bluuebunny/crossref_metadata_2025 huggingface dataset:
Personal Hygiene, Environmental Sanitation and Hepatitis A Infections in Universitas Jember
Authors: Septivita Dian , Ma’rufi Isa , Ningtyias Farida Wahyu
Published: May 2021

Hepatitis A is a disease caused by type A hepatitis virus that attacks human liver cells. The disease is closely related to the lack of clean water, inadequate sanitation and poor personal hygiene. Hepatitis A can lead to the incidence of widespread public health problems and cause outbreaks. The purpose of this study was to analyze the effect of personal hygiene and environmental sanitation on the incidence of hepatitis A at Universitas Jember. The researcher used observational analytics research design with case-control approach. A total of 92 respondent consisting of case and control respondents was taken as samples. Case sample selected by using simple random sampling, and control sample selected by using purposive sampling. The data were analyzed by using Chi-square test. The results showed that personal hygiene had an effect on the incidence of hepatitis A with p-value of 0.000, while environmental sanitation had no effect with p-value of 0.402. There is a need to enhance the active role of health workers in providing health promotion means in schools, such as routine health counseling to improve students' knowledge about hepatitis A and the way to prevent the disease through behavior improvement.

Keywords: hepatitis A virus; personal hygiene; sanitation
The Use of Role Play Method in Efforts to Improve Capability of Posyandu Cadres
Authors: Wisnu Nurwening Tyas
Published: May 2021

Early stimulation, detection and intervention for growth and development of children is a shared responsibility of health and community officials, including cadres of posyandu (integrated service post). The research that has been done is aimed at developing Posyandu cadre, with Role Play approach based on Maternal and child book (MCH book). This study was the classroom action research. The population were posyandu cadres in Bendo Sub-district. The sample size was 33, taken by simple random sampling. Instruments used were questionnaire and observation sheet. Descriptive and multivariate analyzes were used. The 38% of posyandu cadres were of late adulthood, the majority of senior high school (52%). Knowledge before role play: majority enough (88%), after role play, good (73%). Able to measure weight: good (70%). Measuring height: good (51.5%). Ability to measure head circumference well (84.8%). Able to detect developments well 82%. Able to perform vision tests with 94% good. Able to perform hearing test well (100%). Statistical analysis was no relationship between age and education with pretest knowledge. Conclusion: it was necessary to do coaching to Posyandu cadre continuously, with the use of variation of method to make lesson easier to understand.

Keywords: role play; education; children; growth; development
The Effect of Endorphin Massage on the Intensity of Pain in the Normal Primipara Mother in BPS Ririn Dwi Agustin Jombang
Authors: Nufus Hidayatun
Published: May 2021

Background: Maternal primipara at Connecticut's average of 17 per month primipara mothers feel very great pain in stage I. The mother felt a severe pain and anxiety. Purpose: To know the influence of endorphin massage to stage I pain intensity of normal childbirth mother primipara at BPS Ririn Dwi Agustin Jombang. Methods: This research utilized quasi experimental design, the design used was posttest only control group design. Respondents were all childbirth mothers (primipara) at Juny-August 2018, selected by concecutive sampling technique. Results: Childbirth pain at most control group experience severe pain as many as 10 people (66.7%). Respondents who experience medium pain as many as 4 people (26.7%), and very severe pain as many as 1 person (6.7%). Childbirth pain at most treated group experience mild pain as many as 9 people (60.0%). Respondent who experience medium pain as many as 4 people (26.7%), and severe pain as many as 2 people (13.3%). The p-value of hypothesis testing was 0.000. Conclusion: There is influence of endorphin massage to stage I pain intensity of normal childbirth mother primipara (p value = 0,000 < 0,05).

Keywords: endorphin massage; stage I pregnancy; pain intensity
The Profile of Pharmacological Treatment in Trigeminal Neuralgia Patients in The Period of January 2018-December 2018
Authors: Moenaf Marlon Yutimma Roestam , Rochmanti Maftuchah , Sudibyo Devi Ariani
Published: May 2021

Trigeminal neuralgia is a condition that affects the trigeminal nerve, that manifests in a series of stabbing like pain, and often described like electricity. Its treatment guideline is to prioritize pharmacotherapy until patient is well. The gold standard treatment for trigeminal neuralgia is pharmacotherapy of Carbamazepine. However, carbamazepine is proven to cause allergic reaction to some patients. This research aims to describe the pharmacotherapy that is given to patients. The regiments of pharmacotherapy in trigeminal neuralgia shows that CBZ is the main pharmacotherapy given, as it is the gold standard treatment. GBP is the is the second most pharmacotherapy given and a concoction medication of Paracetamol, Diazepam and Amitriptyline being the third most favored therapy. Neurotropic B Vitamins plays a big role, as a support in the therapy to maintain the health of the overall nervous system. The pain scale data shows that almost all patients have significant pain relieve. The therapy of trigeminal neuralgia in this study shows that CBZ is most favored as it is the gold standard, however not all AEDs are accessible. Almost all patients have significant pain relieve eventhough not using gold standard treatment.

