bluuebunny/crossref_metadata_2025 huggingface dataset:
Pemanfaatan Financial Technology bagi Pelaku UMKM Pada Masa New Normal di Provinsi Jambi
Authors: Edward Edward , Ihsan Mohammad , Siregar Ade Perdana
Published: March 2021

The spread of the corona virus does not only have an impact on health but has an impact on the economic sector. Entering the new normal period, health protocols still have to be a concern because the Covid-19 pandemic has not ended. The development of MSMEs can make a positive contribution to the economy. The need for capital is the main reason for MSMEs to sustain their business. Capital is an important factor for business actors in building and developing their business. Knowledge, behavior, attitudes and beliefs about finance play an important role in making decisions, especially decisions about sources of venture capital. The government through regulations regarding financial technology provides solutions to answer the problems of MSME business actors during this new normal period. (1) Assessing the influence of financial literacy on decisions on the use of financial technology during the new normal period; (2) Assessing the influence of financial literacy on business actor confidence; (3) Assessing the influence between the trust of business actors on the decision to use financial technology in the new normal period; (4) Assessing the role of trust in business actors to be able to mediate the effect of financial literacy on decisions on the use of financial technology in the new normal period. The data analysis method used was the measurement of Structural Equation Modeling (SEM) using the SmartPLS software. The results showed that (1) financial literacy showed a significant positive effect on the decision to use financial technology during the new normal period; (2) financial literacy shows a significant positive effect on the trust of business actors; (3) the trust of business actors shows a significant positive effect on the decision to use financial technology during the new normal period; (4) the trust of business actors as a mediator of the effect of financial literacy shows a significant positive effect on decisions to use financial technology in the new normal period
Pengaruh Terapi Psikoreligious: Dzikir dalam Mengontrol Halusinasi Pendengaran Pada Pasien Skizofrenia yang Muslim di Rumah Sakit Jiwa Tampan Provinsi Riau
Authors: Gasril Pratiwi , Suryani Suryani , Sasmita Heppi
Published: March 2021

Data from the American Psychological Association (APA) in 2010 and Riskesdas 2013 show that on the average world population has schizophrenia and 70% of schizophrenic patients experience hallucinations. One of the recommended therapies in an effort to control hallucinations is psychoreligious therapy: dhikr. The purpose of this study was to determine the effect of psycho-religious therapy: dhikr in controlling hallucinations in schizophrenia patients. The research method used is quantitative with a Quasy expriemental approach carried out on 20 respondents at the Tampan Mental Hospital, Riau Province. Researchers used the Auditory Hallucinations Rating Scale (AHRS) module and evaluation sheet before and after the intervention. The results showed that there was an effect of psychoreligious therapy: dhikr in controlling hallucinations in schizophrenic patients (p value = 0,000). The results of this study can be used as additional therapy in controlling hallucinations in patients with auditory hallucinations.
Efektivitas Pelaksanaan Terapi Empati terhadap Kemampuan Manejemen Konflik Perawat Pelaksana di RSUD H. Hanafie Muara Bungo tahun 2019
Authors: Marlina Dewi , Arif Yulastri , Susanti Mira
Published: March 2021

Conflict is an interaction process that results from a mismatch, disagreement and mismatch between two or more parties. There were 52 cases of conflict in the H. Hanafie Hospital that occurred between nurses in the inpatient room with various triggers, such as differences in income, misunderstandings, feeling less valued, feeling lack of tolerance and indiscipline. This study aims to analyze the effectiveness of the implementation of empathy therapy on the conflict management abilities of nurses in RSUD H. Hanafie Muara Bungo. This type of research is quantitative using the research design "Quasy Experimental Pre-Post Test With Control Group. The population in this study were all nurses in the inpatient room of the Hanafie Muara Bungo Regional Hospital with a total of 129 people. The sample of implementing nurses was 34 respondents. Sampling with simple random sampling. The results of the study there was a significant effect of the implementation of empathy therapy on knowledge (p = 0.002), attitude (p = 0.004) and skills (p = 0.008). It is hoped that the nurses will both avoid conflict, be willing to pay attention to the opinions and interests of others and resolve conflicts without harming other parties.
Hubungan Umur, Pendidikan dan Pekerjaan Ibu dengan Akseptor KB Implant di Puskesmas Sri Gunung Kabupaten Musi Banyuasin Tahun 2019
Authors: Hakim S Paula Citra , Aisyah Siti , Afrika Eka
Published: March 2021

The number of acceptors for family planning implants is currently still very low due to the lack of knowledge of acceptors about the quality of family planning implants that are more effective, it is known that family planning programs have a very important role in suppressing population growth, especially prevention of maternal death and morbidity, implants are contraceptives that are inserted under skin, usually attached to the upper arm. This study aims to determine the relationship between age, education and work of mothers with family planning implant acceptors at the Srigunung Health Center, Musi Banyuasin Regency in 2019. The purpose of this study is to determine the relationship between age, education and occupation of mothers with implant family planning acceptors at Srigunung Health Center in 2019. This study using an analytic survey with a cross sectional approach. The population of this study were all women of childbearing age who were active family planning participants visiting the Srigunung Public Health Center, Musi Banyuasin District. The sample of this study were 97 respondents who were taken systematically randomly by dividing the number of samples desired by using the random sampling method. Based on the analysis, it was found that there was a significant relationship between age (ρ value 0,000), education (ρ value 0,000), maternal occupation (ρ value 0,000) with family planning acceptors at the Sri Gunung Puskesmas, Musi Banyuasin Regency in 2019. The conclusions in this study can be seen that there is a relationship between age, education and occupation of mothers with family planning implant acceptors at the Sri Gunung Puskesmas, Musi Banyuasin Regency in 2019.
Faktor-Faktor yang Mempengaruhi Penggunaan Kontrasepsi Implant
Authors: Sugiana Erma , Hamid ST Aisjah , Sari Erma Puspita
Published: March 2021

