bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of serum fibroblast growth factor 19 levels with arteriosclerosis parameters assessed by arterial stiffness and atherogenic index of plasma in patients with type 2 diabetes
Authors: Liu Wang-shu , Tang Meng-jie , Xu Tian-li , Su Jian-bin , Wang Xue-qin , Xu Feng , Zhang Dong-mei , Zhu Qing , Cao Jie , Wang Hong
Published: May 2020

Background

The role of serum fibroblast growth factor 19 (FGF19) in arteriosclerosis is not well known. In the present study, we aimed to explore whether serum FGF19 levels were related to arteriosclerosis parameters, including arterial stiffness and atherogenic index of plasma (AIP), in patients with type 2 diabetes (T2D).

Methods

A total of 200 patients with type 2 diabetes and 50 healthy controls were recruited for this study from Apr 2017 to Oct 2018. Serum FGF19 levels, arterial stiffness assessed by brachial ankle pulse wave velocity (baPWV), and AIP assessed by the triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio were measured in those subjects. In addition, other relevant clinical data were also collected.

Results

Serum FGF19 levels in T2D patients were significantly lower than those in healthy controls (p < 0.05). The arteriosclerosis parameters, including baPWV and AIP, significantly decreased across ascending tertiles of serum FGF19 levels (all p for trend < 0.001). Moreover, the baPWV and AIP were all inversely correlated with serum FGF19 levels (r = − 0.351 and − 0.303, respectively, p < 0.001). Furthermore, after adjusting for other clinical covariates by multiple linear regression analyses, the serum FGF19 levels were independently associated with baPWV (β = − 0.20, t = − 2.23, p = 0.029) and AIP (β = − 0.28, t = − 2.66, p = 0.010).

Conclusions

The serum FGF19 levels were independently and inversely associated with baPWV and AIP, which indicate that serum FGF19 may have a protective role in atherosclerosis in patients with T2D.
Correction to: IGF-1C domain–modified hydrogel enhanced the efficacy of stem cells in the treatment of AMI
Authors: Yao Yong , Yang Liang , Feng Li-feng , Yue Zhi-wei , Zhao Nian-huan , Li Zongjin , He Zuo-xiang
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.
Effect of glutathione-stabilized silver nanoparticles on expression of las I and las R of the genes in Pseudomonas aeruginosa strains
Authors: Pourmbarak Mahnaie Mina , Mahmoudi Hassan
Published: May 2020

Background

Biofilm formation is regarded as a significant factor in the establishment of infections caused by Pseudomonas aeruginosa. P. aeruginosa is one of the most important causes of nosocomial infections. Today silver nanoparticles (Ag-NPs) are used as antimicrobials due to their well-known, chemical, biological, and physical properties. Exposure to nanoparticles could inhibit colonization of new bacteria onto the biofilm.

Methods

In the present work, the green synthesis of Ag-NPs was performed using the alcoholic extract of Eucalyptus camaldulensis. Ag-NPs and glutathione-stabilized silver nanoparticles (GSH–Ag-NPs) were characterized using X-ray diffraction (XRD), dynamic light scattering (DLS), scanning electron microscope (SEM), and carbon, nitrogen, and hydrogen (CNH) and Fourier transform infrared spectroscopy (FTIR) techniques were applied to investigate the structure of the modified nanoparticles. Then, the antimicrobial and antibiofilm potential of the prepared Ag-NPs and GSH–Ag-NPs against P. aeruginosa strains was evaluated using microbroth dilution method and their effects on the expression of las I and las R genes.

Results

In this study, a total of 50 P. aeruginosa isolates were recovered from clinical samples. According to the results, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) value of Ag-NPs against P. aeruginosa was determined to be 512–256 μg/ml, respectively, while the MIC and MBC value of GS–Ag-NPs against P. aeruginosa clinical strains was determined in a range of 128–256 μg/ml and 256–512 μg/ml, respectively. The mean expression level in las R, las I genes in P. aeruginosa strains treated with ½ MIC of Ag-NPs was decreased by −5.7 and −8fold, respectively. The mean expression levels of las R, las I genes in P. aeruginosa strains treated with ½ MIC of GS–Ag-NPs were decreased by −8.7 and −10fold, respectively (P < 0.05).

Conclusions

The results of our study showed that Ag-NPs and GS–Ag-NPs are highly effective against P. aeruginosa strains. Moreover, this study also proves the promising potential of using nanoparticles as anti-biofilm formation and antibacterial agents.
Are high school girls’ lacrosse players at increased risk of concussion because they are not allowed to wear the same helmet boys’ lacrosse players are required to wear?
Authors: Comstock R. Dawn , Arakkal Alan T. , Pierpoint Lauren A. , Fields Sarah K.
Published: May 2020

Background

Boys’ lacrosse (LAX), a full contact sport allowing body and stick checking, mandates hard shell helmets with full face masks. Girls’ LAX, which prohibits body checking and whose sphere rule is supposed to prevent stick checking to the head, allows optional flexible headgear with/without integrated eye protection. Whether the required boys’ LAX helmets should also be mandated in girls’ LAX has been debated.