Keywords: trigeminal neuralgia; pharmacotherapy
Comparation Between Station Management and Water Source on the Quality of Refill Drinking Water in Surabaya
Authors: Khafiya Nida'an , Dewanti Linda , Retnowati Wiwin
Published: May 2021

Drinking water is both a basic human need and a strong determinant of health. In Indonesia, there are drinking water refill stations (DWRS) which conveniently offer refill drinking water at affordable price. This study aims to determine whether station management amd raw water source influence the quality of drinking water. This cross-sectional study used primary data from questionnaires filled by DWRS owners and secondary data about the quality of refill drinking water from the Surabaya City Health Department. Data was then analyzed by using Chi-Square and Mann-Whitney tests. From 33 registered DWRSs, only 18 stations fulfilled all quality standards of drinking water. Some DWRSs failed to pass microbiological (n=13) and chemical (n=2) standards. All DWRS passed the physical standard. There was no significant difference found in duration of operation (pmicro = 0.956, pchemical = 0.382), production capacity (pmicro = 0.384; pchemical = 0.495). There was no significant difference found in terms of station management and raw water sources on the quality of refill drinking water.

Keywords: drinking water refill station (DWRS); duration of operation; production capacity; raw water source
Correlation Between The History of Previous Lower Extremity Amputation as a Risk Factor for the Subsequent Lower Extremity Amputation in Diabetic Patients Among RSUD Dr. Soetomo Patients in 2018
Authors: Wildan Mochamad , Wibisono Sony , Soebroto Heroe
Published: May 2021

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia. Complications are common among patients with this condition, such as diabetic foot syndrome, which is the presence of foot ulcer associated with neuropathy, PAD, and infection, and is a major cause of LEA. Aim of this research is to analyze the correlation between previous LEA as a risk factor for the subsequent LEA in patients with Diabetic Foot among patients in RSUD Dr. Soetomo, Surabaya from January-December 2018. This is descriptive cross-sectional study. Data was analyzed using descriptive statistic and correlation test with Microsoft Excel 2007 and SPSS 20. Statistical testing was performed using Spearman’s rank correlation and Cohen J criteria with significance level of P55 years old (62.9%). Mostly have undergone LEA (74.3%) while the remaining have undergone LEA twice (17.1%). There is a significant correlation between initial LEA and the subsequent LEA (p0.01).

Keywords: diabetes mellitus; lower extremity amputation; risk factors; RSUD Dr. Soetomo
Usage of Foods for Special Medical Purposes in the Pediatric Ward Dr. Soetomo Hospital Surabaya
Authors: Avianti Dwi Lestari , Widjaja Nur Aisiyah , Irawan Roedi
Published: May 2021

Children who are hospitalized are at risk of malnutrition due to increased energy requirements caused by underlying disease, drug use, decreased appetite and inadequate diet during treatment which can inhibit growth and development. Medical nutrition is required to use food for special medical purposes (FSMP) to meet nutritional needs during hospitalization. The aim of this study is to know the number of patients and types of medical indications for FSMP administration. This research was conducted from August 2018 to October 2018 by reviewing the medical records of children who were treated in the pediatric ward Dr. Soetomo Surabaya. The inclusion criteria were children aged 1 month -18 years and received FSMP as indicated. The sampling method is total sampling. Data in the form of age, gender, nutritional status, disease diagnosis and FSMP type administration, were obtained from medical records from April 2017 to April 2018. The samples obtained were grouped according to indications for FSMP use based on the pediatric drug dosage book of the Indonesian Pediatric Association. A total of 402 children were enrolled in this study. Male patients who received FSMP were 229 (56.9%). The highest use of FSMP was at the age of less than 1 year as many as 195 patients (48.5%) with the highest indication of malnutrition. The most indications for FSMP are malnutrition as many as 267 patients (66.4%), which was caused by gastrointestinal (GI) disease (24.4%), malignancy (18.4%) and congenital heart disease (CHD) (11.2%). The second highest indication of FSMP was malabsorption in 210 patients (52.2%), caused by gastrointestinal disease (41.4%) and cholestasis (17.6%). Another indication that there was volume limitation in 51 patients (12.7%), mostly due to CHD accompanied by heart failure and cow's milk protein allergy (CMPA) in 38 patients (9.5%), more with gastrointestinal symptoms (60.5%) than respiratory symptoms (39.5%). The use of FSMP in the pediatric ward Dr. Soetomo Hospital, Surabaya with medical indications of malnutrition (moderate malnutrition, severe malnutrition, failure to thrive), malabsorption, volume limitation and cow's milk protein allergy with malnutrition as the most indications.

Keywords: hospitalized children; medical nutrition; foods for special medical purposes; nutritional requirements
Life After Surviving Vehicular Accident: A Phenomenological Inquiry
Authors: Cacayan Edmelyn B. , Babaran Shayne R. , Tuppal Romella Mendez
Published: May 2021

Worldwide, one of the leading causes of death and injuries are motor vehicle accidents. This study was conducted to explore motor vehicle accident victims’ experiences after vehicular accident in an attempt to further understand the phenomenon. It is important to know the effects of the accident to the life of survivors in order to make a specific intervention to their specific needs. A qualitative phenomenological design is used, using semi-structured, in depth face to face interviews to elicit accounts of vehicular accident survivors. Findings revealed that driving under influence of alcohol, over speeding, slippery road, and first time driving are some of the causes of accident. Five of the respondents had experienced disturbing thoughts, and some of them had dreams of the accident were happening again. Six of the respondents were afraid that it will happen again when something or someone reminded them of the accident or when seeing the place where they experienced the accident. The result of this study will help and assist health professionals in developing a plan of care to victims of vehicular accidents regardless of severity to have psychological assistance to avoid future problems such as recurrent thoughts, sleep disturbances and others.