The implant is an effective and efficient hormonal contraceptive in the form of a rod that is implanted under the skin in the upper arm, and the protection period can be up to five years. The purpose of this study was to determine the factors that influence implant contraceptive use. This research is an analytical survey with a cross sectional research design, the study was conducted in June - August 2020 at Puskesmas Gumawang Kab. Oku Timur South Sumatra. The population in this study were all couples of childbearing age who used family planning who visited the Puskesmas in Puskesmas Gumawang Kab. East Oku, which is estimated to be 7,729 acceptors and the sample used in this study were some of the mothers who used family planning who visited the UPTD Puskesmas Gumawang Kab. East Oku in 2019, amounting to 99 people, through Proportional Random Sampling, univariate (proportion), bivariate (chi square test) and multivariate (logistic regression) analysis. The results of the analysis showed that parity (p value: 0.004) and age (p value: 0.028), occupation (p value: 0.001), had a significant relationship with the use of family planning implants, while education (p value: 0.089) had no significant relationship with use of implant birth control. Based on the final model of multivariate analysis, the variable that has the greatest influence on the use of implant family planning is the occupational variable. It is hoped that the results of this study can increase the active role of midwives to provide IEC about the advantages and disadvantages of contraceptive methods that acceptors will choose according to their goals and age.
Analisis Implementasi Kebijakan Kawasan Tanpa Rokok Berdasarkan Perda Nomor 5 Tahun 2016 Di Dinas Kesehatan Kabupaten Indragiri Hilir
Authors: Perawati Perawati , Nopriadi Nopriadi , Riany Novita , Kiswanto Kiswanto , Gustina Tin
Published: March 2021

The No Smoking Area Program (KTR) is one of the policies taken by the government to control the negative effects of smoking in the community. The purpose of this study was to analyze the implementation of the KTR policy based on Perda No. 5 of 2016 at the Indragiri Hilir District Health Office in 2020. This research uses a qualitative approach with a phenomenological design. Data collection techniques in this study were in-depth interviews, observation and document searches. The number of informants in the study was 8 people. The results showed that the implementation of the Regional Regulation on KTR in the area of Indragiri Hilir District Health Office has not been implemented effectively. This is due to several factors, namely lack of socialization, lack of availability of infrastructure, no organizational structure, no supervisory committee, and no policy against sanctions for violations. It is recommended that the Health Office complete the facilities and infrastructure, provide outreach, compile an organizational structure, form a supervisory committee, and enforce the sanctions for infringement. It is also recommended that the Health Office prepare derivatives of these perda, such as a Regent Regulation, implementing guidelines, and technical guidelines so that there is legal power.
Peningkatan Hasil Belajar Siswa Kelas X IPS 1 dalam Pembelajaran Seni Tari Melalui Metode Jigsaw di SMA Negeri 1 Kerinci Tahun Pelajaran 2019/2020
Authors: Ayuni Ning
Published: March 2021

This research was a classroom action research. The research objective was to improve the student’s achievement on Dancing Art subject by using Jigsaw method. The research participant was the students at grade X IPS 1 SMAN 1 Kerinci consisted of 20 students. The research was done in two cycles which had four phases (1) Planning (2) Action (3) Observation (4) Reflection. The data were collected by using observation, performance test, documentation, interview and questionnaire. The instruments of the research were field note, observation sheet, research sheet, interview guide, and Questionnaire. The analysis result showed that the student’s learning activeness during the two cycles improved. It could be seen from the improvement of the student’s activeness level. It was observed from their well enthusiastic and cooperative team work in forming dancing moves and floor pattern, the students were able to gather the dancing moves into a dancing creation, and they were performing both things confidently.  The improvement in achievement was seen from the quantitative data that there were 5 students (25%) who got 75 in pre-cycle. It went better when Jigsaw method was implementd in cycle 1 and 2. There were 12 students (60%) who got achieved score, and 8 of them (40%) who got unachieved score in the first cycle. Then, the next cycle showed that there were 17 students (85%) who got achieived score and 3 of them (15%) who were at unachieved level. It concluded that Jigsaw method improved the student’s achievement in Dancing Art Subject.
Pijat Oksitosin terhadap Produksi Asi pada Ibu Post Partum
Authors: Fitria Reni , Retmiyanti Nia
Published: March 2021

