bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Analysis of Acral Melanoma in Chinese and Caucasian Patients
Authors: Huang Kai , Xu Yu , Gabriel Emmanuel M. , Misra Subhasis , Chen Yong , Bagaria Sanjay P.
Published: February 2020

Background Acral melanoma is the most common subtype of melanoma in Chinese patients and one of the least common in Caucasian patients. It has been unclear if outcomes differ between Chinese and Caucasian patients diagnosed with Acral Melanoma. This study investigated patient characteristics and survival differences between Chinese and Caucasian Acral Melanoma patients. Methods Two large institutional melanoma databases from Fudan University Shanghai Cancer Center (FUSCC) and Mayo Clinic enterprise, were retrospectively reviewed from 2009 to 2015. Clinicopathologic and survival data were collected and analyzed between the two groups. The primary outcome was disease-specific survival (DSS) and was calculated using the Kaplan Meier (KM) method. Results The Chinese group presented with more advanced disease compared with Caucasians: thicker Breslow depth (median 3.0 mm vs. 1.2 mm, p=0.003), more ulcerated disease (66.1% vs 29%; p<0.001), and advanced stages (stage II/III 84.3% vs. 37.1%; p<0.001). No significant difference was identified in terms of age at diagnosis, location, histologic subtypes, or node positive rate. The 5-year DSS rate was 68.4% and 73% (p=0.56) for Chinese and Caucasians, respectively. Male gender, Breslow thickness, ulceration, and positive sentinel lymph nodes predicted worse DSS on multivariate Cox regression analysis. Conclusions There appears to be no difference in stage-stratified survival between Chinese and Caucasians, supporting the implementation of clinical trials of AM that could include both Chinese and Caucasian patients.
The prognostic nutritional index as a predictor of long-term outcome in patients with resected esophageal squamous cell carcinoma
Authors: Maruyama Tsunehiko , Shimoda Mitsugi , Sako Akihiro , Hakoda Hiroyuki , Ueda Kazumitsu , Suzuki Shuji
Published: February 2020

Background Preoperative nutritional and inflammation indexes have been shown to be associated with postoperative complications and the prognosis of patients with a malignant tumor. We evaluated several clinicopathological prognostic factors in patients with resected esophageal squamous cell carcinoma (ESCC). Methods Seventy-eight patients who underwent curative resection for ESCC were included in this retrospective study. The associations of body mass index (BMI), the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and protein-albumin ratio (CAR) with various clinicopathological factors were evaluated. Results In multivariate analyses, only low PNI (<46.8) independently and significantly predicted overall survival (OS) (P=0.002). Conclusions The PNI is a simple, useful marker for predicting the long-term prognosis of patients with ESCC after esophagectomy. The PNI should be included in the routine assessment of patients with ESCC.
Development and validation of nomogram to predict risk of survival in patients with laryngeal squamous cell carcinoma
Authors: Cui Jie , Wang Liping , Zhong Waisheng , chen zhen , Tan Xiaojun , Yang Hong , Chen Jie , Liu Genglong
Published: February 2020

Background: Due to a wide variation of tumor behavior, prediction of survival in laryngeal squamous cell carcinoma (LSCC) patients received curative-intend surgery is an important but formidable challenge. We attempted to establish a nomogram to precisely predict survival probability in LSCC patients. Methods: A total of 369 consecutive LSCC patients underwent curative resection between 2008 and 2012 at Hunan Province Cancer Hospital were included in this study. Subsequently, 369 LSCC patients were assigned to a training set (N=261) and a validation set (N=108) at random. On the basis of multivariable Cox regression analysis results, we developed a nomogram. The predictive accuracy and discriminative ability of the nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was conducted to estimate clinical usefulness of our nomogram. Results: Six independent parameters to predict prognosis were age, pack years, N-stage, lymph node ratio (LNR), anemia and albumin, which were all assembled into the nomogram. The calibration curve verified excellent models’ concordance. The C-index of the nomogram was 0.73 (0.68-0.78), and the area under curve (AUC) of nomogram in predicting overall survival (OS) were 0.766, which were significantly higher than traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage.Conclusion: A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application.
Gint4.T modified DNA tetrahedron loaded with doxorubicin inhibits glioma cell proliferation by targeting PDGFRβ
Authors: Wang Feng , Zhou Yanghao , Cheng Si , Lou Jinhe , He Qiuguang , Cheng Yuan
Published: February 2020