Keyword: vehicular accident; victim
The Effect of Oxytocin Massage by Using Lemongrass Oil (Cymbopogon citratus) Aromatherapy to the Increased of Breast milk Production in Breastfeeding Mothers in Mojo Health Center, Kediri, Indonesia
Authors: Pratamaningtyas Susanti , Hardjito Kekoeh , Hamim Alfi Rohmatul
Published: May 2021

Breast milk is the best food for babies. In the field of midwifery there are several ways to help increase milk production. Oxytocin massage is a massage on both sides of the mothers' limbs to provide stimulation of oxytocin reflex because it gives comfort to mother. Massage using aromatherapy essential oil is useful to anticipate depression because of relaxation effect caused by smells and massage. The purpose of this research is to know the effect of oxytocin massage using lemongrass aromatherapy oil to increase milk production in breastfeeding mothers in Mojo Health Center. This research used comparative research of 2 dependent samples and comparative research of 2 independent samples designs. The sampling technique used was accidental sampling with random allocation of 16 respondents. Based on the Mc Nemar test in the group that was given the oxytocin massage using Serai Lemongrass aromatherapy oil, χ2 counting value was 4,167. Because of χ2 counting value > χ2 table (3.841), this indicated that there was effect of the oxytocin massage using lemongrass aromatherapy oil in the production of breast milk.

Keywords: oxytocin massage; lemongrass aromatherapy oil; breast milk; breastfeeding
Consultation Liaison Psychiatry on Case Management of Children with Mixed Gonadal Dysgenesis Mosaicism 45X (60%) and 46XY (40%)
Authors: Agung Jeffriey , Setiawati Yunias
Published: May 2021

There is an increasing in admitted patients with cases of gender identity disorder in the daycare clinic of the Child and Adolescent Psychiatry Division Dr. Soetomo, it is necessary to increase understanding and clinical ability in relation to gender identity disorders through psychiatry consultation discussion, so that management can be achieved properly and comprehensively. Disorder of sex development (DSD) is a medical disorder that is associated with an incompatibility between chromosomes, gonads, phenotypes and anatomy which is characterized by the development of external genital organs that are incompatible with whether it is male or female. Genetalia ambiguos can cause significant psychological stressors for patients or their families, where as a result of the conditions experienced, it will lead to gender dysphoria with the resulting effects, among others, in the form of anxiety, depression and low self-esteem, to affect the quality of life of children as adolescents and adults. . The method of preparing this report is a case analysis and the role of CLP which is given based on the results of the examination and references to management in the field of psychiatry of children and adolescents in cases of DSD from children aged 12 years. Conducted to strengthen the adaptation of patients to problems identifying gender development and to their families by emphasizing the importance of achieving optimal quality of life for children. The results of the case reports describe the role of Consultation Liason Psychiatry through communication and consultation between related areas of expertise, supportive psychotherapy and continuous Cognitive Behavior Therapy (CBT) techniques along with psychoeducation in families providing good development results with results in reducing patient anxiety and depression, based on children's scoring Depression Inventory (CDI) of patients with Mosaicism, Mixed Gonadal Dysgenesis (MGD). The conclusion of this case report is that the problem of psychological stressors that arise in DSD requires psychiatric assistance according to the stages of child development. The important role of psychiatrists in the management of DSD cases has been recognized and stated in the joint consensus for the treatment of individuals with DSD since 2006. CLP needs to be built because of the complexity of treatment and therapy in DSD cases, which involve subspecialty pediatric endocrinology, urology, psychiatry, gynecology, genetics, workers. social nurse and medical ethics. described in the algorithm below in the management of cases of gender dysphoric.

Keywords: disorder of sex development; mixed gonadal dysgenesis; consulation liason psychiatry disorder of sex development; mixed gonadal dysgenesis; consulation liason psychiatry
Penurunan Intensitas Nyeri Menstruasi (Dysmenorrhae) dengan Kompres Hangat
Authors: Sumiaty Sumiaty , Dupa Adel Vita Masya , Suryani Lili , Ramadhan Kadar
Published: May 2021

Background: Dysmenorrhea is a pain that occurs during menstruation, caused by the contraction of the uterine muscles during menstrual bleeding which can last between 32-48 hours. This study aims to determine the decrease in pain intensity before and after giving warm compresses. Method; Type of study design is pre-experimental study design with one group pre-test and post-test design with a sample of 38 respondents. The independent variable in this study is warm compress on adolescent girls who have menstrual pain (dysmenorrhea), The dependent variable in this study is the reduction of menstrual pain (dysmenorrhea). The results found a decrease in the average pain scale before and after warm compress therapy and after Wilcoxon signed-rank test u, the results were obtained of p-value<0.001. It shows that warm compress therapy can be reducing dysmenorrhea. Conclusion; In conclusion administration of warm compresses are significantly reduces dysmenorrhea in adolescent girls and it is expected that teenagers can practice warm compresses as an effort to reduce dysmenorrhea.
Age Related Response of Neonatal Rat Retinal Ganglion Cells to Reduced TrkB Signaling in vitro and in vivo
Authors: Beros Jamie , Rodger Jennifer , Harvey Alan R
Published: June 2021