Methods

In this retrospective cohort study we used LAX concussion data from a national high school sports-related injury surveillance study to determine if girls’ LAX players were at increased risk of concussion from stick or ball contact due to differences in helmet regulations by calculating the attributable risk and attributable risk percent (AR%) for concussion resulting from ball or stick impacts.

Results

From 2008-09 through 2018–19, boys’ LAX players sustained 614 concussions during 1,318,278 athletic exposures (AEs) (4.66 per 10,000 AEs) and girls’ LAX players sustained 384 concussions during 983,291 AEs (3.91 per 10,000 AEs). For boys, athlete-athlete contact was the most common mechanism of concussion accounting for 66.4% of all concussions, while stick or ball contact accounted for 23.5%. For girls, stick or ball contact accounted for 72.7% of all concussions, while athlete-athlete contact accounted for 19.8%. Concussion rates from stick or ball contact were significantly higher in girls vs. boys (RR = 2.60, 95% CI 2.12–3.18). The attributable risk associated with playing girls’ vs. boys’ LAX for concussion resulting from stick or ball contact was 1.75 concussions per 10,000 AEs (95% CI 1.37–2.12) and the AR% was 61.5% (95% CI 52.9–68.5). An estimated 44.7% of all girls’ LAX concussions could have been prevented if girls’ LAX players wore the helmet mandated in boys’ LAX.

Conclusions

Girls’ LAX players who are allowed, but not required, to wear a flexible headgear are at increased risk of concussions from stick or ball impacts compared to boys’ LAX players, who are required to wear a hard shell helmet with full face mask. Additional research is needed to determine if there are any defendable arguments to continue justifying restricting girls’ LAX players access to this effective piece of protective equipment.
Sunlight exposed body surface area is associated with serum 25-hydroxyvitamin D (25(OH)D) level in pregnant Minangkabau women, Indonesia
Authors: Ilmiawati Cimi , Oviana Athica , Friadi Andi , Reza Mohamad
Published: May 2020

Background

Vitamin D deficiency is highly prevalent in women, and living in a tropical country with a year-round abundance of sunlight as the primary source of vitamin D does not seem to guarantee adequate serum 25(OH)D. While living in the tropics, Minangkabau women are known to dress specifically according to their culture. This study was aimed to elucidate the association of sunlight exposed body surface area with serum 25(OH)D in pregnant Minangkabau women of Indonesia.

Methods

We performed a cross-sectional study on 88 Minangkabau women in late pregnancy. Lifestyle data were collected using a questionnaire, and dietary intake of vitamin D was calculated from 24-h food recall. The skin pigmentation type was determined by the Fitzpatrick scale, and the body surface area exposed to sunlight was estimated. Serum 25(OH)D was quantified by ELISA method. Serum 25(OH)D differences according to the duration of sunlight exposure, skin pigmentation type, and sunscreen use were statistically analyzed by ANOVA. The correlation of sunlight exposed body surface area and serum 25(OH)D was analyzed by Spearman’s correlation.

Results

Nearly half of the subjects (n = 40; 45.5%) were deficient in vitamin D (< 20 ng/ml) with serum 25(OH)D level 23.0 ± 10.0 ng/ml (mean ± SD) and the estimated daily intake of vitamin D was 5.6 ± 3.9 μg/1000 kcal/day (mean ± SD). The median percentage of body area exposed to sunlight was 15.8%. There were no differences in serum 25(OH)D levels according to sunlight exposure time, skin pigmentation type, and sunscreen use. The percentage of body area exposed to sunlight was positively correlated with serum 25(OH)D level (Spearman’s ρ = 0.403; p < 0.001).

Conclusions

Vitamin D deficiency is prevalent in pregnant Minangkabau women. Since increasing body surface area exposed to sunlight may not be culturally acceptable, vitamin D supplementation needs to be considered in this population.
Making the equivocal unequivocal: standardization of clean margins in diabetic foot osteomyelitis
Authors: Schmidt Brian M. , Jarocki Christine
Published: May 2020

Background

The prevalence of diabetes mellitus continues to rise. Diabetic foot ulcers with osteomyelitis are a diabetes-related complication presenting a significant burden to this cohort. A cure to diabetic foot osteomyelitis remains elusive and standard of care has failed to improve outcomes. To advance research and better patient outcomes, the authors offer specific guidance with terminology to enhance operative dictations which may improve surgical practice and guide treatment.

Methods

A consecutive review of podiatric surgical dictations for inpatient diabetic foot osteomyelitis within a tertiary care facility was performed. Surgical descriptors of bone were standardized: density, anatomic structure, vascular thrombosis, color, and draining sinus. Correlations between the five categories and histopathological results were performed after kappa analysis for interrater reliability was performed.

Results

Kappa coefficient demonstrated high inter-reliability of surgical findings. This suggests potential agreement amongst surgeons performing similar procedures. It was also found that specific bone descriptors had moderate to strong correlation with clean histopathologic bone margins when biopsied. This further suggests that the use of standardized terms may help guide definitive therapy.