Insufficient milk production is often a problem for postpartum mothers. Likewise, what is experienced by post partum mothers in the Puskesmas S work area, such as nipple blisters, crying babies, and decreased baby weight. The purpose of this study was to determine the effect of oxytocin massage on milk production in post partum mothers. This research method is one group pre test post test design. The population in this study were 33 post-partum mothers, a sample of 33 post-partum mothers with a total sampling technique, using the T-test. a number of 0 (0%), quite fluent a number of 7 postpartum mothers (21.2%), less fluent a number of 26 postpartum mothers (78.8%), after the oxytocin massage most of the respondents. The release of ASI was smooth as many as 33 postpartum mothers (100%). The T-test showed that the value of p = o, ooo <a (0.05) which indicates that there is an effect of oxytocin massage on the smoothness of breast milk. This shows the need for oxytocin massage so that it can help accelerate breastfeeding in nursing mothers.
Kerajaan Minangkabau Sebagai Asal-usul Kesultanan Jambi
Authors: Rahim Arif
Published: March 2021

This article discusses the Minangkabau kingdom and its existence as the origin of the Jambi Sultanate. This issue is considered important because at this time there are many people who do not understand the relationship between the kingdoms in the past, which regions are currently included in the kingdoms of these kingdoms. The results of this study are expected to provide an explanation of the main problems proposed and so contribute to the development of knowledge, especially about the local history of Jambi and West Sumatra. Besides, it can be used as material for consideration by related institutions in order to preserve historical and cultural values and for regional development and development. By using a multidimensional approach and supported by the application of historical methods that refer to scientific historical research procedures, it is hoped that the questions raised in the formulation of the problem will be objectively and systematically expressed. The results showed that the Minangkabau area was an old area that had been inhabited by humans at least since the Batu Muda era around 2000 years BC. In the district of 50 Kota there are many Menhir findings which are thought to be from that period. The Minangkabau area is the area where Sang Sapurba's title Datuk Maharaja Diraja descended which in oral tradition is considered the ancestor of the Minangkabau tribe and the Malay family in general and also as a figure who descended the kings who ruled on the island of Sumatra, especially the Malay countries. In the context of Jambi and Minangkabau relations, it can be said that the kings who ruled in the Jambi kingdom were descended from the Minangkabau Kingdom. Putri Selaro Pinang Masak, who in the Jambi royal legend is seen as the founder of the Jambi kingdom, was the son of Ananggawarman who ruled in Pagaruyung from 1376 - 1417 AD. As an old country, Minangkabau has a customary and cultural system that affects the surrounding area, including the Jambi area. A source from the Jambi Malay Customary Institute said that the one who composed Jambi's customs was Datuk Perpatih Nan Sabatang from Pagaruyung, while those from Bandar Jambi were Datuk Ketemanggungan
NASHP Drug Pricing Proposal: A Step in the Right Direction
Authors: Saleh Amr
Published: March 2021

At the heart of the COVID-19 pandemic is a long-lasting question about access to healthcare in America. For years, exorbitant drug prices have caused severe problems for American patients. The ineffective system of determining drug costs, solely influenced by competition in the free market, leaves roughly 25% of Americans unable to afford prescription drugs1. Importantly, this emphasizes the urgent need for structural reform in this area. Interestingly, there has been a renewed political will to address this crisis. In May 2018, the Trump Administration released a blueprint to “put American patients first” and, in the report, “high list prices” was the first challenge identified by Health and Human Services2. Six states have already enacted laws that allow for Canadian drug importation but await for federal approval3. These initiatives at the state and federal level, while not amounting to formal legal action, set the stage for paradigm-shifting policies to be passed. The National Academy for State Health Policy (NASHP), a nonpartisan group of policy makers in state governments, represent a key actor for drug price reform4. Recently, they published a model law to match Canadian drug prices for the American market5. The model accounts for the 250 most expensive drugs in the state and proposes setting an upper limit defined by the lowest price found across Canada’s 4 most populous provinces5. In doing so, this aims to decrease drug prices and improve drug accessibility. While not flawless, this model provides an effective starting point to regulate drug prices in America and addresses key critics.
Looking back Vol 24(1)
Authors: Siddique Md Ibrahim
Published: March 2021

Abstract not available

Journal of Surgical Sciences (2020) Vol. 24 (1) : 40
The new formulation of the 0,05% sodium hypochlorite electrolytic solution for cutaneous use: reasons and advantages
Authors: Scalise Alessandro
Published: March 2021

Superinfection of skin lesions is quite common, and often delays wound recovery. Infection control plays therefore a key role in the management of skin lesions, requiring the use of specific antimicrobials. Among available agents, topic antiseptic drugs are currently recommended as a first-choice option, to be preferred to antibiotics, given the growing resistance to these drugs. Compared to antibiotics, antiseptic drugs have a wider spectrum of action, including bacteria, fungi, virus, protozoa, and prions. The ideal antiseptic for the management of an infected skin lesion is expected to be both highly effective and well tolerated, in order to promote the physiologic process of tissue restoration. Among available antiseptics, the 0,05% sodium hypochlorite electrolytic solution meets these criteria: the product proved to be effective in vitro and in animal experimental models against a wide range of microorganisms, besides exerting an anti-inflammatory action in the absence of any irritating, cytotoxic or carcinogenic adverse effect, and being useful in biofilm removal. Similarly, in several clinical trials, the 0,05% sodium hypochlorite electrolytic solution was demonstrated to be very effective and safe in the management of infected skin wounds: based on these results, this product should be strongly considered among the first-choice options for the disinfection of skin wounds. The new formulation, developed according to the latest reference standards for wound healing and in agreement with current guidelines, is qualitatively improved, with an expected positive impact in every field of clinical application and a subsequent benefit for treated patients.
From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple?
Authors: Kang Seong Hee , Cho Yuri , Jeong Soung Won , Kim Seung Up , Lee Jin-Woo ,   On behalf of Korean NAFLD Study Group
Published: March 2021

