bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality Assessment of Digital Health Applications: Protocol for a Scoping Review
Authors: Giebel Godwin Denk , Schrader Nils Frederik , Speckemeier Christian , Abels Carina , Börchers Kirstin , Wasem Jürgen , Blase Nikola , Neusser Silke
Published: May 2022

Background

All over the world, development and usage of mobile health (mHealth) apps is increasing. While apps offer numerous opportunities to improve health care, there are associated problems that differ significantly from those of traditional health care services. Further investigations on the quality of mHealth apps are needed to address these problems.

Objective

This study aims to identify and map research on quality assessment and quality assurance of mHealth apps and their transferability to continuous quality assurance of mHealth apps.

Methods

The scoping review will follow published methodological frameworks for scoping studies as well as Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews criteria. Electronic databases (Medline, EMBASE, and PsycINFO), reference lists of relevant articles, and websites of relevant institutions will be searched. Two reviewers will independently assess eligibility of articles. Therefore, a 2-stage (title and abstract, followed by full text) screening process was conducted. Quality management systems and quality assessment tools will be analyzed and included in our review. Particular focus is placed on quality dimensions.

Results

This scoping review provides an overview of the available evidence and identifies research gaps regarding continuous quality assessment of mHealth apps. Thereby, relevant quality dimensions and criteria can be identified and their eligibility and relevance for the development of a continuous quality assurance system of mHealth apps can be determined. Our results are planned to be submitted to an indexed, peer-reviewed journal in the second half of 2022.

Conclusions

This is the first review in the context of continuous quality assurance of mHealth apps. Our results will be used within the research “Continuous quality assurance of Digital Health Applications” (“QuaSiApps”) project funded by the German Federal Joint Committee.

International Registered Report Identifier (IRRID)

DERR1-10.2196/36974
Automated Analysis of Drawing Process to Estimate Global Cognition in Older Adults: Preliminary International Validation on the US and Japan Data Sets
Authors: Yamada Yasunori , Shinkawa Kaoru , Kobayashi Masatomo , Badal Varsha D , Glorioso Danielle , Lee Ellen E , Daly Rebecca , Nebeker Camille , Twamley Elizabeth W , Depp Colin , Nemoto Miyuki , Nemoto Kiyotaka , Kim Ho-Cheol , Arai Tetsuaki , Jeste Dilip V
Published: May 2022

Background

With the aging of populations worldwide, early detection of cognitive impairments has become a research and clinical priority, particularly to enable preventive intervention for dementia. Automated analysis of the drawing process has been studied as a promising means for lightweight, self-administered cognitive assessment. However, this approach has not been sufficiently tested for its applicability across populations.

Objective

The aim of this study was to evaluate the applicability of automated analysis of the drawing process for estimating global cognition in community-dwelling older adults across populations in different nations.

Methods

We collected drawing data with a digital tablet, along with Montreal Cognitive Assessment (MoCA) scores for assessment of global cognition, from 92 community-dwelling older adults in the United States and Japan. We automatically extracted 6 drawing features that characterize the drawing process in terms of the drawing speed, pauses between drawings, pen pressure, and pen inclinations. We then investigated the association between the drawing features and MoCA scores through correlation and machine learning–based regression analyses.

Results

We found that, with low MoCA scores, there tended to be higher variability in the drawing speed, a higher pause:drawing duration ratio, and lower variability in the pen’s horizontal inclination in both the US and Japan data sets. A machine learning model that used drawing features to estimate MoCA scores demonstrated its capability to generalize from the US dataset to the Japan dataset (R2=0.35; permutation test, P<.001).

Conclusions

This study presents initial empirical evidence of the capability of automated analysis of the drawing process as an estimator of global cognition that is applicable across populations. Our results suggest that such automated analysis may enable the development of a practical tool for international use in self-administered, automated cognitive assessment.
Patient Portal Messaging for Asynchronous Virtual Care During the COVID-19 Pandemic: Retrospective Analysis (Preprint)
Authors: Huang Ming , Khurana Aditya , Mastorakos George , Wen Andrew , He Huan , Wang Liwei , Liu Sijia , Wang Yanshan , Zong Nansu , Prigge Julie , Costello Brian , Shah Nilay , Ting Henry , Fan Jungwei , Patten Christi , Liu Hongfang
Published: May 2022

BACKGROUND

During the COVID-19 pandemic, patient portals and their message platforms allowed remote access to health care. Utilization patterns in patient messaging during the COVID-19 crisis have not been studied thoroughly. In this work, we propose characterizing patients and their use of asynchronous virtual care for COVID-19 via a retrospective analysis of patient portal messages.

OBJECTIVE

This study aimed to perform a retrospective analysis of portal messages to probe asynchronous patient responses to the COVID-19 crisis.

METHODS

We collected over 2 million patient-generated messages (PGMs) at Mayo Clinic during February 1 to August 31, 2020. We analyzed descriptive statistics on PGMs related to COVID-19 and incorporated patients’ sociodemographic factors into the analysis. We analyzed the PGMs on COVID-19 in terms of COVID-19–related care (eg, COVID-19 symptom self-assessment and COVID-19 tests and results) and other health issues (eg, appointment cancellation, anxiety, and depression).