Glioma is one of the most deadly tumors due to invasive growth. The treatment effect is poor due to the presence of the blood brain barrier (BBB) and blood tumor barrier (BTB) and insufficient drug targeting. DNA tetrahedron (TDN) is considered to have great potential for drug delivery and maybe a novel therapeutic strategy for glioma. In this study, we have developed a doxorubicin loaded-DNA tetrahedron modified by a Gint4.T aptamer(DOX@Apt-TDN) that could target PDGFRβ for therapy of glioma. The TDN and Apt-TDN were self-assembled by one-step synthesis. The characterization and stability were detected using gel electrophoresis analysis, dynamic light scatting and atomic force microscopy. The cytotoxicity of TDN in vitro was determined by CCK-8 assays. Fluorescence spectrophotometry was used to measure the drug loading capacity. Fluorescence microscopy imaging and flow cytometry were used to survey the cellular uptake. The cell viability, cell cycle and early apoptosis were estimated when the U87MG cells were treated with DOX, DOX@TDN and Dox@Apt-TDN. The rusults showed that a single Apt-TDN could carry 60 doxorubicin molecules. The 3D structure of the DNA tetrahedron remarkedly enhanced drug stability in fetal bovine serum, remaining intact for 7h leastwise. The CCK-8 assay showed that the activity of the U87 cells was not affected after co-cultured with different concentrations(10–500 nM) of TDN for 24 h and 48 h. The aptamer Gint4.T enhanced the targeted cellular uptake of TDN by U87MG cells. Dox-loaded Apt-TDN inhibited cell viability and induced early apoptosis. In conclusion this study establishes that the Gint4.T-modified DNA tetrahedron could target PDGFRβ and provide a novel therapy with promising clinical application for gliomas.
“We wouldn't leave if our jobs changed a little”: Understanding the labour market choices of community health workers in Ethiopia
Authors: Arora Nikita , Hanson Kara , Spicer Neil , Estifanos Abiy Seifu , Keraga Dorka Woldesenbet , Welearegay Alemtsehay Tewele , Tela Freweini Gebrearegay , Hussen Yemisrach Ahmed , Mandefro Yordanos Semu , Quaife Matthew
Published: February 2020

Background The motivation and retention of community health workers is a challenge and inadequately addressed in research and policy. In Ethiopia, as part of the country’s Health Extension Program, Health Extension Workers (HEWs) deliver essential primary healthcare services to communities, but low retention of experienced HEWs threatens sustained service delivery and efficient use of their health budget. We sought to identify factors influencing HEW retention and ways to mitigate their exit. Methods Following a review of literature on work motivation and community health worker (CHW) retention to identify a conceptual and theoretical framework to guide analysis, exploratory qualitative work was conducted using in-depth interviews with leavers of HEW positions (n=20), active HEWs (n=16), and key informants (n=11) in two regions in Ethiopia. Interviews were audio recorded, and simultaneously translated into English and transcribed for analysis. Data were analysed in NVivo 12 using an iterative inductive-deductive approach. Results The conceptual framework by Ormel et al, 2019, was adapted to analyse our results thematically. We identified a number of extrinsic and intrinsic motivational factors affecting the retention and labour market choices of HEWs. While financial incentives in the form of salaries, and material incentives in the form of improvements in health facility infrastructure and provision of childcare were reported to be important, non-material factors like HEWs’ self-image, acceptance and validation by the community were found to be critical. A reduction or loss of these non-material factors proved to be the catalysts for many HEWs to leave their jobs. We also found a strong professional self-identity among HEWs, which influenced their willingness to remain in their jobs. Conclusion This is the first study to include job leavers in an analysis of factors affecting motivation of CHWs, aimed to improve retention. In addition to material incentives, our findings suggest that these workers are also socially motivated and identify strongly with their profession. Policy interventions, which also appeal to their social needs, could represent a simpler and more cost-effective means of improving retention of this workforce, especially in resource-constrained settings. Keywords Community health workers, labour market choices, motivation, Ethiopia, pro-social preferences, retention
A rare epidermoid cyst occurring in an young female: a case report and literature review
Authors: Dumitriu Roxana , Dușceac Roxana , Dumitrașcu Anda , Poiană Cătălina
Published: February 2020

Background Epidermoid cysts are very rare benign lesions of epithelial origin, slow growing extra-axial tumours and they accord for 1% of all intracranial tumours. They frequently occur at the cerebellopontine angle and parasellar regions insinuating brain structures. They are often associated with a high rate of residual tumor and recurrence. Clinical Case We present the case of a 18 year old patient who was admitted in the our clinic for secondary amenorrhea. The CT scan showed a large median mass with a mixed structure (calcareous and cystic) resembling a craniopharyngioma. Preoperatively the hormonal profile showed deficiency of all anterior pituitary hormones. Transsphenoidal surgery was performed and the histopathological exam established the diagnosis of sellar epidermoid cyst with parasellar extension. Postoperatively the patient developed iatrogenic Cushing syndrome (due to large amounts of dexamethasone given) and diabetes insipidus. Conclusion Epidermoid cysts are challenging tumours because of the extension along the subarachnoid spaces around delicate neurovascular structures therefore they are difficult to be completely resected. The particularity of this case stands in the rare occurrence of this types of tumours and the fact that although in these patients with hypopituitarism diabetes insipidus is present primarily our patient developed postoperatively.
Healthcare Providers’ Perspectives on Family Presence During Resuscitation in the Emergency Departments of the Kingdom of Bahrain
Authors: Abuzeyad Feras , Elhobi Ahmed , Kamkoum Wael , Bashmi Luma , Qasim Ghada Al , Alqasem Leena , Mansoor Naser Mohamed Ali , Hsu Stephanie , Das Priya
Published: February 2020

