bluuebunny/crossref_metadata_2025 huggingface dataset:
Hipoplasia condilar: Caso clínico
Authors: Silva Agnaldo Plácido da , Plácido Eloá Jessica Mendes dos Santos , Moraes Walber
Published: March 2021

A formação da face e do sistema estomatognático é de natureza complexa e envolve o desenvolvimento de múltiplos processos teciduais que devem se unir e fusionar de modo extremamente ordenado. Distúrbios no crescimento desses processos teciduais ou nas suas fusões podem resultar em alterações faciais. A articulação temporomandibular se apresenta como uma das mais complexas do corpo humano, sendo o processo condilar responsável pela expressão do crescimento mandibular. A hipoplasia condilar é caracterizada por uma formação defeituosa do processo condilar que pode ser congênita ou adquirida. No caso apresentado, a paciente apresenta assimetria facial desde o primeiro ano de vida, somente do lado esquerdo. Assim, os profissionais que atuam na região da articulação temporomandibular devem ter o conhecimento da existência e das implicações clínicas para um diagnóstico precoce com a finalidade de evitar o desenvolvimento das assimetrias faciais, restabelecendo função, estética e o estado psicológico do paciente.
BUDIDAYA AYAM KAMPUNG PADA KELOMPOK IBU RUMAH TANGGA SION KEFAMENANU NTT
Authors: Lisnahan Charles Venirius , Dethan Agustinus Agung , Bani Polikarpia Wilhelmina
Published: March 2021

Pengabdian pada masyarakat ini bertujuan meningkatkan kesejahteraan melalui budidaya ayam kampung ramah lingkungan pada kelompok ibu rumah tangga Sion Kefamenanu, Nusa Tenggara Timur sebagai kelompok mitra. Dalam pengabdian ini digunakan metode participatory action research, kelompok mitra dan Tim pelaksana secara bersama dilibatkan dalam penentuan jenis kegiatan dan pelaksanaan kegiatan di lapangan. Tahapan-tahapan kegiatan dan solusi mengatasi permasalahan kelompok mitra meliputi kegiatan persiapan yaitu tim pengabdian dengan kelompok mitra menetapkan jenis kegiatan berdasarkan hasil analisis situasi awal dan disesuaikan dengan kebutuhan dan kondisi aktual. Kegiatan dilanjutkan dengan penyuluhan dan pelatihan/pendampingan oleh dosen dan tim pendamping untuk meningkatkan kemampuan peternak/kelompok. Tahapan kegiatan meliputi manajemen penetasan, pembuatan pakan komplit, pemeliharaan fase starter dalam brooding, penataan kandang fase grower, pembuatan pupuk bokasi, penjualan ayam dan perhitungan ekonominya serta evaluasi kegiatan sesuai tahapan pelaksanaan. Hasil yang dicapai adalah ketrampilan kelompok peternak meningkat dengan memanfaatkan penggunaan mesin tetas, pemeliharaan dengan brooding dan pemeliharaan fase grower serta manajemen pemeliharaan lainnya seperti pencegahan penyakit dan vaksinasi dan pencampuran pakan dapat dilakukan dengan mudah oleh kelompok peternak sehingga populasi maupun produktivitas ternak ayam kampung bertambah. Terjadi peningkatan pendapatan dan kesejahteraan kelompok peternak dengan keuntungan Rp. 3.250.000 dengan volume pemeliharaan 100 ekor ayam kampung sejak DOC sampai umur 3-5 bulan.
Berat Organ Non Karkas Ayam Broiler Setelah Disuplementasi Dl-Methionine dalam Pakan
Authors: Suni Selviana , Lisnahan Charles Venirius , Dethan Agustinus Agung
Published: March 2021

Tujuan penelitian ini adalah untuk mengetahui pengaruh suplementasi dl-methionine dalam pakan terhadap kinerja organ non karkas ayam broiler. Penelitian ini dilaksanakan di Kandang Program Studi Peternakan, Fakultas Pertanian Universitas Timor, Kelurahan Sasi, Kecamatan Kota Kefamenanu, Kabupaten Timor Tengah Utara. Penelitian ini berlangsung selama 39 (1 masa produksi). Penelitian ini menggunakan 80 ekor ternak ayam broiler berumur 1 hari atau Day Old Chick (DOC) Strain CP 707. Metode yang digunakan dalam penelitian ini adalah metode eksperimen dengan Rancangan Acak Lengkap (RAL) pola searah, terdiri dari 4 perlakuan dan 4 ulangan. Perlakuan yang diuji adalah: T0 (pakan control), T1 (T0 + dl-methionine 0,30%), T2 (T0 + dl-methionine 0,50%), dan T3 (T0 + dl-methionine 0,70%). Variabel yang diamati adalah persentase berat non karkas, persentase darah, persentase bulu, persentase berat potong, persentase berat kepala, persentase berat leher, dan persentase lemak abdominal ayam broiler. Hasil penelitian menunjukkan bahwa perlakuan berpengaruh nyata terhadap berat dan persentase darah, bulu, berat potong dan non karkas ayam broiler (P<0,05) sedangkan berat dan persentase kepala, leher, serta lemak abdominal berpengaruh tidak nyata. Rata-rata berat kepala T0:48,58±2,29; T1:46,07±2,83; T2: 48,48±8,35; dan T3: 52,36±4,13 g/ekor. Berat leher T0: 66,10±11,74; T1: 69,53±4,60; T2: 70,67±19,01; dan T3: 82,13±8,45 g/ekor. Berat lemak abdominal T0: 20,57±2,49; T1: 22,91±8,39; T2: 27,87±11,94; dan T3: 26,62 ±9,56 g/ekor. Disimpulkan bahwa pakan komersial yang disuplementasi dengan dl-methionine sebesar 0,70% meningkatkan pertumbuhan dan perkembangan non karkas berat bulu, berat darah, berat kepala dan leher, lemak abdominal, serta berat potong ayam broiler.
Pengaruh Wadah dan Lama Penyimpanan terhadap Kualitas Fisik dan Jumlah Bakteri Susu Sapi Friesian Holstein di Benlutu
Authors: Teme Novita , Sio Stefanus , Purwantiningsih Theresia I.
Published: March 2021

