bluuebunny/crossref_metadata_2025 huggingface dataset:
Kewenangan Pejabat Kantor Pelayanan Perbendaharaan Negara dalam Pengelolaan Keuangan Negara di Daerah
Authors: Cahyono Wahyu Hadi , Aisyah Rr. Herini Siti
Published: March 2020

Artikel ini menganalisis peraturan perundang-undangan terkait dengan sumber kewenangan Kantor Pelayanan Perbendaharaan Negara dalam pengelolaan keuangan negara di daerah dan menganalisa tanggung jawab pejabat Kantor Pelayanan Perbendaharaan Negara dalam pelaksanaan anggaran yang berasal dari Anggaran Pendapatan dan Belanja Negara. Penelitian ini menitikberatkan pada aspek Hukum Keuangan Negara dan Hukum Administrasi. Sumber kewenangan yang diteliti berhubungan erat dengan pelimpahan kewenangan secara dekonsentrasi. Penelitian ini dalam penulisannya menggunakan tipologi penelitian doctrinal serta menggunakan pendekatan perundang-undangan (statute approach) dan pendekatan konseptual (conceptual approach). Kesimpulan dari skripsi ini menunjukkan bahwa sumber kewenangan Kantor Pelayanan Perbendaharaan Negara sebagai pengelola keuangan negara di daerah adalah mandat dari Menteri Keuangan. Tanggung jawab Jabatan dan Tanggung Gugat Perdata berada pada pemberi mandat, yaitu Menteri Keuangan. Kantor Pelayanan Perbendaharaan Negara menerima pelimpahan sebagian wewenang dari Direktorat Jenderal Perbendaharaan untuk menjadi Kuasa Bendahara Umum Negara di daerah dengan dasar hukum Peraturan Menteri Keuangan Nomor 262/ PMK.01/2016 tentang Organisasi dan Tata Kerja Instansi Vertikal Direktorat Jenderal Perbendaharaan.
Pengembangan Formula Gel Ekstrak Pegagan (Centella asiatica (L.) Urb ) sebagai Antijerawat
Authors: Budi Setia , Rahmawati Mila
Published: March 2020

Pendahuluan: Saat ini obat topikal antijerawat telah banyak beredar dalam bentuk gel dan krim, tetapi masih sedikit antijerawat topikal yang megandung herbal, sebagai bahan aktif atau agen berpotensi dapat mencegah dan mengobati jerawat seperti pegagan (Centella asiatica (L.) Urb) dengan sifat anti bakterinya. Tujuan: Mengembangkan formulasi sediaan gel pegagan yang stabil. Metode: Pengujian Formulasi pegagan sesuai persyaratan evaluasi dengan basis gel konsentrasi 7%, 8%, 9%, selanjutnya dilakukan evaluasi meliputi pengujian organoleptik, pH, dan viskositas. Formula ditambah ekstrak herba pegagan dengan konsentrasi 2,5% dan 5%. Uji evaluasi formula yang dilakukan meliputi pengamatan homogenitas, uji derajat keasaman, kekentalan dan daya sebar sediaan. Hasil: Rerata pH sediaan didapatkan 6,66. Formula 1 dan Formula 2 terdapat sedikit perbedaan viskositas. Formula 1 dan Formula 2 menunjukkan homogenitas dan daya sebar yang sudah sesuai persyaratan. Kesimpulan: Selama 14 hari, pengujian Formula 2 dengan konsentrasi ekstrak 5% lebih stabil dibandingkan Formula 1 dengan konsentrasi ekstrak 2,5%.
The Effect of Vitamin C Addition on Epigallocatechin Gallate (EGCG) Stability in Green Tea Solution
Authors: Rahman Alief Putriana , Purwanto Djoko Agus , Isnaeni Isnaeni
Published: March 2020

Background: Epigallocatechin gallate (EGCG) is the most abundant green tea catechin with a powerful antioxidant effect to prevent cancer cells. EGCG in green tea solution is highly susceptible to degradation, this it is urgent to  increase the stability of EGCG by vitamin C addition. Vitamin C can regenerate radical EGCG to be normal EGCG. Objective: This research aim was to determine percent of decreased level of EGCG before and after vitamin C addition. Methods: This paper was focused on enhancing the stability of EGCG by 1 mg (GTVC1), 1.5 mg (GTVC2), 2 mg (GTVC3), 2.5 mg (GTVC4) and 3 mg (GTVC5) of vitamin C addition to 10 g/L of green tea solution concentration. Evaluations of EGCG were conducted at 0 days, 1 day, 2 days, 3 days, and 4 days of storage time. EGCG was analyzed using thin layer chromatography (TLC) densitometry methods. The stability of EGCG was determined by % of decreased EGCG. Results: Percent of loss of EGCG in GT, GTVC1, GTVC2, GTVC3, GTVC4 and GTVC5 after 4 days storage were 19.93%, 10.89%, 21.08%, 18.18%, 28.56%, and 9.76%, respectively. Conclusion: This study showed that in 4 days storage, the decreased level of EGCG in green tea solution with 3 mg of vitamin C addition (GTVC5) was 9.76% which was smaller than green tea solution without vitamin C addition (GT) which EGCG decreasing 19.93%.
Effect of Guava Powder Addition on Epigallocatechin Gallate (EGCG) Content of Green Tea and Its Antioxidant Activity
Authors: Rabbani Hanifah Ridha , Purwanto Djoko Agus , Isnaeni Isnaeni
Published: March 2020