Background Worldwide, policies exist on family presence during resuscitation (FPDR), however, this is still lacking in the Gulf Corporation Countries (GCC) in general and in the Kingdom of Bahrain in particular. The aim of this study is to assess the perspectives of healthcare providers (HP) on FPDR among those working in the emergency departments (EDs) in the Kingdom. MethodsA self-administered anonymous electronic survey was collected from 146 HPs (emergency physicians and nurses) working in the three major EDs in the Kingdom of Bahrain. Besides demographic data, 18 items measuring HPs’ perceptions of FPDR were generated using the 5-point Likert scale. Results Surveys (n= 146) from physicians and nurses were analysed (45.9% vs. 54.1%, respectively). There were significant differences between physicians and nurses in terms of personal beliefs, FPDR enhancing professional satisfaction and behaviour, and the importance of a support person and saying goodbye ( p < 0.001). However, general responses demonstrated that the majority of HPs encouraged and supported FPDR, but with greater support from physicians than nurses. Conclusion The study reflects that many HPs in EDs participated in and are familiar with FPDR, with the majority of ED physicians supporting it. Further studies should investigate the reasons for the lack of support from nurses. Results may contribute to the development of hospital ED policies that allow FPDR in the region.
Expression of membrane progesterone receptors in eutopic and ectopic endometrium of women with endometriosis
Authors: VAZQUEZ-MARTINEZ EDGAR RICARDO , Bello-Álvarez Claudia , Hermenegildo-Molina Ana Lorena , Solís-Paredes Mario , Parra-Hernández Sandra , Cruz-Orozco Oliver , Silvestri-Tomassoni J. Roberto , Escobar-Ponce Luis F. , Hernández-López Luis A. , Reyes-Mayoral Christian , Olguín-Ortega Andrea , Sánchez-Ramírez Brenda , Osorio-Caballero Mauricio , García-Gómez Elizabeth , Estrada-Gutierrez Guadalupe , Cerbon Marco , Camacho-Arroyo Ignacio
Published: February 2020

Background: Endometriosis is one of the most frequent gynecological diseases in reproductive age women, but its etiology is not completely understood. Endometriosis is characterized by progesterone resistance, which has been explained in part by a decrease in the expression of the intracellular progesterone receptor in the ectopic endometrium. Progesterone action is also mediated by non-genomic mechanisms via membrane progesterone receptors that belong to the class II members of the progesterone and adipoQ receptor (PAQR) family. The aim of the present study was to evaluate the expression at mRNA and protein levels of PAQR family members in the eutopic and ectopic endometrium of women with endometriosis. Methods: Total RNA and total protein were isolated from control endometrium (17 samples), eutopic endometrium (17 samples), and ectopic endometrium (9 samples). The expression of PAQR7 ( mPRα ) , PAQR8 , (mPRβ) PAQR5 ( mPRγ ) , and PAQR6 ( mPRδ ) at mRNA and protein levels was evaluated by RT-qPCR and western blot. Statistical analysis between comparable groups was performed using one-way ANOVA followed by Tukey's multiple comparisons test with a confidence interval of 95%. Results: The analysis of gene expression showed that PAQR7 and PAQR5 expression was lower in both eutopic and ectopic endometrium as compared to the endometrium of women without endometriosis, whereas the expression of PAQR8 and PAQR6 was only reduced in eutopic endometrium. Furthermore, mPRα and mPRβ protein content was decreased in the ectopic endometrium of women with endometriosis. Conclusions: Our results demonstrate a decrease in the expression and protein content of mPRs in eutopic and ectopic endometrium of patients with endometriosis, which could contribute to the progesterone resistance observed in patients with this disease.
Genome-wide identification and characterization of melon bHLH transcription factors in regulation of fruit development
Authors: Bai Selinge , Tan Chao , Tian Yunyun , Ma Ming , Hasi Agula
Published: February 2020