Penelitian ini telah dilaksanakan di Laboratorium Kimia Universitas Widya Mandira Kupang pada tanggal 4 Desember sampai dengan tanggal 22 Desember 2018. Penelitian ini bertujuan untuk mengetahui kualitas fisik susu Sapi Friesian Holstein, jumlah total bakteri dalam jenis wadah dan lama penyimpanan yang berbeda, serta dapat memberikan informasi kepada masyarakat mengenai jenis wadah dan lama penyimpanan susu segar yang baik sehingga mutu dan kualitas susu tetap terjaga. Penelitian ini menggunakan susu segar dengan wadah penyimpanan yang berbeda, yakni wadah berbahan kaca, plastik, dan plastik komersial. Rancangan percobaan yang digunakan adalah rancangan acak lengkap pola faktorial dengan 4 x 3 perlakuan dan 4 kali ulangan. Perlakuan terdiri dari W0= wadah berbahan kaca, W1= wadah berbahan plastik, dan W2= wadah berbahan Tupperware yang disimpan selama 1 hari (P0), 3 hari (P1), 5 hari (P2), dan 7 hari (P3). Adapun variabel yang diamati adalah uji organoleptik, titrasi keasaman, pH, dan uji TPC. Hasil sidik ragam anova menunjukkan wadah penyimpanan dan lama penyimpanan berpengaruh sangat signifikan (P<0,05) terhadap derajat keasaman secara tetrimetri, pH, dan TPC. Selanjutnya, interaksi dari wadah penyimpanan dan lama penyimpanan terhadap derajat keasaman dan TPC sangat signifikan (P<0,05); namun interaksi untuk pH tidak signifikan (P>0,05). Kesimpulan dari penelitian ini menjelaskan bahwa susu yang disimpan dalam wadah berbahan botol plastik dengan lama penyimpanan 1 hari memiliki kualitas yang lebih baik dibandingkan susu dalam wadah berbahan botol kaca dan Tupperware. Hal ini dapat dilihat dari hasil uji organoleptik, titrasi keasaman, pH, dan uji TPC.
Peningkatan Pengetahuan Pendidikan Lingkungan dan Konservasi Siswa/Siswi SDN Tumbang Nusa 2 di Desa Taruna Jaya
Authors: Mariaty Mariaty , Afitah Ise
Published: March 2021

This program's main objective is to instill character education in loving the environment in children, improve thinking skills, and increase children's creativity. The relationship between children and their surroundings is an important foundation for building a good relationship between humans and nature. Community service activities at SDN Tumbang Nusa 2, located in Taruna Jaya Village, Jabiren Raya, Pulang Pisau, Central Kalimantan, were held from July to August 2019. Activities carried out included counseling on environmental education and film screenings. It provides education to school-age children in knowing the environment, managing the environment, and increasing children's creativity in environmental conservation and forest conservation efforts. The implementation of the activity is the introduction of several types of plants that function as cover crops and good tree planting practices and provide training in making goods from used materials. The methods used are counseling, demonstrations, and mentoring. In this case, partners are school children who will have an understanding of environmental education and conservation, starting from the understanding of the environment, the causes of environmental damage, how to manage the environment around schools, and how to anticipate environmental damage. Besides, partners were also given knowledge of planting and caring for trees properly in the school environment. Partners were also given skills to make crafts from used goods, such as making flowers and leaves from plastic bags, making flower pots from used plastic drink bottles, and make a bicycle from cardboard.
Upaya Meningkatkan Disiplin Guru Melalui Sistem Reward And Funishment Guna Menunjang Efektivitas Proses Belajar Mengajar Di SD Negeri Tumbang Kalemei
Authors: Dagan Dagan
Published: March 2021

