bluuebunny/crossref_metadata_2025 huggingface dataset:
Classification of Measures of Restriction: From a “Mixed” Criterion to a Connection with the Object of Restriction
Authors: Mandzhieva E. V.
Published: April 2020

Achieving the aims of criminal proceedings is impossible without coercion, which significantly restricts human rights and freedoms, including constitutional ones, and, therefore, it is permissible only if there are grounds and in the manner prescribed by the criminal procedure legislation. The grounds, conditions and procedure for applying measures of restriction in criminal proceedings largely depend on the correct systematization of criminal procedure legislation, which may be the basis for a systematic interpretation of the text of the law. Combining other measures of procedural coercion in Ch. 14 of the Criminal Procedure Code of the Russian Federation does not have clear criteria, which is fraught with the erroneous use of procedural coercion against participants in criminal proceedings. The purpose of the paper is to assess the directions of possible improvement of the legislation regarding the systematization of procedural coercion measures. Measures of procedural coercion should be structured and systematized in the Criminal Procedure Code of the Russian Federation on clear and uniform grounds, including coercive measures, which are not measures of restriction. Currently, there are no such grounds in relation to other measures of procedural coercion, united in Ch. 14 of the Criminal Procedure Code of the Russian Federation, which impedes their reasonable application. The contents of Ch. 14 of the Criminal Procedure Code of the Russian Federation should be revised taking into account logical and legal ties. As a result of the research the author developed the ideas on logical connections as one of the main bases for the classification of the norms governing the use of procedural coercion, affecting its legality and validity.
Mesleki ve Teknik Anadolu Liseleri Yöneticilerinin Teknik Liderlik Becerilerinin Geliştirilmesi
Authors: ÖZDEMİR Gökçe , ŞAHİN Sevilay
Published: April 2020

Bu araştırmanın amacı, Mesleki ve Teknik Anadolu Liselerinde görev yapan okul yöneticilerinin teknik liderlik becerilerinin geliştirilmesi için bir eğitime ihtiyaç olup olmadığının, eğer eğitime ihtiyaç varsa böyle bir eğitimin nasıl yapılandırılması gerektiğinin yönetici, öğretmen ve eğitim yönetimi alan uzmanları görüşlerine göre belirlenmesidir. Araştırma nitel araştırma yöntemlerinden durum çalışması deseninde yapılmış olup, araştırma verileri yarı yapılandırılmış görüşme formları ile toplanmıştır. Veriler içerik analiz yöntemi ile analiz edilmiştir. Araştırma sonucunda, mesleki ve teknik eğitim yöneticilerinin teknik liderlik becerilerinin geliştirilmesine katkı sağlayacak bir eğitime ihtiyaç olduğu tespit edilmiştir. Eğitimin, mesleki ve teknik eğitimin felsefesine ve var oluş misyonuna uygun dersleri kapsaması ve önce teorik bilgilerin verildiği, eğitim-öğretim süreci içerisinde ise pratik uygulamaların yapıldığı eğitim şeklinde verilmesi gerektiği sonucuna ulaşılmıştır. Ayrıca eğitimin değerlendirme aşamasında eğitimi veren uzmanların ve eğitimden fayda sağlayıcıların birlikte değerlendirme yapması gerektiği ve eğitimden beklenen faydanın sağlanabilmesi için eğitimlerin, alan akademisyenleri, deneyimli müdürler, sektör uzmanları ve AB temsilcileri işbirliği ile verilmesi gerektiği sonucuna varılmıştır.
OS PURI NO SUL DO ESPÍRITO SANTO: OCUPAÇÃO, TERRITORIALIZAÇÃO E TRABALHO COMPULSÓRIO
Authors: Oliveira Tatiana Gonçalves de , Costa Henrique Antônio Valadares
Published: April 2020

Este artigo procura refletir sobre os processos de dispersão e ocupação Puri no território da Capitania e depois Província do Espírito Santo, a partir do diálogo entre Arqueologia e História. Além disso, nos interessa compreender as consequências da territorialização dos índios Puri no Aldeamento Imperial Afonsino, entre 1845 e 1860. Procuramos demonstrar como o trabalho compulsório imposto àqueles aldeados era uma forma de precarização de sua liberdade, que se traduzia no uso forçado da sua mão de obra em diversos serviços públicos. Não obstante toda essa violência nas relações de contato, procuramos evidenciar os modos de resistências que foram acionados por esses indígenas para viverem e sobreviverem às experiências coloniais nas quais estavam inseridos.
A COLÔNIA NACIONAL AGRÍCOLA CACHOEIRA DE ILHÉUS, SÉCULO XIX
Authors: Silva Ayalla Oliveira
Published: April 2020