During development of retinofugal pathways there is naturally occurring cell death of at least 50% of retinal ganglion cells (RGCs). In rats, RGC death occurs over a protracted pre- and early postnatal period, the timing linked to the onset of axonal ingrowth into central visual targets. Gene expression studies suggest that developing RGCs switch from local to target-derived neurotrophic support during this innervation phase. Here we investigated, in vitro and in vivo, how RGC birthdate affects the timing of the transition from intra-retinal to target-derived neurotrophin dependence. RGCs were pre-labeled with 5-Bromo-2′-Deoxyuridine (BrdU) at embryonic (E) day 15 or 18. For in vitro studies, RGCs were purified from postnatal day 1 (P1) rat pups and cultured with or without: (i) brain derived neurotrophic factor (BDNF), (ii) blocking antibodies to BDNF and neurotrophin 4/5 (NT-4/5), or (iii) a tropomyosin receptor kinase B fusion protein (TrkB-Fc). RGC viability was quantified 24 and 48 h after plating. By 48 h, the survival of purified βIII-tubulin immunopositive E15 but not E18 RGCs was dependent on addition of BDNF to the culture medium. For E18 RGCs, in the absence of exogenous BDNF, addition of blocking antibodies or TrkB-Fc reduced RGC viability at both 24 and 48 h by 25–40%. While this decrease was not significant due to high variance, importantly, each blocking method also consistently reduced complex process expression in surviving RGCs. In vivo, survival of BrdU and Brn3a co-labeled E15 or E18 RGCs was quantified in rats 24 h after P1 or P5 injection into the eye or contralateral superior colliculus (SC) of BDNF and NT-4/5 antibodies, or serum vehicle. The density of E15 RGCs 24 h after P1 or P5 injection of blocking antibodies was reduced after SC but not intraretinal injection. Antibody injections into either site had little obvious impact on viability of the substantially smaller population of E18 RGCs. In summary, most early postnatal RGC death in the rat involves the elimination of early-born RGCs with their survival primarily dependent upon the availability of target derived BDNF during this time. In contrast, late-born RGC survival may be influenced by additional factors, suggesting an association between RGC birthdate and developmental death mechanisms.
Targeted Deletion of Loxl3 by Col2a1-Cre Leads to Progressive Hearing Loss
Authors: Liu Ziyi , Bai Xinfeng , Wan Peifeng , Mo Fan , Chen Ge , Zhang Jian , Gao Jiangang
Published: June 2021

Collagens are major constituents of the extracellular matrix (ECM) that play an essential role in the structure of the inner ear and provide elasticity and rigidity when the signals of sound are received and transformed into electrical signals. LOXL3 is a member of the lysyl oxidase (LOX) family that are copper-dependent amine oxidases, generating covalent cross-links to stabilize polymeric elastin and collagen fibers in the ECM. Biallelic missense variant of LOXL3 was found in Stickler syndrome with mild conductive hearing loss. However, available information regarding the specific roles of LOXL3 in auditory function is limited. In this study, we showed that the Col2a1-Cre-mediated ablation of Loxl3 in the inner ear can cause progressive hearing loss, degeneration of hair cells and secondary degeneration of spiral ganglion neurons. The abnormal distribution of type II collagen in the spiral ligament and increased inflammatory responses were also found in Col2a1–Loxl3–/– mice. Amino oxidase activity exerts an effect on collagen; thus, Loxl3 deficiency was expected to result in the instability of collagen in the spiral ligament and the basilar membrane, which may interfere with the mechanical properties of the organ of Corti and induce the inflammatory responses that are responsible for the hearing loss. Overall, our findings suggest that Loxl3 may play an essential role in maintaining hearing function.
Impaired Myocardial Function Is Prognostic for Severe Respiratory Failure in the Course of COVID-19 Infection
Authors: Petersen-Uribe Alvaro , Avdiu Alban , Martus Peter , Witzel Katja , Jaeger Philippa , Zdanyte Monika , Heinzmann David , Tavlaki Elli , Warm Verena , Geisler Tobias , Müller Karin , Gawaz Meinrad , Rath Dominik
Published: June 2021

COVID-19 may lead to severe acute respiratory distress syndrome (ARDS) resulting in increased morbidity and mortality. Heart failure and/or pre-existing cardiovascular disease may correlate with poor outcomes and thus require special attention from treating physicians. The present study sought to investigate a possible impact of impaired myocardial function as well as myocardial distress markers on mortality or ARDS with need for mechanical ventilation in 157 consecutive patients with confirmed SARS-CoV-2 infection. All patients were admitted and treated at the University Hospital of Tübingen, Germany, during the first wave of the pandemic. Electrocardiography, echocardiography, and routine blood sampling were performed at hospital admission. Impaired left-ventricular and right-ventricular function, tricuspid regurgitation > grade 1, and elevated RV-pressure as well as thrombotic and myocardial distress markers (D-dimers, NT-pro-BNP, and troponin-I) were associated with mechanical ventilation and/or all-cause mortality. Impaired cardiac function is more frequent amidst ARDS, leading to subsequent need for mechanical ventilation, and thus denotes a poor outcome in COVID-19. Since a causal treatment for SARS-CoV-2 infection is still lacking, guideline-compliant cardiovascular evaluation and treatment remains the best approach to improve outcomes in COVID-19 patients with cardiovascular comorbidities.
Affordable Three-Dimensional Printed Heart Models
Authors: Gómez-Ciriza Gorka , Gómez-Cía Tomás , Rivas-González José Antonio , Velasco Forte Mari Nieves , Valverde Israel
Published: June 2021