Background: Tea (Camelia sinensis) contains polyphenols including epigallocatechin gallate (EGCG) which is acknowledged to have strong antioxidant properties. However, its stability is strongly influenced by environment. In a neutral and alkaline environment, EGCG could undergo degradation and lose its antioxidant property. There are some researches about the effect of combination of green tea and other plants to their antioxidant capacity. Objective: The research aimed to investigate the effect of guava addition to EGCG content of green tea and their antioxidant activity. Methods: The concentration of EGCG was determined by chromatographic analysis using TLC scanner, meanwhile the antioxidant activity was evaluated by its ability in scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) using UV-Vis Spectrophotometer. Results: Among all the samples, formula 4 (2 parts of green tea and 3 parts of guava) gave the highest EGCG content (39.03 ± 3.65 mg/g). This was 37.5% higher than the control sample (28.39 ± 2.45 mg/g). Formula 4 also had the best antioxidant activity with IC50 of 1917.32±1.75 ppm, 19% lower than control sample (2356.46 ± 3.16 ppm). Conclusion: The addition of guava powder significantly increased the amount of EGCG in green tea extracts and their antioxidant activity.
Physical Properties and Compactability of Various Blends of Fully Gelatinised and Pregelatinised Maize Starch
Authors: Jimmy Ronald Angupale  , Ogwang Patrick Engeu  , Okafor Sylvester Ignatius
Published: March 2020

The use of pregelatinised maize starch in direct compression as a sole binder produces tablets with relatively low tensile strength. Fully gelatinised maize starch possesses better binding properties but its use is limited in immediate release tablets. The aim of this work was to prepare a blend of fully gelatinised and pregelatinised maize starch possessing optimum tabletting properties. The pregelatinised starch was prepared by heating a 15 % slurry at 65 ℃ for 15 min followed by filtration and drying. The fully gelatinised starch was prepared by heating a 10 % slurry at 80 ℃ for 5min followed by precipitation with acetone, filtration and drying. The two samples were blended in 100:0, 25:75, 50:50, 75:25 and 0:100 proportions. Both local and BP starch samples were used and their blends compared for flow, packing characteristics and compactability. The disintegration time of the compacts was also determined. The results indicated that the BP starch blends exhibited better tabletting properties compared to the local starch. The proportion with 100 % fully gelatinised starch showed the best flow and compactability. Compacts containing 50:50 modified starch blends and those containing higher pregelatinised starch content disintegrated within 15 min. The fully gelatinised starch had better tabletting characteristics though physical mixing of the powder sample with pregelatinised starch may not improve the binding properties of the latter, and it could be used for immediate release tablets in such blends at a concentration of <50%.
Theory on Another Type of Temperature-Independent Superconductivity Based on Circuit Approaches with High Critical Current Density
Authors: Ishiguri Shinichi
Published: March 2020