Na segunda metade do século XIX, no sul da Bahia, o governo provincial e os particulares estavam envolvidos em expandir a fronteira agrícola e de ocupação. Contudo, a região era habitada pelos Camacã, Botocudo e Pataxó e parte deles impunha resistência ao avanço da colonização em seus territórios. Nesse processo, foi criada a colônia nacional agrícola Cachoeira de Ilhéus na estrada que ligava a vila de Ilhéus à vila da Vitória, comarcas de Ilhéus e Caetité, respectivamente, como parte de uma política de ‘colonização indígena’ alternativa às missões religiosas destinadas à catequização dos índios. A colônia Cachoeira tinha como papéis centrais: pacificar a região da presença indígena, facilitar o comércio e o acesso de colonos à região. Objetivo, portanto, empreender uma abordagem acerca da prática da colônia Cachoeira de Ilhéus enquanto experiência indigenista, contexto no qual era central a atuação dos frades capuchinhos italianos
Robotik Uygulamalar İçin Titreşime Dayalı Hareket Eden Amfibik İlerleme Mekanizması
Authors: Tapan Ahmed Burak , Reis Murat
Published: April 2020

Bu çalışma, robotik uygulamaları için, titreşime dayalı olarak hem karada hem de su üzerinde hareket edebilen, yenilikçi bir ilerleme mekanizmasını tanıtmaktadır. İlerleme mekanizması, su üzerinde batmadan durmasını sağlayan düşük yoğunluklu dikey kanat profiline sahip iki ayaktan ve U şeklinde yay çeliğinden üretilmiş elastik bir çubuktan oluşmaktadır. U şekilli çubuğun ortasına yerleştirilen basit bir sarkaç vasıtası ile sistem titreşime zorlanarak ilerleme gerçekleştirilmektedir. Su içerisinde dikey konumlandırılmış ayaklar salınım yaptıkça ön ve arka yüzeyler arasında oluşan basınç farkı ile robot ileri yönde hareket etmektedir. Karadaki hareketi ise elastik kirişin doğal titreşim modlarına bağlı olarak gerçekleşmektedir. Çalışmada farklı titreşim frekanslarının ilerleme hızına ve yer değiştirme maliyetine etkisi deneyler ile incelenmiş ve sonuçlar yorumlanmıştır. Buna ek olarak ön modelin yer değiştirme maliyeti (CoT) literatürdeki bazı robotlar ve canlılar ile karşılaştırılmıştır.
Fish Community Resistance and Resilience to Drought in the San Francisco Estuary: A Retrospective of Five Decades of Drought Cycles
Authors: Mahardja Brian , Tobias Vanessa , Khanna Shruti , Mitchell Lara , Lehman Peggy , Sommer Ted , Brown Larry , Culberson Steve , Conrad J. Louise
Published: April 2020

Many estuarine ecosystems and the fish communities that inhabit them have undergone significant changes in the past several decades, largely due to multiple interacting stressors that are often of anthropogenic origin. Few are more impactful than droughts, which are predicted to increase in both frequency and severity with climate change. In this study, we used over five decades of fish monitoring data from the San Francisco Estuary, California, U.S.A, to evaluate the resistance and resilience of fish communities to disturbance from prolonged drought events. High resistance was defined by the lack of decline in species occurrence from a wet to a subsequent drought period, while high resilience was defined by the increase in species occurrence from a drought to a subsequent wet period. We found some unifying themes connecting the multiple drought events over the fifty-year period. Pelagic fishes consistently declined during droughts (low resistance), but exhibit a considerable amount of resiliency and often rebound in the subsequent wet years. However, full recovery does not occur in all wet years following droughts, leading to permanently lower baseline numbers for some pelagic fishes over time. In contrast, littoral fishes seem to be more resistant to drought and may even increase in occurrence during dry years. Based on the consistent detrimental effects of drought on pelagic fishes within the San Francisco Estuary and the inability of these fish populations to recover in some years, we conclude that freshwater flow remains a crucial but not sufficient management tool on its own for the conservation of estuarine biodiversity.
Black-Si as Photoelectrode
Authors: Linklater Denver , Haydous Fatima , Xi Cheng , Pergolesi Daniele , Hu Jingwen , Ivanova Elena , Juodkazis Saulius , Lippert Thomas , Juodkazyte Jurga
Published: April 2020

The fabrication and characterisation of photo-anodes based on black-Si (b-Si) are presented using a photo-electrochemical cell in NaOH solution. Black-Si was fabricated by maskless dry plasma etching and was conformally coated by tens-of-nm of TiO2 using atomic layer deposition (ALD) with a top layer of CoOx cocatalyst deposited by pulsed laser deposition (PLD). Low reﬂectivity R < % of Black-Si over the entire visible and near-IR (λ < 2 µm) spectral range is favourable in better absorption of light while an increased surface area facilities larger current densities. Photoelectrochemical performance of the heterostructured photoanode is discussed in terms of n-n junction between b-Si and TiO2.
The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal
Authors: Ghimire Rajan , Shakya Yogendra Man , Shrestha Tirtha Man , Neupane Ram Prasad
Published: April 2020

Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis.Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively.Conclusion: Area under the curve value for RDW is fair enough to predict the mortality of patients with sepsis in the emergency room. It can be integrated with other severity scores (APACHE II or SOFA score) for better prediction of prognosis of septic patients.
PS4DR: A multimodal workflow for identification and prioritization of drugs based on pathway signatures
Authors: Emon Mhammad Asif , Domingo-Fernández Daniel , Hoyt Charles Tapley , Hofmann-Apitius Martin
Published: April 2020

Background: During the last decade, there has been a surge towards computational drug repositioning owing to constantly increasing -omics data in the biomedical research field. While numerous existing methods focus on the integration of heterogeneous data to propose candidate drugs, it is still challenging to substantiate their results with mechanistic insights of these candidate drugs. Therefore, there is a need for more innovative and efficient methods which can enable better integration of data and knowledge for drug repositioning.Results: Here, we present a customizable workflow (PS4DR) which not only integrates high-throughput data such as genome-wide association study (GWAS) data and gene expression signatures from disease and drug perturbations but also takes pathway knowledge into consideration to predict drug candidates for repositioning. We have collected and integrated publicly available GWAS data and gene expression signatures for several diseases and hundreds of FDA-approved drugs or those under clinical trial in this study. Additionally, different pathway databases were used for mechanistic knowledge integration in the workflow. Using this systematic consolidation of data and knowledge, the workflow computes pathway signatures that assist in the prediction of new indications for approved and investigational drugs. Conclusion: We showcase PS4DR with applications demonstrating how this tool can be used for repositioning and identifying new drugs as well as proposing drugs that can simulate disease dysregulations. We were able to validate our workflow by demonstrating its capability to predict FDA-approved drugs for their known indications for several diseases. Further, PS4DR returned many potential drug candidates for repositioning that were backed up by epidemiological evidence extracted from scientific literature. Source code is freely available at https://github.com/ps4dr/ps4dr.
Live-attenuated Salmonella enterica serotype Choleraesuis vaccine with regulated delayed fur mutation confer protection against Streptococcus suis in mice
Authors: Li Yu-an , New Yunyun Chen , Du Yuan zhao , Guo Weiwei , Chu Dianfeng , Fan Juan , Wang Xiaobo , Bellefleur Matthew , Wang Shifeng , Shi Huoying
Published: April 2020

Background: Recombinant Salmonella enterica serotype Choleraesuis (S. Choleraesuis) vaccine vector could be used to deliver heterologous antigens to prevent and control pig diseases. We have previously shown that a live-attenuated S. Choleraesuis vaccine candidate strain rSC0011 (ΔPcrp527::TT araC PBAD crp Δpmi-2426 ΔrelA199::araC PBAD lacI TT ΔasdA33, Δ, deletion, TT, terminator) delivering SaoA, a conserved surface protein in most of S. suis serotypes, provided excellent protection against S. suis challenge, but occasionally lead to morbidity (enteritidis) in vaccinated mice (approximately 1 in every 10 mice). Thus, alternated attenuation method was sought to reduce the reactogenicity of strain rSC0011. Herein, we described another recombinant attenuated S. Choleraesuis vector, rSC0012 (ΔPfur88:: TT araC PBAD fur Δpmi-2426 ΔrelA199:: araC PBAD lacI TT ΔasdA33) with regulated delayed fur mutation to avoid inducing disease symptoms while exhibiting a high degree of immunogenicity. Results: The strain rSC0012 strain with the ΔPfur88::TT araC PBAD fur mutation induced less production of inflammatory cytokines than strain rSC0011 with the ΔPcrp527::TT araC PBAD crp mutation in mice. When delivering the same pS-SaoA plasmid, the intraperitoneal LD50 of rSC0012 was 18.2 times higher than that of rSC0011 in 3-week-old BALB/C mice. rSC0012 with either pS-SaoA or pYA3493 was cleared from spleen and liver tissues 7 days earlier than rSC0011 with same vectors after oral inoculation. The strain rSC0012 synthesizing SaoA induced high titers of anti-SaoA antibodies in both systemic (IgG in serum) and mucosal (IgA in vaginal washes) sites, as well as increased level of IL-4, the facilitator of Th2-type T cell immune response in mice. The recombinant vaccine rSC0012(pS-SaoA) conferred high percentage of protection against S. suis or S. Choleraesuis challenge in BALB/C mice.Conclusions: The live-attenuated Salmonella enterica serotype Choleraesuis vaccine rSC0012(pS-SaoA) with regulated delayed fur mutation provides a foundation for the development of a safe and effective vaccine against S. Choleraesuis and S. suis.
Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.
Authors: Harrison Virginia , Moore Donna , Lazard Lisa
Published: April 2020

Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods: Women who were either pregnant or within one-year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed.Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.
Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology
Authors: Zhou Jiaqi , Xue Feng , Zhou Xingtao , Naidu Rajeev Krishnan , Qian Yishan
Published: April 2020

Background: To investigate the changes in corneal epithelial thickness along the principle meridians of astigmatic corneas after six months of overnight spherical myopic orthokeratology (OK) lens wear.Methods: A prospective study. Fifty-seven subjects with up to 1.50 diopters (D) of corneal toricity wore spherical OK lenses for 6 months. Evaluations of OK lens fit, visual acuity, refractions and corneal toricity (CT) were performed. Fourier-domain optical coherence tomography (FD-OCT) was conducted to measure the corneal epithelial thickness (ET) along the principle meridians of corneal toricity over a diameter of 6mm. The means of △ET of the same diameter at individual meridians (△ETSm and △ETFm) were calculated and compared. Results: Visual acuity and refraction improved significantly after OK lens wear. △ETFm (-4.2±3.4μm) thinned more than △ETSm (-3.4±4.0μm, P=0.027) at 1.5mm in radius. △ETSm thickened more than △ETFm at 2.5mm (△ETSm: 4.1±5.1μm, △ETFm: 2.8±4.2μm, P=0.019) and 3.0mm (△ETSm: 5.0±5.0μm, △ETFm: 3.7±4.9μm, P=0.036).∣△ETSm - △ETFm∣ were significantly correlated with the baseline central CT at 2.0mm, 2.5mm and 3.0mm (2.0mm: r=0.285, P=0.032; 2.5mm: r=0.422, P=0.001; 3.0mm: r=0.239, P=0.027). ∣△ETSm - △ETFm∣was significantly correlated with the baseline peripheral CT at 2.5mm (r=0.299, P=0.028). Conclusions: Overnight wear of spherical OK lenses resulted in differential changes in the thickness profiles of the corneal epithelium between the steep and flat meridians in eyes with corneal toricity.
Roles of Peritoneal Clearance and Residual Kidney Removal in Control of Uric Acid in Patients on Peritoneal Dialysis
Authors: Xiao Xi , Ye Hongjian , Yi Chunyan , Lin Jianxiong , Peng Yuan , Huang Xuan , Wu Meiju , Wu Haishan , Mao Haiping , Yu Xueqing , Yang Xiao
Published: April 2020

Background: There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD.Methods: This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine.Results: In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1±6.2 vs. 42.0±8.0 L/week/1.73m2; P=0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0±7.0 vs. 36.4±5.6 L/week/1.73 m2; P<0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93-0.99]. Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), -0.32; 95% CI, -6.42 to -0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m2) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β -0.24; 95%CI -7.26 to -0.99), lower body mass index (β -0.29; 95%CI -0.98 to -0.24), higher transporter status (β 0.24; 95%CI 0.72-5.88) and greater dialysis dose (β 0.24; 95%CI 0.26-3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1kg/m2 decrease in body mass index (OR 0.79; 95% CI 0.63-0.99), each 1g/dL decrease in albumin level (OR 0.08; 95%CI 0.01-0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11-2.19) were associated with greater peritoneal UA clearance (>39.8 L/week/1.73m2).Conclusions: For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.
Factors influencing the perceived importance of oral health within a rural Aboriginal and Torres Strait Islander Community in Australia.
Authors: Tynan Anna , Walker David , Tucker Taygan , Fisher Barry , Fisher Tarita
Published: April 2020

Background: Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception.Methods: The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities’ Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed. Results : Twenty-seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities.Conclusion: This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.
Impact of routine assessment of health-related quality of life coupled with therapeutic information on compliance with endocrine therapy in patients with non-metastatic breast cancer: protocol for a randomized controlled trial
Authors: KAMGA Ariane MAMGUEM , MARTINO Cyril DI , ANOTA Amélie , PAGET-BAILLY Sophie , COUTANT Charles , ARVEUX Patrick , DESMOULINS Isabelle , YONLI Tienhan Sandrine DABAKUYO
Published: April 2020