This is a 7-years single institution study on low-cost cardiac three-dimensional (3D) printing based on the use of free open-source programs and affordable printers and materials. The process of 3D printing is based on several steps (image acquisition, segmentation, mesh optimization, slicing, and three-dimensional printing). The necessary technology and the processes to set up an affordable three-dimensional printing laboratory are hereby described in detail. Their impact on surgical and interventional planning, medical training, communication with patients and relatives, patients' perception on care, and new cardiac device development was analyzed. A total of 138 low-cost heart models were designed and printed from 2013 to 2020. All of them were from different congenital heart disease patients. The average time for segmentation and design of the hearts was 136 min; the average time for printing and cleaning the models was 13.5 h. The average production cost of the models was €85.7 per model. This is the most extensive series of 3D printed cardiac models published to date. In this study, the possibility of manufacturing three-dimensional printed heart models in a low-cost facility fulfilling the highest requirements from a technical and clinical point of view is demonstrated.
Serp-1 Promotes Corneal Wound Healing by Facilitating Re-epithelialization and Inhibiting Fibrosis and Angiogenesis
Authors: Ju Brent , Guo Owen , Benissan-Messan Dathe Z. , Shawver McKinley H. , Chen Peng , Geng Bingchuan , Wei Siqi , Yaron Jordan R. , Lucas Alexandra R. , Zhu Hua
Published: June 2021

Purpose: Chemical corneal injuries carry a high morbidity and commonly lead to visual impairment. Here, we investigate the role of Serp-1, a serine protease inhibitor, in corneal wound healing.

Methods: An alkaline-induced corneal injury was induced in 14 mice. Following injury, five mice received daily topical saline application while nine mice received Serp-1 100 μL topically combined with a daily subcutaneous injection of 100 ng/gram body weight of Serp-1. Corneal damage was monitored daily through fluorescein staining and imaging. Cross sectional corneal H&E staining were obtained. CD31 was used as marker for neovascularization.

Results: Serp-1 facilitates corneal wound healing by reducing fibrosis and neovascularization while mitigating inflammatory cell infiltration with no noticeable harm related to its application.

Conclusions: Serp-1 effectively mitigates inflammation, decreases fibrosis, and reduce neovascularization in a murine model of corneal injury without affecting other organs.

Translational Relavence: Our study provides preclinical data for topical application of Serp-1 to treat corneal wounds.
Two Sides of the Same Coin: A Combination of Archaeometallurgy and Environmental Archaeology to Re-Examine the Hypothesis of Yunnan as the Source of Highly Radiogenic Lead in Early Dynastic China
Authors: Liu Ruiliang , Pollard A. Mark , Lv Feiya , Huan Limin , Zhang Shanjia , Ma Minmin
Published: June 2021

Bronze Age Shang China is characterized by its large-scale production system and distinctive ritual world. Both are vividly materialized by a large number of bronze ritual vessels with added lead. Whilst a remarkable amount of research effort has been channeled into the trace elemental and lead isotopic analysis of these ritual vessels, and successfully revealed some important fingerprints such as highly radiogenic lead (HRL), there is as yet no consensus on the metal source(s) which supplied the entire bronze production during the Shang period. In addition to the traditional method to look for matching and mismatching between ores and objects, we propose that environmental archaeological studies can provide crucial clues to address some long-standing questions in archaeometallurgy. In the first part of the paper, we attempt to illustrate the potential and complexity of combining these two subjects together. The second part of the paper offers a case study by reviewing the debate on Yunnan as the source of HRL. Synthesis of various lines of evidence published by most recent studies on environmental archaeology, archaeometallurgy, field reports and radiocarbon dating suggests that this hypothesis appears much less likely than previously suspected.
Small Fractures Caused by the 2019 Ridgecrest Earthquake Sequence: Insights From 3D Coseismic Displacement and Uniaxial Loading Rock Experiments
Authors: Xu Andong , Zhao Yonghong , Wang Teng , Ren Chunmei , Yue Han
Published: June 2021

The moment magnitude (Mw) 6.4 and 7.1 Ridgecrest earthquake sequence that occurred on July 4 and 6, 2019, ruptured a conjugate fault system within the eastern California shear zone. In addition to the ∼50 km surface ruptures, the sequence activated a series of structures with lengths ranging from 1 to 10 km, which are well illuminated by phase gradient maps of Synthetic Aperture Radar (SAR) interferograms. The deformation patterns and mechanisms of these fractures have been well studied, yet the controlling factors of their spatial distribution are less discussed, which are important for understanding how the accumulated strain is releasedviadistributed faulting in the earthquake cycle. Here, we use multi-source SAR images to derive three-dimensional (3D) surface displacement along the main ruptures and the east–west strain across the detected small fractures caused by the 2019 Ridgecrest earthquake sequence. We find that the distribution of these fractures is related to the displacement pattern along the main rupture. Specifically, more fractures appeared in areas with larger slips normal to the main rupture as well as in the junction of the conjugated ruptures. We also conduct uniaxial loading rock experiments to evaluate the strain distribution before the samples were broken. Rock experiments show that rupturing of a conjugated fault system may produce local strain concentration along the main rupture, indicating the important role of the orthogonal faults in generating small fractures with different striking angles and deformation patterns. The 2019 Ridgecrest earthquake sequence exhibits complicated crust behaviors by rupturing an immature fault system, implying that the simple elastic rebound theory may be insufficient to model the coseismic deformation during the earthquake cycle, particularly in the zone with weak crust.
The Causes and Consequences of Spatial Organization of the Genome in Regulation of Gene Expression
Authors: Agelopoulos Marios , Foutadakis Spyros , Thanos Dimitris
Published: June 2021