Conclusions

The authors suggest a standardized approach which includes consistent descriptors of intraoperative bone. With use of standardized terms, vague and blanket descriptors are eliminated. This has potential to improve understanding of changes within bone as a result of infection and diabetes. Early and improved communication of intraoperative findings will enhance the multidisciplinary approach. This could potentially lead to changes in diabetic foot management and may limit hospital waste waiting for final cultures and pathology reports.
When predictions are used to allocate scarce health care resources: three considerations for models in the era of Covid-19
Authors: Kent David M. , Paulus Jessica K. , Sharp Richard R. , Hajizadeh Negin
Published: May 2020

Background

The need for life-saving interventions such as mechanical ventilation may threaten to outstrip resources during the Covid-19 pandemic. Allocation of these resources to those most likely to benefit can be supported by clinical prediction models. The ethical and practical considerations relevant to predictions supporting decisions about microallocation are distinct from those that inform shared decision-making in ways important for model design.

Main body

We review three issues of importance for microallocation: (1) Prediction of benefit (or of medical futility) may be technically very challenging; (2) When resources are scarce, calibration is less important for microallocation than is ranking to prioritize patients, since capacity determines thresholds for resource utilization; (3) The concept of group fairness, which is not germane in shared decision-making, is of central importance in microallocation. Therefore, model transparency is important.

Conclusion

Prediction supporting allocation of life-saving interventions should be explicit, data-driven, frequently updated and open to public scrutiny. This implies a preference for simple, easily understood and easily applied prognostic models.
Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes
Authors: Zeiger Joanna S. , Silvers William S. , Fleegler Edward M. , Zeiger Robert S.
Published: May 2020

Background

Little is known about how cannabis knowledge and attitudes impact cannabis use behavior.

Objective

To test the knowledge-attitudes-behavior paradigm in active adult athletes.

Design

The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data.

Participants

Self-defined active adult athletes (n = 1161).

Main measures

Knowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use.

Key results

A three-cluster solution was the best fit to the data. The clusters were named Conservative (n = 374, 32.2%), Unsure (n = 533, 45.9%), and Liberal (n = 254, 21.9). There was a significant difference among the clusters for all 11 attitudesitems (allp < 0.001). Attitude cluster membership was significantly different by age (p < 0.001), primary sport (p < 0.05), and knowledge about cannabis (p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user (p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. (p < 0.001).

Conclusions

Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.
The associations among RARRES2 rs17173608 gene polymorphism, serum chemerin, and non-traditional lipid profile in patients with metabolic syndrome
Authors: Dahpy Marwa A. , Khairallah Marwa K. , Azoz Nashwa Mostafa A. , Ezzat Ghada M.
Published: May 2020

Background

The adipokine chemerin retinoic acid receptor responder protein 2 (RARRES2) has been associated with insulin resistance, type II diabetes mellitus (T2DM), obesity, and metabolic syndrome (MetS). The impact of RARRES2 rs17173608 gene polymorphism on MetS and chemerin levels is not completely elucidated. This study included 100 patients with MetS and 68 healthy subjects (non-MetS group). The RARRES2 rs17173608 gene variant was analyzed by tetra amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR). Circulating chemerin levels were determined by ELISA. Serum urea, creatinine, fasting blood glucose, glycated hemoglobin, and traditional lipid profile were measured by colorimetric methods. The estimated glomerular filtration rate (eGFR) and non-traditional lipid parameters were calculated.

Results

Serum chemerin levels were significantly higher in MetS than in non-MetS subjects, type II diabetics (T2DM) than non-diabetics, and overweight compared to lean subjects, but it did not differ significantly between patients with and without hypertension. Strikingly, newly diagnosed diabetic patients had significantly higher serum chermerin levels. Correlation and multiple linear regression analysis showed that serum chemerin levels and non-traditional lipid parameters were correlated significantly with the clinical criteria of MetS. Genotyping and allelic frequency distribution of RARRES2 rs17173608 gene polymorphism showed its significant association with MetS. The TT genotype of RARRES2 rs17173608 SNP was more distributed in T2DM in comparison with non-diabetics, and it was associated significantly with higher serum chemerin and higher glycated hemoglobin levels. RARRES2 rs17173608 GG genotype and G allele frequency were less distributed in T2DM patients than in non-diabetic patients.

Conclusions

The RARRES2 rs17173608 SNP might have an impact on chemerin levels and lipid parameters. The GG genotype and G allele may have a protective role towards the risk of T2DM but not for MetS. Serum chemerin and non-traditional lipid profile are significantly associated with MetS.
Management of Cancer Cachexia: ASCO Guideline
Authors: Roeland Eric J. , Bohlke Kari , Baracos Vickie E. , Bruera Eduardo , del Fabbro Egidio , Dixon Suzanne , Fallon Marie , Herrstedt Jørn , Lau Harold , Platek Mary , Rugo Hope S. , Schnipper Hester H. , Smith Thomas J. , Tan Winston , Loprinzi Charles L.
Published: May 2020

PURPOSE

To provide evidence-based guidance on the clinical management of cancer cachexia in adult patients with advanced cancer.