Background: Despite its proven efficacy in reducing recurrence and improving survival, adherence to endocrine therapy (ET) is suboptimal in women with breast cancer (BC). Health-related quality of life (HRQoL) in BC has been widely studied and many positive effects have been highlighted. Recently, a link between HRQoL and compliance with ET has been suggested, which would suggest a potential role for HRQoL assessment in improving compliance with ET. With the advent of digital technologies, electronic collection of HRQoL on a tablet is now possible. Thus, we hypothesize that systematic HRQoL assessment (using a tablet, prior to each consultation, with presentation of scores to clinicians) coupled with therapeutic information could have an impact on 12-month compliance with ET in patients with non-metastatic BC.Methods: In this study, we will include 342 women with non-metastatic hormone receptor positive BC with an indication for treatment with ET. Patients will be randomized 1:1 by minimization and stratified by: age, stage, type of ET prescribed and presence of comorbidities or not, in 2 arms. The intervention will consist of numerical HRQoL assessment using the CHES software before each consultation (with delivery of scores to clinicians) coupled with therapeutic information. Therapeutic information will consist on 3 workshops related to understanding the prescription, nutrition and fatigue. A reminder letter will also be send to patients every month. Patients in the control group will follow standard care. HRQoL will be assessed using a classic “paper-pencil” collection at baseline in both arms to ensure comparability between arms and at 12-month. The primary endpoint is 12-month compliance with ET. Patient satisfaction with care, and clinicians' perception of the usefulness of routine HRQoL assessment will also be assessed. Discussion: This study will allow clinicians to identify and better understand the areas in which patients on ET have difficulties, and thus assist clinicians with patient management. Systematic evaluation of HRQoL could also provide an additional endpoint for measuring patients' health status and treatment-related symptoms, including ET. If the results of this study are positive, this intervention could be proposed as an integral part of daily clinical practice in patients treated with ET.Trial Registration: ClinicalTrials.gov NCT04176809. Registered 25 November 2019, https://clinicaltrials.gov/ct2/show/NCT04176809.
Impact of relative dose intensity of FOLFOX adjuvant chemotherapy on risk of death among stage III colon cancer patients
Authors: Zhou Meijiao , Thompson Trevor D. , Lin Hui-Yi , Chen Vivien W. , Karlitz Jordan J. , Fontham Elizabeth T.H. , Theall Katherine P. , Zhang Lu , Pollack Lori A. , Wu Xiao-Cheng
Published: April 2020

Background: Clinical trials have suggested high-risk (T4 and/or N2) and low-risk (T1-T3 and N1) stage III colon cancer patients might need different doses of FOLFOX to reserve a similar survival probability. Observational studies have investigated the effect of relative dose intensity (RDI) of FOLFOX on cancer survival for patients with stage III colon cancer, but nonetheless, the studies focused on very specific populations, and none performed stratified analysis by risk profiles. This study aims to identify the optimal RDI of FOLFOX administered for high-risk and low-risk stage III colon cancer patients. Methods: Data on 407 eligible patients, diagnosed with stage III colon cancer in 2011 who received FOLFOX, were collected by the eight population-based cancer registries for a CDC National Program of Cancer Registries (NPCR) project focused on Comparative Effectiveness Research. We employed Kaplan-Meier method, cumulative incidence function (CIF), Multivariable Cox model and Fine-Gray competing risks model to explore Optimal RDI defined as the lowest RDI administered without significant differences in either overall or cause-specific death. Results: Among the 168 high-risk patients, the optimal RDI cut-off point was 70% where there was no statistically significant difference in overall mortality (HR=1.59; 95% CI: 0.69-3.66) and cause-specific mortality (HR=1.24; 95% CI: 0.42-3.64) when RDI<70% vs. RDI≥70%, adjusting for sociodemographic and clinical covariates. When the RDI cut-off was lower than the optimal one (<55% vs. ≥55%, <60% vs. ≥60%, or <65% vs. ≥65%), the overall mortality was significantly statistically different between the two groups of each comparison. Among the 239 low-risk patients, none of the evaluated cut-offs were associated with statistically significant differences in overall and cause-specific mortalities between comparison groups. The lowest RDI we assessed was 45%, HR=0.80; 95% CI: 0.24-2.73 for the overall mortality and HR=0.53; 95% CI: 0.06-4.95 for the cause-specific mortality, when RDI<45% vs. RDI≥45%. Conclusions: To best utilize health care resources while maintaining efficacy, RDI can be maintained at a minimum of 70% for high-risk stage III colon cancer patients. For low-risk patients, we found that RDI as low as 45% did not significantly affect the risk of death.
Improvement in functional gait parameters following corrective thoracolumbar surgery in children affected by Mucopolysaccharidosis 1(Hurler syndrome)
Authors: Sundarapandian Rajkumar , Jones Simon , Broomfield Alexander , Hensman Pauline , Oxborrow Neil
Published: April 2020