This paper proposes a method to generate a new type of superconductivity that is temperature independent with a high critical current density. This study is significant because the method does not require refrigeration, specific setups, or specific substances. That is, the method for generating the superconductivity is very simple. Many conventional superconductor studies have not yet reached this point. Moreover, compared with our previously developed superconductivity (PNS) [1-3], the critical currents in this study are much larger, which is important for practical applications. In the theoretical approaches, even though the mechanism of pairing, and the Bose–Einstein condensation are the same in this study as in PNS, the present paper emphasizes the mechanism of the Meissner effect in addition to formulating the critical current density. Further, we establish a simulation method with an equivalent circuit that reveals the superconductivity properties in terms of the transport current and the electromagnetic characteristics.The principles of the presented system are as follows:First a voltage source, a current source and a load are connected in series.Then, the voltage of the voltage source is adjusted to balance the voltage of the load.Under this condition, the balance of the two voltages provides a zero voltage between the taps of the current source and the generated current from the voltage source becomes zero because of the internal infinite resistance of the current source.As a result, the electric power generated by the two sources is zero, and therefore, the load cannot generate Joule heating because of energy conservation.However, the current from the current source (not the voltage source) is not zero; therefore, we can predict that the resistance of the load must be zero.A summary of our theory and numerical calculations is as follows. First, the strong combination of a two-electron pair is demonstrated. Then, given that two electrons combine extremely strongly because of the spin magnetic attractive force, analytical calculations of the center-of-mass motion of the Hamiltonian of the pair eventually result in a macroscopic wave function. From this macroscopic wave function, we derive a London equation using the concept of an internal toroid. The key point is that, when a sample exhibits a Meissner effect, it should release the additional energy from the internal magnetic field as a discharge current, which involves a negative voltage. Based on the inductance of this toroid, an equivalent circuit is produced. Using this circuit, we simulate this phenomenon, which results in the generation of a negative voltage and evidence of the Meissner effect, in addition to zero voltages and non-zero currents for the sample.
Methodological Variations Affect the Release of VEGF in Vitro and Fibrinolysis’ Time from Platelet Concentrates
Authors: de Oliveira Leonel Alves , Borges Tatiana Karla , Soares Renata Oliveira , Buzzi Marcelo , Kuckelhaus Selma Aparecida Souza
Published: March 2020

Blood Concentrates (BCs) are autologous non-transfusional therapeutical preparations with biological properties applied in tissue regeneration. These BCs differ in the preparation method, in fibrin network architecture, growth factors release as well as in platelet/cell content. Methodological changes result in distinct matrices that can compromise their clinical effectiveness. The present study evaluated the influence of different g-forces and types of tubes in the release of vascular endothelial growth factor (VEGF) from platelet-rich fibrin (PRF) as a function of time. The PRF-like samples were obtained with three g-forces (200, 400, and 800 x g) for 10 minutes in pure glass tubes or in polystyrene-clot activator tubes. Scanning and Transmission electron microscopy was used to morphometric analyzes of PRF’s specimens and flow cytometry was used to quantify VEGF slow release until 7 days. Our results showed that platelets were intact and adhered to the fibrin network, emitting pseudopods and in degranulation. The fibrin network was rough and twisted with exosomic granulations impregnated on its surface. An increase in the concentration of VEGF in the PRF supernatant was observed until 7 days for all g forces (200, 400 or 800 x g), with the highest concentrations observed with 200 x g, in both tubes, glass or plastic. Morphological analyzes showed a reduction in the diameter of the PRF fibers after 7 days. Our results showed that g-force interferes with the shape of the fibrin network in the PRF, as well as affect the release of VEGF stored into platelets. This finding may be useful in applying PRF to skin lesions, in which the rapid release of growth factors can favor the tissue repair process. Our observations point to a greater clarification on the methodological variations related to obtaining PRF matrices, as they can generate products with different characteristics and degrees of effectiveness in specific applications.
Modelling of Non-Spherical Particles in Dilute Non-Colloidal Suspensions Using SPH
Authors: Kijanski Nadine , Krach David , Steeb Holger
Published: March 2020

Suspensions and their applications can be found in many engineering, environmental or medical fields. Considering the special field of dilute suspensions, possible applications are cement paste or procedural processes in the production of medication or food. While the homogenized behavior of these applications is well understood, contributions in the field of pore-scale fully resolved numerical simulations with non-spherical particles are rare. Using Smoothed Particle Hydrodynamics as a simulation framework we therefore present a model for Direct Numerical Simulations of single-phase fluid containing non-spherically formed solid aggregates. Notable and discussed model specifications are the surface-coupled fluid-solid interaction forces as well as the contact forces between solid aggregates. Moreover we simulate and analyze the behavior of dilute non-colloidal suspensions of non-spherical solid particles in Newtonian fluids. The focus of this contribution is the numerical model for suspensions and its implementation in SPH. Therefore shown numerical examples present application examples for a first numerical analysis of influence factors in suspension flow. Results show that direct numerical simulations reproduce known phenomena like shear induced migration very well. Moreover the present investigation exemplifies the influence of concentration and form of particles on the flow processes in greater detail.
Generation System for Renewable Energy Density Substantially Higher than that of Power Stations and Presentation of Novel Superconductivity
Authors: Ishiguri Shinichi
Published: March 2020