There is some dissatisfaction with the term “nonalcoholic fatty liver disease (NAFLD),” which overemphasizes alcohol and underemphasizes the importance of metabolic risk factors in this disease. Recently, a consensus recommended “metabolic (dysfunction)-associated fatty liver disease (MAFLD)” as a more appropriate term to describe fatty liver diseases (FLD) associated with metabolic dysfunction. During the definition change from NAFLD to MAFLD, subjects with FLD and metabolic abnormalities, together with other etiologies of liver diseases such as alcohol, virus, or medication who have been excluded from the NAFLD criteria, were added to the MAFLD criteria, while subjects with FLD but without metabolic abnormality, who have been included in the NAFLD criteria, were excluded from the MAFLD criteria. This means that there is an emphasis on the metabolic dysfunction in MAFLD which may underestimate the prognostic value of hepatic steatosis itself, whereas the MAFLD criteria might better identify subjects who are at a higher risk of hepatic or cardiovascular outcomes. However, non-metabolic risk NAFLD subjects who are excluded from the MAFLD criteria are missed from the diagnosis, and their potential risk can be the cause of future diseases. Although huge controversies remain, this review focused on summarizing recent studies that compared the clinical and prognostic characteristics between subjects with NAFLD and MAFLD.
Performance of Different Criteria Sets for Inflammatory Back Pain in Radiographic and Nonradiographic Axial Spondyloarthritis
Authors: Islam Md. Toufiqul , Sultan Mohammad Imtiaz , Rudra Sujan
Published: March 2021

Introduction: It is important to recognise inflammatory back pain (IBP) for early diagnosis of ankylosing spondylitis (AS). The aims of this study were to develop a valid, reliable Bengali IBP tool and to assess the performance of different IBP criteria sets, including Calin, Berlin set 8a and 7b, and new Assessment of SpondyloArthritis International Society (ASAS) expert criteria, in radiographic axial spondyloarthritis (axSpA) and nonradiographic axSpA.
Method: This case-control study was performed in three phases. The first phase involved development of an IBP tool by adding the fifth parameter of ASAS expert criteria to the National Health and Nutrition Examination Survey (NHANES) 2009–2010 arthritis questionnaires; the second phase assessed reliability by test-retest statistics among 87 participants at a 5-day interval. Finally, according to the imaging arm of ASAS axSpA classification criteria, 50 patients with axSpA were included as cases while 50 patients with chronic mechanical back pain (MBP) were included as a control.
Results: The presence of IBP with SpA versus patients with MBP, detected by Calin criteria, were 76.0% versus 10.0%, by Berlin 8a were 72.0% versus 6.0%, by Berlin 7b were 58.0% versus 12.0%, and by ASAS were 64.0% versus 18.0%, respectively. Results suggested the Calin criteria set has the highest sensitivity (76.0%) and Berlin set 8a has the highest specificity (78.9%) in the differentiation of IBP from MBP.
Conclusion: The performance of the new ASAS criteria was analogous to the other existing criteria sets. The highest positive likelihood ratio and odds ratio were found for Berlin set 8a criteria. The Berlin set 8a criteria can still be used in primary care practice at the first screening because of high sensitivity.
IMPLEMENTASI APLIKASI E-SURAT PADA PERANGKAT DESA DI DESA MENTURUS KUDU JOMBANG
Authors: Hadi Sucipto  , Ahmad Heru Mujianto  , Chamdan Mashuri,  , Mahrus Ali  , Mahfudiyanto
Published: March 2021

Pelayanan Desa menggambarkan identitas Desa itu sendiri. Selama ini pelayanan pembuatan surat di kantor Desa Menturus menggunakan pelayanan dalam bentuk sistem informasi manual, pelayanan dilakukan oleh sorang petugas. Beberapa permasalahan yang dihadapi dari sistem pelayanan seperti ini seperti sulit dan lambat dalam proses pengajuan usulan surat baru, surat ijin dan surat keterangan. Sementara masyarakat menginginkan pelayanan yang ramah, cepat dan efektif. Sistem layanan E-SuratDesa dapat dijadikan solusi untuk memberikan layanan prima kepada masyarakat. Sistem yang dibangun ini diharapkan masyarakat dapat mengakses layanan seperti mengurus surat keterangan dan surat pengantar untuk berbagai keperluan dengan cara memsukkan atau mengetik Nomor Induk kependudukan (NIK) ke web layanan mandiri desa. Jika data ditemukan, masyarakat bisa langsung melakukan layanan yang diinginkan. Hasil dari penelitian ini adalah aplikasi administrasi desa berbasis web.
Exosomal miR-130b-3p Promotes Progression and Tubular Formation Through Targeting PTEN in Oral Squamous Cell Carcinoma
Authors: Yan Wei , Wang Yuping , Chen Yong , Guo Yanjun , Li Qiang , Wei Xiaotong
Published: March 2021