METHODS

A systematic review of the literature collected evidence regarding nutritional, pharmacologic, and other interventions, such as exercise, for cancer cachexia. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and systematic reviews of RCTs published from 1966 through October 17, 2019. ASCO convened an Expert Panel to review the evidence and formulate recommendations.

RESULTS

The review included 20 systematic reviews and 13 additional RCTs. Dietary counseling, with or without oral nutritional supplements, was reported to increase body weight in some trials, but evidence remains limited. Pharmacologic interventions associated with improvements in appetite and/or body weight include progesterone analogs and corticosteroids. The other evaluated interventions either had no benefit or insufficient evidence of benefit to draw conclusions on efficacy. Limitations of the evidence include high drop-out rates, consistent with advanced cancer, as well as variability across studies in outcomes of interest and methods for outcome assessment.

RECOMMENDATIONS

Dietary counseling may be offered with the goals of providing patients and caregivers with advice for the management of cachexia. Enteral feeding tubes and parenteral nutrition should not be used routinely. In the absence of more robust evidence, no specific pharmacological intervention can be recommended as the standard of care; therefore, clinicians may choose not to prescribe medications specifically for the treatment of cancer cachexia. Nonetheless, when it is decided to trial a drug to improve appetite and/or improve weight gain, currently available pharmacologic interventions that may be used include progesterone analogs and short-term (weeks) corticosteroids.
MUCO-DIS: a New AFM-Based Nanoscale Dissolution Technique
Authors: Ghori Muhammad Usman , Nirwan Jorabar Singh , Asim Taimoor , Chahid Younes , Farhaj Samia , Khizer Zara , Timmins Peter , Conway Barbara R.
Published: May 2020

Mucoadhesion-based drug delivery systems have recently gained interest because of their bio-adhesion capability, which results in enhanced residence time leading to prolonged duration of action with the mucosal surface, potentially improving compliance and convenience. Mucoadhesion testing of these formulations is widely reported; however, this is technically challenging due to the absence of any standard methods and difficulty in conducting mucoadhesion, formulation-mucosal surface interaction, mucosal surface topography and drug release in a single experiment. As these measurements are currently conducted separately, on replicate formulations, results can often be subjective and difficult to correlate. Hence, the aim of the present study was to develop a new AFM-based single-entity ex vivo muco-dissolution (MUCO-DIS) technique to simultaneously evaluate mucoadhesion force, 3D surface topography, polymer dissolution and drug release characteristics. To demonstrate the potential of the current technique, the interactions between model pectin microparticles containing metformin HCl and a range of gastrointestinal mucosal surfaces (gastric, small intestine, large intestine and buccal) were studied. This novel system has not only successfully determined the mucoadhesion force, polymer dissolution and drug release information but has also highlighted the difference in microparticle performance with different mucosal targets. The current work has highlighted the potential of this newly developed MUCO-DIS system and we believe this will be a valuable tool for characterising these popular pharmaceutical formulations. This technique could also provide an opportunity to other scientific fields to evaluate materials, substrate behaviour and their interactions in their hydrated state at nanoscale with real-time chemical and surface mapping.
Pseudouridine-mediated stop codon readthrough in S. cerevisiae is sequence context–independent
Authors: Adachi Hironori , Yu Yi-Tao
Published: May 2020

We have previously shown that when the uridine of a stop codon (UAA, UAG, or UGA) is pseudouridylated, the ribosome reads through the modified stop codon. However, it is not clear as to whether or not the pseudouridine (Ψ)-mediated readthrough is dependent on the sequence context of mRNA. Here, we use several different approaches and the yeast system to address this question. We show that when a stop codon (premature termination codon, PTC) is introduced into the coding region of a reporter mRNA at several different positions (with different sequence contexts) and pseudouridylated, we detect similar levels of readthrough. Using mutational and selection/screen analyses, we also show that the upstream sequence (relative to PTC) as well as the nucleotides surrounding the PTC (upstream and downstream) play a minimal role (if at all) in Ψ-mediated ribosome readthrough. Interestingly, we detect no suppression of NMD (nonsense-mediated mRNA decay) by targeted PTC pseudouridylation in the yeast system. Our results indicate that Ψ-mediated nonsense suppression occurs at the translational level, and that the suppression is sequence context-independent, unlike some previously characterized rare stop codon readthrough events.
Knowledge and factors influencing long-acting reversible contraceptives use among women of reproductive age in Nigeria
Authors: Bolarinwa Obasanjo Afolabi , Olagunju Olalekan Seun
Published: May 2020

Background: Approximately 48% of unintended pregnancies occur as a result of contraceptives failure around the world, which is mostly due to incorrect use, poor adherence, and/or technology failure. Long-acting reversible contraceptive (LARC) methods have been developed to close this gap. The main aim of this study is to identify factors associated with the use of LARCs among women of reproductive age and to examine the relationship between knowledge of LARCs and the current use of LARCs in Nigeria.

Methods: This study assessed the PMA2020 methodology and secondary dataset using female datasets from PMA 2016 (Round 3) exercise. The survey was conducted out in seven states of Nigeria. The target population for this study was women of reproductive age (15-49 years) currently using contraception prior to the survey. The sample size of women that met the inclusion criteria was 1927. The data were analyzed using frequency distribution, chi-square, and logistic regression at a 5% level of significance.