Societies around the world face serious energy problems related to the consumption of fossil fuels and the emission of dangerous radiation. To solve these problems, a new superconductor exhibiting a critical temperature higher than room temperature has been pursued but not achieved. This paper proposes a new energy generation system based on a circuit approach. Secondary to this process, a new type of superconductivity without refrigeration is demonstrated. In our previous paper [1], this system was proposed, but it did not describe the underlying theory in detail and did not mention an actual method to generate energy from the system. The present paper describes the theory of the existence of divergent current density and new superconductivity with no refrigeration. Moreover, the present paper proposes a method for extracting energy from the system by employing a voltage-controlled current source (i.e., a voltage–current converting method).The principle of the system is based on a circuit of two loops and independent current sources. First, the two electric loops are prepared, each with 4 diodes, where the diodes are oriented in the same direction within each loop, but their direction is opposite from loop to loop; four independent current sources connect the loops. In this circuit system, current is added iteratively as it flows along the loop according to Kirchhoff’s circuit law. As a result, a large current and electric potential are present along the loop. To confirm that this system works properly, it is necessary to demonstrate the presence of divergent currents in the transient state, and to do this, the present paper employs the Dirac equation and Lorentz conservation. Electric circuit software is employed to demonstrate that the presented method generates energy actually from our system.Our results confirm the presence of divergent current at a connected point of an independent current source in the transient state. Moreover, in the steady state, the theory demonstrates the Meissner effect (i.e., a London equation) and a new type of macroscopic wave function and condensation. For an initial small input current of 0.1 μA, the simulation reveals a large generating current of 7 kA and electric power of 1011 W, which is much larger than unit of power from an average thermal power station; moreover, the system presents with superconducting electrical transport conditions.The present study is significant because it demonstrates theoretically the existence of divergent current density and a new type of superconductivity requiring no refrigeration. Secondly, the simulations show the generation of a large energy density that can be obtained in a small laboratory room with minimal cost.
Fibrous Cleanout Fluids in Horizontal and Inclined Wells
Authors: Elgaddafi Rida , Ahmed Ramadan
Published: March 2020

This paper presents the results of experimental and theoretical studies conducted to investigate the hole cleaning performance of fibrous fluids in horizontal and inclined wells. Coiled tubing is commonly applied in the wellbore cleanout operations of highly deviated and horizontal wells. Accumulation of proppant and other solid debris in the wellbore remarkably impedes field operations and oil and gas production. Fibrous fluids have shown great potential for cleaning solids that are difficult to remove with conventional fluid systems. The addition of fiber substantially reduces the settling velocity of particles in fluids due to the formation of a fiber network. This study is aimed to investigate wellbore cleanout and hydraulics of fibrous fracturing fluid in horizontal and inclined wells.

Cleanout experiments were carried out using Xanthan gum suspensions with and without fiber (i.e. monoﬁlament synthetic ﬁber). Extensive flow loop tests were performed varying fiber concentration and inclination while measuring the equilibrium bed height at different flow rates. A 22-ft long annular test section was utilized to perform the cleanout (erosion) experiments. To better explain the results, rheological and hydraulic characteristics of the test fluids were examined using the pipe viscometer and the annular test section. A model has been developed to calculate the critical velocity and flow rate needed to initiate the movement of bed particles during hole cleaning operation. The model is formulated to account for the presence of fiber through a fiber drag coefficient.

Results show a noticeable reduction in critical velocity or equilibrium bed height owing to the addition of a small amount (0.04% by wt.) of fiber. Fibrous fluid demonstrated better cleanout performance than the non-fibrous fluid (base fluid). The addition of fiber to the base fluid, significantly enhanced hole cleanout, resulting in a drastic reduction of equilibrium bed height. At 70 gpm, fibrous fluid cleaned the test section 50% better than the base fluid. One possible explanation for this observation could be the development of a fiber network in the fluid that provides additional drag to agitate bed particles and initiate their movement. Results of rheology and hydraulic tests show that the addition of fiber (0 to 0.08%) had very little effect on the rheology and hydraulics of fibrous fluid. Fibrous fluid displayed slightly lower pressure loss as compared to the base fluid, which indicates minor friction reduction due to the fiber.

The accuracy of the hydraulic model developed in the study has been assessed using flow loop measurements. Results show good agreement between predictions and measurements. The new model can be employed in the field to optimize the wellbore cleanout operation with fibrous fluid without increasing bottom hole pressure.
Psychosocial Syndemic of Suicidal Ideation: A Cross-sectional Study among Sexually Transmitted Infection Patients in Shanghai, China
Authors: Wang Suping , Ni Yang , Gong Ruijie , Shi Yuan , Cai Yong , Ma Jin
Published: March 2020