Objective-Thoracolumbar kyphosis is a common indication for spinal surgery in children with Mucopolysaccharidosis. Functional outcome of spinal surgical intervention has never been published in patients with this rare disease. We present a cohort of patients with Mucopolysaccharidosis 1(Hurler syndrome) who underwent thoraco-lumbar spinal deformity correction and functional outcome assessed by pre-operative and post-operative gait analysis. This study represents the first attempt at presenting a functional assessment of surgical outcome in any Mucopolysaccharidosis subtype. Methods-A retrospective analysis of prospectively collected data was carried out from 11 children diagnosed with this subtype of Mucopolysaccharidosis. All patients underwent thoracolumbar kyphosis correction between the years 2013 to 2016. Gait assessment was performed using GAITRiteTM electronic walkway pre-operatively and post-operatively within 9 to 24 months from the index surgery. Walking distance, cadence and gait velocity were the three spatio-temporal parameters analysed. Wilcoxon signed rank test was used to analyse the data and P-Value £0.05 was deemed significant.Results-There was a statistically significant improvement in walking distance in 9 out of 11 patient post-operatively with a mean increase of 232.06 cms (P=0.05). There was marginal improvement in cadence by 6.33 steps/min post-operatively (P-value 0.79). Gait velocity also showed a marginal increase by 8.73 cms/sec post-operatively (P-value 0.32).Conclusion-The results of our study suggest that correction of thoracolumbar kyphosis in children with Mucopolysaccharidosis 1 resulted in a significant improvement of walking distance with a trend towards improved gait in the other parameters. Post-operative change in cadence was not statistically significant suggesting that physiological maturation of gait had minimal effect in the specified post-operative assessment timeframe. This study emphasizes that outcomes of spinal surgery in children with Mucopolysaccharidosis 1 should be determined by functional measures aiming to maintain or improve quality of life.
Dental expenditure, Progressivity and Horizontal inequality in Chinese adults: Based on the 4th National Oral Health Epidemiology Survey
Authors: CHENG MengLin , WANG ChunXiao , WANG Xing , FENG XiPing , TAI BaoJun , HU DeYu , LIN HuanCai , WANG Bo , ZHENG ShuGuo , LIU XueNan , RONG WenSheng , WANG WeiJian , Si Yan , Xu Tao
Published: April 2020

Background: The financial burden of oral diseases is getting more important. The aim of this study was to describe the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of this inequality for Chinese adults. Methods: A secondary analysis used the data of 13,464 adults from the 4 th National Oral Health Epidemiological Survey (NOHES) in China was undertook. The dental expenditure in the past year divided into out-of-pocket and health insurance payments was collected. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. Decomposition of concentration index was made to explore the associated socioeconomic determinants. Results: Mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval, CI: 18.83,22.26) and for those who used dental service in the past year, the number was $100.95(95%CI: 93.22,108.68). More than 90% of the expenditure was out-of-pocket. Horizontal inequality indices and Kakwani indices were both negative and that indicated inequalities were in favor of the rich. The socioeconomic factors including income, urban or rural area and educational attainment were the main contributors to the inequality of dental expenditure. Conclusion: Dental expenditure for Chinese adults was not too much under a pretty low utilization. The payments of dental expenditure were regressive. People with the most oral health need didn’t meet appropriate dental services. Socioeconomic characteristic including household income, area and education was the main determinant while oral hygiene practice and self-reported oral health were the main individual determinants for the inequality of dental expenditure.
Genetic variation in toll like Receptors 2, 7, 9 and interleukin-6 is associated with Cytomegalovirus infection in late pregnancy
Authors: Mhandire Doreen , Mhandire Kudakwashe , Magadze Mulalo , Wonkam Ambroise , Kengne Andre P , Dandara Collet
Published: April 2020

