other Spanish Universities and Latin America that have given a significant findings, examples that will be located at different levels - research, production, etc.-; lastly, some of the lines that we consider that they can open up for the collaboration among people and institutions interested by the educational use of the ITC