bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypokalemia in Patients With Eating Disorders Is Associated With Binge-Purge Behavior, Lower Body Mass Index, and Hypoalbuminemia ~Predicting Hypokalemia During Refeeding~
Authors: Funayama Michitaka , Mimura Yu , Takata Taketo , Koreki Akihiro , Ogino Satoyuki , Kurose Shin , Shimizu Yusuke
Published: June 2021

Aim
To identify potential mechanisms underlying hypokalemia in patients with eating disorders
Background
Hypokalemia is frequently found in patients with eating disorders and sometimes leads to life-threatening conditions. The mechanisms underlying hypokalemia have yet to be elucidated except for binge-purge behavior, although other factors, e.g., malnutrition and refeeding, are proposed to induce hypokalemia. In this study, we investigated factors associated with hypokalemia during acute treatment of patients with eating disorders.
Methods
We recruited 52 independent patients from 89 admissions with eating disorders (body mass index, 13.0 ± 3.3) and analyzed serum potassium levels at admission. Similarly, 66 admissions with > 1-week hospitalization were recruited to determine the lowest potassium levels during the refeeding period. We analyzed these levels with multiple linear regression analysis with explanatory variables, including data upon admission and treatment-related indicators.
Results
A lower serum potassium level at admission and a lower nadir potassium level during refeeding were associated with a lower body mass index, hypoalbuminemia, and binge-purge behavior. Similar results were obtained when the analysis included restrictive or binge-purge types as well as the independent patient group. The lowest potassium levels during the refeeding period was observed an average of 2.5 days after admission.
Conclusions
Thus lower body mass index, hypoalbuminemia, and binge-purge behavior might predict hypokalemia among patients with eating disorders both at admission and during refeeding. Our study is the first to demonstrate that malnutrition and refeeding themselves might induce hypokalemia among patients with eating disorders. These factors might be used as indicators to guide clinical approaches for controlling serum potassium levels during refeeding.
Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis
Authors: Zhu Ling , Wang Zhenghao , Zhou Ye , Gou Liping , Huang Yan , Zheng Xiaofeng
Published: June 2021

Background
A systematic review and meta-analysis was conducted to compare the safety and efficacy between the vacuum-assisted sheath and conventional sheath in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis.
Methods
PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2021) were searched for studies assessing the effect of vacuum-assisted sheath in patients who underwent MPCNL. The search strategy and study selection processes were managed according to the PRISMA statement.
Results
Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheath was significantly higher than those who underwent conventional sheath (RR = 1.18, 95% CI = 1.08,1.29; P = 0.0002), with insignificant heterogeneity among the studies (I2 = 44%, P = 0.13). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR = 0.45, 95%CI = 0.33,0.61; P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.76). There was no significant difference in blood transfusion rate (RR = 0.54, 95%CI = 0.23,1.29; P = 0.17) with insignificant heterogeneity (I2 = 41%, P = 0.15,). Only two studies reported the perforation and the results were statistically insignificant (RR = 0.25, 95%CI = 0.05,1.17; P = 0.08) with insignificant heterogeneity (I2 = 0%, P = 0.43).
Conclusions
Using vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. Vacuum-assisted sheath significantly increases the SFR and reduces complications like postoperative infection, blood transfusion, and perforation
Zone 2 Hybrid Thoracic Endovascular Aortic Repair: Is It a Good Option for All Types of Thoracic Aortic Disease?
Authors: Sohn Bongyeon , Lee Jae Hang , Jung Joon Chul , Chang Hyoung Woo , Kim Dong Jung , Kim Jun Sung , Lim Cheong , Park Kay-Hyun
Published: June 2021

Background
Zone 2 thoracic endovascular aortic repair (TEVAR) is performed for the treatment of various thoracic aortic diseases involving the left subclavian artery. This study aimed to analyze the late clinical outcomes of zone 2 hybrid TEVAR according to the various indications.
Methods
A total of 48 patients who underwent zone 2 TEVAR at our institution between December, 2010 and July, 2020 were enrolled. The indications were aortic aneurysm (AA, n = 15), acute type B aortic dissection (AD, n = 14), penetrating aortic ulcer (PAU, n = 8), traumatic aortic injury (TAI, n = 8), and others (n = 3). The clinical outcomes including early complications and mid-term aortic measurements were retrospectively reviewed.
Results
The technical success rate was 100% and in-hospital mortality occurred in one patient. The early postoperative complications included stroke (n = 1), transient spinal cord ischemia (n = 1), neck wound hematoma (n = 1), and left phrenic or vagus nerve injury (n = 9). In patients with AD, positive remodeling was observed in ten patients (76.9%) (false lumen regression in the entire or thoracic aorta [n = 9], false lumen thrombosis in the thoracic aorta [n = 1]). However, in patients with AA, increased aneurysm was found in six patients (40%). Persistent aneurysmal growth was found in patients with a maximal aortic diameter of > 60 mm on initial imaging (4/6, 50%). No aortic expansion was observed in those with TAI or PAU. Endoleak was noted in five patients (10.4%), and among them, aortic reintervention was required only in patients with large AAs.
Conclusions
Zone 2 hybrid TEVAR was associated with an acceptable early complication rate and provided acceptable mid-term aortic results for patients with AD, PAU, and TAI. However, patients with large AAs were at increased risk of aortic reintervention. In cases of large AA, clinicians should carefully consider whether zone 2 hybrid TEVAR or open surgical repair will be more effective for the patient.
Improved Differentiation of hESC-derived Pancreatic Progenitors by Using Human Fetal Pancreatic Mesenchymal Cells in a Micro-Scalable Three-dimensional Co-culture System
Authors: Ghezelayagh Zahra , Zabihi Mahsa , Zarkesh Ibrahim , Gonçalves Carla A. C. , Larsen Michael , Hagh-parast Newsha , Pakzad Mohammad , Vosough Masoud , Arjmand Babak , Baharvand Hossein , Larijani Bagher , Grapin-Botton Anne , Aghayan Hamid Reza , Tahamtani Yaser
Published: June 2021