Background: The basic helix-loop-helix (bHLH) transcription factor family is one of the largest transcription factor families in plants, and plays crucial roles in plant development. Melon is one of an important horticulture plants, and is an attractive model plant for studying fruit ripening. However, the bHLH gene family of melon has not been identified yet, and functions in fruit growth and ripening are seldom researched. Results: In this study, 118 bHLH genes were identified in the genome of melon. Phylogenetic analysis illustrated that these CmbHLHs could be classified into 16 subfamilies. Intron distribution pattern analysis of bHLH domain found 13 intron distribution patterns in CmbHLHs. CmbHLH genes were unevenly distributed on chromosomes 1 to 12 of the melon genome, and five CmbHLH s were tandem repeat on chromosomes 4 and 8. Expression characters of CmbHLH genes were studied using the transcriptome data. Tissue analysis of indicated CmbHLH32 high expressed in female flowers and early fruit growth stage. Transgenic plant lines of overexpression of CmbHLH32 were constructed, and overexpression of CmbHLH32 result in early fruit ripening compared to the wild type fruit. Conclusions: The bHLH transcription factor family was identified and analyzed for the first time in the melon, overexpression of CmbHLH32 will affect the ripening time of melon fruit, these findings laid a theoretical foundation for further study on the role of bHLH family members in the growth and development of melon .
Corporate Governance and Economic Performance: The Limit of Short Termism
Authors: Tommaso F. D. , Gulinelli A.
Published: February 2020

This article includes exploring arguments and counterarguments in the context of conducting a scientific discussion on the impact of corporate governance on a company’s financial and economic performance. The main purpose of this paper is to determine the nature of the impact of corporate governance policy on the activities of economic entities. The systematization of literary sources and approaches to problem solving has shown that there are two opposing points of view: firm value, efficiency), on the other hand, a number of scientists are convinced that there is a positive influence of the functioning of the corporate governance system on the valuation of listed companies. The work emphasizes the decisive role of the board of directors of the company in the development and adoption of the strategic direction of development of the organization. The author points out in the study the need for coordinated interaction of the board of directors with the financial management of the company and the business owners in order to increase the efficiency and profitability of the business entity. It is stated that the key economic tools for achieving and implementing the strategic plans of the company can be the key performance indicators and accordingly developed measures to achieve such success. As a result, it is justified that corporate governance should not be a set of rules and mechanisms aimed at managing and controlling companies, but rather as a process by which companies become sensitive to stakeholder rights. The spread of corporate culture, according to the author of a work aimed at protecting the common interest, is facilitated by the existence of good rules and effective authorities that control their observance.
Keywords: corporate governance, financial and economic activity, board of directors, key performance indicators.
The impact of the supervisory board on bond ratings of non-financial companies
Authors: Abidin Sahabuddin Zainal , Hadianto Bram
Published: February 2020

Issuing bonds is one of the alternative ways for non-financial companies to get money from the public besides borrowing money from banks. Compared with getting money banks, obtaining money from the bond market is slightly economical because the companies are not essential to borne the intermediation cost anymore. As a consequence, the companies in the bond market will get the assessment from the appointed agency. Furthermore, the rating of bonds will determine their reputation. Mentioning the literature review, the bond ratings are affected by the features of the supervisory board: size, independence, and audit committee. Therefore, this research intends to attain two goals. Firstly, it aims to prove and analyze the impact of the supervisory board size and independence, as well as the audit committee size on the company’s possibility to get a high bond rating with profitability as the control variable. Secondly, it intends to know the accuracy rate of grouping the company bond ratings through the classification matrix.The population originates from the non-financial companies. The total samples are determined by the Slovin formula with a boundary of the fault of 10%. Based on this formula, the total samples are 36 companies. Furthermore, they are randomly grabbed from the population. The ordered probit regression model and the classification matrix are utilized to analyze the data. Based on the data analysis, this research finds out that the supervisory board size and independence, the audit committee size, and profitability positively affect the bond ratings. It means that the number of the commissioner board and the members of the audit committee have to be added until achieving the maximum level to monitor the performance of the directors so that the company can reach a high bond rating. To sum up, board governance is effective in improving the company’s bond rating.
Penerapan Metode Gallery Walk Terhadap Berpikir Kreatif dan Komunikasi Matematis Siswa
Authors: Septiyati Nanda
Published: February 2020

The purpose of this study was to determine differences in students 'creative thinking abilities and mathematical communication with the application of the Gallery Walk method and conventional learning, as well as improve students' creative thinking and mathematical communication skills in groups using the Gallery Walk method. The population in this study were eighth grade students of SMP Negeri 2 Dawe. The sample taken was class VIII G as the experimental class and class VIII D as the control class. The results showed that: (1) the average ability of creative thinking and mathematical communication of students in groups using the Gallery Walk method was higher than the average value using conventional learning models; (2) there is an increase in the ability to think creatively and mathematical communication skills in groups using the Gallery Walk method.
                                                                                                                               

Keywords: first keyword, second keyword, third keyword, etc.