Results: The results showed that 21.0% of women were using traditional methods. 14.8% of the sampled women were using LARCs methods. Findings further showed that at both levels of analyses, there is a significant relationship (P<0.05 and P=0.00 for binary and logistic regression, respectively) between knowledge of LARCs and the use of LARCs. This means that knowledge of LARCs and socio-demographic variables among women of reproductive age in Nigeria can influence the use of LARCs.

Conclusions: We concluded in this study that 14.8% of women using contraception were using LARCs. Additionally, the level of education, age of women, household wealth, and the number of living children were significantly associated with using LARCs in Nigeria. Also, when discussing contraception with women, health care practitioners should discuss the risks and benefits of LARCs with women of reproductive age and recommend them as a first-line method.
Hand Hygiene Practices and the Risk of Human Coronavirus Infections in a UK Community Cohort
Authors: Beale Sarah , Johnson Anne M. , Zambon Maria ,   Flu Watch Group, Hayward Andrew C. , Fragaszy Ellen B.
Published: May 2020

Background: Hand hygiene may mitigate the spread of COVID-19 in community settings; however, empirical evidence is limited. Given reports of similar transmission mechanisms for COVID-19 and seasonal coronaviruses, we investigated whether hand hygiene impacted the risk of acquiring seasonal coronavirus infections.

Methods: Data were drawn from three successive winter cohorts (2006-2009) of the England-wide Flu Watch study.  Participants (n=1633) provided baseline estimates of hand hygiene behaviour. Coronavirus infections were identified from nasal swabs using RT-PCR. Poisson mixed models estimated the effect of hand hygiene on personal risk of coronavirus illness, both unadjusted and adjusted for confounding by age and healthcare worker status.

Results: Moderate-frequency handwashing (6-10 times per day) predicted a lower personal risk of coronavirus infection (adjusted incidence rate ratio (aIRR) =0.64, p=0.04). There was no evidence for a dose-response effect of handwashing, with results for higher levels of hand hygiene (>10 times per day) not significant (aIRR =0.83, p=0.42).

Conclusions: This is the first empirical evidence that regular handwashing can reduce personal risk of acquiring seasonal coronavirus infection. These findings support clear public health messaging around the protective effects of hand washing in the context of the current COVID-19 pandemic.
Global development of children’s palliative care: the picture in 2017
Authors: Clelland David , van Steijn Danny , Macdonald Mary Ellen , Connor Stephen , Centeno Carlos , Clark David
Published: May 2020

Background:The growing interest in tracking the global development of palliative care provision is not matched by research on the development of palliative care services specifically for children. Yet it is estimated that worldwide, 21 million children annually could benefit from the provision of palliative care. We report on a global study of children’s palliative care development and offer suggestions for further improvement in design and method.

Methods:Primary data on the level of children’s palliative care development in 2017 was collected from in-country experts through a specific question in an online questionnaire that sought to measure the overall level of palliative care provision globally. Countries were assigned to one of six categories on the basis of the responses obtained. Conflicting responses from the same country were resolved with reference to a hierarchy of preferred respondents.

Results:Our data allowed the categorisation of 113 countries, accounting for 65% of the global population aged under 20. Number of countries (% of global child population) in each category were as follows: 1) no known activity, 21 (4%); 2) capacity-building, 16 (24%); 3a) isolated provision, 55 (30%); 3b) generalized provision, 5 (1%); 4a) preliminary integration into mainstream provision, 14 (8%); 4b) advanced integration, 7 (2%).

Conclusions:Children’s palliative care at the highest level of provision is available in just 21 countries, accounting for fewer than 10% of the global population aged under 20. It is concentrated in high income settings, whilst the majority of the global need for such care is in low- and middle-income countries. Our study is a useful tool for global advocacy relating to children’s palliative care and a stimulus for the creation of improved indicators to measure it at the country level.
MODEL FOR DETERMINING THE OPTIMAL SIZE OF A MULTI-NOMENCLATURE CARGO BATCH, TAKING INTO ACCOUNT THE WEIGHT AND VOLUME CHARACTERISTICS OF THE TRANSPORT VEHICLE
Authors: Lutsenko Elizaveta Aleksandrovna
Published: May 2020

Рассмотрена динамика грузоперевозок, свидетельствующая об увеличении объема малых партий грузов. Определены основные критерии доставки малых партий грузов по отношению к транспортным компаниям и их клиентам. На основе этих критериев было предложено решение по оптимизации доставки грузов. Это решение заключается в консолидации поставок грузов различных номенклатурных позиций в одном транспортном средстве. Предложена модель определения задачи оптимизации размера груза, позволяющая эффективно загружать транспортное средство несколькими номенклатурными позициями товаров.Цель. Определить размер партии грузов с помощью объемно-массовых характеристик укрупненных грузовых единиц и транспортного средства.Методология / Методы. В статье используется метод математической статистики.Результаты. Предложен алгоритм определения оптимального размера партии грузов.
АНАЛИЗ ОСТАТОЧНЫХ ДЕФОРМАЦИЙ В ЭЛЕМЕНТАХ КУЗОВА ЛЕГКОВОГО АВТОМОБИЛЯ МЕТОДОМ ПРЯМОГО ИНТЕГРИРОВАНИЯ
Authors: Ablaev Remzi Rustemovich , Ablaev Alim Rustemovich , Abramova Larisa Sergeevna , Ksenofontova Viktoriya Anatolievna
Published: May 2020