RESULTS

The majority of PGMs on COVID-19 pertained to COVID-19 symptom self-assessment (42.50%) and COVID-19 tests and results (30.84%). The PGMs related to COVID-19 symptom self-assessment and COVID-19 test results had dynamic patterns and peaks similar to the newly confirmed cases in the United States and in Minnesota. The trend of PGMs related to COVID-19 care plans paralleled trends in newly hospitalized cases and deaths. After an initial peak in March, the PGMs on issues such as appointment cancellations and anxiety regarding COVID-19 displayed a declining trend. The majority of message senders were 30-64 years old, married, female, White, or urban residents. This majority was an even higher proportion among patients who sent portal messages on COVID-19.

CONCLUSIONS

During the COVID-19 pandemic, patients increased portal messaging utilization to address health care issues about COVID-19 (in particular, symptom self-assessment and tests and results). Trends in message usage closely followed national trends in new cases and hospitalizations. There is a wide disparity for minority and rural populations in the use of PGMs for addressing the COVID-19 crisis.
Comparison Between the 24-hour Holter Test and 72-hour Single-Lead Electrocardiogram Monitoring With an Adhesive Patch-Type Device for Atrial Fibrillation Detection: Prospective Cohort Study (Preprint)
Authors: Kwon Soonil , Lee So-Ryoung , Choi Eue-Keun , Ahn Hyo-Jeong , Song Hee-Seok , Lee Young-Shin , Oh Seil , Lip Gregory Y H
Published: May 2022

BACKGROUND

There is insufficient evidence for the use of single-lead electrocardiogram (ECG) monitoring with an adhesive patch-type device (APD) over an extended period compared to that of the 24-hour Holter test for atrial fibrillation (AF) detection.

OBJECTIVE

In this paper, we aimed to compare AF detection by the 24-hour Holter test and 72-hour single-lead ECG monitoring using an APD among patients with AF.

METHODS

This was a prospective, single-center cohort study. A total of 210 patients with AF with clinical indications for the Holter test at cardiology outpatient clinics were enrolled in the study. The study participants were equipped with both the Holter device and APD for the first 24 hours. Subsequently, only the APD continued ECG monitoring for an additional 48 hours. AF detection during the first 24 hours was compared between the two devices. The diagnostic benefits of extended monitoring using the APD were evaluated.

RESULTS

A total of 200 patients (mean age 60 years; n=141, 70.5% male; and n=59, 29.5% female) completed 72-hour ECG monitoring with the APD. During the first 24 hours, both monitoring methods detected AF in the same 40/200 (20%) patients (including 20 patients each with paroxysmal and persistent AF). Compared to the 24-hour Holter test, the APD increased the AF detection rate by 1.5-fold (58/200; 29%) and 1.6-fold (64/200; 32%) with 48- and 72-hour monitoring, respectively. With the APD, the number of newly discovered patients with paroxysmal AF was 20/44 (45.5%), 18/44 (40.9%), and 6/44 (13.6%) at 24-, 48-, and 72-hour monitoring, respectively. Compared with 24-hour Holter monitoring, 72-hour monitoring with the APD increased the detection rate of paroxysmal AF by 2.2-fold (44/20).

CONCLUSIONS

Compared to the 24-hour Holter test, AF detection could be improved with 72-hour single-lead ECG monitoring with the APD.
The relationship between nutrient intake and cataract in the older adult population of Korea (Preprint)
Authors: Lee Sangyun , Lee Soyeon , Jeong Myeonghyeon , Jung Sunwoo , Yoo Sunyong
Published: May 2022

BACKGROUND

The prevalence of cataract among the Korean older adult population is rapidly increasing. To prevent the disease at the individual level through diet control, it is important to examine which nutrients are highly associated with cataract.

OBJECTIVE

This study aimed to investigate the relationship between nutrient intake and cataract in the older adult population in Korea.

METHODS

We analyzed data from 5,634 Korean adults over the age of 60 years using the Korean National Health and Nutrition Examination Survey. We performed univariate simple and multiple logistic regressions to identify the associations between nutrient intake and cataracts. Additionally, multiple logistic regression was applied to the factor analysis results to identify the associations between sets of nutrient variables and cataracts.

RESULTS

The study sample included 2,137 individuals (764 men and 1,373 women) with cataract and 3,497 individuals (1,662 men and 1,835 women) without cataracts. The intake of polyunsaturated fatty acids, phosphorus, and vitamin B1 were statistically significant (P<0.05) in the men’s group, while that of monounsaturated fatty acids, sugar, and vitamin A were statistically significant (P<0.05) in the women’s group. A higher intake of polyunsaturated fatty acids (ORhigh_mid =1.524) and vitamin B1 (ORhigh_mid =0.605) in the men’s group and the lower intake of sugar (ORlow_mid=1.321) and vitamin A (ORlow_mid =1.364) in the women’s group were found to be associated with higher incidence of cataract. A lower intake of phosphorus (ORlow_mid=0.718) in the men’s group and higher intake of monounsaturated fatty acids (ORhigh_mid=0.611) in the women’s group were associated with lower incidence of cataract.