 
Pengaruh Partikel Nano Zn dan ZnO terhadap Aliran MHD Fluida Nano Pada Lapisan Batas Bola Bermagnet
Authors: Norasia Yolanda , Zulaikha Zulaikha
Published: February 2020

Fluida terdiri atas fluida Newtonian dan fluida non-Newtonian. Fluida newtonian adalah fluida yang tidak mengalami perubahan viskositas ketika terdapat gaya yang bekerja terhadap fluida tersebut. Fluida non-Newtonian bersifat sebaliknya dari fluida newtonian. Beberapa contoh fluida newtonian adalah air, minyak, dan etanol. Fluida nano adalah salah satu fluida newtonian yang terdiri atas fluida dasar air dan partikel nano. Partikel nano terdiri atas logam dan oksida logam. Partikel nano berupa logam adalah Zinc yang memiliki simbol Zn. Partikel nano berupa non logam adalah Zinc Oxide yang memiliki simbol ZnO. Pada penelitian ini dibahas mengenai magnetohidrodinamik (MHD) dari aliran fluida nano  dan  yang mengalir melewati bola bermagnet dengan pengaruh konveksi campuran.Pemodelan aliran fluida diperoleh dari persamaan pembangun dimensional yang meliputi persamaan kontinuitas, persamaan momentum, dan persamaan energi. Persamaan pembangun dimensional yang terbentuk ditransformasikan kedalam persamaan non-dimensional.Persamaan non-dimensional kemudian diubah menjadi persamaan similaritas dan diselesaikan menggunakan metode implicit Euler. Hasi lsimulasi menunjukkan bahwa ketika parameter magnetik ditingkatkan, maka kecepatan dan temperature aliran fluida nano Zn-Air dan ZnO-Air mengalami penurunan.Ketika fluida nano Zn-Air dan ZnO-Air dibandingkan, kecepatan aliran fluida nano Zn-Air lebih cepat mengalami peningkatan dibandingkan dengan fluida nano ZnO-Air. Sedangkan untuk profil temperatur, fluida nano ZnO-Air lebih cepat mengalami penurunan temperature dibandingkan dengan fluida nano Zn-Air.
Stepwise Development of Biomimetic Chimeric Peptides for Gene Delivery
Authors: Cheraghi Roya , Nazari Mahboobeh , Alipour Mohsen , Hosseinkhani Saman
Published: February 2020

Gene-based therapy largely relies on the vector type that allows a selective and efficient
transfection into the target cells with maximum efficacy and minimal toxicity. Although, genes
delivered utilizing modified viruses transfect efficiently and precisely, these vectors can cause
severe immunological responses and are potentially carcinogenic. A promising method of
overcoming this limitation is the use of non-viral vectors, including cationic lipids, polymers,
dendrimers, and peptides, which offer potential routes for compacting DNA for targeted delivery.
Although non-viral vectors exhibit reduced transfection efficiency compared to their viral
counterpart, their superior biocompatibility, non-immunogenicity and potential for large-scale
production make them increasingly attractive for modern therapy. There has been a great deal of
interest in the development of biomimetic chimeric peptides. Biomimetic chimeric peptides contain
different motifs for gene translocation into the nucleus of the desired cells. They have motifs for
gene targeting into the desired cell, condense DNA into nanosize particles, translocate the gene into
the nucleus and enhance the release of the particle into the cytoplasm. These carriers were
developed in recent years. This review highlights the stepwise development of the biomimetic
chimeric peptides currently being used in gene delivery.
Extraction of Essential Oils from Medicinal Plants and their Utilization as Food Antioxidants
Authors: Ferrentino Giovanna , Morozova Ksenia , Horn Christine , Scampicchio Matteo
Published: February 2020

Background:

The use of essential oils is receiving increasing attention worldwide, as these oils are
good sources of several bioactive compounds. Nowadays essential oils are preferred over synthetic preservatives
thanks to their antioxidant and antimicrobial properties. Several studies highlight the beneficial effect of essential
oils extracted from medicinal plants to cure human diseases such as hypertension, diabetes, or obesity. However,
to preserve their bioactivity, the use of appropriate extraction technologies is required.

Method:

The present review aims to describe the studies published so far on the essential oils focusing on their
sources and chemical composition, the technologies used for their recovery and their application as antioxidants
in food products.

Results:

The review has been structured in three parts. In the first part, the main compounds present in essential
oils extracted from medicinal plants have been listed and described. In the second part, the most important technologies
used for extraction and distillation, have been presented. In detail, conventional methods have been
described and compared with innovative and green technologies. Finally, in the last part, the studies related to the
application of essential oils as antioxidants in food products have been reviewed and the main findings discussed
in detail.

Conclusions:

In summary, an overview of the aforementioned subjects is presented by discussing the results of the
most recent published studies.
Lipid-Based Nanosystem As Intelligent Carriers for Versatile Drug Delivery Applications
Authors: Harshita  , Barkat Md. Abul , Das Sabya S. , Pottoo Faheem H. , Beg Sarwar , Rahman Ziyaur
Published: February 2020

:

The contemporary drug discovery research shows that most of the drug candidates are highly potent, but showing poor aqueous solubility leads a variety of challenges for formulation scientists to develop a suitable formulation to improve the systemic bioavailability of such drugs. Lipid-based nanocarriers act as a major and most projecting approach overcoming the limitations which affect several physiochemical properties of drug such as the solubility, partition coefficient and bioavailability or absorption. This also fulfills a variety of product requirements and helps to overcome several limitations as decided by symptoms of the disease, various routes of administration of drug, price concern, increasing strength of product, noxious or harmful effect of drug, and dose efficacy. The lipidic nanosystem formulates aqueous drug in lipid base and is also a commercially feasible approach for the formulation of different dosage forms meant for topical or transdermal, oral, ocular, pulmonary, and parenteral delivery. This review provides a brief on lipid-based drug delivery nanocarrier and the mechanisms by which lipids and lipidic excipients improve the oral absorption of drugs with poor aqueous solubility and also provide a viewpoint on the promising applications of lipidic nanoparticulate systems.
Redefining Cardiovascular (CV) Death as a Primary Endpoint Component in Cardiovascular Outcome Trials
Authors: Ghosal Samit , Sinha Binayak
Published: February 2020

Sodium-Glucose cotransporter-2 inhibitors (SGLT-2i) and Glucagon-like peptide 1 receptor
agonists (GLP1-RA) have revolutionised the approach for modern management of type 2 diabetes in
view of their outcome altering abilities. An objective component of the primary endpoints used in the
Cardiovascular Outcome Trials (CVOT) is cardiovascular (CV) death. However, the reason behind the
decrease in CV deaths (compared to the placebo arm) appear to arise from divergent underlying processes.
A recent meta-analysis of SGLT-2i and GLP1-RA indicated that the reduction in CV death associated
with the former is predominantly due to its impact on heart failure (HF), while the association
with the latter is due to its effect on atherosclerotic cardiovascular disease (ASCVD). A Pearson’s product-
moment correlation coefficient (r) analysis was performed on SGLT-2i exposed to CVOTs,
exploring the strength of the association between CV death and hospitalisation for HF (hHF) and myocardial
infarction (MI). The strength of association was strongest with hHF and negative with MI. In
view of these findings, it has been proposed that future CVOTs should use a more objective definition
of CVD, defining well in advance the anticipated impact on CVD (either as a consequence of the reduction
in HF or ASCVD).
Use of Social Media at Cardiovascular Congresses: Opportunities for Education and Dissemination
Authors: Mihailidou Anastashia S. , McCall Debbe , Hiremath Swapnil , Costello Briana , Tunuguntla Anuradha , Mihailidis Harris
Published: February 2020

:

Social Media includes different forms of online communication from Twitter, Facebook,
Instagram, LinkedIn, podcasts, YouTube etc. and has advanced how information is exchanged. A
notable use is engaging on Twitter at medical conferences, both for those attending the conference
and the global audience who are not able to attend. It is also increasingly used as an educational
tool similar to e-learning. The objective of this paper is to: 1) highlight the impact of using Twitter
at cardiovascular congresses as an interactive platform for active learning as compared to passively
listening to a presentation; 2) present perspectives from not only clinicians, researchers but also patients
on how this information is interpreted; 3) provide recommendations for conference organizers
for best practice live tweeting to share the information and knowledge beyond those in attendance;
with potential for not only engagement but also educating our global community.
Risk Factors and Management of Kidney Diseases in Saudi Women with Diabetes
Authors: Siddiqui Khalid , Joy Salini Scaria
Published: February 2020

Background:

The prevalence of diabetic kidney diseases (DKD) in the Saudi population is increasing and its prevalence has been reported as 37.4%. Recently, a higher prevalence of albuminuria in women has been proven through population-based studies.

Objectives:

Recently, the Kingdom of Saudi Arabia (KSA) has witnessed many changes in women’s activities, and women are more actively participating in the social and cultural development of the country. Thus, focusing on women’s health-related issues has become crucial. The necessity of research focusing on the influence of various risk factors on DKD has emerged as a priority.

Methods:

The literature search was done by search engines and databases (PubMed, Google scholar and EMBASE). From a total of 21 selected articles, 18 articles are included in this study.

Results:

This review emphasizes on the higher influence of certain DKD risk factors on Saudi women including a high prevalence of glucose intolerance during pregnancy, obesity due to lack of physical activity, and genetic predisposition due to consanguineous marriages, etc.

Conclusion:

This study can raise awareness regarding the prevention and management of DKD in Saudi diabetic women.
Evaluation of Radiolucent Lesions Associated with Impacted Teeth: A Retrospective Study
Authors: Karabas Hulya Cakir , Ozcan Ilknur , Tekkesin Merva Soluk , Tasyapan Sedef Ayse , Guray Beliz , Atapek Murat Mert
Published: February 2020

Background:

Impacted teeth are commonly asymptomatic and not associated with any
pathologic lesions for years. Any change in the size of the follicle associated with impacted teeth
may result in odontogenic cysts or tumors. CBCT plays an important role in determining the radiographic
features of a lesion and therefore, is very helpful for accurate diagnosis and treatment
planning.

Objective:

This study aims to evaluate radiolucent lesions associated with impacted teeth in terms
of age and sex distribution, localization, and comparison with the pathological diagnosis.