Background: We sought to verify whether psychosocial health problems among patients with sexually transmitted infections (STIs) were associated with these patients’ suicidal ideation and to examine the syndemic effect of multiple psychosocial problems on suicidal ideation. Methods: This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Demographic, psychosocial, and suicidal ideation information about the participants was collected by questionnaire. Logistic regressions were performed to detect the association between demographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors. Results: Of the participants, 25.0% (130/519) reported having suicidal ideation. In univariable analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (odds ratio [OR]: 4.1; 95% confidence interval [CI]: 2.3–7.2) and entrapment (OR: 2.1; 95%CI: 1.1–4.1) each had a more significant relation with suicidal ideation than the other psychosocial problems examined. STI patients who experienced two or more psychosocial health problems had approximately fourfold odds of suicide ideation (adjusted OR [AOR]: 4.2; 95%CI: 2.6–6.8) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (AOR: 7.0; 95%CI: 3.9–12.5). Conclusions: The study found the participants had a high rate of suicidal ideation and suffered from severe psychosocial problems. These results show a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. Our findings suggest an urgent need for efforts to prevent suicidal ideation among STI patients toward improving the social and health conditions of this population.
360-Degree Delphi: addressing sociotechnical challenges of healthcare IT
Authors: Waldmueller Heiko Dominik , Spreckelsen Cord , Rudat Hannah , Krumm Norbert , Rolke Roman , Jonas Stephan Michael
Published: March 2020

This approach uses the strong advantages a Delhi study has, identifies the disadvantages of traditional Delphi techniques and aims to introduce and evaluate a modified approach called 360-Degree Delphi. Key aspects of 360-Degree Delphi are tested by applying the approach to the needs and requirements analysis of a system for managing patients’ advance directives and living wills. 360-Degree Delphi, as a modified Delphi process, is specified as a structured workflow with the optional use of stakeholder groups. Consensus is created within individual stakeholder groups, but is also communicated between groups, while the iterative structure of the Delphi process remains unchanged. We hypothesize that (1) 360-Degree Delphi yields complementary statements from different stakeholders, which would be lost in classical Delphi; while (2) the variation of statements within individual stakeholder groups is lower than within the total collective. A user study is performed that addresses five stakeholder groups (patients, relatives, medical doctors, nurses and software developers) on the topic of living will communication in an emergency context. About 25% of the invited experts (stakeholders) agreed to take part in the Delphi round 0 (three patients, two relatives, three medical doctors, two qualified nurses and three developers), forming a structured panel of the five stakeholder groups. Two raters created a bottom-up coding, and 238 thematic codes were identified by the qualitative text analysis. Based on a consented coding list, a quantitative online-questionnaire was developed and send to different stakeholder groups. With respect to the hypotheses, Delphi round 0 had the following results: (1) doctors had a completely different focus from all the other stakeholder groups on possible channels of communications with the patient; (2) the dispersion of codes within individual stakeholder groups and within the total collective was approximately 28% higher in the total collective than in the sub-collectives, but without a marked effect size. With respect to the hypotheses, Delphi round 1 had the following results: different stakeholder groups had highly diverging opinions with respect to central questions on IT-development. In comparison, the total group would not be representative of either of these individual stakeholder needs (mean 4.344, stdev +/- 1.870)
Gene expression profiling identifies pathways involved in seed maturation of Jatropha curcas
Authors: Maghuly Fatemeh , Deak Tamas , Vierlinger Klemens , Pabinger Stephan , Tafer Hakim , Laimer Margit
Published: March 2020

Background: Jatropha curcas, a tropical shrub, is a promising biofuel crop, which produces seeds with high content of oil and protein. To better understand the maturation process of J. curcas seeds and to improve its agronomic performance, a two-step approach was performed in six different maturation stages of seeds: 1) generation of the entire transcriptome of J. curcas seeds using 454-Roche sequencing of a cDNA library, 2) comparison of transcriptional expression levels using a custom Agilent 8x60K oligonucleotide microarray.
Results: A total of 793,875 high-quality reads were assembled into 19,382 unique full-length contigs, of which 13,507 could be annotated with Gene Ontology (GO) terms. Microarray data analysis identified 9,111 probes (out of 57,842 probes), which were differentially expressed between the six maturation stages. The expression results were validated for 75 selected transcripts based on expression levels, predicted function, pathway, and length.
Result from cluster analyses showed that transcripts associated with fatty acid, flavonoid, and phenylpropanoid biosynthesis were over-represented in the early stages, while those of lipid storage were over-represented in the late stages. Expression analyses of different maturation stages of J. curcas seed showed that most changes in transcript abundance occurred between the two last stages, suggesting that the timing of metabolic pathways during seed maturation in J. curcas occurs in late stages. The co-expression results showed that the hubs (CB5-D, CDR1, TT8, DFR, HVA22) with the highest number of edges, associated with fatty acid and flavonoid biosynthesis, are showing a decrease in their expression during seed maturation. Furthermore, seed development and hormone pathways are significantly well connected.
Conclusion: The obtained results revealed differentially expressed sequences (DESs) regulating important pathways related to seed maturation, which could contribute to the understanding of the complex regulatory network during seed maturation with the focus on lipid, flavonoid and phenylpropanoid biosynthesis. This study provides detailed information on transcriptional changes during J. curcas seed maturation and provides a starting point for a genomic survey of seed quality traits. The results highlighted specific genes and processes relevant to the molecular mechanisms involved in Jatropha seed maturation. These data can also be utilized regarding other Euphorbiaceae species.
How can we support best practice? A situational assessment of injury prevention practice in public health.
Authors: Richmond Sarah A. , Carsley Sarah , Prowse Rachel , Manson Heather , Moloughney Brent
Published: March 2020