Background: Maternal cytomegalovirus (CMV) infection and/or reactivation in pregnancy is associated with a myriad of adverse infant outcomes. However, the role of host genetic polymorphisms in modulating maternal CMV status is inconclusive. This study investigated the possible association of single nucleotide polymorphisms in toll like receptor (TLR) and cytokine genes with maternal plasma CMV DNA status in black Zimbabweans.Methods: In a cross-sectional study, 110 women in late gestation who included 36 CMV infected cases and 74 CMV uninfected, age and HIV status matched controls were enrolled. Twenty single nucleotide polymorphisms (SNPs) in 10 genes which code for proteins involved in immunity against CMV were genotyped using Iplex GOLD SNP genotyping protocol on the Agena MassARRAY® system. Statistical analyses were performed using Stata SE and the ‘Genetics’ and ‘SNPassoc’ packages of the statistical package R.Results: The TLR7 rs179008A>T (p<0.001) polymorphism was associated while the TLR9 rs352139T>C (p=0.049) polymorphism was on the borderline for association with CMV positive (CMV+) status. In contrast, the interleukin (IL)-6 rs10499563T>C and (p<0.001) TLR2 rs1816702C>T (p=0.001) polymorphisms were associated with CMV negative (CMV-) status. Furthermore, allele frequencies of SNPs in TLR2, TLR4, TLR9, TLR7, IL-6, IL-10, IL-28B, IL-1A and interferon AR1 (IFNAR1) genes are being reported here for the first time in a Zimbabwean population. The allele frequencies in the Zimbabwean population re generally comparable to other African populations but different when compared to European and Asian populations.Conclusions: Toll like receptor and interleukin genetic polymorphisms influence CMV status in late gestation among black Zimbabweans. This is attributable to possible modulation of immune responses to CMV reactivation in a population previously exposed to CMV infection.
Comparison of whole-body vibration training, strength training and health education on physical function and neuromuscular function of individuals with knee osteoarthritis: a randomized clinical trial
Authors: Lai Zhangqi , Lee Seullee , Chen Yiyang , Wang Lin
Published: April 2020

Background Knee osteoarthritis (KOA) is among the most common osteoarthritis diseases that affect adults older than 65 years old. Impaired neuromuscular function contributes to the development and/or progression of KOA. As a new modality in strength training, whole-body vibration (WBV) training is considered in the management of KOA. However, the inconsistent results of previous studies dampened the enthusiasm for the clinical application of WBV. Methods Eligible participants with KOA were randomly allocated to WBV, strength training (ST) and health education (HE) groups. Finally, 57 participants completed the intervention and measurements. The participants in each group were encouraged to perform the WBV training, similar strength training or health education program. These supervised interventions were performed three times per week for 8 weeks. Physical function was assessed with Timed Up and Go (TUG) and 6-min Walk Distance tests. Neuromuscular function was measured with isokinetic muscle strength and proprioception. Results All variables of physical function and neuromuscular function failed to change significantly among three groups (p > 0.05). However, compared with the baseline, the time of TUG (mean difference = 0.88 ± 0.78, 95% CI = 0.50 – 1.26, p < 0.001) and most of the variables related to isokinetic knee muscle strength (peak work of flexor at 90°/s, peak torque of extensor at 180°/s, peak work of extensor at 180°/s, peak torque of flexors at 180°/s, and peak work of flexors at 180°/s, all p < 0.05) improved significantly in WBV group. Conclusion WBV training has been recommended for strength training in elderly people and patients with musculoskeletal diseases. The 8-week WBV training under the protocol of our study was not superior to ST and HE. Hence, more clinical studies are required in the future to develop an optimal training protocol. Trial registration It was registered at Chinese Clinical Trial Registry a priori as a clinical trial (ID: ChiCTR-IOR-16009234). Registered 21 September 2016.
Dietary pattern and its’ association with anemia among infants aged 6-23 months in central-south China.
Authors: Huang Zhi , Zhen Ai-bing
Published: April 2020

Background: Anemia is widely prevalent among children, and this study aim to understand dietary patterns and its’ association with anemia. Methods: A cross-sectional design in two waves were conducted at Mayang in 2015 and in 2018. The diet data was collected by questionnaire, and dietary patterns were designed by using principal component analysis. Hemoglobin (Hb) was measured to assess the status of anemia. The association between the dietary patterns and anemia was assessed using the logistic regression model. Results: Four dietary patterns were identified among infants aged 6-23 months in central-south China. Diversified pattern:mainly tubers, dairy products, bean and bean products; traditional pattern: cereals, water and soup, and other vegetables and fruits; breast milk pattern: mainly breast milk but less powered formulas; and multi-nutrient powders pattern: mainly multi-nutrient powders. The prevalence of anemia among infant reduced from 29.49% in 2015 to 20.26% in 2018. The top quartile (Q4) of diversified pattern and multi-nutrient powders pattern deminished the risk of anemia by 45% (OR = 0.55, 95% CI: 0.30 to 0.99, P = 0.047) and 59% (OR = 0.41,95% CI: 0.22 to 0.78, P = 0.006) compared to the lowest quartile (Q1), while the breast milk pattern had a 3.26-fold greater risk of anemia than the lowest quartile (Q1) (OR = 3.26,95%CI:1.83 to 5.81, P <0.001). Conclusions: Four dietary patterns were identified among infants aged 6-23 months in central-south China. The pattern with a variety of food groups should be strengthened to improve anemia among infants.
Intravitreal Conbercept For Branch Retinal Vein Occlusion induced Macular Edema: One Initial Injection Versus Three Monthly Injections
Authors: Chen Xi , Hu Tianming , Zuo Jing , Wu Hao , Liu Zehao , Zhan Yaxin , Xia Ying , Wang Jing , Wei Wei
Published: April 2020