Regulation of gene expression in time, space and quantity is orchestrated by the functional interplay of cis-acting elements and trans-acting factors. Our current view postulates that transcription factors recognize enhancer DNA and read the transcriptional regulatory code by cooperative DNA binding to specific DNA motifs, thus instructing the recruitment of transcriptional regulatory complexes forming a plethora of higher-ordered multi-protein-DNA and protein-protein complexes. Here, we reviewed the formation of multi-dimensional chromatin assemblies implicated in gene expression with emphasis on the regulatory role of enhancer hubs as coordinators of stochastic gene expression. Enhancer hubs contain many interacting regulatory elements and represent a remarkably dynamic and heterogeneous network of multivalent interactions. A functional consequence of such complex interaction networks could be that individual enhancers function synergistically to ensure coordination, tight control and robustness in regulation of expression of spatially connected genes. In this review, we discuss fundamental paradigms of such inter- and intra- chromosomal associations both in the context of immune-related genes and beyond.
Seasonal Stratification and Biogeochemical Turnover in the Freshwater Reach of a Partially Mixed Dredged Estuary
Authors: Pein Johannes , Eisele Annika , Sanders Tina , Daewel Ute , Stanev Emil V. , van Beusekom Justus E. E. , Staneva Joanna , Schrum Corinna
Published: June 2021

The Elbe estuary is a substantially engineered tidal water body that receives high loads of organic matter from the eutrophied Elbe river. The organic matter entering the estuary at the tidal weir is dominated by diatom populations that collapse in the deepened freshwater reach. Although the estuary’s freshwater reach is considered to manifest vertically homogenous density distribution (i.e., to be well-mixed), several indicators like trapping of particulate organic matter, near-bottom oxygen depletion and ammonium accumulation suggest that the vertical exchange of organic particles and dissolved oxygen is weakened at least temporarily. To better understand the causal links between the hydrodynamics and the oxygen and nutrient cycling in the deepened freshwater reach of the Elbe estuary, we establish a three-dimensional coupled hydrodynamical-biogeochemical model. The model demonstrates good skill in simulating the variability of the physical and biogeochemical parameters in the focal area. Coupled simulations reveal that this region is a hotspot of the degradation of diatoms and organic matter transported from the shallow productive upper estuary and the tidal weir. In summer, the water column weakly stratifies when at the bathymetric jump warmer water from the shallow upper estuary spreads over the colder water of the deepened mid reaches. Enhanced thermal stratification also occurs also in the narrow port basins and channels. Model results show intensification of the particle trapping due to the thermal gradients. The stratification also reduces the oxygenation of the near-bottom region and sedimentary layer inducing oxygen depletion and accumulation of ammonium. The study highlights that the vertical resolution is important for the understanding and simulation of estuarine ecological processes, because even weak stratification impacts the cycling of nutrients via modulation of the vertical mixing of oxygen, particularly in deepened navigation channels and port areas.
Personal Care and Cosmetic Products as a Potential Source of Environmental Contamination by Microplastics in a Densely Populated Asian City
Authors: Bashir Saidu M. , Kimiko Sam , Mak Chu-Wa , Fang James Kar-Hei , Gonçalves David
Published: June 2021

The prevalence of microplastics in the environment has become a major global conservation issue. One primary source of environmental microplastics is personal care and cosmetic products (PCCPs) containing microbeads. The market availability of PCCPs containing microbeads and the level of contamination of coastal sediments by microplastics was studied in one of the most densely populated cities in the world, Macao in China. We found that PCCPs containing microbeads are still widely available for sale in the region, with over 70% of surveyed PCCPs containing at least one type of microbeads as an ingredient, with polyethylene (PE) being the most common one. In an estimate, the use of PCCPs in the territory may release over 37 billion microbeads per year into the environment via wastewater treatment plants. The density of microplastics in coastal sediments varied between 259 and 1,743 items/L of sediment, amongst the highest reported in the world. The fraction of < 1 mm was the most abundant, representing an average of 98.6% of the total, and correlated positively with the abundance of larger sized fragments. The results show that although environmental pollution with microplastics released from PCCPs usage is significant, other sources, namely fragmentation of larger plastic debris, likely contribute more to the issue. The study highlights the magnitude of the problem at a local level and suggests possible mitigating strategies.
Health Protection of CT Radiographers During the Outbreak of COVID-19: Application of Automatic Positioning Technology for Relocatable CT in the Fang Cang Hospital
Authors: Jiang Shan , Jiang Zhongbiao , Luo Li-Hua , Yu Kun , Cai Yeyu , Xie Xingzhi , Zhao Wei , Situ Weijun , Liu Jun , Chen Zhu
Published: June 2021

Background: To investigate the value of automatic positioning technology in improving the protection of radiographers in the relocatable CT room of a Fang Cang hospital during the outbreak of coronavirus disease 2019 (COVID-19).