В настоящее время существует множество различных методов определения скорости движения транспортного средства в момент столкновения. В условиях ограниченных исходных данных для экспертов, таких как следы колес на проезжей части в условиях места происшествия, наиболее оптимальным методом является метод определения скорости автомобиля в момент столкновения, основанный на учете затрат кинетической энергии на деформацию элементов и деталей автомобилей. В связи с чем, статья посвящена проблеме анализа остаточных деформаций в элементах кузова автомобиля при определении скорости его движения в момент столкновения. Проведен анализ различных видов остаточных деформаций и методов их оценки. Предложен метод прямого интегрирования для анализа остаточных деформаций в элементах кузова легкового автомобиля, поскольку он наиболее точно отражает всю механику образования деформаций кузова и на уровне низкой трудоемкости. Этот фактор является одним из важных при выборе методики исследования обстоятельств дорожно-транспортного происшествия. Предложенная методика показывает наименьшую погрешность вычислений при определении скорости движения автомобилей в момент столкновения.Цель – разработать и обосновать модель учета затрат кинетической энергии да деформацию конструктивных элементов кузова легкового автомобиля при определении его скорости движения в момент столкновения на основании анализ остаточных деформаций в элементах кузова автомобиля методом прямого интегрирования.Метод или методология проведения работы: в статье использовались системный подход, методы анализа и математического моделирования.Результаты: предложенная в работе методика дает возможность на стадии исследования обстоятельств дорожно-транспортного происшествия определить скорость движения автомобилей в момент столкновения по их деформациям, которая более полно учитывает все затраты кинетической энергии на механизм деформирования сложных кузовных элементов, имеющих ребра, гофры и другие элементы, повышающие их жесткость при изгибе.Область применения результатов: полученные результаты целесообразно применять в экспертной практике исследования обстоятельств и механизма дорожно-транспортного происшествия при определении скорости движения автомобилей в момент столкновения.
ВЛИЯНИЕ ЭЛЕКТРОМОБИЛЕЙ НА ЭКОЛОГИЮ
Authors: Rahimov Elmar Agarahim
Published: May 2020

Часто считается, что электромобили являются важным средством сокращения выбросов парниковых газов и энергопотребления в глобальном транспорте, особенно для автомобильного пассажирского транспорта.Целью данной статьи является изучение относительного использования энергии и выбросов парниковых газов электромобилей по сравнению с автомобилями с двигателем внутреннего сгорания. Сравнение энергоэффективности, а также сравнение выбросов парниковых газов были использованы в качестве методов в данной статье. Cравнения энергоэффективности осложняются противоречивыми методами, используемыми для первичных источников электроэнергии, таких как гидро, солнечная энергия или энергия ветра.В этой статье пересматривается степень, в которой электромобили могут эффективно решать проблемы глобального изменения климата и истощения запасов ископаемого топлива.Более того, в статье утверждается, что сравнение электромобилей и транспортных средств с двигателем внутреннего сгорания намного сложнее, чем общепризнанно. Неопределенности возникают как при использовании первичной энергии, так и при расчете выбросов парниковых газов.В целом, должен быть сделан вывод о том, что выгоды от использования электромобилей для энергии и парниковых газов меньше, чем обычно предполагается.Только когда во взаимосвязанных энергосистемах преобладают возобновляемые источники энергии, будет безопасно заявлять о превосходстве электромобилей.
Opportunities for the use of natural and preformed physical factors in the complex treatment of patients with chronic viral hepatitis C with associated non-alcoholic fatty liver disease
Authors: Izha Аnna
Published: May 2020

One of the urgent problems of modern hepatology remains the treatment of patients with chronic viral hepatitis C, which is associated with an increase in the incidence and development of complications - cirrhosis of the liver and hepatocellular carcinoma. The presence of non-alcoholic fatty liver disease in patients accelerates the progression rate of HCV infection and reduces the effectiveness and tolerability of antiviral therapy. The above circumstances initiated us to the search for new non-drug technologies for the treatment of this category of patients.  The work aimed to evaluate the effectiveness of the integrated use of standard antiviral therapy, drinking silicon low-mineralized sodium bicarbonate mineral water, and EHF-therapy in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease. We used the following methods: anamnestic, general clinical, biochemical, serological, immunological, Ultrasonographic examination of the digestive organs. We examined 42 patients who were divided into two groups. The control group (22 people) received the basic treatment complex, which included dietary nutrition, standard antiviral therapy for 12 months, and an internal intake of mineral water during the first month of treatment. The main group (20 people), in addition to the basic complex of treatment, additionally received EHF-therapy procedures for three months. Evaluation of the effectiveness of treatment was carried out after 1 and 3 months from the start of treatment. The treatment was accompanied by the positive dynamics of most signs of the disease in both groups, with a predominance of EHF-therapy. In patients of main group, the disappearance of complications of antiviral therapy was established - the absence of cytopenic syndrome, normalization of immunological status, stimulation of interferonogenesis, restoration of equilibrium in the lipid peroxidation system and antioxidant system. These positive results made it possible to complete the course of therapy for all patients and obtain a virological response in 50% of patients.
Modeling Commuting Flows via Fixed Components
Authors: Babri Sahar , Jörnsten Kurt , Thorsen Inge , Ubøe Jan
Published: May 2020