Oral squamous cell carcinoma (OSCC), accounting for two-thirds of head and neck cancer, is characterized by poor prognosis and a high rate of mortality. Exosomes have emerged as potential molecule-shuttle in intercellular communication, thereby regulating the physiological processes of recipient cells. To date, the effect of exosomal microRNAs (miRNAs) on the progression of OSCC has not been fully investigated. In this study, we found that the protein, but not mRNA expression of Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) was decreased in OSCC. The results revealed that miR-130b-3p was an important negative regulator for PTEN expression. Additionally, overexpression and knockdown of miR-130b-3p enhanced and inhibited angiogenesis in human umbilical vein endothelial cells (HUVECs), respectively. Also, miR-130b-3p was transferred by exosomes to HUVECs and then promoted angiogenesis and inhibit the expression of PTEN. Furthermore, exosomal miR-130b-3p derived from OSCC cells promoted tumor growth and blood vessel formation in the xenograft mice model. Taken together, we demonstrated that exosome-mediated miR-130b-3p promoted progression and tubular formation in OSCC in vitro and in vivo. These results would provide new insight into exploring biomarkers and effective therapeutic strategies for OSCC.
Cabozantinib Reverses Topotecan Resistance in Human Non-Small Cell Lung Cancer NCI-H460/TPT10 Cell Line and Tumor Xenograft Model
Authors: Lei Zi-Ning , Teng Qiu-Xu , Gupta Pranav , Zhang Wei , Narayanan Silpa , Yang Dong-Hua , Wurpel John N. D. , Fan Ying-Fang , Chen Zhe-Sheng
Published: March 2021

Cabozantinib (CBZ) is a small molecule tyrosine kinase receptor inhibitor, which could also inhibit the ABCG2 transporter function. Therefore, CBZ could re-sensitize cancer cells that are resistant to ABCG2 substrate drugs including topotecan (TPT). However, its reversal effect against TPT resistance has not been tested in a TPT-induced resistant cancer model. In this study, a new TPT selected human non-small cell lung cancer (NSCLC)-resistant cell model NCI-H460/TPT10 with ABCG2 overexpression and its parental NCI-H460 cells were utilized to investigate the role of CBZ in drug resistance. The in vitro study showed that CBZ, at a non-toxic concentration, could re-sensitize NCI-H460/TPT10 cells to TPT by restoring intracellular TPT accumulation via inhibiting ABCG2 function. In addition, the increased cytotoxicity by co-administration of CBZ and TPT may be contributed by the synergistic effect on downregulating ABCG2 expression in NCI-H460/TPT10 cells. To further verify the applicability of the NCI-H460/TPT10 cell line to test multidrug resistance (MDR) reversal agents in vivo and to evaluate the in vivo efficacy of CBZ on reversing TPT resistance, a tumor xenograft mouse model was established by implanting NCI-H460 and NCI-H460/TPT10 into nude mice. The NCI-H460/TPT10 xenograft tumors treated with the combination of TPT and CBZ dramatically reduced in size compared to tumors treated with TPT or CBZ alone. The TPT-resistant phenotype of NCI-H460/TPT10 cell line and the reversal capability of CBZ in NCI-H460/TPT10 cells could be extended from in vitro cell model to in vivo xenograft model. Collectively, CBZ is considered to be a potential approach in overcoming ABCG2-mediated MDR in NSCLC. The established NCI-H460/TPT10 xenograft model could be a sound clinically relevant resource for future drug screening to eradicate ABCG2-mediated MDR in NSCLC.
Regulatory Mechanisms of Autophagy-Targeted Antimicrobial Therapeutics Against Mycobacterial Infection
Authors: Silwal Prashanta , Paik Seungwha , Kim Jin Kyung , Yoshimori Tamotsu , Jo Eun-Kyeong
Published: March 2021

Mycobacterium tuberculosis (Mtb) is an intracellular pathogen causing human tuberculosis, an infectious disease that still remains as a global health problem. Autophagy, a lysosomal degradative process, has emerged as a critical pathway to restrict intracellular Mtb growth through enhancement of phagosomal maturation. Indeed, several autophagy-modulating agents show promise as host-directed therapeutics for Mtb infection. In this Review, we discuss recent progress in our understanding the molecular mechanisms underlying the action of autophagy-modulating agents to overcome the immune escape strategies mediated by Mtb. The factors and pathways that govern such mechanisms include adenosine 5′-monophosphate-activated protein kinase, Akt/mammalian TOR kinase, Wnt signaling, transcription factor EB, cathelicidins, inflammation, endoplasmic reticulum stress, and autophagy-related genes. A further understanding of these mechanisms will facilitate the development of host-directed therapies against tuberculosis as well as infections with other intracellular bacteria targeted by autophagic degradation.
Low Heart Rate Variability Predicts Stroke and Other Complications in the First Six Postoperative Months After a Hip Fracture Operation
Authors: Ernst Gernot , Watne Leiv Otto , Frihagen Frede , Wyller Torgeier Bruun , Dominik Andreas , Rostrup Morten
Published: March 2021

Background: One-year mortality after hip fractures is underestimated and is reported as 25%. An improved risk stratifying could contribute to a better follow up of these patients. Heart Rate Variability (HRV) is an easy point-of-care investigation and is been used in cardiology, endocrinology, and perioperative care. This observational study intended to explore relevant associations between HRV parameters and 6-months mortality and morbidity after a hip fracture.

Methods: One hundred and sixty-five patients admitted to two hospitals were included, and short-time HRV measurements (5 min, and 10 min at the two hospitals, respectively) were obtained. Mortality data were gathered by means of the Norwegian central address register. Patients, close relatives of patients, and in some cases their general physicians or nursery home physicians were interviewed 6 months postoperatively regarding the incidence of pneumonia, cardiac events, or stroke.

Results: One and hundred fifty-seven (95.2%) patients were followed up after 6 months post-surgery. Twenty-one (13%) died during this period. Twenty patients (13%) developed pneumonia, eight (5 %) stroke, and four (2%) myocardial infarction. No HRV parameter was associated with 6-month general mortality. However, patients who developed stroke had significantly lower High Frequency Power (HF, p < 0.001) and lower Very Low Frequency Power (VLF, p = 0.003) at inclusion compared to patients without complications. Patients who developed pneumonia had at the inclusion lower root mean square of successive differences (RMSSD, p = 0.044). Patients with a history of coronary heart disease (n = 41) showed a mortality of 7%. Mortality in this group was associated with standard deviation of beat-to-beat intervals (SDNN, p = 0.006), Total Power (TP, p = 0.009), HF (p = 0.026), and Low Frequency Power (LF, p = 0.012). Beta-blocker intake was associated with lower heart rate, but not with differences in HRV parameters.

Conclusion: In this exploratory study, we present for the first-time significant associations between different preoperative HRV parameters and stroke, myocardial infarction, and pneumonia during a 6-month period after hip fracture. HRV might be a simple and effective tool to identify patients at risk that would warrant better follow-up.
Resilience Modeling of Flood Induced Electrical Distribution Network Failures: Munich, Germany
Authors: Leandro Jorge , Cunneff Shane , Viernstein Lorenz
Published: March 2021

Of many defining characteristics for a flood resilient city and its infrastructure networks, mitigating flooding impacts and recovering quickly to a pre-flood state are to be considered of high importance. With a likely increase in the frequency and intensity of future heavy precipitation and flooding events in Europe, the vulnerability of the electrical distribution network of Maxvorstadt, Munich will also increase. These facts justify the need for quantifying how the electrical distribution network would respond to flooding, and more so, how stakeholders can better prepare for such an event. For a synthetic electrical distribution network of Maxvorstadt, the timing and location of network components failure due to flooding and affected persons without power have been computed for a combination of realistic future flooding events via the Electrical Network Flood Resilience Model developed in this study. It has been learned that most buildings, and therefore their inhabitants, lose power due to the failure of a specific component, Medium Voltage—Low Voltage transformer buses, and that flood risk solutions should focus on protecting network components from inundation to ensure its functionality through flooding events. Solutions like dry proofing such components before severe flooding occurs is recommended for several neighborhoods analyzed in this study.
Firn Evolution at Camp Century, Greenland: 1966–2100
Authors: Vandecrux Baptiste , Colgan William , Solgaard Anne M. , Steffensen Jørgen Peder , Karlsson Nanna B.
Published: March 2021

Camp Century is an American military base built in 1959 under the surface of the Greenland ice sheet and decommissioned in 1967. Here, we use outputs from RACMO2.3p2 and CanESM2 climate models, adjusted to meteorological observations, and a firn model to simulate the firn density and temperature at Camp Century between 1966 and 2100. The model output is evaluated against an extensive set of firn 3observations and three Representative Concentration Pathways (RCP2.6, 4.5 and 8.5) are considered as future scenarios. Our model suggests that the upper horizon of the Camp Century debris field – observed at a depth of 32 m in 2017 – will continue to be buried by persistent net accumulation over the next eighty years under all RCP scenarios. This horizon depth will be between 58 and 64 m in 2100, depending on the RCP scenario. We estimate a maximum meltwater percolation depth of 1.1 m under all RCP scenarios. We therefore find it extremely unlikely that surface meltwater interacts with the subsurface debris field at Camp Century before 2100 under all RCP scenarios. Camp Century’s future is representative of the firn area in northwestern Greenland, bound to shift from dry snow to a percolation regime. Our model suggests that 10 m firn temperatures at Camp Century will increase from −24.0°C in 1966 to −21.3, −20.0 and −18.6°C in 2100 under the RCP2.6, 4.5 and 8.5 scenarios, respectively. We reveal a previously unknown warm bias in air temperatures simulated at Camp Century by both RACMO2.3p2 and CanESM2 climate models which needs to be accounted for when using these models to predict melt, firn evolution and sea-level contribution of the Greenland ice sheet. We also present novelin situmeasurements of firn compaction rates, which indicate that about 25% of firn compaction of the top 62 m of firn occurs below 20 m depth. This highlights the importance of deep-firn compaction measurements for model evaluation and correction of altimetry products.
Personalized and Automated Feedback in Summative Assessment Using Recommender Systems
Authors: de Schipper Eva , Feskens Remco , Keuning Jos
Published: March 2021

In this study we explore the use of recommender systems as a means of providing automated and personalized feedback to students following summative assessment. The intended feedback is a personalized set of test questions (items) for each student that they could benefit from practicing with. Recommended items can be beneficial for students as they can support their learning process by targeting specific gaps in their knowledge, especially when there is little time to get feedback from instructors. The items are recommended using several commonly used recommender system algorithms, and are based on the students' scores in a summative assessment. The results show that in the context of the Dutch secondary education final examinations, item recommendations can be made to students with an acceptable level of model performance. Furthermore, it does not take a computationally complex model to do so: a simple baseline model which takes into account global, student-specific, and item-specific averages obtained similar performance to more complex models. Overall, we conclude that recommender systems are a promising tool for helping students in their learning process by combining multiple data sources and new methodologies, without putting additional strain on their instructors.
Human Pluripotent Stem Cells to Model Islet Defects in Diabetes
Authors: Balboa Diego , Iworima Diepiriye G. , Kieffer Timothy J.
Published: March 2021