Methods: The National Emergency Medical Team of our hospital assumed command of Wuchang Fang Cang Hospital and treated confirmed COVID-19 patients with mild symptoms. Relocatable CT was used to examine patients in this hospital. Automatic positioning technology was applied to avoid close contact between medical staff and patients and to protect medical staff more effectively.

Results: Seven hundred lung CT scans acquired from 269 patients were completed from February 17 to 26, 2020 with automatic positioning technology for relocatable CT in a Fang Cang hospital. All scans were conducted successfully using automatic positioning technology. All patients entered the scanning room from a separate door. All the position lines were accurate, and all images met the requirement for diagnosis of COVID-19, with satisfied quality. None of our medical staff had any close contact with patients.

Conclusion: Automatic positioning technology applied to relocatable CT can minimize the close contact between technologists and patients and effectively improve the protection of medical staff without sacrificing image quality.
Comparison of Vaccine Acceptance Between COVID-19 and Seasonal Influenza Among Women in China: A National Online Survey Based on Health Belief Model
Authors: Tao Liyuan , Wang Ruitong , Liu Jue
Published: June 2021

Background: Influenza could circulate in parallel with COVID-19. Studies focusing on the comparison of vaccine acceptance between COVID-19 and seasonal influenza are lacking. The aim of the study was to assess and compare vaccine acceptance of COVID-19 and influenza among reproductive women in China, in order to better understand and address factors associated with vaccine acceptance and to provide guidance for targeted measures to promote vaccination.

Methods: A national anonymous cross-sectional survey on COVID-19 and influenza vaccine acceptance among reproductive women aged 18–49 years in China was conducted online based on health belief model, a model widely used to evaluate health beliefs. Sociodemographic characteristics, health status, knowledge, attitude, and health beliefs related to COVID-19 and influenza infection and vaccination were retrieved. Pearson's χ2 test was used to compare the vaccine acceptance by the factors mentioned above. Multivariable logistic regression was used to assess the adjusted associations of factors related to vaccine acceptance. Paired t-test was used to compare scores of health beliefs between influenza and COVID-19 vaccinations.

Results: COVID-19 vaccine acceptance rate among reproductive women was 90.3% (95% CI 89.2–91.3%), which was significantly higher than influenza vaccine acceptance rate (85.5%, 95% CI: 84.2–86.7%). Influenza and COVID-19 vaccine acceptance both had the trends to decrease with age (all p < 0.05). Living in the western region, young age, a high level of knowledge scores on disease and vaccines, a high level of perceived susceptibility, a high level of cues to action, and a low level of perceived barriers were positively associated with both COVID-19 and influenza vaccine acceptance (all p < 0.05), while influenza vaccination history was additionally associated with influenza vaccine acceptance (p < 0.05).

Conclusions: Our findings suggest that tailored public health measures are needed to improve reproductive women's knowledge of COVID-19, influenza, and vaccines to alleviate women's vaccine hesitancy and expand vaccine uptake.
Cerebral Tissue Regional Oxygen Saturation as a Valuable Monitoring Parameter in Pediatric Patients Undergoing Extracorporeal Membrane Oxygenation
Authors: Chen Song , Fang Fang , Liu Wenjun , Liu Chengjun , Xu Feng
Published: June 2021

Objective: Brain function monitoring technology for extracorporeal membrane oxygenation (ECMO) support has been developing quite slowly. Our objective was to explore the data distribution, variation trend, and variability of cerebral tissue regional oxygen saturation (CrSO2) in pediatric patients undergoing ECMO.

Methods: Eight patients who received venoarterial ECMO (V-A ECMO) were included in our study. All of them accepted continuous CrSO2 monitoring by near-infrared spectroscopy (NIRS) within 12 h of ECMO initiation until ECMO wean. Differences in the CrSO2 distribution characteristic, the variation trend of daily CrSO2, and the variability of CrSO2 for the first 5 days following ECMO initiation were compared between survivors and non-survivors according to pediatric intensive care unit (PICU) mortality.

Results: The percentage of time of CrSO2 <60% against the whole monitoring time was significantly lower in survivors in both hemispheres {right: 4.34% [interquartile range (IQR) = 0.39–8.55%] vs. 47.45% [IQR = 36.03–64.52%], p = 0.036; left: 0.40% [IQR = 0.01–1.15%] vs. 30.9% [IQR = 26.92–49.62%], p = 0.036}. Survivors had significantly higher CrSO2 on the first 4 days. Root mean of successive squared differences (RMSSD), the variability variable of CrSO2, was significantly lower in survivors (right: 3.29 ± 0.79 vs. 6.16 ± 0.67, p = 0.002; left: 3.56 ± 1.20 vs. 6.04 ± 1.44, p = 0.039).

Conclusion: Lower CrSO2, CrSO2 <60% over a longer period of time, and higher fluctuation of CrSO2 are likely associated with PICU mortality in pediatric patients undergoing V-A ECMO.