Objective To compare the efficacy of one initial intravitreal injection of conbercept (IVC) versus three monthly IVCs in patients with macular edema (ME) after branch retinal vein occlusion (BRVO). Both options were followed by a pro re nata (PRN) retreatment regimen.Methods This study retrospectively investigated and followed 49 patients with acute ME secondary to BRVO for over a year. 24 subjects received one initial injection (1+PRN group); while, 25 received three monthly injections (3+PRN group). The functional and anatomic outcomes were assessed during each follow-up.Results The general characteristics of the 49 subjects were as follows: mean [SD] age, 56.12 [12.54] years; 28 [57.1%] female; 30 [61.2%] non-ischemic form. Both groups showed a stable gain in visual acuity (VA) with similar logMAR (mean ± SD) (1+PRN group 0.308±0.431, 3+PRN group 0.345±0.366) during the first 12 months. Additionally, both groups exhibited a significant reduction in central foveal thickness (CFT) with no statistically significant difference between them (1+PRN group 220.5 μm ±219.9 μm , 3+PRN group 230.2 μm ±220 μm ). Both treatment groups had similar improvements in logMAR and anatomic outcomes over time. The stratified analysis showed that patients with the non-ischemic form and those with the ischemic form had similar improvements in VA (0.351±0.387 VS 0.289±0.417, P =0.601) during the 12 months follow-ups. The number of injections was lower in the 1+PRN group (4.0±1.7) than in the 3+PRN group (4.6±1.2) ( P =0.155). No adverse effects or unexpected safety issues were reported in either group.Conclusions Conpercept yielded stronger improvements in VA and CFT among patients with BRVO induced ME，independent of their retinal ischemia status. The results showed that the 3+PRN regimens do not lead to better functional outcomes or lower treatment needs in clinical practice as compared to the 1+PRN regimen.
Raynaud`s Phenomenon and MMP-7 are Clinicoserologic Biomarkers in Patients with Connective Tissue Disease Associated Interstitial Lung Disease.
Authors: Chung Sang Wan , Shin So Youn , Lee Seung Hyeun , Choi Hye Sook , Park Myung Jae , Hong Seung-Jae , Lee Yeon-Ah
Published: April 2020

Background: The aim of this study was to investigate clinicoserologic biomarkers associated with the development, progression, and prognosis of connective tissue diseases associated interstitial lung disease (CTD-ILD). Methods: We conducted a single center, a retrospective study including 70 incident patients diagnosed with CTD-ILD and 70 age-, sex-, and type of CTD-matched patients without ILD. Clinical informations, pulmonary function test, and chest CT findings were reviewed using medical records. To identify serologic biomarkers, serum interferon-r-induced protein 10 (IP-10), interleukin (IL)-6, IL-8, IL-10, and matrix metalloproteinase 7 (MMP-7) in patients with CTD-ILD and CTD without ILD were measured. Results: A total of 140 patients were enrolled. The mean was 63.3 ± 11.2 years, and 102 (72.9%) patients were female. Raynaud`s phenomenon (OR 5.96, 95% CI 2.11–16.86) was proved to be a risk factor for developing ILD in CTD by multivariable logistic regression analysis. To analyze distinctive features according to the onset of ILD, CTD-ILD was stratified into three groups: ILD-preceding, simultaneous, and CTD-preceding. The majority of the ILD-preceding group (75%) had worse baseline pulmonary function requiring treatment (DLCO <65%). Serum levels of MMP-7 were associated with the development of ILD in patients with CTD, and also had a significant correlation with CT extent score in the present study. Conclusion: In this study, Raynaud`s phenomenon, and serum levels of MMP-7 were clinicoserologic biomarkers CTD-ILD. Therefore, clinicoserologic biomarkers associated with ILD should be assessed in patients with CTD to provide proper management.
Influence of the margin of error due to the use of aerial photographs on the interpretation of the shoreline changes: Three cases of study (Atlantic coast of Morocco)
Authors: KHALID Khalid El , Maanan Mehdi , Hakkou Mounir , Zourarah Bendahhou
Published: April 2020

In mesotidal environments, the monitoring of shoreline changes is hampered by the determination of this line on aerial photographs. This paper discusses and evaluates the importance of taking into account the margin of error associated in determining the state of the shoreline.
To demonstrate this effect, three cases were selected and studied using aerial photographs from 1946 and 2016 (70-year period). The sites chosen on the Moroccan Atantic coast are very close to each other but evolve differently. We proved statically that the impact of taking into account the margin of error will not have the same effect on the interpretation of the results.
By taking these errors into consideration, the interpretation of the results becomes more consistent and more suitable for the decision-makers.