CONCLUSIONS

Our study demonstrated that polyunsaturated fatty acids, monounsaturated fatty acids, phosphorus, sugar, vitamin B1, and vitamin A can affect the incidence of cataracts by sex. The findings of this study could be used to control nutrient intake for cataract prevention based on sex and age.
Does The Internet Know More Than My Doctor: A Qualitative Study of People with Rare Diseases and How They Use Online Support Groups (Preprint)
Authors: Ashtari Sadaf , Taylor Adam Daniel
Published: May 2022

BACKGROUND

Patients struggling with rare diseases may face challenges caused by care providers unfamiliar with their condition1. The life span of people with rare diseases may be the same as healthy people, but their quality of life is different. Patients with chronic pain are constantly looking for a way to mitigate their pain. Pain killers are not a permanent solution. In addition to the medical and non-medical costs of rare diseases for both patients and healthcare providers, there is a need for sustainable sources of information that are available for patients to help with their pain and improve their quality of life with the goal of reducing physician visits and hospital admission.

OBJECTIVE

The aim of this study is to investigate the challenges patients with genetic disorders face managing their health conditions and finding disease-related information as well as the effect of online peer support groups on pain mitigation and care management.

METHODS

Interviews were held via Zoom between July 2021 and December 2021. Eligible participants were older than 18 years old, had a medical diagnosis or a suspected case of any type of Ehlers-Danlos Syndrome with chronic pain, and were a member of any support group. Participants were recruited through an announcement under the research/survey section of the Ehlers-Danlos Syndrome Society webpage. Interviews were analyzed using the framework approach. Data were systematically searched to recognize patterns, analyze them and identify themes. Interview audio files were transcribed and independently coded by 2 researchers (SA, AT). Through an iterative process, a final coding table was agreed on by researchers and used to thematically analyze the data.

RESULTS

We interviewed 30 participants (mean age of 37.7 years, 96% female, 77% resided in the U.S.). Thematic analysis revealed participants (EDS patients) were constantly in pain and majority of them have not received accurate and timely diagnoses for many years. They expressed their challenges with healthcare providers regarding diagnosis and treatment and complained about their providers’ lack of support and knowledge in offering quality care. Participants’ main sources of information were online search, academic journals, The EDS Society webpage, and online peer support groups in Facebook, Reddit, Twitter, and Instagram. Although pain killers, cannabis and opioids are providing some pain relief, most of the patients focused on non-medical approaches such as hot/ice packs, physical therapy, exercises, massage, mindfulness, and meditation.

CONCLUSIONS

This study highlights the information gap between healthcare providers and genetic disorder patients. EDS patients seek access to information from different online sources. To appeal to needs of genetic disorder patients, future interventions for improving quality of care must consider by healthcare professionals and government agencies via online resources.
Conception of a tool to measure digital vaccine literacy: the DVL scale (Preprint)
Authors: Montagni Ilaria , Pouymayou Aude , Pereira Edwige , Tzourio Christophe , Schück Stéphane , Texier Nathalie , González Caballero Juan Luis
Published: May 2022

BACKGROUND

The use of the Internet to look for information about vaccines has skyrocketed in the last years, especially with the Covid-19 crisis. Digital vaccine literacy refers to understanding, trust, appraisal and application of vaccine-related information online.

OBJECTIVE

To develop a tool measuring digital vaccine literacy and assess its psychometric properties.

METHODS

A seven-item online questionnaire was administered to 848 French adults. Performed psychometric analyses were: descriptive statistics, exploratory factor analysis, reliability, consistency, and convergent and discriminatory validity.

RESULTS

We obtained the Digital Vaccine Literacy (DVL) 7-item scale composed of 3 factors (understanding and trust official information; understanding and trust information in social media; and appraisal of vaccine information online in terms of evaluation of the information and its application for decision-making). The mean DVL score was 19.5 (± 2.8) with a minimum of 7 and a maximum of 28. The median was 20 and 25% had a score below 18 and 25% above 21. Scores were significantly different by sex, age, studying or working in the field of health, and receiving regular flu shots.

CONCLUSIONS

The DVL tool showed good content validity, reliability, internal consistency and convergent and discriminant validity, thus proving to be a promising measure of digital vaccine literacy.

CLINICALTRIAL

None
Mental illness concordance between hospital clinical records and mentions in domestic violence police narratives: Data linkage study (Preprint)
Authors: Karystianis George , Cabral Rina Carines , Adily Armita , Lukmanjaya Wilson , Schofield Peter , Buchan Iain , Nenadic Goran , Butler Tony Gerald
Published: May 2022

BACKGROUND

To better understand domestic violence, data sources from multiple sectors such as police, justice, health, and welfare are needed. Linking police data to databases from other agencies could provide unique insights and promote an all-of-government response to domestic violence. The New South Wales Police Force attends domestic violence events and records information in the form of both structured data and a free text narrative, with the latter shown to be a rich source of information.

OBJECTIVE

To examine the concordance (i.e., matching) between mental illness mentions extracted from the police’s event narratives with mental health diagnoses from hospital and emergency department records.

METHODS

Using different window periods (one/three/six/twelve months) before and after a domestic violence event, we automatically linked data from 416,441 police event narratives between December 2005 and January 2016 to clinical records from the Emergency Department Data Collection and the Admitted Patient Data Collection in New South Wales, Australia.

RESULTS

Using a two-year (i.e., twelve months before and after) window period, <1% (3,020) of events had a mental illness mention and a corresponding hospital record. 16% of domestic violence events for both persons of interest (POIs) (382 out of 2,395) and victims (101 out of 631) had agreement between hospital records and police narrative mentions of mental illness. 51,025 (12.2%) events for POIs and 14,802 (3.5%) events for victims had mental illness mentions in their narratives but no hospital record. Only 841 events for POIs and 919 events for victims had a hospital record within 48 hours of the DV event.

CONCLUSIONS

Our findings reinforce the view that surveillance systems based solely on hospital presentations are very limited in terms of coverage, with hospitals seeing only a fraction of mental illness conditions arising from domestic violence situations. This demonstrates that police appear to have substantial visibility of mental illness in domestic violence covering scope and the severity of conditions. While the police data come with their own set of limitations, the coverage of mental health within domestic violence police narratives highlights the need to be able to link various data sources for large scale surveillance and reporting that could prove beneficial for vulnerable populations.
Indicators of carbohydrate and fat metabolism in patients with various degrees of fatty liver dystrophy
Authors: Yagmur V.B. , Kislova R.M. , Klenina I.A. , Tatarchuk O.M. , Melanich S.L.
Published: May 2022

Background. Non-alcoholic fatty liver disease (NAFLD) ranks first among chronic liver diseases and covers almost a quarter of the population. Enough data have been accumulated on the mutual influence of metabolic changes and steatosis of the liver of varying degrees on the existence and progression of each other. The coexistence of non-alcoholic steatohepatitis (NASH) with various comorbidal conditions has already been recorded in many studies, a direct relationship has been determined between the presence of fatty degeneration and various components of the metabolic syndrome— arterial hypertension, type 2 diabetes, obesity and dyslipidemia. The purpose was to determine the relationship between carbohydrate and fat metabolism in patients with NAFLD depending on the degree of fat accumulation in the liver. Materials and methods. Data were obtained from 72 patients with NAFLD, who were divided into two groups according to the degree of steatosis. The I group included 46 patients with moderate steatosis (the proportion of hepatocytes containing fatty is 33–66%). The indicator of the controlled parameter of ultrasonic attenuation (CAP) ranged from 232 to 256dB/m. The II group consisted of 26 patients with severe steatosis (the proportion of hepatocytes containing fatty inclusions more than 66%), with CAP more than 256dB/m. The trophological status, the parameters of carbohydrate and fat metabolism were determined. A statistical analysis of the data was carried out— the mean values in the groups were compared and the contribution of variables to the value of CAP was estimated using the method of multiple regression analysis. Results. The level of insulin and HOMA-IR in patients with severe fatty degeneration of the liver was (22.7±9.7) and (5.4±2.7) μU/ml, respectively. These indicators were higher than the corresponding indicators of group I (p<0.05), (17.1±10.3) and (4.01±2.9) μU/ml for insulin and HOMA-IR, respectively. Glucose, lipid spectrum did not differ significantly between the groups, except for the fraction of very-low density lipoproteins (VLDL), which were significantly higher in patients with a higher degree of fatty degeneration and amounted to 3.4 (2.3–4.1) and 3.0 (2.4–3.8) mmol/L in groupsII and I, respectively. Multiple regression analysis was performed to determine the contribution of fat and carbohydrate metabolism to CAP values. As a result of step-by-step analysis, two indicators remained in the model, namely the HOMA index (regression coefficient β 5.285, p=0.04) and BMI (regression coefficient β 4.666, p=0.001). Itwas determined that changes in BMI and HOMA are responsible for 31% of changes in the value of CAP. Conclusions. Insulin values, HOMA index, BMI and VLDL are higher in patients with severe steatosis. According to the results of multiple regression analysis, a significant contribution of HOMA and BMI values to the CAP was revealed.
From the past zemstvo medicine in the outback: Zhovte village in Katerynoslavshchina
Authors: Chaban M.P. , Shevtsova Z.I. , Gaponov V.V.
Published: May 2022

The article covers the formation of zemstvo medicine in the Verkhnyodniprovskdistrict of Ekaterinoslav province on the example of the village Zhovte. Historical and local lore information about this region has been provided. The development of the medical service in the early twentieth century has been presented. The life and professional path of ascetic physicians Mykhailo Dudkevych, Gavrilo Kossovsky, Volodymyr Tatarynov and others have been studied.
Proses difusi relativistik melalui persamaan langevin dan fokker-planck
Authors: Romadani Arista , Rosyid Muhammad Farchani
Published: May 2022

Brownian motion theory is always challenging how to describe diffusion phenomena with the main issue is how to extend the classical theory of Brownian motion to the special relativity framework. In this study, we formulated dynamics and distribution of a Brownian particle in relativistic framework by using Langevin and Fokker-Planck equation. By representing Brownian particle dynamics by Langevin equation, the velocity curves  were dependent on the presence of viscous friction coefficient (heat bath), and were used generalized in special relativity theory, A relativistic Langevin equation reduces to the classical theory at low velocities. Likewise, the distribution of Brownian particles is represented  as a stationary solution of the relativistic Fokker-Planck equation. From numerical results, we found that the probability density in the relativistic Fokker-Planck equation for  was reduced to the standard Fokker-Planck equation in Netownian classical theory. For  the calculation result showed that the Hanggi-Klimontovich approach has a consistent result to the relativistic Maxwell distribution. This work could open a promising interpretation to formulate the diffusion phenomena into general relativity theory.
IMPACT OF PHARMACIST LED HYPERTENSION MANAGEMENT
Authors: MATHEWS ANJU SARAH , KUMARI SRESHI
Published: May 2022

Objective: The study objective was to analyze the effect of pharmacist interventions in improving blood pressure control.
Methods: The prospective interventional study was conducted on a population who were known hypertensive for more than 2 years. They were randomly categorized into two groups, interventional group and usual care group. Pharmaceutical care, involving telephonic follow-up, adherence analysis, patient education was given in the former group in a time interval of 2 months for about 12 months while the later was on regular therapeutical care only. Blood pressure was monitored in each follow-up. The difference in control of blood pressure was measured in terms of mm/Hg unit. The improvement in the measure from start and end of the study was analyzed within the group and between the groups.
Results: Lowered blood pressure was observed in both the groups in the end of study. But statistically significant difference was seen in interventional group compared to the other. Involvement of pharmacist led care helped in achievement of AHA goal.
Conclusions: Including clinical pharmacist in a health-care team can provide unerring therapeutic regimen to patients thereby their health-care outcome.
RESVERATROL PROTECTS WHOLE BODY HEAT STRESS-INDUCED TESTICULAR DAMAGE IN RAT MODEL
Authors: ROY PUJA , KUMAR SOUMYA SUNDAR , MANNA KRISHNENDU , DAS ASIMA
Published: May 2022

Objective: The local thermoregulation in testis is important for optimum spermatozoa development. Excessive heat hampers this regulation resulting in alteration of normal testicular function. The present investigation confirms the role of free radicals in hyperthermia induced oxidative damage in testis and elucidates the dose-dependent ameliorating effect of resveratrol (RSV) against testicular oxidative damage. The aim of the present investigation is also to observe the role of selective concentration of RSV on heat induced oxidative changes in the damaged tissue.
Methods: 48 male Wister rats were exposed to hyperthermic condition for the past 7 days of the total 21 days of experiment. RSV was pre- and co-treated with heat stress daily in a dose-dependent manner (1 mg, 5 mg, and 10 mg/kg body weight) for 21days.
Results: Reactive oxygen species level was estimated using flow cytometry. Enhancement of hepatotoxicity markers in serum, lipid peroxidation and decreasing antioxidant status in the testis homogenate demonstrated that the oxidative damage in heat exposed tissue.
Conclusion: Histological study along with biochemical and molecular assessment of the redox balance of testicular tissue in the present study revealed that RSV significantly ameliorated the heat induced damage in testis. The findings suggest that RSV is an effective antioxidant polyphenolic compound that can protect testis against hyperthermia induced oxidative damage.
GC-MS ANALYSIS AND PREDICTION OF BIOLOGICAL ACTIVITIES USING MOLECULAR DOCKING OF CODIUM DECORTICATUM (WOODWARD) M. HOWE AGAINST CANCER
Authors: PRIYA P ANUSATHYA , PAUL J JOHN PETER
Published: May 2022

Objective: The objective of this study was to analyze the phytochemicals and the prediction of biological activities in the petroleum ether extract of marine green macro alga Codium decorticatum (Woodward) M. Howe (Green algae) collected from Mandapam, Tamil Nadu, India.
Methods: The characterization of biochemical was done by gas chromatography–mass spectroscopic (GC-MS) spectra analysis and the biological activities were analyzed using the Prediction of Activity Spectra for Substances (PASS) technique.
Results: GC-MS spectral analysis showed a prevailing compound 1,2-benzenedicarboxylic acid, mono(2-ethylhexyl) ester (100%) with retention time of 22.33 min. The PASS result showed 1,933 different kinds of biological activities, namely, anti-cancer (93.5%), anti-seborrheic (89.4%), antieczematic (81.2%), anti-hypercholesterolemic (81.5%), antiviral (81.2%), insulin promoter (79.4%), and anti-inflammatory (77.8%).
Conclusion: The present study confirmed the inter-molecular hydrogen bonding of the bioactive compound 1,2-benzenedicarboxylic acid, mono(2-ethylhexyl) ester with the active site of ARF6 (PDB ID 2w83) and the binding energy is −7.49 kcal/mol. Four hydrogen bond interactions were present at GLY80, THR81, GLY80, and GLY80 at the active site.
IMMUNOMODULATORY NATURAL PRODUCT: REVIEW
Authors: GOND SURYA PRATAP , SAHU SUDHANSHU , RAWAT SUDEER , RAJENDIRAN A. , SINGH ANJU
Published: May 2022

Immunomodulation is also known as immune system modulation that is preceding changes the immune response result helps the tissue damage and immoderate response that is obtained by natural and unnatural (human-made) from. The review on an immunomodulatory natural products that is attention on anti-infective treatments for various numbers of justifications. Various traditional natural medicines are used for the immune response directly or indirectly impact antigen through adaptive defense mechanism of the host cell. And there currently various medicinal plants used for anti-effective such as Aloe Vera mill, Panax ginseng, Andrographispaniculata, and Clausenaexcavate that are gives immunomodulatory and anti-infective. Response and these responses have been modulated by using in their past and further developed by research change their modulation effects and many natural phytoconstituents used for immune system modulation and seen their activity on the various disease and effects and action and modulation.
AN ANALYSIS OF THE PREVALENCE OF POLYPHARMACY AMONG INPATIENTS OF A TERTIARY CARE HOSPITAL IN KERALA
Authors: SHAJAHAN JIHANA , P ABDUL ASLAM , JOY JOBIN , BABY MINU
Published: May 2022

Objectives: The aim of the study was to estimate the prevalence of polypharmacy, identify the age groups commonly associated with polypharmacy, study the correlation between duration of hospital stay and polypharmacy, and identify the diseases commonly associated with polypharmacy
Methods: Record-based, prospective, and cross-sectional study among 370 inpatients of a tertiary care hospital in Kerala. Prescriptions containing ≥3 drugs were collected from inpatient medical records of patients with at least 3 days hospital stay. The number of drugs ≥5 was considered as polypharmacy in the present study.
Results: The prevalence of polypharmacy was 93% and average the number of drugs per prescription was 8.81±3.097. Average number of drugs per prescription was significantly high among patients >60 years. Percentage of prescriptions with polypharmacy among patients with duration of stay 3–5 days, 6–8 days, and ≥ 9 days was found to be 89.4, 98.6, and 100, respectively. There was a significant positive association between duration of hospital stay and percentage of prescriptions with polypharmacy as well as average number of drugs per prescription. Diseases or comorbidities most commonly associated with polypharmacy were hypertension, diabetes mellitus, cerebrovascular accidents, coronary artery disease, and dyslipidemia.
Conclusion: The prevalence of polypharmacy was high in the present study (93%) when compared to similar studies. Age >60 years was strongly associated with the prevalence of polypharmacy, but gender was not found to be factor. Duration of hospital stay was an important factor positively associated with percentage of prescriptions with polypharmacy as well as number of drugs per prescription.
Facility and Technological Supports, and Information Transparancy to Improve the Success of a Contract Farming between Farmers Group and Company
Authors: Sinaga Agung , Gayatri Siwi , Prasetyo Agus Subhan
Published: May 2022

Contract farming is carried out to encourage the improvement of economic and social condition of farmer community so it can increase their income and achieve more equitable and sustainable development. The process of contract farming is affected by various factors, internal factors or external factors. This sudy aims to (i) describe contract farming between PT Bloom Agro and Bangkit Merbabu farmer group, (ii) describe the challenges and benefits of contract farming, and (iii) analyze the factors that effect the success of contract farming between PT Bloom Agro and Bangkit Merbabu farmer group. The research was conducted in Desa Batur, Kecamatan Getasan using the cencus method with the total population of 35 organic vegetable farmers in Bangkit Merbabu farmer group. The analysis method in this research was descriptive analysis and multiple linear regresion. The data analysis showed that the F test result of variable education, farming experience, production input, technological support and information transparancy simultaneously have a significant effect on the success of contract farming betwen PT Bloom Agro with Bangkit Merbabu farmer group. The t test result showed production input, technological support and transparancy of information individually have a  significant efect on the success of contract farming.  Pattern of contract farming that was applied between PT Bloom Agro and Bangkit Merbabu farmer group is a general trading contract. Covid-19 pandemic, climatic condition and limitation of education were found to be the inhibiting factors that farmers faced in the implementation of contract farming. PT Bloom Agro can provide  more intensive assistance and training about contract farming to increase farmer’s knowledge and skill for sustainability of contract farming.
Analysis of Consumer Attitudes towards MSME-produced and Factory-produced Coffee Powder in East Java
Authors: Febriyanti Amirotul Nabila  , Mardiyah Hayati
Published: May 2022

The increasing trend of coffee consumption creates opportunities for business actors and coffee producers of various regions to produce MSME-made coffee powder as a competitor to the factory-made one. As the market competition becomes tougher, coffee powder producers need to equip themselves with the information on attributes useful to attract and maintain customers’ choice. The purpose of this study is to understand the characteristics of coffee powder consumers produced by both MSMEs and factories as well as to determine and analyze the level of importance, trust, and consumer attitudes. The sampling method used is accidental sampling with 100 respondents. As for the research methods, this research used descriptive and multi-attribute Fishbein analysis methods. The included attributes are taste, aroma, price, halal logo, packaging, coffee powder dregs, marketing place, and promotion. The results of the study informed that the characteristics of consumers are mostly aged 17-25 years old, male, working as students, residing in East Java, and having monthly income less than IDR 500,000. Consumer attitudes (Ao) towards MSMEs produced powder coffee is considered good by consumers.
The Effect of Agreed Export Tonnage Scheme (AETS) Policy on Indonesia's Natural Rubber Exports to Japan
Authors: Hanivia Safira Retna , Suprehatin
Published: May 2022

Natural rubber is one of Indonesia's major agricultural export commodities. However, the export performance of Indonesia’s natural rubber to several destination countries experienced a downward trend during the 2011-2019 period. Japan is one of the leading export destinations for Indonesia’s natural rubber, experiencing a downward trend in export value. This study aims to analyze Indonesia’s natural rubber exports to Japan and its agreed export tonnage scheme (AETS) policy. The study utilized a monthly time series data from 2011 to 2019. The data were analyzed using descriptive qualitative and error correction model (ECM) methods. The results showed the implementation of AETS policy and world natural rubber price had significant effect on the export value of Indonesia’s natural rubber to Japan in the long-run, but it is not applied in the short-run. Indonesia needs to improve the quality and productivity of natural rubber production to increase the performance of Indonesia’s natural rubber exports to Japan. Furthermore, Indonesia needs to evaluate the effectiveness of the AETS policy on natural rubber.
An assessment of the policy and regulatory outcome by the telecom services users: The emerging economy study
Authors: Mishra Pankaj , Singh Netra Pal , Farooq Ayesha
Published: May 2022

Outcome-based policy evaluation is an established practice in the distributive and redistributive public policies. Such practices are not evident for competitive regulatory policies of telecom, especially in India. This study bridges this research gap by carrying out an outcome-based evaluation of telecom policy and highlighting the importance of such evaluation. Using the methodological pluralism model from Schalock (2002), the outcome of India’s telecom policies was evaluated. Outcome measures from the vision statement of telecom policy were appraised by telecom users by responding to a structured questionnaire-based survey. Factor analysis confirmed that our survey instrument measured the identified policy outcomes. Regression analysis confirmed that users’ appraisal was based on their experiences of telecom services. Against five policy outcome measures, the survey respondents agreed on the achievement of affordability of services: 68.9% of the respondents found telecom services not secure; 74.7% of the survey respondents indicated an issue with quality; 55.6% of the respondents did not agree that the services are available anytime, anywhere. Outcome measures like telephone density (teledensity) as adopted by Telecom Regulatory Authority of India (TRAI) and Department of Telecommunications (DoT) are not the true representative of policy outcome. A multistakeholder policy evaluation will reveal the actual policy outcomes. International Telecommunications Union (ITU) should establish a standardized framework for outcome-based policy evaluation to address such issues.
QTLs for soybean seed isoflavones are linked to laccases, BANYULS and the MBW complex
Authors: Li Xueying , Zhang Jun , Chen Liangyu , Wang Zhenhui , Yu Cheng , Han Xiao , Song Yang , Yao Dan , Fan Sujie , Murray Jeremy , Yang Songnan , Ma Jian , Zhang Jian
Published: May 2022

Isoflavones are secondary metabolites present in seeds of soybean [
Glycine max (L.) Merr.] which have been recognized their
benefit to human health. In this study, QTL mapping for soybean
isoflavone gylcones including daidzin, glycitin and genistin and total
isoflavones content was performed in population of 178 F2:6 recombinant
inbred lines (RILs) which was generated from cross between varieties
Jinong17 and Jinong18. A genetic linkage map covering 1248 cM was
constructed using the simple sequence repeat (SSR) molecular markers.
The results revealed 22 isoflavone- related QTLs, 5 for daidzin, 7 for
genistin, 6 for glycitin, and 4 for total isoflavone content. Seven of
these represent new QTLs. Twenty candidate genes were identified,
including eight laccases with presumed role in lignin biosynthesis, and
the transcriptional regulator BANYULS and all three components of the
MYB-bHLH-WD40 (MBW) complex that regulate its expression. These findings
suggest that alterations in lignin and proanthocyanidin metabolism
influence isoflavone accumulation in seeds. These leads might be helpful
in the efforts to breed new soybean varieties with improved isoflavone
composition and content.
Psychotropic medication in pregnancy and lactation and early development of exposed children
Authors: Leutritz Anna Linda , Braam Lara van , Preis Katharina , Gehrmann Andrea , Scherf-Clavel Maike , Fiedler Katrin , Unterecker Stefan , Kittel-Schneider Sarah
Published: May 2022

Aim There is still only little knowledge about alterations of blood
concentrations of psychotropic drugs during pregnancy, the transfer of
psychotropic drugs into breast-milk and the effects on exposed children.
Methods We investigated changes in concentrations of
psychopharmacological medication during pregnancy and lactation in serum
and breast milk at different time points in a naturalistic sample of 60
mothers and observed the development of the exposed children in the
first 12 months. Results We found a decrease in serum concentrations
from the first to the second trimester of amitriptyline, duloxetine,
escitalopram, quetiapine and sertraline. Citalopram stayed rather stable
during pregnancy, sertraline levels interestingly increased again from
the second to the third trimester. Highest concentration-by-dose-ratios
in breast milk were found for venlafaxine as well as lamotrigine, lowest
for quetiapine and clomipramine. Similarly, clomipramine and quetiapine
showed lowest milk/serum-penetration-ratios. Regarding the birth outcome
measures in children we found no significant differences between in
utero exposed compared to non-exposed new-borns. There were no
significant differences in the development in the first 12 months.
Conclusion Psychotropic medication in the peripartum needs a balancing
of risks and benefits and a continuous therapeutic drug monitoring (TDM)
can be a guidance for clinicians to monitor drug alteration patterns,
which are likely to occur due to physiological pregnancy-associated
changes in pharmacokinetics. Accordingly, TDM can optimize a medication
in pregnancy and lactation with the lowest but effective dose.
Chorus and Character in “Samson Agonistes”
Authors: Martz Louis L.
Published: May 2022

The tragic action of Samson Agonistes develops through a contrast between the language of Samson and that of the Chorus. An essential clue to Milton's art in this drama lies in his effect of deliberately playing down the choruses in the middle, refusing to give the chorus very good lines, except toward the beginning and again toward the end. After each of the central episodes, Milton has given the chorus words that are for the most part dry and commonplace, often surprisingly flat. It would appear that Milton's use of rhyme and partial rhyme in the choruses has frequently the effect of lowering the tone of high seriousness and making impossible any high dignity in the choric speech. The basic effect is to stress, by contrast, the grandeur of Samson, the greatness of his mind and spirit. The weak and ordinary character of Manoa, the complex and enigmatic character of Dalila, and the braggart character of Harapha are all related to this basic contrast between Samson and the chorus.
Milton's Blank Verse Sonnets
Authors: Johnson Lee M.
Published: May 2022

At critical points in their destinies, characters in Milton's last three poems often speak in blank verse sonnets to pledge their acceptance of one another, of themselves, or of divine purposes. These blank verse units of fourteen lines, which display structural proportions similar to those of Milton's rhymed sonnets, generally recall and extend the traditional function of the form as a love poem. In Paradise Lost, they often accompany the resolutions of characters to embody gestures of reconciliation. They are a way of revealing the spiritual identities of both speakers in Paradise Regained and of epitomizing Christ's assent to his mission. To signify acceptance of divine ways, they point to the farewell speeches of Samson and the chorus. Milton's blank verse sonnets appear throughout the major poems and always in the conclusions of narrative or dramatic actions, where they help him impart a final, Christian perspective and form to the larger forms and structural patterns he inherits from classical epic and dramatic traditions.
“Virga Iesse”: Analogy, Typology, and Anagogy in a Miltonic Simile
Authors: Goldberg Jonathan
Published: May 2022

The analogy of the tree that Raphael uses in Milton's Paradise Lost (V, 469–503) has generally been understood as a cosmic tree suggesting the Great Chain of Being. However, this interpretation needs to be modified to account for the temporal aspects of the image of the tree's growth. Once viewed as a spatial analogy for a temporal process, the tree can be said to function not only as an analogy but as a typological metaphor. In this context, it is most reminiscent of the Old Testament figura of the rod of Jesse. By considering the vertical, horizontal and circular motions described by Raphael, the image can be associated both with the Neoplatonic universe as well as the Christian drama of salvation. Within the imagery of Paradise Lost, this image reflects and relates to the “Forbidden Tree” and its fruit reunderstood as Christ upon the cross, Christ as creative Word and re-creative food in the Eucharist. Its revelation of Christ as cosmic and historical image is not, however, the entire meaning of Raphael's image; ultimately, the image is constructed from the eternal vantage point, and its motion and circularity fix a still point of eternity from which all is seen.
Kinship and the Role of Women in “Paradise Lost”
Authors: Landy Marcia
Published: May 2022

In Paradise Lost, Milton places marriage at the center of social institutions. It is from the point of view of marriage that all social roles and attitudes are defined and judged valuable or destructive. Sibling relationships and parental roles function to establish and maintain male authority. Male-female relations in the human sphere reflect the pattern of dominance and submission characteristic of the divine sphere, where it is seen particularly in the relationship of the Father to the Son. Adam's prelapsarian role is analogous to that of God. He is defined as creator, author, disposer, while Eve is confined to being a source of inspiration, and to the roles of mother and wife, summed up in her title “Mother of mankind.” After the Fall, Eve must learn through pain, humiliation, and abasement that she should not have striven for equality with Adam, that her duty is to be submissive to him as wife and mother. In general, worldly activity belongs to the man: he is artist, ruler, intellect. The woman's role is to be procreative, skilled in domesticity, and obedient to her husband, upon whom she depends for education and guidance. Her freedom is fully expressed in her fulfillment of her family role as wife and mother.
A Reading of Milton's Twenty–Third Sonnet
Authors: Williamson Marilyn L.
Published: May 2022

Milton's twenty-third sonnet may be read without reference to Mary Powell, Katherine Woodcock, or the poet's blindness. The poem is structured on a progressive definition of salvation from death and of the human condition in this world. It contains a rising movement from physical salvation, according to the Alcestis legend, to ritualistic salvation, according to the Old Dispensation, to true Christian salvation, in which the saint is bride of the Lamb, and her virtues shine from inside her person. The marriage theme provides a tragic countermovement; for the Christian saint, though she may share Alcestis’ impulse and incline to embrace her husband, is unalterably lost to him in this world, and he can only dream of sharing her separate and purified existence after his death. Hope in the true salvation is set forth in the contrast between pale and faint Alcestis and the bright figure of the saint, and the falling movement lies in the contrast between the reunion of Alcestis and Admetus and the separation of the saint and the speaker of the poem.