Clinical Trial Registry: URL: http://www.chictr.org.cn/showproj.aspx?proj=46639, trial registry number: ChiCTR1900028021.
Assessing Family Functioning Before and After an Integrated Multidisciplinary Family Treatment for Adolescents With Restrictive Eating Disorders
Authors: Mensi Martina M. , Orlandi Marika , Rogantini Chiara , Provenzi Livio , Chiappedi Matteo , Criscuolo Michela , Castiglioni Maria C. , Zanna Valeria , Borgatti Renato
Published: June 2021

The present study presents an investigation of family functioning in the families of adolescents with severe restrictive eating disorders (REDs) assessed before and 6 months after a multidisciplinary family treatment program that combined psychodynamic psychotherapy, parental role intervention, and triadic or family-centered interventions. Nutritional counseling and neuropsychiatric monitoring of the overall treatment and care process were also provided. Family functioning was assessed using the clinical version of the Lausanne Trilogue Play (LTPc), a semi-structured procedure for observing family dynamics, previously validated for this patient population. The LTPc is divided into four phases. In phase 1, the mother interacts with the patient while the father assumes the role of observer. In phase 2, the father plans an activity with the patient while the mother observes. In phase 3, all the family members interact. Finally, in phase 4, the parents talk while the adolescent observes. A significant change emerged in family functioning after the treatment, but only for the interactive phase 2, when the father is required to interact with the daughter while the mother silently observes. The results of this study suggest that a relatively brief multidisciplinary treatment program may significantly improve family functioning in the families of patients diagnosed with severe REDs. Although appropriate clinical trials are needed to further test the efficacy of this treatment, the results also reinforce the concept that treatment programs targeting the individual patient and both the parents should be a first-line approach in adolescents with severe REDs.
Environmental and Genetic Determinants of Major Chronic Disease in Beijing–Tianjin–Hebei Region: Protocol for a Community-Based Cohort Study
Authors: Liu Kuo , Cao Han , Guo Chunyue , Pan Li , Cui Ze , Sun Jixin , Zhao Wei , Han Xiaoyan , Zhang Han , Wang Zhengfang , Niu Kaijun , Tang Naijun , Shan Guangliang , Zhang Ling
Published: June 2021

Introduction: Personal lifestyle and air pollution are potential risk factors for major non-communicable diseases (NCDs). However, these risk factors have experienced dramatic changes in the Beijing–Tianjin–Hebei (BTH) region in recent years, and few cohorts have focused on identifying risk factors for major NCDs in this specific region. The current study is a large, prospective, long-term, population-based cohort study that investigated environmental and genetic determinants of NCDs in BTH areas. The results of this study may provide scientific support for efforts to develop health recommendations for personalized prevention.

Methods: About 36,000 participants 18 years or older would be obtained by multistage, stratified cluster sampling from five cities for the baseline assessment. Participants underwent seven examinations primarily targeting respiratory and circulatory system function and filled out questionnaires regarding lifestyle behavior, pollutant exposure, medical and family history, medication history, and psychological factors. Biochemistry indicators and inflammation markers were tested, and a biobank was established. Participants will be followed up every 2 years. Genetic determinants of NCDs will be demonstrated by using multiomics, and risk prediction models will be constructed using machine learning methods based on a multitude of environmental exposure, examination data, biomarkers, and psychosocial and behavioral assessments. Significant spatial and temporal differentiation is well-suited to demonstrating the health determinants of NCDs in the BTH region, which may facilitate public health strategies with respect to disease prevention and survivorship-related aspects.
The Use of the General Animal-Based Measures Codified Terms in the Scientific Literature on Farm Animal Welfare
Authors: Brscic Marta , Contiero Barbara , Magrin Luisa , Riuzzi Giorgia , Gottardo Flaviana
Published: June 2021

Background:The approach to farm animal welfare evaluation has changed and animal-based measures (ABM), defined as the responses of an animal or effects on an animal, were introduced to assess animal welfare. Animal-based measures can be taken directly on the animal or indirectly and include the use of animal records. They can result from a specific event or be the cumulative outcome of many days, weeks, or months. The objective of the current study was to analyze the use of general ABM codified terms in the scientific literature, the presence of their definitions, and the gap mapping of their use across animal species, categories, years of publication, and geographical areas of the corresponding author's institution. The ultimate aim was to propose a common standard terminology to improve communication among stakeholders. In this study, data models were populated by collecting information coming from scientific papers extracted through a transparent and reproducible protocol using Web of ScienceTMand filtering for the general ABM codified terms (or synonyms/equivalents). A total of 199 papers were retained, and their full texts were assessed. The frequency of general codified ABM terms was analyzed according to the classification factors listed in the objectives. These papers were prevalently European (159 documents), and the most represented species was cattle. Fifty percent of the papers did not provide a definition of the general ABM terms, and 54% cited other sources as reference for their definition. The results of the study showed a very low penetration of the general codified ABM term in the literature on farm animal welfare, with only 1.5% of the papers including the term ABM. This does not mean that specific ABM are not studied, but rather that these specific ABM are not defined as such under a common umbrella, and there is no consensus on the use of terminology, not even among scientists. Thus, we cannot expect the stakeholders to use a common language and a standardized terminology. The recognition and the inclusion of ABM in the lists of commonly accepted abbreviations of scientific journals could be a first step to harmonize the terminology in the scientific literature.