Methods:

In this retrospective study, out of 6758 CBCT images, 400 images revealing radiolucent
lesions were detected. The study included only 190 cases (regarding 180 patients) which had a
matching histopathological evaluation. Data related to the age and sex of the patients, localization
of the lesions, and their comparison with the pathological diagnosis were recorded and analyzed.

Results:

The most encountered lesions were dentigerous cysts (60%) and odontogenic keratocysts
(26.3%). Males were the most affected (63.3%). Most of the lesions were found in the left and
right posterior mandible and mostly (66.8 %) associated with third molars. Out of 123 radiological
diagnoses of dentigerous cyst cases, histopathological diagnoses confirmed 108 cases. Regarding
odontogenic keratocyst, histopathological diagnosis confirmed 40 cases out of 48.

Conclusion:

Radiological diagnoses of the lesions mostly match with their pathological diagnosis
unless their characteristics are changed due to infection. CBCT, as a technique enabling detailed
imaging of the involved dental structures, is a helpful instrument for differential diagnosis.
A Comprehensive Review of the Aizoaceae Family: Phytochemical and Biological Studies
Authors: Bakr Riham Omar
Published: February 2020

The Aizoaceae “ice plant” family, is one of the neglected plant family despite its promising
phytoconstituents. It includes approximately 135 genera and 2499 succulent species distributed
throughout the tropics and subtropics worldwide. Many of the species in this family have a long history
in traditional medicine, and many phytochemical and biological studies have attempted to confirm
the folk uses of these plants. This review gathers all the available information concerning this
family offering an in-depth search for all published papers, websites, and proceedings for the identified
compounds besides their biological activities. More than one hundred eighty compounds belonging
to different classes have been identified and found responsible for a wide range of therapeutic
activity including, antioxidant, anti-inflammatory, anti-hepatotoxic, anticancer and antimicrobial
activities revealing Aizoaceae species as very promising candidates for all phytochemical and biological
studies.
Experimental Investigation of the Bullet-proof Properties of Different Kevlar, Comparing .22 Inch with 9 mm Projectiles
Authors: Stopforth Riaan , Adali Sarp
Published: February 2020

Background:

Results of an experimental study are given involving high-impact
ballistic tests using .22 inch diameter ammunition (commonly known only as .22 ammunition)
with the target set up as a combination of different numbers and weights of Kevlar layers.
These experimental tests are conducted as literature indicating that the .22 projectiles are
not as effective as with larger calibre ammunition. Present work is part of a research study to
assess the safety limits of Kevlar layers of different weights against various calibre projectiles.

Objective:

The objective is to obtain test data to determine the number of Kevlar layers and
weights needed for the design of safe bullet proof vests capable of stopping various size
ammunition. In the present study, results are given for .22 inch ammunition, which provide
data on the characteristics of high-speed ballistic penetration of .22 bullets into Kevlar layers
and stopping distances in gel/Kevlar combinations.

Methods:

Tests were performed with Kevlar fabrics of different weights of Gram per Square
Meter (GSM) to provide a comparison among different Kevlar fabrics as well as with different
number of Kevlar layers. The tests were conducted with the use of a chronograph in a
controlled test environment. The penetration depth in ballistic gelatine was recorded.

Results:

The results identify the number of layers of Kevlar required to stop a .22 projectile
and the relationship between the different layers and weights of Kevlar materials. The results
of the .22 projectile penetration are compared with those of different 9 mm Parabellum
projectiles to assess the effect of different size ammunition on the bullet-proof capabilities of
Kevlar. Experimental data on the penetration depths of different types of bullets into the
gel/Kevlar combinations are presented using various graphs.

Conclusion:

The .22 projectiles perform similar penetration depths compared to that of
9 mm projectiles, and therefore cannot be considered as ineffective ammunition as literature
has indicated.
A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women’s Cancer: Pre-Post Pilot Study (Preprint)
Authors: Chow Philip I , Drago Fabrizio , Kennedy Erin M , Cohn Wendy F
Published: February 2020

BACKGROUND

Psychological distress is a major issue among survivors of women’s cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app–based interventions are scalable and have the potential to increase access to mental health care among survivors of women’s cancer worldwide.

OBJECTIVE

This study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women’s cancer.

METHODS

In a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women’s cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention.

RESULTS

There were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention.