The basic, reasonable hypothesis underlying this paper is that many individuals are comfortable with their current combination of job and residential location and have no intention of changing job location or moving from where they live. This causes autocorrelation in the time series of commuting flows and provides a rationale for introducing fixed components in the trip distribution model. The fixed components are assumed to be constant in time and separated from the observed trip distribution. We next consider the residuals and fit the model by a constrained entropy-maximization procedure. Based on commuting data from Stockholm County in Sweden, the fixed component spatial interaction model is demonstrated to lead to a substantial improvement in goodness of fit compared with conventional spatial interaction models. The identification of fixed components leads to significantly lower estimates of the distance deterrence parameter, and fixed components are further argued to be potentially useful in a prediction perspective. The distance deterrence parameter in the fixed component model reflects the spatial interaction of workers who are actually considering changes in their residential and/or job location. We also compare alternative measures of spatial separation and discuss differences in commuting behaviour by gender.
Chicken Eggshell Waste as a Vegetable Breeding Media at the Culinary Department of SMK Negeri 4 Yogyakarta
Authors: Purwanti Heni , Heruwati Yuni
Published: May 2020

The culture of managing waste at the culinary department of SMK Negeri 4 Yogyakarta—a school of Adiwiyata which has a good environment for students to learn and to foster a sense of loving the environment—is by utilizing the organic waste, one of which is the chicken eggshell waste. Chicken eggs are widely used to process foods in the culinary department of SMK Negeri 4 Yogyakarta. Various types of processed foods use chicken eggs as the main ingredient or as supporting/additional material. The need for chicken eggs is quite large every day, causing an abundance of chicken eggshell waste in the culinary department of SMK Negeri 4 Yogyakarta. This experimental study aims to utilize chicken eggshell waste as a vegetable nursery media by direct practice of nursery vegetable plants with chicken eggshell media. The results showed that eggshells can be used as a plant medium and even the growth of seedlings looks better and fertile. This is probably due to the content of calcium, phosphorus, nitrogen, and potassium in eggshells.
Practicum Workshop and Learning Media Quality in the Light Vehicle Engineering Department of Vocational High Schools
Authors: Kurniawan Arief , Kuat Tri , Purnawan Purnawan
Published: May 2020

The study is to determine the quality of workshop practice and media learning of light vehicle engineering in Vocational High Schools in terms of (1) the facilities and infrastructure of laboratory and (2) the use of instructional media practices of light vehicle engineering. The collection of data used the method of observation, documentation, interview. This type of qualitative research is a case study approach, involving five internship supervisor teachers and workshop managers. The results of the study showed that the practice of Automotive Engine Repair with spacious 84 m2, Automotive Chassis Repair with a spacious 72 m2, Automotive Electrical Repair with spacious 24 m2 had not yet met the standard minimum as suggested at the Minister of Education and Culture Regulation number 34 of 2018. The use of practical learning media was less effective because: (1) the comparison of study groups with the area of the workshop was not balanced, (2) the existence of some practicum subjects scheduled in the same day resulted in the students were practicing simultaneously at one time, and (3) the lack of practicum facilities.
Nurse-led chest pain hot clinics: improving patient flow in the emergency department
Authors: Taylor Jon , Kopanska Agnieszka , Cobb Tessa
Published: May 2020

This article describes the authors' experiences of a specialist pathway for low-risk patients with chest pain admitted to the emergency department. This pathway uses a modified HEART score and highly sensitive troponin I testing to categorise patients. This was introduced to facilitate safe and speedy discharge of these patients within the 4-hour target. The aim was to demonstrate a reduction in length of stay and a reduction in overcrowding in the emergency department. This also included the introduction of a new nurse-led chest pain hot clinic to provide a specialist cardiology review within 72 hours of discharge. This clinic enabled more appropriate targeted investigation and treatment for patients. As a new initiative, it was important to ensure patient safety with a <1% incidence of major adverse cardiac event at 30 days, which was achieved. The modified HEART score also enabled more low-risk patients to be rapidly discharged from the emergency department. The chest pain hot clinics ensure patients are appropriately assessed and investigated for coronary artery disease reducing the number of unnecessary investigations. It also demonstrated a reduction in the number of computerised tomography coronary angiogram requests enabling more appropriate and timely investigations. In addition, there was a reduction in medical admissions and emergency department overcrowding. These initiatives also reduced the overall length of stay and increased the number of patients discharged within the 4-hour target from the emergency department.
Highlighting the latest research: May 2020
Authors: Palmer Sarah Jane
Published: May 2020

Sarah Jane Palmer presents a selection of recently published articles of interest to nurses working in cardiovascular care. The aim of this roundup is to provide a brief overview of the research papers selected. A full reference is provided for those who wish to explore the research in further detail.
Removable Prosthodontics for the Management of Severe Toothwear
Authors: Addy Liam , Thomas Matthew , Cummings Carly , King Elizabeth
Published: May 2020

Toothwear is becoming increasingly more common for dentists to manage as the population is maintaining its teeth for longer. A large proportion of cases can be managed by means of adhesive dentistry in conjunction with preventive advice. There are, however, patients with severe toothwear alone, or toothwear in conjunction with missing teeth, which would be best served with a removable prosthodontic approach. This is particularly the case where dental implants are not indicated or appropriate. This article illustrates the use of removable prosthodontics for the management of toothwear and highlights the importance of these restorations in certain cases. It also considers the supportive programme required to ensure success of this treatment modality.

CPD/Clinical Relevance: Toothwear is a prevalent dental problem that cannot always be addressed with an adhesive restorative or fixed prosthodontic approach, particularly when the toothwear is severe and or in combination with existing missing teeth.
Orthodontic Bonded Retainers: a Narrative Review
Authors: Meade Maurice J , Millett Declan T
Published: May 2020

Indefinite retention is now considered essential to prevent relapse after orthodontic treatment. Compliance with removable retainer wear is suboptimal and appears to decline with time post-treatment. As a result, use of bonded retainers may become more commonplace in the future. In this narrative review, the characteristics of bonded retainers are outlined and a summary of the evidence from randomized clinical trials regarding their effectiveness is provided. Guidance is also offered regarding care and maintenance.

CPD/Clinical Relevance: All general dental practitioners (GDPs) should be familiar with types of bonded retainers, evidence relating to their effectiveness and the GDP's role regarding their care and maintenance.
The impact of COVID-19 on people with autism, learning disabilities and mental health conditions
Authors: Frankova Helena
Published: May 2020

The coronavirus pandemic has put a halt to the Care Quality Commission's final report on restraint and its updated registration guidance for people with autism, learning disabilities and mental health conditions. What does this mean for these groups, and what should carers do in response? Helena Frankova investigates
Developing effective working relationships with external healthcare services
Authors: Ashurst Adrian
Published: May 2020

Now, more than ever, establishing a good partnership between a home and healthcare service providers is incredibly important. Adrian Ashurst discusses relationship-building strategies and what to do should a health professional need to visit residents during the pandemic
Recognising pain in dementia: what has changed?
Authors: Dening Karen Harrison
Published: May 2020

Pain is common among older people due to the increased prevalence of age-related conditions. However, this might be misidentified and poorly managed in those with dementia. Karen Harrison Dening presents effective diagnostic and treatment strategies
The metaphyseal fossa surrounding the epiphyseal tubercle is larger in hips with moderate and severe slipped capital femoral epiphysis than normal hips
Authors: Hosseinzadeh Shayan , Kiapour Ata M. , Maranho Daniel A. , Emami Seyed Alireza , Portilla Gabriela , Kim Young-Jo , Novais Eduardo N.
Published: May 2020

Purpose

To compare the 3D morphology of the metaphyseal fossa among mild, moderate and severe stable slipped capital femoral epiphysis (SCFE) and normal hips.

Methods

We identified pelvic CT of 51 patients (55% male; mean 12.7 years (sd 1.9; 8-15)) with stable SCFE. In all, 16 of 51 hips (31%) had mild, 14 (27%) moderate and 21 (41%) severe SCFE. A total of 80 patients (50% male; mean age 11.5 years (sd 2.3; 8 to 15)) with normal hips who underwent pelvic CT due to abdominal pain made up the control cohort. CT scans were segmented, and the femur was reformatted using 3D software. We measured the metaphyseal fossa depth, width, length and surface area after the epiphysis was subtracted from the metaphysis in the 3D model.

Results

The metaphyseal fossa width was significantly larger in severe (adjusted difference: 6.9%; 95% confidence interval (CI) 2.1 to 11.8; p = 0.001), moderate (6.5%; 95% CI 0.8 to 12.2; p = 0.02) and mild SCFE (6.2%; 95% CI 0.8 to 11.6; p = 0.01), in comparison with normal hips. Severe SCFE showed larger fossa length compared with mild SCFE (6.8%; 95% CI 0.6 to 13.0; p = 0.02) and normal hips (6.0%; 95% CI 1.4 to 10.6; p = 0.004). The fossa surface area was larger in severe (3.5%; 95% CI 1.3 to 5.7; p < 0.001) and moderate SCFE (2.7%; 95% CI 0.1 to 5.2; p = 0.03) when compared with normal hips. There were no differences in fossa depth between SCFE and normal hips.

Conclusion

The metaphyseal fossa is wider and more extensive but not deeper in hips with moderate and severe SCFE in comparison with normal hips. Although hips with severe SCFE had larger length and surface area than mild SCFE hips, further research is needed to clarify whether enlargement of the metaphyseal fossa is a consequence of slip progression.

Level of Evidence

III