Diabetes mellitus is characterized by elevated levels of blood glucose and is ultimately caused by insufficient insulin production from pancreatic beta cells. Different research models have been utilized to unravel the molecular mechanisms leading to the onset of diabetes. The generation of pancreatic endocrine cells from human pluripotent stem cells constitutes an approach to study genetic defects leading to impaired beta cell development and function. Here, we review the recent progress in generating and characterizing functional stem cell-derived beta cells. We summarize the diabetes disease modeling possibilities that stem cells offer and the challenges that lie ahead to further improve these models.
Torrefaction of Almond and Walnut Byproducts
Authors: McCaffrey Zach , Torres Lennard , Chiou Bor-Sen , Ferreira Saulo Rocha , Silva Luiz Eduardo , Wood Delilah F. , Orts William John
Published: March 2021

While the US nut industry is growing, markets for nut by-products, particularly nutshells and tree prunings, have not kept pace. Torrefaction is a thermochemical process used to improve physicochemical properties of biomass for energy and other applications. The goal of the paper was to characterize the effects of a range of torrefaction conditions on the properties of nut by-product feedstock. The process consists of thermal treatment of biomass at a temperature between 200 and 300°C in the absence of oxygen, where final material properties of the torrefied biomass depend on the temperature, heating rate, and residence time. In general, torrefied biomass exhibits higher hydrophobicity and calorific value with reduced moisture absorption compared to untreated biomass, making it an ideal fuel source for energy applications compared to raw biomass. In this study, almond shells of soft, semi-soft, and hardshell varieties, as well as walnut shells and almond wood, were torrefied at two different temperatures (230 and 290°C) and three different residence times (20, 40, and 60 min) in order to characterize the physicochemical properties. The thermal behavior of raw and heat-treated biomass was investigated by TGA analysis, elemental analysis, pH, helium pycnometry, FTIR spectroscopy, and dynamic vapor sorption analysis.
Ramsar Wetlands of International Importance–Improving Conservation Outcomes
Authors: Kingsford R. T. , Bino G. , Finlayson C. M. , Falster D. , Fitzsimons J.A. , Gawlik D. E. , Murray N. J. , Grillas P. , Gardner R. C. , Regan T. J. , Roux D. J. , Thomas R. F.
Published: March 2021

The Ramsar Convention (or the Convention on Wetlands), signed in 1971, was one of the first international conservation agreements, promoting global wise use of wetlands. It has three primary objectives: national designation and management of wetlands of international importance; general wise use of wetlands; and international cooperation. We examined lessons learnt for improving wetland conservation after Ramsar’s nearly five decades of operation. The number of wetlands in the Ramsar Site Network has grown over time (2,391 Ramsar Sites, 2.5 million km2, as at 2020-06-09) but unevenly around the world, with decreasing rate of growth in recent decades. Ramsar Sites are concentrated in countries with a high Gross Domestic Product and human pressure (e.g., western Europe) but, in contrast, Ramsar Sites with the largest wetland extent are in central-west Africa and South America. We identified three key challenges for improving effectiveness of the Ramsar Site Network: increasing number of sites and wetland area, improved representation (functional, geographical and biological); and effective management and reporting. Increasing the number of sites and area in the Ramsar network could benefit from targets, implemented at national scales. Knowledge of representativeness is inadequate, requiring analyses of functional ecotypes, geographical and biological representativeness. Finally, most countries have inadequate management planning and reporting on the ecological character of their Ramsar Sites, requiring more focused attention on a vision and objectives, with regular reporting of key indicators to guide management. There are increasing opportunities to rigorously track ecological character, utilizing new tools and available indicators (e.g., remote sensing). It is critical that the world protect its wetlands, with an effective Ramsar Convention or the Convention on Wetlands at the core.
Spread and Severity of Ash Dieback in Switzerland – Tree Characteristics and Landscape Features Explain Varying Mortality Probability
Authors: Klesse Stefan , Abegg Meinrad , Hopf Sven E. , Gossner Martin M. , Rigling Andreas , Queloz Valentin
Published: March 2021

Since the 1990s the invasive fungusHymenoscyphus fraxineushas been threatening European ash (Fraxinus excelsior), a tree species with high ecological and economic importance. This pathogen is causing severe crown dieback, leading to high mortality rates across Europe and is present in Switzerland since 2008. In this study, we provide a comprehensive overview of the temporal evolution of crown damage and mortality rates in Switzerland over the 2009–2019 period. Harnessing the power of the annualized design of the Swiss national forest inventory (NFI), we show that annual mortality rates (AMRs) of ash increased significantly since the arrival of the fungus, with stronger effects in small trees [<26 cm diameter at breast height (DBH)]. Mortality modeling confirmed a size and growth-rate dependent mortality probability (MP). It also revealed that stands with higher humidity – either through higher mean annual precipitation or more humid soil conditions – showed also increased MP. Decreasing host abundance with increasing elevation was also associated with lower MP. Special ash surveys performed over the last 10 years still show a large percentage of ash trees with very low defoliation. This gives hope to finding possible tolerant or resistant trees for (inter-)national breeding programs. In the mean-time our results reinforce previously published management guidelines to promote not only healthy big trees, but also healthy and fast-growing young trees in more open stands for long-term conservation of ash in Europe.
Risk Prediction in Patients With Heart Failure With Preserved Ejection Fraction Using Gene Expression Data and Machine Learning
Authors: Zhou Liye , Guo Zhifei , Wang Bijue , Wu Yongqing , Li Zhi , Yao Hongmei , Fang Ruiling , Yang Haitao , Cao Hongyan , Cui Yuehua
Published: March 2021

Heart failure with preserved ejection fraction (HFpEF) has become a major health issue because of its high mortality, high heterogeneity, and poor prognosis. Using genomic data to classify patients into different risk groups is a promising method to facilitate the identification of high-risk groups for further precision treatment. Here, we applied six machine learning models, namely kernel partial least squares with the genetic algorithm (GA-KPLS), the least absolute shrinkage and selection operator (LASSO), random forest, ridge regression, support vector machine, and the conventional logistic regression model, to predict HFpEF risk and to identify subgroups at high risk of death based on gene expression data. The model performance was evaluated using various criteria. Our analysis was focused on 149 HFpEF patients from the Framingham Heart Study cohort who were classified into good-outcome and poor-outcome groups based on their 3-year survival outcome. The results showed that the GA-KPLS model exhibited the best performance in predicting patient risk. We further identified 116 differentially expressed genes (DEGs) between the two groups, thus providing novel therapeutic targets for HFpEF. Additionally, the DEGs were enriched in Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways related to HFpEF. The GA-KPLS-based HFpEF model is a powerful method for risk stratification of 3-year mortality in HFpEF patients.
Case Report: Novel SAVI-Causing Variants in STING1 Expand the Clinical Disease Spectrum and Suggest a Refined Model of STING Activation
Authors: Lin Bin , Torreggiani Sofia , Kahle Dana , Rumsey Dax G. , Wright Benjamin L. , Montes-Cano Marco A. , Silveira Laura Fernandez , Alehashemi Sara , Mitchell Jacob , Aue Alexander G. , Ji Zheng , Jin Tengchuan , de Jesus Adriana A. , Goldbach-Mansky Raphaela
Published: March 2021

Gain-of-function mutations in STING1 cause the monogenic interferonopathy, SAVI, which presents with early-onset systemic inflammation, cold-induced vasculopathy and/or interstitial lung disease. We identified 5 patients (3 kindreds) with predominantly peripheral vascular disease who harbor 3 novel STING1 variants, p.H72N, p.F153V, and p.G158A. The latter two were predicted by a previous cryo-EM structure model to cause STING autoactivation. The p.H72N variant in exon 3, however, is the first SAVI-causing variant in the transmembrane linker region. Mutations of p.H72 into either charged residues or hydrophobic residues all led to dramatic loss of cGAMP response, while amino acid changes to residues with polar side chains were able to maintain the wild type status. Structural modeling of these novel mutations suggests a reconciled model of STING activation, which indicates that STING dimers can oligomerize in both open and closed states which would obliviate a high-energy 180° rotation of the ligand-binding head for STING activation, thus refining existing models of STING activation. Quantitative comparison showed that an overall lower autoactivating potential of the disease-causing mutations was associated with less severe lung disease, more severe peripheral vascular disease and the absence of a robust interferon signature in whole blood. Our findings are important in understanding genotype-phenotype correlation, designing targeted STING inhibitors and in dissecting differentially activated pathways downstream of different STING mutations.
Restoration of NK Cell Cytotoxic Function With Elotuzumab and Daratumumab Promotes Elimination of Circulating Plasma Cells in Patients With SLE
Authors: Humbel Morgane , Bellanger Florence , Fluder Natalia , Horisberger Alice , Suffiotti Madeleine , Fenwick Craig , Ribi Camillo , Comte Denis
Published: March 2021

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by multiple cellular and molecular dysfunctions of the innate and adaptive immunity. Cytotoxic function of NK cells is compromised in patients with SLE. Herein, we characterized the phenotypic alterations of SLE NK cells in a comprehensive manner to further delineate the mechanisms underlying the cytotoxic dysfunction of SLE NK cells and identify novel potential therapeutic targets. Therefore, we examined PBMC from SLE patients and matched healthy controls by single-cell mass cytometry to assess the phenotype of NK cells. In addition, we evaluated the cell function of NK cells (degranulation and cytokine production) and the killing of B cell subpopulations in a B cell-NK cell in vitro co-culture model. We found that SLE NK cells expressed higher levels of CD38 and were not able to adequately upregulate SLAMF1 and SLAMF7 following activation. In addition, ligation of SLAMF7 with elotuzumab or of CD38 with daratumumab on SLE NK cells enhanced degranulation of both healthy and SLE NK cells and primed them to kill circulating plasma cells in an in vitro co-culture system. Overall, our data indicated that dysregulated expression of CD38, SLAMF1 and SLAMF7 on SLE NK cells is associated with an altered interplay between SLE NK cells and plasma cells, thus suggesting their contribution to the accumulation of (auto)antibody producing cells. Accordingly, targeting SLAMF7 and CD38 may represent novel therapeutic approaches in SLE by enhancing NK cell function and promoting elimination of circulating plasma cell.