CONCLUSIONS

This pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women’s cancer.
Bringing Code to Data: Do Not Forget Governance (Preprint)
Authors: Suver Christine , Thorogood Adrian , Doerr Megan , Wilbanks John , Knoppers Bartha
Published: February 2020

UNSTRUCTURED

Developing or independently evaluating algorithms in biomedical research is difficult because of restrictions on access to clinical data. Access is restricted because of privacy concerns, the proprietary treatment of data by institutions (fueled in part by the cost of data hosting, curation, and distribution), concerns over misuse, and the complexities of applicable regulatory frameworks. The use of cloud technology and services can address many of the barriers to data sharing. For example, researchers can access data in high performance, secure, and auditable cloud computing environments without the need for copying or downloading. An alternative path to accessing data sets requiring additional protection is the model-to-data approach. In model-to-data, researchers submit algorithms to run on secure data sets that remain hidden. Model-to-data is designed to enhance security and local control while enabling communities of researchers to generate new knowledge from sequestered data. Model-to-data has not yet been widely implemented, but pilots have demonstrated its utility when technical or legal constraints preclude other methods of sharing. We argue that model-to-data can make a valuable addition to our data sharing arsenal, with 2 caveats. First, model-to-data should only be adopted where necessary to supplement rather than replace existing data-sharing approaches given that it requires significant resource commitments from data stewards and limits scientific freedom, reproducibility, and scalability. Second, although model-to-data reduces concerns over data privacy and loss of local control when sharing clinical data, it is not an ethical panacea. Data stewards will remain hesitant to adopt model-to-data approaches without guidance on how to do so responsibly. To address this gap, we explored how commitments to open science, reproducibility, security, respect for data subjects, and research ethics oversight must be re-evaluated in a model-to-data context.
Cognitive Training Using Fully Immersive, Enriched Environment Virtual Reality for Patients With Mild Cognitive Impairment and Mild Dementia: Feasibility and Usability Study (Preprint)
Authors: Yun Seo Jung , Kang Min-Gu , Yang Dongseok , Choi Younggeun , Kim Heejae , Oh Byung-Mo , Seo Han Gil
Published: February 2020

BACKGROUND

Cognitive training using virtual reality (VR) may result in motivational and playful training for patients with mild cognitive impairment and mild dementia. Fully immersive VR sets patients free from external interference and thus encourages patients with cognitive impairment to maintain selective attention. The enriched environment, which refers to a rich and stimulating environment, has a positive effect on cognitive function and mood.

OBJECTIVE

The aim of this study was to investigate the feasibility and usability of cognitive training using fully immersive VR programs in enriched environments with physiatrists, occupational therapists (OTs), and patients with mild cognitive impairment and mild dementia.

METHODS

The VR interface system consisted of a commercialized head-mounted display and a custom-made hand motion tracking module. We developed the virtual harvest and cook programs in enriched environments representing rural scenery. Physiatrists, OTs, and patients with mild cognitive impairment and mild dementia received 30 minutes of VR training to evaluate the feasibility and usability of the test for cognitive training. At the end of the test, the usability and feasibility were assessed by a self-report questionnaire based on a 7-point Likert-type scale. Response time and finger tapping were measured in patients before and after the test.

RESULTS

Participants included 10 physiatrists, 6 OTs, and 11 patients with mild cognitive impairment and mild dementia. The mean scores for overall satisfaction with the program were 5.75 (SD 1.00) for rehabilitation specialists and 5.64 (SD 1.43) for patients. The response time of the dominant hand in patients decreased after the single session of cognitive training using VR, but this was not statistically significant (P=.25). There was no significant change in finger tapping in either the right or left hand (P=.48 and P=.42, respectively). None of the participants reported headaches, dizziness, or any other motion sickness after the test.

CONCLUSIONS

A fully immersive VR cognitive training program may be feasible and usable in patients with mild cognitive impairment and mild dementia based on the positive satisfaction and willingness to use the program reported by physiatrists, OTs, and patients. Although not statistically significant, decreased response time without a change in finger tapping rate may reflect a temporary increase in attention after the test. Additional clinical trials are needed to investigate the effect on cognitive function, mood, and physical outcomes.
Wechat App Combined Case-Based Learning in Clinical Training of Oral Medicine: Comparison and Feasibility Study (Preprint)
Authors: He Hong , Xia Xinyu , Deng Xiaotong , Zhou Mimi , Liu Chao , Fan Lijie , Zeng Li
Published: February 2020

BACKGROUND

Case Based Learning (CBL) is being hottly used in student-centered medical education worldwide. In China, Wechat is the most popular communication app in China and is widely used in all walks of life. We have practiced several years combining Wechat and CBL in the clinical training of oral medicine, promoting outcomes in traditional bedside training.

OBJECTIVE

This study aimed to demonstrate the acceptability and merits of Wechat CBL in the clinical training of oral medicine.

METHODS

A total of eighty students and two tutors participated in this study within a 2-month training during Jan. 2018 and Jan. 2020. The control group used bedside mode and the experimental group used bedside plus Wechat CBL mode. The evaluations included participation passion and routine and finial test. The students of clerkship as 10 and residents as 30 in same number respectively between experiment and control groups.

RESULTS

The participants in the experimental group had a higher degree of participation in the discussion. And the daily assessment and final examination scores of the participants in the experimental group were significantly better than those in the control group (P<0.001).

CONCLUSIONS

Wechat CBL mode has a positive effect on students’ learning enthusiasm and knowledge assessments & technology evaluations in clinical training of oral medicine.