Prosedur penelitian tindakan sekolah ini terdiri atas dua tahapan (siklus). Tiap siklus dilaksanakan sesuai dengan perubahan yang ingin dicapai. Penelitian ini difokuskan pada Meningkatkan disiplin guru melalui pemberian reward dan funisment guna terciptanya efektivitas proses belajar mengajar di SD Negeri Tumbang Kalemei. Pada siklus II menunjukan bahwa disiplin waktu guru sudah mengalami peningkatkan yang signifikan pada akhir siklus I hanya sekitar 77,78% meningkat menjadi 88,89%, demikian halnya dalam disiplin dalam mengadakan persiapan perangkat pembelajaran yang tadinya hanya 66,67% dari jumlah guru pada siklus ini sudah dapat mencapai 81,82%. Hal ini ternyata memiliki dampak terhadap kegiatan proses pembelajaran di kelas tercermin dari ketercapaian target kurikulum yang menstandarkan pada KKM tiap mata pelajaran masing-masing. Pada akhir siklus I rata-rata ketercapaian target kurikulum mencapai 55,56% saja, sedangkan pada siklus ini mencapai 88,89%. Ini menunjukkan kenaikan yang cukup memuaskan sesuai dengan target yang diinginkan yakni sekurang-kurangnya mencapai 85%.
Analysis of Leading Sectors in Increasing Economic Growth in the Province of East Nusa Tenggara in 2014-2018
Authors: Kiha Emilia Khristina , Frederic Winston Nalle  , Gustaf Inyong Kobi
Published: March 2021

The aims of the study is to find out the leading sectors in increasing economic growth in the province of east nusa tenggara. This study uses secondary data in the form of PDRB data for the 2014-2018 period obtained through literature books, readings related to the problem under study. Sources of data were obtained from government agencies such as the East Nusa Tenggara Province Central Statistics Agency (BPS), as well as related agencies. The result in this study. 1.     Based on the results of the Klassen Typology analysis, the sector which is included in the advanced sector and growing rapidly or the leading sector is the sector Mandatory Government Administration, Defense and Social Security. Meanwhile, sectors that are included in the advanced but depressed sector are the Agriculture, Forestry and Fisheries sector, the Construction sector, the Transportation and Warehousing sector, the Information and Communication sector, the Education Services sector, the Health Services sector and Social Activities and the Other Services sector. Sectors classified as potential or still developing sectors are mining and quarrying sector, processing industry sector, electricity and gas supply sector, wholesale and retail trade: car and motorcycle repair and accommodation and food and drink provision sector. Meanwhile, sectors that are relatively lagging behind are the water supply sector, waste management, waste and recycling, the financial services and insurance sector, the real estate sector and the corporate services sector.
Mobilization of innovative and resource factors for development of national outsourcing IT companies
Authors: Tsygankov T. , Yatsenko O. , Mozgovyy O. , Didukh T. , Patsola L.
Published: March 2021

Purpose. To systematize and justify the mobilization optimization of internal resource potential and innovative indicators for development of national outsourcing IT companies. Methodology. To complete this paper work the authors followed the justification of the forecast based on the use of the following methods: trend method (establishing the forecast indicators of development on the basis of determining the average trend of the previous periods) to identify and systematize ways to ensure forecast efficiency of resource potential, innovative development of outsourcing companies in IT; comparative and statistical methods (application of methods for analysis of reporting data, their comparison with forecast) and forecasting method (forecasting according to the main quantitative and qualitative indicators) to determine the comparative characteristics of the given paths; geometric method of direct change dependence (determination of the level of change dependence, calculated by the method of direct geometric progression) to assess the forecast scheme for Ukrainian outsourcing IT subjects of unification in the form of cooperation. Findings. The basic methods of resource potential optimization, innovative indicators for development of outsourcing IT companies in Ukraine are investigated and substantiated. Systematization of scientific approaches, views of researchers allowed forming a list of optimization paths of these companies development. Originality. For the first time the organizational and economic form of integration of the subjects of the IT-outsourcing market in Ukraine is proposed as a way to optimize the resource potential of the association in cooperation, which provides functioning of competitive structures based on cooperation and partnership relation with clients, distribution of functional loads, creation of additional market economic effects, possible solution of social and economic problems of regions. Practical value. The practical significance of the study lies in the development and testing of methodological tools designed for rapid assessment of the development level of innovation and resource potential of IT enterprises. The results of the study can be used by national IT outsourcing companies to increase capital and maintain operational efficiency, to ensure functioning of competitive structures of different categories aimed at increasing the added economic value of their participants.
Responsabilidad Social en la elección de los servicios educativos de una institución superior de Lima Este 2020
Authors: Olivo-Valenzuela Silvia , Alcalde-Martinez Eber , Garro-Aburto Luzmila
Published: March 2021

El objetivo fue determinar la influencia de la responsabilidad social en la elección del servicio educativo de una Institución superior en Lima este, 2020, nivel básico, tipo explicativa, correlacional causal, enfoque cuantitativo, cuya población fue 400 y la muestra 120 padres y estudiantes, el instrumento fue el cuestionario, la confiabilidad fue con Alfa de Cronbach, en la responsabilidad social la confiabilidad fue 0,840 y en la elección del servicio educativo 0,822. Los resultados fueron los siguientes: en la responsabilidad social el nivel es regular en un 78,3%, en la elección del servicio educativo es adecuada en 83,3% y en las dimensiones de la elección del servicio educativo en la gestión estratégica adecuada en un 72,5%; en la formación integral adecuada en un 80%, en el soporte institucional adecuada en 78,3% y en los resultados adecuada en 77,5%. Se concluye que la responsabilidad social influye entre el 67,5% y 67,6% en la elección que realizan los estudiantes.
Accepting Dominion Status as a Way of Reconciliation of British-Irish Disputes?
Authors: Valkoun Jaroslav
Published: March 2021

The article is focused on an analysis of British-Irish relations in 1921. From the British point of view, the best solution to the conflict seemed to be the granting of Dominion status. It was based on the assumption that the British Empire represented the largest community of free sister nations in the world. On the contrary, Irish officials did not have the confidence to participate in various colonial or imperial projects because they considered themselves a victim of British colonialism. The question of the accepting of the Dominion status divided the Irish political scene into supporters and opponents of the Anglo-Irish treaty. Supporters of the agreement calmed their own sympathizers by claiming that freedom and equality derive directly from Dominion status. However, the lack of precise determination of the rights and duties of the Dominions was a complication of the situation. The question arises as to whether negotiations on reconciliation between Britain and Ireland led from the British and Irish perspectives, in the context of the then unclear situation of what precisely it means to be a Dominion, to a fair solution to the British-Irish Disputes.
Poly(3-hydroxypropionate): Biosynthesis Pathways and Malonyl-CoA Biosensor Material Properties
Authors: Aduhene Albert Gyapong , Cui Hongliang , Yang Hongyi , Liu Chengwei , Sui Guangchao , Liu Changli
Published: March 2021

Many single-use non-degradable plastics are a threat to life today, and several polyhydroxyalkanoates (PHAs) biopolymers have been developed in the bioplastic industry to place petrochemical-based plastics. One of such is the novel biomaterial poly(3-hydroxypropionate) [poly(3HP)] because of its biocompatibility, biodegradability, and high yield synthesis using engineered strains. To date, many bio-polymer-based functional composites have been developed to increase the value of raw microbial-biopolymers obtained from cheap sources. This review article broadly covers poly(3HP), a comprehensive summary of critical biosynthetic production pathways comparing the yields and titers achieved in different Microbial cell Factories. This article also provides extensive knowledge and highlights recent progress on biosensors’ use to optimize poly(3HP) production, some bacteria host adopted for production, chemical and physical properties, life cycle assessment for poly(3HP) production using corn oil as carbon source, and some essential medical applications of poly(3HP).
Light Stimuli and Circadian Clock Affect Neural Development in Drosophila melanogaster
Authors: Dapergola Eleni , Menegazzi Pamela , Raabe Thomas , Hovhanyan Anna
Published: March 2021

Endogenous clocks enable organisms to adapt cellular processes, physiology, and behavior to daily variation in environmental conditions. Metabolic processes in cyanobacteria to humans are under the influence of the circadian clock, and dysregulation of the circadian clock causes metabolic disorders. In mouse andDrosophila, the circadian clock influences translation of factors involved in ribosome biogenesis and synchronizes protein synthesis. Notably, nutrition signals are mediated by the insulin receptor/target of rapamycin (InR/TOR) pathways to regulate cellular metabolism and growth. However, the role of the circadian clock inDrosophilabrain development and the potential impact of clock impairment on neural circuit formation and function is less understood. Here we demonstrate that changes in light stimuli or disruption of the molecular circadian clock cause a defect in neural stem cell growth and proliferation. Moreover, we show that disturbed cell growth and proliferation are accompanied by reduced nucleolar size indicative of impaired ribosomal biogenesis. Further, we define that light and clock independently affect the InR/TOR growth regulatory pathway due to the effect on regulators of protein biosynthesis. Altogether, these data suggest that alterations in InR/TOR signaling induced by changes in light conditions or disruption of the molecular clock have an impact on growth and proliferation properties of neural stem cells in the developingDrosophilabrain.
Evaluation of a Newly Identified Endophytic Fungus, Trichoderma phayaoense for Plant Growth Promotion and Biological Control of Gummy Stem Blight and Wilt of Muskmelon
Authors: Nuangmek Wipornpan , Aiduang Worawoot , Kumla Jaturong , Lumyong Saisamorn , Suwannarach Nakarin
Published: March 2021

Gummy stem blight and wilt are known to cause enormous losses to the global production of muskmelon (Cucumis melo). In this study, the potential of endophytic fungi isolated from leaves of Siam weed (Chromolaena odorata) was investigated for the inhibition of mycelial growth of Stagonosporopsis cucurbitacearum and Fusarium equiseti. Twenty-one fungal isolates were obtained. The results indicated that a fungal isolate UP-L1I3 displayed the highest percentage in terms of inhibition of the mycelial growth of F. equiseti and S. cucurbitacearum at 90.80 and 81.60%, respectively. Consequently, this isolate was selected for its potential ability to promote plant growth and control gummy stem blight and wilt in muskmelon seedlings. Morphological and multilocus phylogenetic analyses revealed that the isolate UP-L1I3 was a new species that has been described herein as Trichoderma phayaoense. Pathogenicity test confirmed that F. equiseti and S. cucurbitacearum were the cause of gummy stem blight and wilt disease in muskmelon seedlings, respectively. However, no disease symptoms were observed in seedlings inoculated with T. phayaoense. It was found that T. phayaoense could be used preventively in muskmelon seedlings that were inoculated with F. equiseti and S. cucurbitacearum, which could then reduce the impact on the disease severity index. T. phayaoense was also effective in improving plant development by increasing plant height, as well as shoot and root dry weight values. Moreover, T. phayaoense could effectively increase weight, diameter, and the circumference and total soluble solid of fruit without having a negative effect on fruit quality parameters. Additionally, T. phayaoense was able to tolerate a commonly applied fungicide (metalaxyl) in recommended dosages for field applications.
Integrated GC–MS- and LC–MS-Based Untargeted Metabolomics Studies of the Effect of Vitamin D3 on Pearl Production Traits in Pearl Oyster Pinctada fucata martensii
Authors: Yang Chuangye , Zeng Yetao , Liao Yongshan , Deng Yuewen , Du Xiaodong , Wang Qingheng
Published: March 2021

Pearl oyster Pinctada fucata martensii is widely recognized for biomineralization and has been cultured for high-quality marine pearl production. To ascertain how dietary vitamin D3 (VD3) levels affect the features of pearl production by P. f. martensii and discover the mechanisms regulating this occurrence, five experimental diets with variable levels of VD3 were used with inclusion levels of 0, 500, 1,000, 3,000, and 10,000 IU/kg. The distinct inclusion levels were distributed into five experimental groups (EG1, EG2, EG3, EG4, and EG5). All the experimental groups were reared indoors except the control group (CG) reared at the sea. Pearl oysters, one year and a half old, were used in the grafting operation to culture pearls. During the growing period that lasted 137 days, EG3 had the highest survival rate, retention rate, and high-quality pearl rate. A similar trend was found for EG3 and CG with significantly higher pearl thickness and nacre deposition rates than other groups, but no significant differences were observed between them. A metabolomics profiling using GC–MS and LC–MS of pearl oysters fed with low quantities of dietary VD3 and optimal levels of dietary VD3 revealed 135 statistically differential metabolites (SDMs) (VIP > 1 and p < 0.05). Pathway analysis indicated that SDMs were involved in 32 pathways, such as phenylalanine metabolism, histidine metabolism, glycerophospholipid metabolism, alanine aspartate and glutamate metabolism, arginine and proline metabolism, glycerolipid metabolism, amino sugar and nucleotide sugar metabolism, and tyrosine metabolism. These results provide a theoretical foundation for understanding the impacts of VD3 on pearl production traits in pearl oyster and reinforce forthcoming prospects and application of VD3 in pearl oyster in aquaculture rearing conditions.
Acidic pH Decreases the Endonuclease Activity of Initiator RepB and Increases the Stability of the Covalent RepB-DNA Intermediate while Has Only a Limited Effect on the Replication of Plasmid pMV158 in Lactococcus lactis
Authors: Valdelvira Rafael , Bordanaba-Ruiseco Lorena , Martín-Huestamendía Cristina , Ruiz-Masó José Angel , del Solar Gloria
Published: March 2021

Plasmid vectors constitute a valuable tool for homologous and heterologous gene expression, for characterization of promoter and regulatory regions, and for genetic manipulation and labeling of bacteria. During the last years, a series of vectors based on promiscuous replicons of the pMV158 family have been developed for their employment in a variety of Gram-positive bacteria and proved to be useful for all above applications in lactic acid bacteria. A proper use of the plasmid vectors requires detailed knowledge of their main replicative features under the changing growth conditions of the studied bacteria, such as the acidification of the culture medium by lactic acid production. Initiation of pMV158 rolling-circle replication is catalyzed by the plasmid-encoded RepB protein, which performs a sequence-specific cleavage on one of the parental DNA strands and, as demonstrated in this work, establishes a covalent bond with the 5′-P end generated in the DNA. This covalent adduct must last until the leading-strand termination stage, where a new cleavage on the regenerated nick site and a subsequent strand-transfer reaction result in rejoining of the ends of the cleaved parental strand, whereas hydrolysis of the newly-generated adduct would release the protein from a nicked double-stranded DNA plasmid form. We have analyzed here the effect of pH on the different in vitro reactions catalyzed by RepB and on the in vivo replication ability of plasmid pMV158. We show that acidic pH greatly impairs the catalytic activity of the protein and reduces hydrolysis of the covalent RepB-DNA adduct, as expected for the nucleophilic nature of these reactions. Conversely, the ability of pMV158 to replicate in vivo, as monitored by the copy number and segregational stability of the plasmid in Lactococcus lactis, remains almost intact at extracellular pHs ranging from 7.0 to 5.0, and a significant reduction (by ∼50%) in the plasmid copy number per chromosome equivalent is only observed at pH 4.5. Moreover, the RepB to pMV158 molar ratio is increased at pH 4.5, suggesting the existence of compensatory mechanisms that operate in vivo to allow pMV158 replication at pH values that severely disturb the catalytic activity of the initiator protein.
Effects of COVID-19 Lockdown on Movement Disorders Patients With Deep Brain Stimulation: A Multicenter Survey
Authors: Piano Carla , Bove Francesco , Tufo Tommaso , Imbimbo Isabella , Genovese Danilo , Stefani Alessandro , Marano Massimo , Peppe Antonella , Brusa Livia , Cerroni Rocco , Motolese Francesco , Di Stasio Enrico , Mazza Marianna , Daniele Antonio , Olivi Alessandro , Calabresi Paolo , Bentivoglio Anna Rita ,   Lazio DBS Study Group
Published: March 2021

Background: The containment measures taken by Italian government authorities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic caused the interruption of neurological activities of outpatient clinics. Vulnerable patients, as Parkinson's disease (PD) and dystonic patients with deep brain stimulation (DBS), may have an increased risk of chronic stress related to social restriction measures and may show a potential worsening of motor and psychiatric symptoms.

Methods: This cross-sectional multicenter study was carried out during the SARS-CoV-2 pandemic and was based on a structured survey administered during a telephone call. The questionnaire was designed to gather motor and/or psychiatric effects of the lockdown and coronavirus disease 2019 (COVID-19) epidemiologic information in PD and dystonic patients with a functioning DBS implant.

Results: One hundred four patients were included in the study, 90 affected by PD and 14 by dystonia. Forty-nine patients reported a subjective perception of worsening of global neurological symptoms (motor and/or psychiatric) related to the containment measures. In the multivariate analysis, having problems with the DBS device was the only independent predictor of motor worsening [odds ratio (OR) = 3.10 (1.22–7.91), p = 0.018]. Independent predictors of psychiatric worsening were instrumental activities of daily living (IADL) score [OR = 0.78 (0.64–0.95), p = 0.012] and problems with DBS [OR = 5.69 (1.95–16.62), p = 0.001]. Only one patient underwent nasopharyngeal swabs, both negative, and no patient received a diagnosis of COVID-19.

Conclusions: Lockdown restriction measures were associated with subjective worsening of motor and psychiatric symptoms in PD and dystonic patients treated with DBS, and they may have exacerbated the burden of neurological disease and increased the chronic stress related to the DBS management.
Effectiveness of the Beyond Good Intentions Program on Improving Dietary Quality Among People With Type 2 Diabetes Mellitus: A Randomized Controlled Trial
Authors: van der Velde Laura A. , Kiefte-de Jong Jessica C. , Rutten Guy E. , Vos Rimke C.
Published: March 2021

Background and Aims:An appropriate diet is an essential component of the management of Type 2 Diabetes Mellitus (T2DM). However, for many people with T2DM, self-management is difficult. Therefore, the Beyond Good Intentions (BGI) education program was developed based on self-regulation and proactive coping theories to enhance people's capabilities for self-management. The aim of this study was to determine the effectiveness of the BGI program on improving dietary quality among a preselected group of people with T2DM after two-and-a-half years follow-up.

Methods:In this randomized controlled trial, 108 people with T2DM were randomized (1:1) to the intervention (n= 56) (BGI-program) or control group (n= 52) (care as usual). Linear regression analyses were used to determine the effect of the BGI program on change in dietary quality between baseline and two-and-a-half years follow-up. In addition, potential effect modification by having a nutritional goal at baseline was evaluated. Multiple imputation (n= 15 imputations) was performed to account for potential bias due to missing data.

Results:According to intention-to-treat analysis, participants in the intervention group showed greater improvements in dietary quality score than participants in the control group (β = 0.71; 95%CI: 0.09; 1.33) after follow-up. Having a nutritional goal at baseline had a moderating effect on the effectiveness of the BGI program on dietary quality (p-interaction = 0.01), and stratified results showed that the favorable effect of the intervention on dietary quality was stronger for participants without a nutritional goal at baseline (no nutritional goal: β = 1.46; 95%CI: 0.65; 2.27 vs. nutritional goal: β = −0.24; 95%CI: −1.17; 0.69).

Conclusions:The BGI program was significantly effective in improving dietary quality among preselected people with T2DM compared to care as usual. This effect was stronger among participants without a nutritional goal at baseline. A possible explanation for this finding is that persons with a nutritional goal at baseline already started improving their dietary intake before the start of the BGI program. Future studies are needed to elucidate the moderating role of goalsetting on the effectiveness of the BGI program.
Negative Association Between Mediterranean Diet Adherence and COVID-19 Cases and Related Deaths in Spain and 23 OECD Countries: An Ecological Study
Authors: Greene Michael W. , Roberts Alexis P. , Frugé Andrew D.
Published: March 2021

In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) emerged in Wuhan, China, sparking the Coronavirus disease 2019 (COVID-19) pandemic. The high prevalence of nutrition-related COVID-19 risk factors including obesity, type 2 diabetes, and hypertension, suggests that healthy dietary approaches may mitigate COVID-19 related outcomes and possibly SARS-CoV-2 infection. Based on the fundamental role of nutrition in immune function and the well-documented association between Mediterranean diet consumption and risk reduction for chronic diseases that are comorbidities in COVID-19 patients, we hypothesized that there would be a relationship between Mediterranean diet adherence and COVID-19 cases and related deaths. In this perspective, we examined the association between regional adherence to a Mediterranean diet and COVID-19 cases and deaths using an ecological study design. We observed that Mediterranean diet adherence was negatively associated with both COVID-19 cases and related deaths across 17 regions in Spain and that the relationship remained when adjusted for factors of well-being. We also observed a negative association between Mediterranean diet adherence and COVID-19 related deaths across 23 countries when adjusted for factors of well-being and physical inactivity. The anti-inflammatory properties of the Mediterranean diet - likely due to the polyphenol content of the diet - may be a biological basis to explain our findings. However, there are confounding factors unrelated to dietary factors driving COVID-19 cases and related deaths across the regions in Spain and the 23 countries examined in our analysis. Our findings will need to be confirmed and further explored in cohort studies.
The Timing, Nature and Extent of Social Media Marketing by Unhealthy Food and Drinks Brands During the COVID-19 Pandemic in New Zealand
Authors: Gerritsen Sarah , Sing Fiona , Lin Karen , Martino Florentine , Backholer Kathryn , Culpin Angela , Mackay Sally
Published: March 2021

Background: Concerns have been raised that health and societal causes surrounding the COVID-19 pandemic were misappropriated by companies to promote their unhealthy products to vulnerable populations during a time of increased stress and hardship (i.e., COVID-washing). Social media is a common medium for unhealthy foods and beverage marketing due to lack of regulation and low levels of monitoring.

Purpose: This study aimed to investigate the timing, nature and extent of COVID-washing on public social media accounts by New Zealand's major food and drink brands in the initial stage of the pandemic after the first case was detected in New Zealand and when stay-at-home lockdown restrictions (Level 4 and 3 Alert levels) were in place.

Methods: A content analysis of social media posts from February to May 2020 by the twenty largest confectionery, snacks, non-alcoholic beverages, and quick-service restaurant (fast-food) brands was undertaken. COVID-19 related posts were identified and classified to investigate the timing, themes and engagement with social media marketing campaigns, flagging those that may breach New Zealand's Advertising Standards.

Results: 14 of 20 unhealthy food and drink brands referenced COVID-19 in posts during the 4-month period, peaking during nationwide lockdown restrictions. Over a quarter of all posts by the 14 brands (n = 372, 27.2%) were COVID-19 themed. Fast-food brands were most likely to use COVID-19 themed posts (n = 251/550 posts, 46%). Fast-food brands also had the highest number of posts overall during the pandemic and the highest engagement. The most commonly-used theme, present in 36% of all social media posts referring to COVID-19, was to draw on feelings of community support during this challenging time. Suggesting brand-related isolation activities was also common (23%), and the message that “consumption helps with coping” (22%). Six posts were found to potentially breach one of New Zealand's advertising standards codes by promoting excessive consumption or targeting children.

Conclusion: COVID-washing was used by unhealthy food and drinks brands to increase brand loyalty and encourage consumption. The current Advertising Standards system is ineffective and must be replaced with a government-led approach to effectively regulate social media advertising to protect all New Zealanders, particularly in times of crisis.
Overcoming Resistance to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinomas
Authors: dos Santos Lucas V. , Abrahão Carina M. , William William N.
Published: March 2021

Preclinical data suggest that head and neck squamous cell carcinomas (HNSCC) may evade immune surveillance and induce immunosuppression. One mechanism of immune evasion involves the expression of programmed death ligand-1 (PD-L1) in tumor and immune cells, which is, to date, the only biomarker routinely used in clinical practice to select patients with advanced HNSCCs more likely to benefit from anti-PD-1 therapy. Nonetheless, PD-L1 expression alone incompletely captures the degree of sensitivity of HNSCCs to PD-1 inhibitors. Most patients exposed to anti-PD-1 antibodies do not respond to therapy, suggesting the existence of mechanisms ofde novoresistance to immunotherapy. Furthermore, patients that initially respond to PD-1 inhibitors will eventually develop acquired resistance to immunotherapy through mechanisms that have not yet been completely elucidated. In this article, we will provide an overview of the immune landscape of HNSCCs. We will briefly describe the clinical activity of inhibitors of the PD-1/PD-L1 axis in this disease, as well as biomarkers of benefit from these agents that have been identified so far. We will review pre-clinical and clinical work in cancers in general, and in HNSCCs specifically, that have characterized the mechanisms ofde novoand acquired resistance to immunotherapy. Lastly, we will provide insights into novel strategies under investigation to overcome resistance to immune checkpoint inhibitors.
Characteristics and Absolute Survival of Metastatic Colorectal Cancer Patients Treated With Biologics: A Real-World Data Analysis From Three European Countries
Authors: Oppelt Katja A. , Kuiper Josephina G. , Ingrasciotta Ylenia , Ientile Valentina , Herings Ron M. C. , Tari Michele , Trifirò Gianluca , Haug Ulrike
Published: March 2021

Introduction: Biologics were approved for the treatment of advanced colorectal cancer (CRC) based on favorable benefit-risk-assessments from randomized controlled trials (RCTs), but evidence on their use in the real-world setting is scarce. Based on descriptive analyses we therefore aimed to assess characteristics and survival of CRC patients treated with biologics using large healthcare databases from three European countries (Netherlands, Italy, Germany).

Methods: We included CRC patients treated with a biologic in 2010 or 2014 and characterized them regarding age, sex, comorbidities, and absolute survival.

Results: Among 4,758 patients, the mean age ranged from 64.8 to 66.8 years, the majority was male, and comorbidities used as exclusion criteria in RCTs were coded in up to 30% of these patients. The proportion of bevacizumab users decreased between 2010 (72–93%) and 2014 (63–85%). In 2014, the absolute 12-month survival in new users was 64% (95% CI 51–77%), 56% (30–80%), and 61% (58–63%) in the Dutch, Italian, and German database, respectively, varying by age and comorbidity.

Conclusions: Our study suggests that in the real-world setting, CRC patients treated with biologics are older and less selected regarding comorbidities compared to patients in RCTs, potentially explaining the relatively low 12-month survival we found. Treatment decisions in the real-world setting may require careful evaluation given that the risk-benefit ratio may vary depending on age and co-existing conditions.
Circulating Plasma Cells as a Biomarker to Predict Newly Diagnosed Multiple Myeloma Prognosis: Developing Nomogram Prognostic Models
Authors: Cheng Qianwen , Cai Li , Zhang Yuyang , Chen Lei , Hu Yu , Sun Chunyan
Published: March 2021

Background: To investigate the prognostic value of circulating plasma cells (CPC) and establish novel nomograms to predict individual progression-free survival (PFS) as well as overall survival (OS) of patients with newly diagnosed multiple myeloma (NDMM).

Methods: One hundred ninetyone NDMM patients in Wuhan Union Hospital from 2017.10 to 2020.8 were included in the study. The entire cohort was randomly divided into a training (n = 130) and a validation cohort (n = 61). Univariate and multivariate analyses were performed on the training cohort to establish nomograms for the prediction of survival outcomes, and the nomograms were validated by calibration curves.

Results: When the cut-off value was 0.038%, CPC could well distinguish patients with higher tumor burden and lower response rates (P < 0.05), and could be used as an independent predictor of PFS and OS. Nomograms predicting PFS and OS were developed according to CPC, lactate dehydrogenase (LDH) and creatinine. The C-index and the area under receiver operating characteristic curves (AUC) of the nomograms showed excellent individually predictive effects in training cohort, validation cohort or entire cohort. Patients with total points of the nomograms ≤ 60.7 for PFS and 75.8 for OS could be defined as low-risk group and the remaining as high-risk group. The 2-year PFS and OS rates of patients in low-risk group was significantly higher than those in high-risk group (p < 0.001).

Conclusions: CPC is an independent prognostic factor for NDMM patients. The proposed nomograms could provide individualized PFS and OS prediction and risk stratification.
Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children
Authors: Ho Shaun S. C. , Ross Michael , Keenan Jacqueline I. , Day Andrew S.
Published: March 2021

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.

Methods: Children aged <17 years who had FC (normal range <50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.

Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC <50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC >50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.

Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.
Expanding the Role Repertoire While Aging: A Drama Therapy Model
Authors: Keisari Shoshi
Published: March 2021

Drama therapy has been found to improve various facets of mental health while aging. It provides opportunities for personal growth and creative expression and enhances group relationships. Drama therapy is a widely acknowledged way to explore the life stories in late life. However, only a handful of studies have empirically explored the value of drama therapy for the aging population. This conceptual analysis was designed to address this need by developing a new integrative model of drama therapy. The analysis is based on the review of the results of four studies that explored the integration of life-review and playback theater as a drama therapy approach for older adults. The therapeutic process focused on the exploration of life-crossroads stories, a short unique technique which enables the participants to craft a harmonious view of their life stories in a short-term dramatic creative group process. Combining the four results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life story, the evolution of improvised dramatic expression, and the expansion of social engagement. The transformative routes are described through the lens ofrole theoryin drama therapy.
Depressive and Anxiety Symptoms of Healthcare Workers in Intensive Care Unit Under the COVID-19 Epidemic: An Online Cross-Sectional Study in China
Authors: Peng Xiaofan , Meng Xiangyu , Li Li , Hu Chenghuan , Liu Wei , Liu Zhiyong , Ma Xinhua , Xu Daomiao , Xing Zhenhua , Zhu Zhaowei , Liu Bangshan , Zhang Lina , Peng Milin
Published: March 2021

Background: Since the coronavirus disease-2019 (COVID-19) outbreak, intensive care unit (ICU) healthcare workers were responsible for the critical infected patients. However, few studies focused on the mental health of ICU healthcare workers. This study aimed to investigate the psychological impact of COVID-19 on ICU healthcare workers in China.

Methods: We distributed the nine-item Patient Health Questionnaire (PHQ-9) and seven-item General Anxiety Disorder questionnaire (GAD-7) online to ICU healthcare workers in China. Respondents were divided into frontline and second-line according to whether they have contact with COVID-19 patients. Depressive and anxiety symptoms of all respondents were evaluated based on their questionnaire scores.

Results: There were 731 ICU healthcare workers finally enrolled in our study, including 303 (41.5%) male, 383 (52.4%) doctors, and 617 (84.4%) aged 26–45 years. All in all, 482 (65.9%) ICU healthcare workers reported symptoms of depression, while 429 (58.7%) reported anxiety. There was no significant difference between frontline (n = 325) and second-line (n = 406) respondents in depression (P = 0.15) and anxiety severity (P = 0.56). Logistic regression analysis showed that being female, ICU work time >5 years, and night duty number ≥10 were risk factors of developing depressive and anxiety symptoms. Income reduction was separately identified as risk of anxiety. Additionally, ICU work time >5 years was also identified as risk of developing moderate–severe depressive and anxiety symptoms.

Conclusions: Frontline ICU work was not associated with higher risk of depressive and anxiety symptoms during COVID-19 pandemic remission period in China. Actions like controlling night duty number, ensuring vacation, and increasing income should be taken to relieve mental health problem. Furthermore, we should pay close attention to those who had worked long years in ICU.