Background: To effectively impact the significant population burden of injury, we completed a situational assessment of injury prevention practice within a provincial public health system to identify system-wide priorities for capacity-building to advance injury prevention in public health. Methods: A descriptive qualitative study was used to collect data on the current practice, challenges and needs of support for injury prevention. Data was collected through semi-structured interviews (n=20) and focus groups (n=19). Participants included a cross-section of injury prevention practitioners and leadership from public health units reflecting different population sizes and geographic characteristics, in addition to public health researchers and experts from academia, public health and not-for-profit organizations. Thematic analysis was used to code all of the data by one reviewer, followed by a second independent reviewer who coded a random selection of interview notes. Major codes and sub codes were identified and final themes were decided through iterations of coding comparisons and categorization. Once data were analysed, we confirmed the findings with the field, in addition to participating in a prioritization exercise to surface the top three needs for support. Results: Major themes that were identified from the data included: current public health practice challenges; capacity and resource constraints, and; injury as a low priority area. Overall, injury prevention is a broad, complex topic that competes with other areas of public health. Best practices are challenged by system-wide factors related to resources, direction, coordination, collaboration, and emerging injury public health issues. Injury is a reportedly under prioritized and under resourced public health area of practice. Practitioners believe that increasing access to data and evidence, and improving collaboration and networking is required to promote best practice. Conclusions: The results of this study suggest that there are several system level needs to support best practice in public health injury prevention in Ontario including reducing research to practice gaps and supporting opportunities for collaboration. Our research contributes to the literature of the complexity of public health practice, and presents several mechanisms of support to increase capacity at a system level to improve injury prevention practice, and eventually lessen the population burden of injury.
Virtual Reality Video Promotes Effectiveness in Advance Care Planning
Authors: Hsieh Wan-Ting
Published: March 2020

Background: In 2019, the Patient Autonomy Act went into effect, allowing Taiwanese citizens to establish legal advance decisions. In an effort to secure a more realistic and accurate perception of situations, a virtual reality video was developed by the palliative care team of Chi-Mei hospital in southern Taiwan for citizens to use before advance care planning. This study explores the change in participants’ preference and certainty regarding end-of-life decisions after using this tool.
Methods: Participants were at least 20 years old and capable of reading and understanding the information provided in the written handout with information about the legal process of making an advance decision. They completed pre-test questionnaires, viewed a six-minute 360-degree virtual reality video on a portable headset and then completed a post-test questionnaire about their preference on the 5 medical options including CPR, life-sustaining treatments, antibiotics, blood transfusion, and artificial nutrition and hydration, followed by feedback on the helpfulness of the virtual reality. The control group included 40 participants who only read the handout and they also completed pre-test and post-test questionnaires.
Results: After viewing the virtual reality video, preference for refusing CPR, life-sustaining treatment, antibiotics, blood transfusion, and artificial nutrition and hydration increased significantly in the virtual reality intervention group. Uncertainty regarding the 5 medical options mentioned above are significantly decreasing. The intervention was generally recognized by participants for its help of making decision.
Discussion: The decrease in the number of participants who could not make decisions indicate that the virtual reality video may be helpful for users in making end-of-life decision. According to feedback, the virtual reality video helped equip users with better understanding of medical scenarios, and it is a good decision aid for advance care planning.
Conclusion: This is the first study since the Patient Autonomy Act has been passed that explores the effectiveness of using a virtual reality video as a decision aid in advance care planning and reveals decreased preference of CPR, life sustaining treatment, antibiotics, blood transfusion and artificial nutrition and hydration after intervention. This decision aid proved to be an effective tool for clarifying their end-of-life care preferences.
DNMT1 inhibits hepatocellular carcinoma cells by altering the epigenetic modification of Marveld1 gene
Authors: Zhang Song Yan , Luo Qian , Wang Peng , Zhao Hao Ran , Xu Hai Tao , Zhao Liang , Qu Zhao Wei , Sun Jian Min , Zhang Yu Bao , Zheng Biao
Published: March 2020

Objective

To study the effect of DNA methyltransferase (DNMT1) on Marveld1 in hepatocellular Carcinoma (HCC), and explore its role in the molecular mechanism of HCC occurrence and development.