Mesenchymal cells of diverse origins differ in gene and protein expression besides producing varying effects on their organ-matched epithelial cells’ maintenance and differentiation capacity. Co-culture with rodent’s tissue-specific pancreatic mesenchyme accelerates proliferation, self-renewal, and differentiation of pancreatic epithelial progenitors. Therefore, in our study, the impact of three-dimensional (3D) co-culture of human fetal pancreatic-derived mesenchymal cells (hFP-MCs) with human embryonic stem cell-derived pancreatic progenitors (hESC-PPs) development towards endocrine and beta cells was assessed. Besides, the ability to maintain scalable cultures combining hFP-MCs and hESC-PPs was investigated. hFP-MCs expressed many markers in common with bone marrow-derived mesenchymal stem cells (BM-MSCs). However, they showed higher expression of DESMIN compared to BM-MSCs. After co-culture of hESC-PPs with hFP-MCs, the pancreatic progenitor (PP) spheroids generated in Matrigel had higher expression of NGN3 and INSULIN than BM-MSCs co-culture group, which shows an inductive impact of pancreatic mesenchyme on hESC-PPs beta-cells maturation. Pancreatic aggregates generated by forced aggregation through scalable AggreWell system showed similar features compared to the spheroids. These aggregates, a combination of hFP-MCs and hESC-PPs can be applied as an appropriate tool for assessing endocrine-niche interactions and developmental processes by mimicking the pancreatic tissue.
Quality of Life and Challenges Experienced by the Surviving Adults With Transfusion Dependent Thalassaemia in Malaysia: A Cross Sectional Study
Authors: Foong Wai Cheng , Chean Kooi Yau , Rahim Fairuz Fadzilah , Goh Ai Sim , Yeoh Seoh Leng , Yeoh Angeline Aing Chiee
Published: June 2021

Background
Improvement in medical management has enabled transfusion dependent thalassaemia (TDT) patients to survive beyond childhood, building families, and contributing to the labour force and society. Knowledge about their adult life would provide guidance on how to support their needs. This study aims to explore the general well-being of adults with TDT, their employment status and challenges.
Methods
We contacted all regional Thalassaemia societies in Malaysia to invite TDT members aged 18 or over to participate. Participants were also recruited from the two participating hospitals. A self-administered questionnaire including ‘CDC Healthy-days’, WHOQOL-BREF and employment measurements was used. Multiple linear regression models were fitted with associations adjusted for several potential confounders.
Results
Of the 196 participants, almost half (45%) had comorbidities and 20% suffered multiple types: bone-related (13%), hormonal (12%), cardiac (3%) and infections (2%), resulting in 23% seeking treatment more than twice monthly. Within a month, they suffered from a mean 3.1 (SD 3.0) days of feeling unhealthy physically, a mean 2.6 (SD 3.5) days mentally unhealthy and their normal daily activities performance were affected for approximately 2.5 (SD 3.3) days - leading to 36% being jobless and 38% of those with a job receiving salaries below RM1000. The mean quality of life (QOL) score (mean (SD) for each QOL domain was: physical health 62.6 (15.5), psychological health 64.7 (15.7), social relationship 64 (15.9), environmental health 60.8 (16.7). Frequent activities limited days, being single, unwillingness to disclose thalassaemia status, presence of comorbidities, discrimination experiences and perceptions about employment difficulties were associated with lower QOL scores. Dissatisfaction with health service provision, conflicting judgement in prioritising between health and job, and poor public empathy were expressed.
Conclusion
Adults with TDT appeared to be fairly positive about their life in spite of high number of dysfunctional days and had perceptions that health services do not meet their needs. They continued to face life disruption in a rather non-supportive community. Supportive approaches and life-skill training are necessary where interventions should be started during childhood. Adjustment to health services should be considered.
Fusion of Fully Integrated Analog Machine Learning Classifier with Electronic Medical Records for Real-Time Prediction of Sepsis Onset
Authors: Sadasivuni Sudarsan , Saha Monjoy , Bhatia Neal , Banerjee Imon , Sanyal Arindam
Published: June 2021

The objective of this work is to develop a fusion artificial intelligence (AI) model that combines patient electronic medical record (EMR) and physiological sensor data to accurately predict early risk of sepsis. The fusion AI model has two components - an on-chip AI model that continuously analyzes patient electrocardiogram (ECG) data and a cloud AI model that combines EMR and prediction scores from on-chip AI model to predict fusion sepsis onset score. The on-chip AI model is designed using analog circuits for sepsis prediction with high energy efficiency for integration with resource constrained wearable device. Combination of EMR and sensor physiological data improves prediction performance compared to EMR or physiological data alone, and the late fusion model has an accuracy of 93% in predicting sepsis 4 hours before onset. The key differentiation of this work over existing sepsis prediction literature is the use of single modality patient vital (ECG) and simple demographic information, instead of comprehensive laboratory test results and multiple vital signs. Such simple configuration and high accuracy makes our solution favorable for real-time, at-home use for self-monitoring.
Role of Matrix Metalloproteinase MMP-2, MMP-9 and Tissue Inhibitor of Metalloproteinase (TIMP-1) in Clinical Progression of Pediatric Acute Lymphoblastic Leukemia
Authors: Saleh Maha , Khalil Mohamed , Abdellateif Mona S. , Ebeid Emad , Kandeel Eman Z.
Published: June 2021

Background: Matrix metalloproteinases (MMPs) play a crucial role in cancer progression and metastasis, however their role in pediatric Acute lymphoblastic leukemia (ALL) is still unrevealed.Methods: The diagnostic, prognostic and predictive value of tissue inhibitor of metalloproteinase (TIMP-1), MMP-2, MMP-9 and CD34+CD38- CSCs were assessed in bone marrow (BM) samples of 76 ALL children using Flow Cytometry analysis. Results: There was a significant increase in TIMP-1 [1.52 (0.41-10) versus 0.91(0.6-1.12); respectively, P<0.001], and CSCs CD84+CD38- [1 (0.03-18.6) versus 0.3 (0.01-1.1), P<0.001] expression in ALL patients compared to controls. While there were no significant differences regarding MMP-2 and MMP-9 expression between the two groups. The sensitivity, specificity, AUC of MMP-2 were (80.3%, 53.3% and 0.568, P=0.404), and that of MMP-9 were (53.9%, 40% and 0.660, P=0.053). While that of TIMP-1 were (78.9%, 100% and 0.892, P<0.001), and that of CSCs CD34+ CD38- were (78.9%, 73.3% and 0.855, P<0.001). There was a significant association between MMP-2 overexpression and MRD at day-15, increased BM blast cell count at diagnosis and at day-15, (P=0.020, P=0.047 and P=0.001). Increased TIMP-1 expression associated with the high-risk disease (P<0.001), increased BM blast cell count at diagnosis and at day-15 (P=0.033 and P=0.001), as well as MRD at day 15 and day 42 (P<0.001 for both). CD34+CD38- CSCs associated with MRD at day-15, increased BM blast cell count at diagnosis and at day-15 (P=0.015, P=0.005 and P=0.003). TIMP-1 overexpression associated with shorter DFS and OS rates (P=0.009 and P=0.048). Multivariate logistic regression analysis showed that both TIMP-1 [OR: 4.224, P=0.046], and CD34+CD38- CSCs [OR: 6.873, P=0.005] are independent diagnostic factors for pediatric ALL.Conclusion: TIMP-1 and CD34+CD38- CSCs could be useful independent diagnostic markers for pediatric ALL. Also, TIMP-1 is a promising prognostic marker for poor outcome of the patients.
Bilateral breast cancer in a 65-year-old man
Authors: Sharbatdaran Arman , Twam Mohammed , Ghorbane Hosseine , Nikbakhsh Novin
Published: June 2021

Globally, breast cancer in men is exceedingly uncommon. The misinterpretation of signs and symptoms and lack of a proper medical history can lead to the progression of rare conditions to advanced stages. We report the case of a 65-year-old man who presented to the clinic complaining about progressive bilateral dull breast pain. He had been diagnosed with bilateral grade II invasive ductal carcinoma three months prior, and he underwent bilateral mastectomy followed by chemotherapy as a part of his treatment plan.
Methodological Guidelines to Estimate Population-based Health Indicators Using Linked Data and/or Machine Learning Techniques
Authors: Haneef Romana , Tijhuis Mariken , Thiébaut Rodolphe , Májek Ondřej , Pristaš Ivan , Tolenan Hanna , Gallay Anne
Published: June 2021

Background: The capacity to use data linkage and artificial intelligence to estimate and predict health indicators varies across European countries. However, the estimation of health indicators from linked administrative data is challenging due to several reasons such as variability in data sources and data collection methods resulting in reduced interoperability at various levels and timeliness, availability of a large number of variables, lack of skills and capacity to link and analyze big data. The main objective of this study is to develop the methodological guidelines calculating population-based health indicators to guide European countries using linked data and/or machine learning (ML) techniques with new methods. Method: We have performed the following step-wise approach systematically to develop the methodological guidelines: i. Scientific literature review, ii. Identification of inspiring examples from European countries, and iii. Developing the checklist of guidelines contents.Results: We have developed the methodological guidelines, which provide a systematic approach for studies using linked data and/or ML-techniques to produce population-based health indicators. These guidelines include a detailed checklist of the following items: rationale and objective of the study (i.e., research question), study design, linked data sources, study population/sample size, study outcomes, data preparation, data analysis (i.e., statistical techniques, sensitivity analysis and potential issues during data analysis) and study limitations. Conclusions: This is the first study to develop the methodological guidelines for studies focused on population health using linked data and/or machine learning techniques. These guidelines would support researchers to adopt and develop a systematic approach for high-quality research methods. There is a need for high-quality research methodologies using more linked data and ML-techniques to develop a structured cross-disciplinary approach for improving the population health information and thereby the population health.
Severe Multi-inflammatory syndrome in children amidst tropical fevers– an overlapping spectrum, its clinical and laboratory attributes from a tertiary care centre in India.
Authors: Chattopadhyay Arpita , Kalra Karnika Saigal , Saikia Diganta , Yadav Varshanjali , Chouksey Juhi , Jajoo Mamta , Sherwal B L
Published: June 2021

Objective: We aim to describe our experience in terms of clinical and laboratory attributes in children with Multi – inflammatory syndrome in children temporally related to COVID-19 (MISC) presenting amidst other prevalent tropical infections.Design: Prospective case series.Setting: A tertiary care hospital pediatric intensive care unit (PICU).Patients: Seventeen children with severe MIS-C managed in PICU.Methods: We did a prospective case series of children (aged ≤ 12 years), admitted to PICU betweenMay 1, 2020 and January 31, 2021, fulfilling the case definition of MIS-C published by World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC). We analysed routinely collected demographic, clinical, laboratory data and echocardiographic findings. We also plotted the variation in trends between survivors and nonsurvivors.Results: 17 critically ill children with no previous comorbidities fulfilled the WHO/CDC classification of MIS-C. Median age at admission was 4 years (range 1y 6 mo-8 years). Fever, rash and conjunctival redness were most prominent symptoms. Myocardial involvement was seen in 70.5% while 76.4% developed shock; Invasive mechanical ventilation was required in 64.7% cases. Inflammation markers were highly raised - median C- reactive protein (mg/L) showed serial reduction in levels - from (median/IQR) 210 (132.6, 246.9) at admission to PICU to 52.3 (42, 120) on Day 3. Median Ferritin (ng/ml) (n=12) was 690 (203, 1324), serum LDH (IU/L) (n=12) was 505 (229.5, 1032) and Mean D-dimer (ng/ml) (n=7) was 5093.85 (1991.65), suggestive of hyperinflammatory syndrome. Although neutrophilia was seen in 16 patients [Mean (SD) - 14,952.9/μl (7175.2)], lymphopenia was uncommon and seen in only 4/17, median (IQR) [3000/μl (2245, 4508)]. 12 patients received intravenous immune globulin, with adjunctive steroid therapy used in two third of the cases. Six patients expired.Conclusions: With our case series we wish to highlight the pattern of clinical and laboratory features in a cohort of severe MISC who were positive for SARSCOV2 antibody. We suggest refining the spectra of phenotypes of MIS-C for tropical countries keeping other exanthematous infections that present with fulminant myocarditis and refractory shock in perspective.
Effectiveness of a Long-Lasting Insecticide Treatment Kit (ICON® Maxx) for Polyester Nets Over Three Years of Household use: A WHO Phase III Trial in Tanzania
Authors: Tungu Patrick , Sudi Wema , Kisinza William , Rowland Mark
Published: June 2021

BackgroundICON® Maxx (Syngenta) is an insecticide treatment kit of pyrethroid and binding agent for long-lasting treatment of mosquito nets. Interim recommendation for use on nets was granted by WHO after successful evaluation in experimental huts following multiple washes. A full WHO recommendation is contingent upon demonstration of continued bio-efficacy after 3 years of use. MethodsA household-randomised prospective study design was used to assess ICON Maxx treated nets over 3 years in north-eastern Tanzania. Conventional treated nets (with lambda-cyhalothrin but without binder) served as a positive control. At 6-monthly intervals, cross-sectional household surveys monitored net use and physical integrity, while cone and tunnel tests assessed insecticidal efficacy. Pyrethroid content was determined after 12 and 36 months. A parallel cohort of nets was monitored annually for evidence of net deterioration and attrition. ResultsAfter 12 months’ use, 97% of ICON Maxx treated nets but only 67% of CTN passed the WHO efficacy threshold for insecticidal durability (>80% mortality in cone or tunnel or 90% feeding inhibition in tunnel). After 24- and 36-months use, 67% and 26% of ICON Maxx treated nets met the cone criteria respectively and over 90% met the combined cone and tunnel criteria. Lambda-cyhalothrin content after 36 months was 17% (15.8 ± 4.3 mg/m2) of initial content. ICON Maxx nets were used year-round and washed approximately 4 times per year. In cross-sectional survey after 36 months the average number of holes was 20 and hole index was 740 cm2 per net. Cohort nets had fewer holes and smaller hole index than cross-sectional nets. However, only 15% (40/264) of cohort nets were not lost to follow-up or not worn out after 36 months.ConclusionsBecause more than 80% of nets met the WHO efficacy criteria after 36 months use, ICON Maxx was granted WHO full recommendation. Cross-sectional and cohort surveys were complementary and gave a fuller understanding of net durability. To improve net usage and retention, stronger incentives and health messaging should be introduced in WHO LLIN longitudinal trials. Untreated polyester nets may be made long-lastingly insecticidal in Africa through simple household treatment using ICON Maxx pyrethroid-binder kits.
A study of buckling phenomenon in dielectric elastomeric actuator with different potential energy functions
Authors: Kumar Deepak , Yadav Vinod , Gour Sankalp , Srivas Ayush
Published: June 2021

The present study deals with the buckling phenomenon modeling in a dome-shaped dielectric elastomeric (DE) actuator used in different aerodynamic and fluid power system applications. The DE actuator is a circular membrane type of actuator, which shows a large out-of-plane axial-symmetric deformation with an electrically induced loading condition. A classical continuum mechanics-based analytical model is developed to predict the electrically induced buckling deformation in the actuator. A detailed parametric study has been performed to see the influence of standard Neo-Hookean and Mooney-Rivlin types of potential energies on the geometrical and physical parameters. The findings show that the present model successfully links the sensitivity of different potential energies concerning the actuator’s initial dome height and radius.
Neurotrauma in the Syrian War: Analysis of 41,143 cases from July 2013-July 2015
Authors: Fatima Nida , Mowafi  , Hariri M MD Mahmoud , Alnahhas  , Al-Kassem F MSc MD Anas , Saqqur F MPH MD Maher
Published: June 2021

Introduction: Despite nearly a decade of conflict, little is known about trauma and injuries resulting from the Syrian war.Methods: Secondary analysis was conducted of an administrative dataset of patient presentations to a network of 95 war-affected hospitals in Syria from July 2013 - July 2015. Logistic regression was performed to identify factors associated with mortality of neurotrauma patients. Results: Of 193,618 overall trauma presentations, 41,143 were for neurotrauma (37,410 head trauma, 1,407 spinal trauma and 3,133 peripheral nervous system). There were 31,359 males (76.2%) and 9,784 females (23.8%). Males aged 19-30 years (10,113; 24.6%) were the largest single demographic group. Presumed non-combatants including females, elders and children under 13 years (16,214; 39.4%) were the largest group of patients overall. There were 16,881 (41.0%) presentations with blunt injuries (blunt/crush injuries) and 21,307 (51.8%) patients with penetrating injuries (shrapnel, cut, gunshot). A total of 36,589 patients (89.6%) were treated and discharged from the hospital, 2,100 (5.1%) were transferred to another facility, 2,050 patients (5.0%) died in-hospital, 26 remained in the hospital (0.1%), 108 (0.3%) had unknown disposition. The median length of hospital stay was 1 day. There were 4,034 (9.7%) neurosurgical procedures documented. Patients with combined neurotrauma and general trauma suffered 30 times higher mortality than neurotrauma alone (aOR: 30.4; 95%CI: 20.8-44.2, p<0.0001).Conclusion: The Syrian War resulted in large volumes of neurotrauma patients. Presumed non-combatants comprised 39.4% of patients who survived to treatment at a facility. Further study is needed on long-term needs of neurotrauma victims of the Syrian war.
Pandemic consequences and crisis recovery scenarios
Authors: Minchenko Mariia , Demchuk Kateryna
Published: June 2021

The global economy develops in completely new and unpredictable conditions due to the COVID-19 pandemic spread. The current COVID-19 crisis has changed the supply and demand ratio. Economic recovery requires the right macroeconomic policy to support national economies, maintain economic and financial relationships between workers and enterprises, creditors and borrowers, suppliers, and end consumers. Therefore, there is a challenge to minimize the influence of the long-term COVID-19 crisis to avoid irreparable damage to people and companies due to job losses and mass bankruptcies. This study aims to analyze the COVID-19 consequences and scenarios of economic recovery after the pandemic crisis. The study’s relevance is that the global economy needs significant behavioral, structural, and institutional changes to stabilize the system and form the basis for further development. The findings showed that the COVID-19 pandemic has become a trigger of devastating large-scale world economic imbalances. The authors noted that one of the combating methods against the pandemic spread was quarantine measures. However, the massive population isolation, limiting its mobility and economic activity, has created an extraordinary socio-economic situation. The authors conclude that pandemic significantly increased the demand for food delivery services since people preferred (or were forced) to stay at home. At the same time, people were apprehensive about coronavirus transmission through couriers. The prolonged quarantine has changed consumer behavior. Notably, the demand for such goods as cars and clothing decreased while increased for household products. Most developed and many developing countries have sacrificed their economies to defend the population. The authors concluded that the social changes caused by quarantine restrictions have divided the world into current and «post-COVID» and affect all global economic fields. The obtained results indicated the need to find new possibilities to simplify production and manage remote work. The study findings emphasize the need to find new possibilities to simplify production. Moreover, it is essential to establish links between manufacturers and economic systems under remote work.
Nonlinear Model Selection for Fruit and Kernel Development as a Function of Heat in Pistachio
Authors: Zhang Lu , Laca Emilio , Allan Cara J. , Mahvelati Narges M. , Ferguson Louise
Published: June 2021

Knowing a tree crop’s seasonal growth and development as a function of heat accumulation can facilitate scheduling of irrigation, pesticide applications, and harvest. Our objective was to compare the goodness of fit of applied models and determine which provides the best description of pistachio nut growth as a function of thermal unit accumulation. Three fruit growth traits of pistachio—pericarp (hull) + endocarp (shell) size, endocarp thickening and hardening, and embryo (kernel) size—exhibited clear nonlinear dependence on heat accumulation. We tested three nonlinear models—Michaelis–Menten, three-parameter logistic, and Gompertz—fitted to fruit development data to create a tool to forecast pest susceptibility and harvest timing. Observation of development began at full bloom and ended at harvest. Data were collected from six pistachio cultivars in one experimental and eight commercial orchards over 3 years. Analyses of residual distribution, parameter standard errors, coefficient of determination (R2) and the Akaike information criterion (AIC) all demonstrated the Gompertz function was the best model. Cultivars differed significantly in all the three parameters (Asym, b, and c) for all three traits with the Gompertz model, demonstrating the Gompertz model can adjust to incorporate cultivar differences. The growth curve of the three traits together provided integrated information on nut biomass accumulation that facilitates predicting the critical timing for multiple orchard management practices.
Early Performance of Selected Citrus Rootstocks Grafted with ‘Valencia’ Sweet Orange in Commercial Settings within a Citrus Greening Endemic Environment
Authors: Singerman Ariel , Futch Stephen H. , Page Brandon
Published: June 2021

Citrus greening or Huanglongbing (HLB) has caused sweet orange (Citrus sinensis) yield in Florida to decrease by 55% since the disease was first discovered in 2005. As a consequence, the profitability and sustainability of citrus (Citrus sp.) production in Florida have been jeopardized, as evidenced by the 62% reduction in the number of citrus growers statewide. Because there is still no effective treatment or management strategy to cure the disease, it is crucial to optimize grove practices and management. The use of improved rootstocks could increase the tolerance of citrus scions to biotic and abiotic stresses, thereby allowing growers to cope better with the impact of HLB in the field. We used yield data collected from commercial trials over the course of multiple seasons to assess the side-by-side performance of various commercially available rootstocks developed by the two major breeding programs in Florida in HLB-endemic field conditions. We found that some of the rootstocks attained not only statistically significant differences in yield relative to the control but also meaningful differences in revenue. Those estimates provide evidence regarding the effect of rootstock during the first few seasons after planting. Our findings are useful to improve growers’ decision-making processes regarding rootstock selection for new groves.
DIREITO À MORADIA E OS BENEFÍCIOS DE UMA POLÍTICA DE ACOLHIMENTO PERMANENTE PARA AS PESSOAS EM SITUAÇÃO DE RUA
Authors: Do Nascimento Luiz Sales , Albergaria Barreto Carlos Gustavo Guimarães
Published: June 2021

Este artigo objetivou identificar os benefícios e dificuldades relacionadas ao acolhimento permanente de pessoas em situação de rua, verificando-se a real possibilidade de se adotar tal sistemática no Brasil. Para compor o estudo, utilizou-se metodologia hipotético-dedutiva, no tocante ao impacto da referida política pública na vida dos indivíduos beneficiados, seguida de método comparativo no âmbito do acolhimento permanente em outros Estados. Conclui-se que caso do Brasil, dentre os inúmeros modelos adotados pelo Mundo, o modelo de acolhimento permanente que mais se adequa às nossas peculiaridades é o CHF (Communal Housing First), por conciliar baixo custo fiscal com eficiência na alocação de serviços públicos.
ESCRAVIDÃO CONTEMPORÂNEA: UMA ANÁLISE DO CASO DO TRABALHO ANÁLOGO AO DE ESCRAVO NO ESTADO DO AMAZONAS
Authors: Vasconcelos Brychtn Ribeiro de , Herrera Daphine Ramiro
Published: June 2021

Este artigo trata da análise do caso do trabalho análogo ao de escravo no Estado do Amazonas, no município de Barcelos em 2014. O combate ao trabalho escravo no Brasil passou a ter expressão a partir da alteração do Código Penal brasileiro e através da Constituição Federal. Atualmente a escravidão contemporânea apresenta-se como violação à dignidade humana e ao trabalhador e, apesar das leis e intervenções existentes, a escravidão persiste, todavia, sob novas formas. O resgate de 13 trabalhadores em condições análogas à de escravo em Barcelos, demonstra a importância de fiscalização e participação dos órgãos públicos. Porém, para o combate ao trabalho escravo é necessário a regulamentação da atividade extrativista e a eliminação do aviamento em conjunto com leis precisas e fiscalização eficaz.
A Novel Quinazoline-4-one Derivatives as a Promising Cytokine Inhibitors:
Synthesis, Molecular Docking, and Structure-activity Relationship
Authors: Hussein Mohammed Abdalla , Borik Rita M.
Published: June 2021

Context:

Quinazolines are a common class of nitrogen-containing heterocyclic scaffolds, which exhibit a broad spectrum of pharmacological activities.

Objective:

In the present study, quinazoline and quinazolin-4-one derivatives were prepared, characterized, and evaluated for their biological activity, which may pave the way for possible therapeutic applications.

Materials & Methods:

New derivatives of quinazoline and quinazolin-4-one were prepared and tested for antiulcerogenic, anti-inflammatory and hepatoprotective activities.

Results:

The synthesized compounds were characterized by elemental analysis and spectral data. Also, the median lethal doses (LD50s) of compounds 1-3 in rats were 1125, 835 and 1785 mg/kg b.w., respectively. IC50 values of compounds (1-3) as measured by ABTS•+ radical method were 0.8, 0.92 and 0.08 mg/mL, respectively. Antiulcerogenic activity at dose 1/20 LD50 in albino rats was observed at 47.94, 24.60 and 56.45%, respectively. Anti-inflammatory effect at dose 1/20 LD50 of compounds (1-3) was observed in the induced edema model after 120 min. The prepared compounds were found to possess hepato gastric mucosa protective activity against ibuprofen-induced ulceration and LPS-induced liver toxicity, respectively, in rats etc. normalization of oxidative stress biomarkers, and inflammatory mediators were inhibited in peritoneal macrophage cells at a concentration of 100 μg/L. Molecular docking suggested that the most active compounds 1 and 2 could be positioned within the active sites of COX-2 at Arg121 and Tyr356, similarly to ibuprofen (Arg-120, Glu-524, and Tyr-355). The compound 3–COX-2 complex generated by docking revealed intricate interactions with a COX-2 channel.

Conclusion:

These findings suggest that compounds 1-3 exhibited good antioxidant, antiulcer, and anti-inflammatory activities, and were safe on liver enzymes in rats.
Role of Exosomes in Breast Cancer Management: Evidence-Based Review
Authors: Al-Humaidi Razan B. , Fayed Bahgat , Sharif Suleiman I. , Noreddin Ayman , Soliman Sameh S.M.
Published: June 2021

The field of cancer research has massively grown in recent decades, leading to a better
understanding of the underlying causes and greatly improving the therapeutic approaches. Breast
cancer (BC) is the third leading cause of mortality among all cancers and the most common malignant
disease in women worldwide, representing one in four of all cancers in women. The crosstalk
between cancer cells and the surrounding microenvironment is crucial for tumor progression and
metastatic process. Tumor cells communicate not only through classical paracrine signaling mechanisms,
including cytokines, chemokines, growth factors, but also through “exosomes”. Exosomes
are nano-vesicles that are released by various types of cells. Over the last decade, researchers have
been attracted by the role of exosomes in breast cancer. It has been proven that exosomes influence
major tumor-related pathways, including invasion, migration, epithelial-to-mesenchymal transition
(EMT), metastasis, and drug resistance. Additionally, exosomes play important roles in clinical applications.
Several studies have demonstrated the potential applications of exosomes in cancer therapy
and diagnosis. Furthermore, exosomes have been engineered to function as nano-delivery systems
of chemotherapeutic drugs. They can also be designed as vaccines to trigger the patient’s immune
system. This review discusses the recent progress regarding the use of exosomes as drug delivery
systems, therapeutic agents, biomarkers, and vaccines against breast cancer.
Analysis of Differences in Individual Characteristics, Lifestyle, Nutritional Status and Dieting Patterns in Pregnant Women with Preeclampsian History
Authors: Astari Asti Melani , Evi Nurul , Choiriyah Muladefi , Ariyani Puji , Fitriy Anif Lailatul
Published: June 2021

Preeclampsia is a multisystem complication that occurs after 20 weeks of gestation. In recent years there has been no significant decrease in the incidence of preeclampsia, even in developed countries it is still the main cause of maternal and fetal morbidity and mortality. This study aims to analyze differences in individual characteristics, lifestyle (physical activity), nutritional status and diet in pregnant women with a history of preeclampsia. This research design is descriptive analytic with cross sectional approach. Samples were obtained from 55 pregnant women with consecutive sampling who met the inclusion criteria. Data analysis used chi-square test and spearman correlation test. The results showed a relationship between physical activity with systolic blood pressure (p value 0.001, r = 0.449) and diastolic (p value 0.43, r = 0.273), there was also a relationship between diet and risk factors for preeclampsia through blood pressure measurements as evidenced by increase in blood pressure (p value 0.000) in pregnant women in the working area of Puskesmas Kedungkandang Malang. The results of this study are expected to be used as a reference in intervening pregnant women at risk of preeclampsia, so that the disease does not develop more severely so that it does not endanger the lives of the mother and the fetus she is carrying.
Relationship of Physical Activity Levels with the Incidence of Overweight in Children
Authors:   Poltekkes Palangka Raya, Sulistyowati Reny , Kusuma Raden Ramadhan , Rahmawaty Fetty , Natalansyah Natalansyah
Published: June 2021

Obesity or Overweight is presently international epidemic and occurs in all age groups, including with children. The rise in overweight in youngsters is partly because of lack of physical activity. This study aims to analyze the connection between the amount of physical activity and also the incidence of overweight in youngsters at SDIT Al-Furqan Palangka Raya. This research style is descriptive-analytic with a cross-sectional approach. The sample was taken mistreatment the probability/random sampling technique with a complete of fifty-nine respondents. The outcomes of the have a look at the usage of the Pearson correlation test obtained the price of r = -0.897 which is closer to number one and has a negative sign (-), the conclusion is there's a sizeable dating among the stage of level of physical activity and the incidence of overweight in children at SDIT Al-Furqan Palangka Raya. The dating among the 2 variables is opposite (negative sign (-)), which means that the smaller the price of physical activity variable, the more the overweight event variable. Nurses have a position in imparting training to mothers and fathers who've kids who're vulnerable to being obese in kids so they can create a healthy future generation.
Gender Equality and Social Inclusion (GESI) for Strengthening Disaster Resilient Village
Authors: Yumarni Tri , Sulistiani Lilis Sri , Idanati Rukna , Gunarto Guntur
Published: June 2021

Gender equality and social inclusion (GESI) is essential to ensure gender equality and to achieve sustainable Disaster Risk Reduction (DRR). The implementation of decentralisation reform in developing countries has transferred roles of implementing DRR program to lower level of government including to community or village government. Hence, effective strategies to mainstream GESI in DRR activities in the community or village government is important to promote gender equality and to achieve sustainable development. However, what key issues and effective strategies to mainstream GESI in the lower level of community or village has not well-documented in developing countries. This study aims to identify key issues and GESI strategies for strengthening disaster resilient village based on existing literature in developing countries. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to identify GESI strategies for strengthening disaster resilient village in the existing literature. We able to find 142 studies related to GESI and disaster risk reduction in community level which published on SCOPUS, Web of Science, and Med Line between 2009 and 2019. From 142 studies we select 10 studies which are strongly relevant with the aim of this study. Five key issues are identified such as low human capital, patriarchal culture, resistance from traditional society, weak GESI institution and poor governance, and lack capacity of policy makers and implementers. There are four key GESI strategies area for strengthening disaster resilient in community level: (1) Organizational, (2) Capacity, (3) Operational, and (4) Resources. In the organizational area, the main strategy is provision of GESI sensitive policies and practices. In the capacity area, the main strategy is capacity development and lesson learning in the community disaster resilient program. In the operational area, the main strategy is embedding GESI in all phases of the community disaster resilient program. In the resources area, the main strategy is mobilizing funding and GESI expertise in the community disaster resilient program.
Tracking Lower Urinary Tract Symptoms and Tamsulosin Side Effects Among Older Men Using a Mobile App (PERSONAL): Feasibility and Usability Study (Preprint)
Authors: Lee Austin W , Kenfield Stacey A , Wang Elizabeth Y , Enriquez Anthony , Oni-Orisan Akinyemi , Steinman Michael A , Sim Ida , Breyer Benjamin N , Bauer Scott R
Published: June 2021

BACKGROUND

Continuous α1a-blockade is the first-line treatment for lower urinary tract symptoms (LUTS) among older men with suspected benign prostatic hyperplasia. Variable efficacy and safety for individual men necessitate a more personalized, data-driven approach to prescribing and deprescribing tamsulosin for LUTS in older men.

OBJECTIVE

We aim to evaluate the feasibility and usability of the PERSONAL (Placebo–Controlled, Randomized, Patient-Selected Outcomes, N-of-1 Trials) mobile app for tracking daily LUTS severity and medication side effects among older men receiving chronic tamsulosin therapy.

METHODS

We recruited patients from the University of California, San Francisco health care system to participate in a 2-week pilot study. The primary objectives were to assess recruitment feasibility, study completion rates, frequency of symptom tracking, duration of tracking sessions, and app usability rankings measured using a follow-up survey. As secondary outcomes, we evaluated whether daily symptom tracking led to changes in LUTS severity, perceptions of tamsulosin, overall quality of life, medication adherence between baseline and follow-up surveys, and perceived app utility.

RESULTS

We enrolled 19 men within 23 days, and 100% (19/19) of the participants completed the study. Each participant selected a unique combination of symptoms to track and recorded data in the PERSONAL app, with a median daily completion rate of 79% (11/14 days). The median duration of the app session was 44 (IQR 33) seconds. On a scale of 1 (strongly disagree) to 5 (strongly agree), the participants reported that the PERSONAL app was easy to use (mean 4.3, SD 1.0), that others could learn to use it quickly (mean 4.2, SD 0.9), and that they felt confident using the app (mean 4.4, SD 0.8). LUTS severity, quality of life, and medication adherence remained unchanged after the 2-week study period. Fewer men were satisfied with tamsulosin after using the app (14/19, 74% vs 17/19, 89% at baseline), although the perceived benefit from tamsulosin remained unchanged (18/19, 95% at baseline and at follow-up). In total, 58% (11/19) of the participants agreed that the PERSONAL app could help people like them manage their urinary symptoms.

CONCLUSIONS

This pilot study demonstrated the high feasibility and usability of the PERSONAL mobile app to track patient-selected urinary symptoms and medication side effects among older men taking tamsulosin to manage LUTS. We observed that daily symptom monitoring had no adverse effects on the secondary outcomes. This proof-of-concept study establishes a framework for future mobile app studies, such as digital n-of-1 trials, to collect comprehensive individual-level data for personalized LUTS management in older men.

CLINICALTRIAL
HIV prevalence and risk behaviours among men who have sex with men using geosocial networking smartphone applications: a cross-sectional study in Beijing, China (Preprint)
Authors: Ren Xianlong , Zhang Binbin , Yu Fei , Ong Jason , Hong Chenglin , Mi Guodong , Fan Yaqi , Zhang Mianzhi , Zhang Minying
Published: June 2021

BACKGROUND

Extensive use of geosocial networking (GSN) apps has substantially changed the behaviors and HIV risk among men who have sex with men (MSM).

OBJECTIVE

We aim to examine the HIV prevalence and risky behaviors among GSN app-using MSM.

METHODS

We conducted a cross-sectional study among MSM users of Blued (a GSN app) from July 2017 to December 2018. Sociodemographic and behavioural data in the preceding six months were collected through an app-assistant questionnaire, and blood samples were also obtained to test for HIV. HIV prevalence was calculated, and multivariable logistic regression models were constructed to explore the correlates of HIV infection

RESULTS

A total of 7252 app-using MSM in Beijing were included. The HIV prevalence was 4.7% (95%CI 4.2%-5.2%). In the last six months, nearly half (49.0%) had multiple sexual partners, 3.3% reported having HIV-positive partners, 50.9% were not sure about their current partners’ HIV status. The majority (62.3%) of participants reported consistent condom use, 6.1% had engaged in group sex, and 19.1% had used recreational drug in the past six months. Having college or undergraduate (AOR=0.35, 95%CI 0.16-0.75), or postgraduate (AOR=0.22, 95%CI 0.06-0.78) education, being exclusively insertive in anal intercourse (AOR=0.18, 95%CI 0.07-0.48) were correlated with decreased odds of HIV infection. However, having anal sex (AOR=4.74, 95%CI 1.17-19.19), having 2 to 5 (ORa=1.47 95%CI 1.17-1.86) or six and more (AOR=2.18, 95%CI 1.34-3.55) male sex partners, not consistently using condoms during anal sex (AOR=1.93, 95%CI 1.06-3.52), and being diagnosed with STIs (AOR=3.02, 95%CI 0.95-9.56) in the preceding six months were associated with greater odds of HIV infection.

CONCLUSIONS

HIV risky behaviors were prevalent among app-using MSM, suggesting more targeted interventions are needed among this population.