Methods

The expression level of Dnmt1 and Marveld1 genes was detected by RT-PCR in the intraoperative pathological specimens. The human hepatoma Bel7402 and SMMC7721 cell lines down-regulated by DNMT1 gene expression were constructed by SiRNA transfection. The methylation level of Marveld1 promoter region was detected after RT-PCR and West-blot verification. The expression of Marveld1 gene, cell proliferation, invasion and change of cell cycle were detected by RT-PCR and West-blot. The expressions of P53, CyclinD1, P21 and P16 protein were detected by West-blot method.

Results

The expression of DNMT1 gene in human hepatocarcinoma tissues was higher than that in adjacent tissues. The methylation level of the Marveld1 gene promoter region in human hepatoma cell line down-regulated by DNMT1 gene expression was decreased, the expression level of Marveld1 gene was increased, and the proliferation and invasion ability of cells were weakened. The cell cycle was showed as G1-S phase arrest; P53 and P16 protein expressions were up-regulated, and CyclinD1 and P21 protein expressions were down-regulated.

Conclusions

Dnmt1 gene is highly expressed in human hepatocarcinoma tissues. Down-regulation of DNMT1 gene expression can decrease the methylation level of Marveld1 promoter region, up-regulate Marveld1 gene and human P53 and P16 proteins expressions, and down-regulate CyclinD1 and P21 proteins expressions, inhibit the proliferation and invasion of human hepatoma cells and can cause cell cycle G1-S arrest.
Primary care service use by end-of-life cancer patients: a nationwide population-based cohort study in the United Kingdom
Authors: Gao Wei , Gulliford Martin , Morgan Myfanwy , Higginson Irene J
Published: March 2020

Background End of life(EoL) care becomes more complex and increasingly takes place in the community, but there is little data on the use of general practice(GP) services to guide care improvement. This study aims to determine the trends and factors associated with GP consultation, prescribing and referral to other care services amongst cancer patients in the last year of life. Methods A retrospective cohort study of cancer patients who died in 2000-2014, based on routinely collected primary care data(the Clinical Practice Research DataLink, CPRD) covering a representative sample of the population in the United Kingdom. Outcome variables were number of GP consultations(primary), number of prescriptions and referral to other care services(yes vs no) in the last year of life. Explanatory variables included socio-demographics, clinical characteristics and the status of palliative care needs recognised or not. The association between outcome and explanatory variables were evaluated using multiple-adjusted risk ratio(aRR). Results Of 68,523 terminal cancer patients, 70% were aged 70+, 75% had comorbidities and 45.5% had palliative care needs recognised. In the last year of life, a typical cancer patient had 43 GP consultations(Standard deviation(SD): 31.7; total=3,031,734), 71.5 prescriptions(SD: 68.0; total=5,074,178), and 21(SD: 13.0) different drugs; 58.0% of patients had at least one referral covering all main clinical specialities. More comorbid conditions, prostate cancer and having palliative care needs recognised were associated with more primary care consultations, more prescriptions and a higher chance of referral(aRRs 1.07-2.03). Increasing age was related to fewer consultations(aRRs 0.77-0.96), less prescriptions(aRR 1.09-1.44), and a higher chance of referral(aRRs 1.08-1.16) but less likely to have palliative care needs recognised(aRRs 0.53-0.89). Conclusions GPs are very involved in end of life care of cancer patients, most of whom having complex care needs, i.e. older age, comorbidity and polypharmacy. This highlights the importance of enhancing primary palliative care skills among GPs and the imperative of greater integration of primary care with other healthcare professionals including oncologists, palliative care specialists, geriatricians and pharmacists. Research into the potential of deprescribing is warranted. Older patients have poorer access to both primary care and palliative care need to be addressed in future practices.
Socio-demographic, environmental and behavioural factors of diarrhoea among under-five children in Rural Ethiopia: further analysis of the 2016 Ethiopian demographic and health survey
Authors: Ferede Melkamu Molla
Published: March 2020

Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.
Cerebrospinal fluid of chronic osteoarthritic patients induced interleukin-6 release in human glial cell-line T98G
Authors: Liu Weiling , Li Chunmei , Tan Francis Chee Kuan , Neo Hong Jye , Chan Yiong Huak , Low Chian-Ming , Lee Tat Leang
Published: March 2020

Background Chronic osteoarthritic pain is not well understood in terms of its pathophysiological mechanism. Activated glial cells are thought to play a role in the maintenance of chronic pain. T98G glioblastoma cell line was previously observed to release higher amounts of interleukin-6 (IL-6) when treated with cerebrospinal fluid (CSF) from patients with another chronic pain condition, post-herpetic neuralgia. In this study, we investigated the ability of CSF from patients diagnosed with knee osteoarthritis suffering from chronic pain, to trigger the release of pro-inflammatory cytokines, IL-6, IL-1beta and tumour necrosis factor alpha (TNF-α) from T98G. Characterization of upstream signalling was also explored. Methods 15 osteoarthritis patients undergoing total knee replacement due to chronic knee pain and 15 patients without pain undergoing other surgeries with spinal anaesthesia were prospectively recruited. CSF was collected during anaesthesia. CSF were added to cultured T98G cells in the presence of lipopolysaccharide. IL-6, IL-1β and TNF-α release from T98G cells were measured using enzyme immunoassay. Antibody array and western blotting were performed using CSF-triggered T98G cell lysates to identify possible signalling targets. Age, gender and pain scores were recorded. Mann-Whitney U test was used to compare IL-6 release and protein expression between groups. Association between IL-6 and pain score was analysed using linear regression. Results Significant higher levels of IL-6 were released by T98G cells when induced by osteoarthritis patients' CSF in presence of lipopolysaccharide. IL-6 levels showed positive association with pain score (adjusted B estimate= 10.1 (95% Confidence Interval 4.3-15.9); p= 0.001). Antibody array conducted with 6 pooled T98G cell lysate induced with osteoarthritis pain patient CSF identified greater than 2-fold proteins including STE20-related kinase adaptor protein and spleen tyrosine kinase. Further validation done using western blotting of individual CSF-triggered T98G cell lysate showed non-significant increase. Conclusion Higher IL-6 release from T98G when triggered by OA CSF, in the presence of lipopolysaccharide, suggest presence of "unknown molecule" in CSF that may be crucial in the maintenance phase of chronic pain in our osteoarthritis population. Further studies on the signalling pathways involved in pain and relevance of IL-6 release from T98G in other pain models are needed.
Associations between individual perceptions of PM2.5 pollution and pulmonary function in Chinese middle-aged and elderly residents
Authors: Chen Qi , Zhang Jiayao , Xu Yan , Sun Hong , Ding Zhen
Published: March 2020

Background: PM2.5 pollution has become a major public health concern in urban China. Understanding the residents’ individual perceptions toward haze pollution is critical for policymaking and risk communication. However, the perceptions of middle-aged and elderly residents, who particularly vulnerable to haze pollution, are poorly understood. In this study, we aimed to explore their risk perceptions of haze pollution and investigate its relationship with health status and pulmonary function parameters.
Methods: A cross-sectional study of 400 randomly sampled individuals (aged 40 to 90 years) was conducted in Wuxi, a typical PM2.5-polluted city in Jiangsu Province, China (during 2015-2017, daily average concentration of PM2.5 was 52.73 μg/m3). Each participant’s demographic and health information, individual perception and pulmonary function outcomes were collected to explore the relationships between perception factors and personal characteristics and pulmonary function parameters, using linear models.
Results: We found that the mean values for controllability (4.99 ± 2.78) and dread of risk to oneself (levels of fear for haze-related harm to oneself) (6.9 ± 2.45) were the lowest and the highest values, respectively, in our study. Education and average family income were positively related with all individual perception factors, while age was negatively associated. A history of respiratory disease was positively associated with all individual perception factors except controllability. Significant positive associations were observed between PEF (coefficients ranged from 0.18 to 0.22) and FEF75% (coefficients ranged from 0.18 to 0.29) with a variety of individual perception factors.
Conclusions: There were a lack of concern and knowledge, weak self-protection consciousness and a strong dread of PM2.5 pollution among the middle-aged and elderly residents in Wuxi. Their individual perceptions were associated with age, education levels, average family income, history of respiratory disease, PEF and FEF75%. Our findings may help policymakers develop effective policies and communication strategies to mitigate the hazards of haze among older residents.
Rural Chronic Disease Research Patterns In The United Kingdom, United States, Canada, Australia And New Zealand: A Systematic Integrative Review
Authors: Disler Rebecca , Glenister Kristen , Wright Julian
Published: March 2020

Background
People living in rural communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. This review aims to describe the state of knowledge regarding innovative models of care and clinical outcomes for people living with chronic disease in rural areas in developed countries where a metropolitan comparator is included.
Methods
An integrative systematic review was undertaken. P referred R eporting I tems for S ystematic Reviews and M eta- A nalyses (PRISMA) method was used to understand data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom
Results
Literature searching revealed 620 articles published in English between 2000 and 2019. 160 were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations.
Conclusions
This integrated review reveals published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease.