bluuebunny/crossref_metadata_2025 huggingface dataset:
Peranan Petani Milenial mendukung Ekspor Hasil Pertanian di Indonesia
Authors: Rachmawati Rika Reviza , Gunawan Endro
Published: December 2020

A variety of start-ups and agricultural applications show that there has been an increasing interest in agriculture. Using information and communication technology to make agricultural products distribution and marketing more effective and efficient, millennial farmers are expected to improve the agricultural product export. However, exporting agricultural products is a challenge. Agricultural products are perishable and the exporters have to meet international food safety standards. The farmers deal with regulations, lack of facilities and infrastructures for production process, as well as the standards of Good Manufacturing Practices. This article aims to assess potentials of millennial farmers pioneering agricultural product export in Indonesia and to analyze the impact of various government policies to millennial farmers. They need appropriate technology to improve agricultural product value added and support for development potential of various agricultural start-ups. Required government supports include farm practice, export procedure training, and export market survey using internet, as well as conducive regulation easy access to financial service provider institution. Those supports will boost the millennial farmers’ spirit along with Ministry of Agriculture’s program of three-fold agricultural product export.
Desconfianza, regímenes de verdad, conspiraciones y montajes en el contexto de la covid-19 en México
Authors: Murillo Andrea
Published: December 2020

Este ensayo examina la reproducción y circulación de  videos, imágenes y memes para la construcción de regímenes de verdad en la esfera pública mexicana durante  la pandemia de la covid-19. Desde marzo de 2020, fecha  en que comenzó la circulación de información sobre contagios, muertes y repuntes de casos, medios digitales y  sus plataformas de verificación de datos, familiares de  personas fallecidas y hospitalizadas de covid-19 se movilizaron en redes sociales videos e imágenes para evidenciar  y comprobar lo que acontecía. Este cúmulo de información, sumada a los memes, generó un estado de ánimo  de desconfianza en México ante las diferentes versiones  compartidas. A partir de metodologías visuales, este ensayo examina cómo la imagen a través de las diferentes plataformas es apropiada y recombinada con otros géneros  discursivos en la pandemia de la covid-19 para la obtención de legitimidad y legibilidad. Dentro de la abundante  información, la figura del subsecretario de salud, Hugo Ló pez-Gatell, especialista y encargado en dar a conocer a los  mexicanos los detalles de la pandemia figuró de manera.
Dinámicas e identificación grupal en gamers de Lima, el caso de competitividad en el videojuego League of Legends
Authors: Toykin Minaya Francis Irineo
Published: December 2020

Se busca comprender los aspectos culturales que  emergen en las dinámicas grupales a partir del consumo  de videojuegos en Lima. Se efectuó investigación cualitativa en imaginarios y prácticas de gamers de los equipos  ANG y SHOT del videojuego League of Legends en el ámbito competitivo local. Se realizó trabajo de campo en el  festival World Cyber Games 2013 en el Perú, observación  y participación en cabinas de videojuegos y espacios afines. ¿Cómo es la identificación grupal de estos jugadores?  La respuesta conlleva el análisis de variables culturales  como identificación, juego, performance, territorialidad,  consumo, distinción y masculinidad, en los dos espacios  de representación: el virtual, como escenario donde los  jugadores se transfiguran en personajes; y el físico, en  que actúan como jugadores, mediante la interacción y  el empleo de aparatos tecnológicos. Son «tribus urbano virtuales» que comparten valores e intereses, cuyo sentido  de pertenencia se funda en lazos afectivos, emocionales y  competitivos.
Development of a decision support intervention for family members of adults who lack capacity to consent to trials
Authors: Shepherd Victoria , Wood Fiona , Griffith Richard , Sheehan Mark , Hood Kerenza
Published: December 2020

Background Informed consent is required for participation in clinical trials, however trials involving adults who lack capacity to consent require different enrolment processes. A family member usually acts as a proxy to make a decision based on the patient’s ‘presumed will’, but they can experience an emotional and decisional burden as a result. Decisions made on behalf of others are conceptually different from those we make for ourselves. Despite innovations to improve informed consent processes for research, including the development of decision aid, there are no interventions for proxies who arguably are faced with more complex decisions. This article outlines the development of a novel decision aid aimed at supporting families making decisions about research participation on behalf of an adult who lacks capacity to consent. Methods Decision support interventions should be developed using rigorous and evidence-based methods. This intervention was developed using the MRC guidance for the development of complex interventions, and a conceptual framework for the development and evaluation of decision aids for people considering taking part in a clinical trial. The intervention was informed by a systematic review and analysis of existing information provision. Previous qualitative research with families who had acted as proxies enabled the development of a theoretical framework to underpin the intervention. The intervention was iteratively developed in conjunction with lay advisors and relevant stakeholders. Results Previous research, theoretical frameworks, and decision aid development frameworks were used to identify and develop the intervention components. The decision aid includes information about the proxy’s role and uses a values clarification exercise and decision support methods to enable a more informed and better-quality decision. Stakeholders, including those representing implementers and receivers of the intervention, contributed to the design and comprehensibility of the decision aid and helped to ensure that it would be acceptable for use.Conclusions Frameworks for the development of decision aids for people considering participating in a clinical trial can be used to develop interventions for family members acting as proxy decision-makers. The decision support tool is acceptable to users but requires feasibility testing and outcome measure development prior to any evaluation of its effectiveness.
Using practical wisdom to facilitate ethical decision-making: a major empirical study of phronesis in the decision narratives of doctors.
Authors: Conroy Mervyn , Malik Aisha Y , Hale Catherine , Weir Catherine , Brockie Alan , Turner Chris
Published: December 2020

Background Medical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis -based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians. Methods The primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n=131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process. Results We found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua. Conclusion Given the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well.
System wide learning from first wave Covid 19: A realist synthesis of what works?
Authors: Jackson Carolyn , Manley Kim , Webster Jonathan , Hardy Sally
Published: December 2020

Background

This paper presents a thematic analysis of 176 interview transcripts from front line staff working during the first wave of COVID-19 in the East of England.
Methods

Presented as a descriptive case study it reflects the complexity and numerous variables that influenced staff experiences of delivering care and support across the health and social care system between April and August 2020. Drawing upon the methodology of realist synthesis, it addresses the question “What works for whom and in what contexts and why?” to help illuminate real-world issues that people have faced.
Results

Thirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. Four tentative theories of system transformation are presented to highlight support mechanisms that are needed to enable front line teams to be effective in further waves of the pandemic, capitalising on system wide learning, patient, resident and staff wellbeing.
Conclusions

This paper presents a unique insight into front line staff experiences of working during the first wave of the Covid-19 pandemic using realist synthesis methods to distil key themes and tentative theories about what strategies work to enable and empower front line teams to be effective and to support system wide learning and transformation.
Willingness to Receive Future Covid-19 Vaccines Following the Covid-19 Epidemic In Shanghai, China
Authors: Zhou Yehong , Zhang Junjie , Wu Wenwen , Liang Man , Wu Qiangsong
Published: December 2020

Background

There are no pharmacological interventions currently available to prevent the transmission of SARS-CoV-2 or to treat COVID-19. The development of vaccines against COVID-19 is essential to contain the pandemic. we conducted a cross-sectional survey of Shanghai residents to understand residents' willingness to be vaccinated with any future COVID-19 vaccines and take measures to further improve vaccination coverage.
Methods

We conducted a cross-sectional survey using self-administered anonymous questionnaires from 1 July to 8 September 2020. The main outcome was willingness of participants, and any children or older individuals living with them, to receive future COVID-19 vaccines. Logistic regression analyses were used to explore potential factors associated with vaccination willingness.
Results

A total of 1,071 participants were asked about their willingness to receive future COVID-19 vaccines, for themselves and at least 747 children and 375 older individuals (≥ 60 years old) living with them. The highest proportion of willingness to vaccinate was among adults (88.9%), followed by children (85.3%) and older individuals (84.0%). The main reasons for reluctance to vaccinate among 119 participants were doubts regarding vaccine safety (60.0%) and efficacy (28.8%). Participants with a self-reported history of influenza vaccination were more likely to accept COVID-19 vaccines for themselves [adjusted odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.19–2.82], their children (adjusted OR = 2.08; 95%CI: 1.30–3.33), and older individuals in their household (adjusted OR = 2.12; 95%CI: 1.14–3.99). Participants with older individuals in their families were less willing to vaccinate themselves (adjusted OR = 0.59; 95%CI: 0.40–0.87) and their children (adjusted OR = 0.58; 95%CI: 0.38–0.89).
Conclusions

Participants were more reluctant to accept COVID-19 vaccines for older individuals living with them. The presence of older individuals in the home also affected willingness of participants and their children to be vaccinated.
Women’s Experience of Pregnancy and Birth during the Covid-19 Pandemic: A Qualitative Study
Authors: Keating Niamh , Dempsey Brendan , Corcoran Siobhan , Lalor Joan , Higgins Mary
Published: December 2020

BACKGROUND: The COVID-19 pandemic has changed how maternity care services are provided worldwide. In an effort to contain the virus many providers have reduced the number of face-to-face visits for women. In addition, partner attendance is now prohibited in many circumstances in order to protect staff, and other service users, from potential infection. METHODS: A qualitative study with 14 women was conducted using a grounded theory approach. Data were collected between April to June 2020 and in-depth interviews were conducted either in pregnancy or in the first 12 weeks after the birth. RESULTS: Six categories emerged: loss of normality, navigating "new" maternity care systems, partners as bystanders, balancing information, uncertainty and unexpected benefits of pregnancy during the pandemic. Women described the challenges they faced with accessing information of the risk of COVID-19 in pregnancy and how to navigate the new hospital and community restrictions. For the most part women accepted many of the restrictions as they understood as being in place to keep them safe. They perceived themselves as vulnerable group despite apparent available evidence to the contrary. The loss of the partner as an advocate, particularly at the anomaly scan and in the neonatal intensive care, was a source of anxiety. Social media was the main source of information for many in place of traditional sources such as healthcare providers. Some unexpected benefits of restrictions included working from home which allowed women to manage normal pregnancy symptoms such as fatigue at home. CONCLUSION: The pandemic caused anxiety for pregnant women. This is exacerbated by uncertainty about the effects of COVID-19 on pregnancy and unclear messaging about restrictions. Pregnancy has a significant temporal component and so maternity services need to respond to women’s needs for information and support rapidly and effectively, with more interactive and personalised communication to support them to cope with uncertainty. The birth partner is an important role as an advocate for women. Containment strategies for the pandemic should be developed with this in mind and attempt to view the family as a unit rather than the woman in isolation.
Cystoscopic Findings in Women with Minimal and Maximal Lower Urinary Tract Symptoms
Authors: Marcu Ioana , Gavard Jeffrey , Varizabadi Golnar , Shi Joe , Steele Andrew , Leong Fah Che , McLennan Mary , Bickhaus Jennifer , Holloran-Schwartz Mary , Yeung Patrick , Campian Eugen
Published: December 2020

Background: Glomerulations are not specific for interstitial cystitis/bladder pain syndrome (IC/BPS). Controversy exists about whether cystoscopic findings differ between patients with and without lower urinary tract symptoms. We sought to compare the prevalence of cystoscopic findings in women with “no or minimal” urinary symptoms to those with a “high” symptom burden. Methods: This is a prospective cohort study performed at a University Educational Facility. Participants in this study were part of a larger prospective study, in which female patients scheduled to undergo routine gynecologic procedures were all consented for cystoscopy with hydrodistension (CWHD). We defined the “minimally symptomatic group” as those with <1 on each of the O’Leary/Sant Interstitial Cystitis Symptom Index (ICSI) subscores and without history of IC/BPS. The “highly symptomatic” cohort of women had composite ICSI score > 12 and a Burning/Pain subscore of 4 or 5. All were non-smokers. Results: 84 women underwent CWHD, with 33 having minimal symptoms and 51 being highly symptomatic. The two groups were not statistically different when assessing for ‘any glomerulations’ compared to ‘no glomerulations.’ However, minimally symptomatic women had an eight-fold lower prevalence of significant glomerulations than highly symptomatic women 3.0% versus 23.5% vs 3.0%, p< 0.05. Pairwise comparisons showed significant differences between > 10 glomerulations in 3 or 4 quadrants and no glomerations, with 4% of minimally symptomatic women having > 10 glomerulations in 3 or 4 quadrants versus 28.6% of highly symptomatic women having > 10 glomerations in 3 or 4 quadrants (p<0.05). Conclusion: Extensive glomerulations (>10 in 3 or 4 quadrants) are rare in women without urinary symptoms. These findings contrast with prior limited prospective data which quoted similar incidence of glomerulations in IC/BPS patients and asymptomatic patients. This study highlights the importance of evaluating objective evidence on CWHD and merits further investigation.
Study of Outcomes and Characteristics of COVID-19 Positive Geriatric Patients in a Scottish Rehabilitation Community Hospital.
Authors: Ong Ying Ern Elena , Khor Zhong Wei , McGovern Ryan , Testrow Sean , Tipton Carolyn
Published: December 2020

BackgroundA dedicated step-down unit was instated in a community geriatric rehabilitation hospital in Dundee to meet the ongoing rehabilitation needs of a Scottish COVID-19 positive geriatric patient cohort. As the profound chronic health effects of COVID-19 on our ageing populations are still poorly understood, our study aims to investigate patient characteristics and outcomes in this cohort of patients stepped-down to the community geriatric hospital COVID-19 ward. Design This was a retrospective observational study of all patients admitted to the COVID-19 step-down unit. Patient demographic data and data on pre- and post-COVID-19 infection patient functional status, clinical frailty score, mobility status and mortality were collected to quantify extent of physical-functional decline in this patient cohort from inpatient notes and electronic databases.Results33 COVID-19 positive patients were included in this study. 36% of patients lost their independent function status and there was a 45% increase (15 patients) in care requirements, accompanied by a 41% decline mobility. Average length of inpatient stay of the surviving population was longer compared to the cohort who died, (35.3 days vs 20.6 days, p=0.028). Stroke as a co-morbidity was associated with increased mortality in this patient cohort (p=0.006, <0.05). Obstructive lung disease is noted to be associated with an increased length of stay (33.4 days vs 20 days, p=0.011).ConclusionsThis study demonstrates quantifiable physical functional decline demonstrated by loss of independent function, increase in care requirements, increased frailty, and reduced mobility in this geriatric cohort post COVID-19 infection.
Realization of nearly dispersionless bands with strong orbital anisotropy from destructive interference in twisted bilayer MoS2
Authors: Xian Lede , Claassen Martin , Kiese Dominik , Scherer Michael M. , Trebst Simon , Kennes Dante , Rubio Angel
Published: December 2020

Recently, the twist angle between adjacent sheets of stacked van der Waals materials emerged as a new knob to engineer correlated states of matter in twodimensional heterostructures in a controlled manner, giving rise to emergent phenomena such as superconductivity or correlated insulating states. Here, we use an ab initio based approach to characterize the electronic properties of twisted bilayer MoS2. We report that, in marked contrast to twisted bilayer graphene, slightly hole-doped MoS2 realizes a strongly asymmetric px-py Hubbard model on the honeycomb lattice, with two almost entirely dispersionless
bands emerging due to destructive interference. The origin of these dispersionless bands, is similar to that of the flat bands in the prototypical Lieb or Kagome lattices and co-exists with the general band flattening at small twist angle due to the Moir´e interference. We study the collective behavior of twisted bilayer MoS2 in the presence of interactions, and characterize an array of different magnetic and orbitally-ordered correlated phases, which may be susceptible to quantum fluctuations giving rise to exotic, purely quantum, states of matter.
Macrophage migration inhibitory factor is a novel structure component of centrioles and a novel transcriptional factor
Authors: Zhang Lu , Zhang Hongbing , Li Xiaoyan , Agborbesong Ewud , Li Xiaogang
Published: December 2020

Ciliopathies are a group of human diseases that affect the cellular cilia or the cilia anchoring structures, the bosal bodies, or ciliary function. Macrophage migration inhibitory factor (MIF) as an important inflammatory cytokine plays a prominent role in the pathogenesis of various human diseases. However, the role of MIF in ciliopathies remains elusive. In this study, we show that MIF is a structure protein of basal bodies, which forms a ring-like structure at proximal end of centrioles to regulate cilia assembly and elongation. Importantly, we identify MIF as a novel transcriptional factor, which regulates the expression of ciliary genes and genes associated with different signaling pathways. The phosphatidylinositol-5-phosphate 4-kinase type 2 alpha (PIP4K2a) mediated MIF phosphorylation at S91 is necessary for the nuclear translocation of MIF, a process that is regulated by 14-3-3ζ. This study suggests that MIF is a key player in cilia biogenesis and transcriptional regulation in homeostasis.
Electrochemical C-C Bond Cleavage of Cyclopropanes towards the Synthesis of 1,3-Difunctionalized Molecules
Authors: Peng Pan , Yan Xingxiu , Zhang Ke , Liu Zhao , Zeng Li , Chen Yixuan , Zhang Heng , Lei Aiwen
Published: December 2020

Electrochemistry had a lot of inherent advantages in organic synthesis and many redox reactions have been achieved under electrochemical condition. However, the electrochemical C-C bond cleavage and functionalization reactions are less studied. Here we developed electrochemical C-C bond cleavage and 1,3-difuntionalization of arylcyclopropanes under catalyst-free and external-oxidant-free conditions. 1,3-difluorination, 1,3-oxyfluorination and 1,3-dioxygenation of arylcyclopropanes were achieved with a highly chemo- and regioselectivity by the strategic choice of nucleophiles. This protocol has good functional groups tolerance and can be scaled up. Mechanistic studies demonstrate that arylcyclopropane radical cation yielded from the anode oxidation and the following generated benzyl carbonium are the key intermediates in this transformation. This development provides a new scenario for constructing 1,3-difunctionalized molecules.
Comprehensive Analysis of Metal Deformation Law Based on Numerical Simulation of Cold Rolling Process
Authors: Yan Zhu-Wen , Wang Bao-Sheng , Bu He-Nan , Li Hao , Hong Lei , Zhang Dian-Hua
Published: December 2020

Through taking the cold rolling process as the research object, the three-dimensional finite element model of the strip rolling process is established by using ANSYS/LS-DYNA software. The simulation results of the finite element model have a good fit with the actual production data. The rolling process is dynamically simulated, and the distribution curves of important rolling parameters such as equivalent stress, control efficiency coefficient, transverse rolling pressure, lateral thickness and work roll deflection is obtained. The research results of this paper have strong practicability for the process control of cold strip rolling mill. The research results have certain guiding significance for the development and optimization of the rolling control system.
Knowledge of Postpartum Women About Modern Contraceptive Methods and Attitudes Towards its Utilization in Debre Tabor Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study
Authors: Taye Eden , Mekonnen Dawit , Debele Tibeb , Tiguh Agumas , Kebede Azmeraw
Published: December 2020

Background: The postpartum period is a crucial time to prevent short inter-pregnancy interval and unwanted pregnancies. Despite it is the most ideal period to create awareness regarding knowledge and attitudes of postpartum mothers about contraceptive methods, it is the most neglected part of the continuum of care. Therefore, this study aimed to assess knowledge of postpartum women about modern contraceptive methods and attitudes towards its utilization in Debre Tabor town, northwest Ethiopia, 2018.Methods: A community-based cross-sectional study was conducted among 552 postpartum mothers at Debre Tabor town from September 20 to October 20, 2018. A cluster sampling technique was used to select the study participants. A pre-tested structured questionnaire was used to collect the data. Data were entered into Epi info version 7 and analyzed by SPSS version 20 software. Multivariable logistic regression model was fitted to identify associated factors. Results: The overall prevalence of good knowledge and favorable attitude towards modern contraceptive methods was 57.6% (95% CI: 53.3%, 61.6%) and 40.6% (95% CI: 36.8, 44.6) respectively. Higher education [AOR: 2.15 (95% CI: 1.36, 3.4)], ever had a discussion with their husband about contraception [AOR: 2.15 (95% CI: 1.48, 3.14)] and ever used modern contraceptive methods [AOR: 1.87 (95% CI: 1.15, 3.03)] were found to be significantly associated with good knowledge of postpartum modern contraceptive methods. Besides, maternal age of 25-34-year-old (AOR= 0.42; 95% CI: 0.27, 0.65), having prior information about contraceptive methods (AOR= 1.73; 95% CI: 1.19, 2.53) and good knowledge of postpartum modern contraceptive methods were associated with the attitude of mothers towards modern contraceptive methods.Conclusion: More than half of the respondents had good knowledge about modern contraceptive methods. But, mother’s favorable attitude towards its utilization is lower compared to other studies. Mother’s higher educational status, ever discussed about contraceptive methods with their husband, and ever used contraceptive methods were the factors significantly associated with knowledge of postpartum modern contraceptive methods. Furthermore, adequate knowledge of postpartum modern contraceptive methods, age group of 25-34 years old and having prior information about contraceptive methods were the factors that significantly associated with the attitude of women.
EARN: An Ensemble Machine Learning Algorithm to Predict Driver Genes in Metastatic Breast Cancer
Authors: Mirsadeghi Leila , Hosseini Reza Haji , Banaei-Moghaddam Ali Mohammad , Kavousi Kaveh
Published: December 2020

Background Today, there are a lot of markers on the prognosis and diagnosis of complex diseases such as primary breast cancer. However, our understanding of the drivers that influence cancer aggression is limited.Methods In this work, we study somatic mutation data consists of 450 metastatic breast tumor samples from cBio Cancer Genomics Portal. We use four software tools to extract features from this data. Then, an ensemble classifier (EC) learning algorithm called EARN (Ensemble of Artificial Neural Network, Random Forest, and non-linear Support Vector Machine) is proposed to evaluate plausible driver genes for metastatic breast cancer (MBCA). The decision-making strategy for the proposed ensemble machine is based on the aggregation of the predicted scores obtained from individual learning classifiers to be prioritized homo sapiens genes annotated as protein-coding from NCBI.Results This study is an attempt to focus on the findings in several aspects of MBCA prognosis and diagnosis. First, drivers and passengers predicted by SVM, ANN, RF, and EARN are introduced. Second, biological inferences of predictions are discussed based on gene set enrichment analysis. Third, statistical validation and comparison of all learning methods are performed by some evaluation metrics. Finally, the pathway enrichment analysis (PEA) using ReactomeFIVIz tool (FDR<0.03) for the top 100 genes predicted by EARN leads us to propose a new gene set panel for MBCA. It includes HDAC3, ABAT, GRIN1, PLCB1, and KPNA2 as well as NCOR1, TBL1XR1, SIRT4, KRAS, CACNA1E, PRKCG, GPS2, SIN3A, ACTB, KDM6B, and PRMT1. Furthermore, we compare results for MBCA to other outputs regarding 983 primary tumor samples of breast invasive carcinoma (BRCA) obtained from the Cancer Genome Atlas (TCGA). The comparison between outputs shows that ROC-AUC reaches 99.24% using EARN for MBCA and 99.79% for BRCA. This statistical result is better than three individual classifiers in each case.Conclusions This research using an integrative approach assists precision oncologists to design compact targeted panels that eliminate the need for whole-genome/exome sequencing. The schematic representation of the proposed model is presented as the Graphical Abstract (Figure 1).
Victorian Healthcare Experience Survey 2016 – 2018; Evaluation of Interventions to Improve the Patient Experience.
Authors: Wong Eunice , Mavondo Felix , Horvat Lidia , McKinlay Louise , Fisher Jane
Published: December 2020

BackgroundPatient experience is recognised as a quality of care indicator and increasingly health services are working on achieving set targets and improving their performance. Interventions at the point of care targeting communication with patients, patient engagement in care processes and discharge planning are associated with better patient experience. However, their efficacy and application to different contexts are still unclear. The aims were to describe the interventions implemented by health services to improve patient experience, their impact on overall patient experiences and specific experiences in areas of communication, discharge planning, patient education on treatment/tests, the physical environment and access to care.MethodsSecondary data analysis of the Victorian Healthcare Experience inpatient surveys reported in September 2016 and 2018 and content analysis of interventions published in the Victorian Quality Account for 2017 from 59 public health services in Victoria, Australia. The interventions were categorised using an adapted taxonomy of professional interventions by the Cochrane EPOC Review Group. Univariate tests and confirmatory factor analysis were conducted to test measure invariance across the 2016 and 2018 groups and examine the association between each of the intervention categories on overall patient experience measure and specific outcome measures.ResultsThis study found that the overall patient experience was consistent (93%) between 2016 and 2018 samples. In comparing impact, a single intervention rather than none or multiple interventions in communication, respect and dignity and treatment and disease education areas were associated with a higher level of the overall patient experience. Interventions in waiting time, access to service, care continuity and emotional support categories were associated with a decrease in overall patient experience. ConclusionThis study found that to improve the overall patient experience, more focus is needed on evidence-based interventions in dignity and respect and emotional support. Furthermore, the choice of interventions should be guided by evidence of their efficacy and prioritising implementing one intervention well, provides more gains.
Outcomes of Pregnancy-Related Referrals From Rural Health Facilities to Two Central Hospitals in Harare, Zimbabwe: A Prospective Descriptive Study
Authors: Busumani William , Mundagowa Paddington
Published: December 2020

BackgroundBetween the years 2000 and 2017, the global maternal mortality rate dropped by 38% however, 94% of all maternal deaths still emanated from low and lower-middle-income countries. Rural women at a significantly higher risk of dying from pregnancy when compared to women living in urban settings and early detection of complications as well as prompt referral to higher levels of care can reduce the associated maternal and perinatal mortality. This study aimed to determine the maternal and perinatal outcomes of pregnancy-related referrals from rural health facilities to two central hospitals in Harare, Zimbabwe.MethodsA prospective descriptive study was conducted using a sample of 206 patients. All mothers who were referred from rural healthcare facilities were recruited for participation. Data were extracted from patient notes using a structured questionnaire and missing information was obtained from the mother after she had recovered. Bivariate analysis was done using IBM SPSS.ResultsThe average age of study participants was 27.4±7.7 years. 87.4% were booked and 81.6% presented to the tertiary facility with their referral notes. The major reasons for referral were previous cesarean section (20.4%) and hypertensive disorders in pregnancy (18.4%). There were nine maternal deaths thus a case fatality rate of 4.4% while the perinatal mortality rate was 151/1000 live births. Young mothers were more likely to have adverse perinatal outcomes and primiparous mothers were more likely to have a blood transfusion. Mothers who traveled for >100km to the tertiary facility and mothers who did not attend any antenatal visit were more likely to be transfused. Delivering at the rural health facility was significantly associated with receiving a blood transfusion at the tertiary facility. Mothers who did not attend antenatal clinic visits were more likely to have negative perinatal outcomes.ConclusionThe proportion of obstetric patients being referred from rural facilities to tertiary institutions for complications in Zimbabwe reveals how primary and secondary healthcare facilities are falling short of offering the services they should be offering. Equipping these facilities with skilled human resources as well as contemporary equipment could help decongest the central hospitals, reduce the adverse maternal and perinatal outcomes.
Cortical Development Assessed by Ultrasound in Fetuses with Isolated Mild Fetal Ventriculomegaly: Asymmetric Cortical Growth, 'catch-up growth' Pattern and Postnatal Neurodevelopment Outcome
Authors: Zhu Rong , Chen JunYa , Hou Xinlin , Liu Lili , Sun GuoYu
Published: December 2020

Background: Assessment of cortical development and identifying factors that may result in a poor prognosis for fetuses with isolated mild ventriculomegaly (IMVM) is a hot research topic. We aimed to perform a constant detailed assessment of cortical development in IMVM fetuses by ultrasound and determine whether asymmetric cortical development occurs in IMVM fetuses. Moreover, we aimed to estimate the prognosis of IMVM fetuses and compare the difference of prognosis of IMVM fetuses with symmetric and asymmetric cortical maturation.Methods: IMVM was diagnosed by regular ultrasound, neurosonography, fetal MRI, and genetic and TORCH examinations. Ultrasound examinations were carried out with an interval of 2-3 weeks to record sulcus development in IMVM fetuses using a scoring system. The neonatal behavioral neurological assessment (NBNA), the Ages and Stages Questionnaire, Third Edition (ASQ-3) and the Bayley Scales of Infant Development (BSID-I) were used after birth.Results: Forty IMVM fetuses were included, twenty showed asymmetric cortical maturation, and twenty showed symmetric cortical maturation. The mean gestational age (GA) at the first diagnosis of relatively delayed development was 24.23weeks for the parieto-occipital sulcus, 24.71weeks for the calcarine sulcus, and 26.43weeks for the cingulate sulcus. The mean GA that two sides developed to the same grade was 29.40weeks for the parieto-occipital sulcus, 29.30weeks for the calcarine sulcus and 31.27weeks for the cingulate sulcus. The NBNA, ASQ-3 and BSID-I scores of all patients were in the normal range.Conclusion: IMVM fetuses may show mild asymmetric cortical maturation in the second trimester, but the relatively delayed sulci would undergo 'catch-up growth'. The neurodevelopment of IMVM fetuses with asymmetric cortical maturation and 'catch-up growth' is not statistically significantly different from that of IMVM fetuses with symmetric cortical maturation.
Improved Thermal Tolerance of Silicon-based Lateral Spin Valves
Authors: Yamashita Naoto , Lee Soobeom , Ohshima Ryo , Shigematsu Ei , Koike Hayato , Suzuki Yoshishige , Miwa Shinji , Goto Minori , Ando Yuichiro , Shiraishi Masashi
Published: December 2020

Improvement in the thermal tolerance of Si-based spin devices is realized by employing thermally stable nonmagnetic (NM) electrodes. For Au/Ta/Al electrodes, intermixing between Al atoms and Au atoms occurs at approximately 300°C, resulting in the formation of a Au/Si interface. The Au-Si liquid phase is formed and diffuses mainly along an in-plane direction between the Si and AlN capping layers, eventually breaking the MgO layer of the ferromagnetic (FM) metal/MgO electrodes, which is located 7 mm away from the NM electrodes. By changing the layer structure of the NM electrode from Au/Ta/Al to Au/Ta, the thermal tolerance is clearly enhanced. Clear spin transport signals are obtained even after annealing at 400°C. To investigate the effects of Mg insertion in FM electrodes on thermal tolerance, we also compare the thermal tolerance among Fe/Co/MgO, Fe/Co/Mg/MgO and Fe/Co/MgO/Mg contacts. Although a highly efficient spin injection has been reported by insertion of a thin Mg layer below or above the MgO layer, these thermal tolerances decrease obviously.
Survival of Colorectal Cancer Patients in Brunei Darussalam: Comparison between 2002-09 and 2010-17
Authors: Lee Shirley , Rahman Hanif Abdul , Abidin Nadiah 'Aqilah , Ong Sok King , Leong Elvynna , Naing Lin
Published: December 2020

BACKGROUND Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. METHODS This retrospective cohort study (n = 1,035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002-2017), to compare survival rates between two study periods (2002-2009 and 2010-2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. RESULTS The 1-, 3- and 5-year survival rates of CRC patients are 78.6%, 62.5%, and 56.0% respectively from 2002-2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002-2009 are 82.2%, 69.6%, and 64.7%; 77.0%, 59.1%, and 51.3% for 2010-2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p<0.001). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010-17 period (Adj. HR=1.78, p<0.001), older age group (>=60 years) (Adj. HR=1.93, p=0.005), distant cancer (Adj. HR=4.69, p<0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR=2.44, p=0.009), and lower in the Chinese group (Adj. HR=0.63, p=0.003). CONCLUSION This study highlights the lower survival rates of CRC patients in 2010-2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.
Effect of Body Direction on Taking the Perspective of a Humanoid Avatar in a Virtual Environment
Authors: Ueda Sachiyo , Nagamachi Kazuya , Sugimoto Maki , Inami Masahiko , Kitazaki Michiteru
Published: December 2020

Understanding another’s viewpoint is the ability to infer others’ minds, which is important for successful social communication. To clarify this process, we investigated whether employing a humanoid avatar as the viewpoint would facilitate an imagined perspective shift in a virtual environment. We used a task that involved reporting how an object looks by a simple direction judgment either from the avatar’s position or an empty chair’s position. We found that the humanoid avatar’s presence improved task performance. Furthermore, the avatar’s facilitation effect was observed only when the avatar was facing the visual stimulus to be judged; performance was worse when it faced backwards. This suggests that the facilitation effect is based not only on attention capture but also the embodied perspective-taking to the avatar.
WITHDRAWN: Land-Use Change Along Altitudinal Gradients in Mountain Ecosystem of Eastern Himalaya (Northeast India): Effect on Plant-Available Soil Micronutrients
Authors: Choudhury Burhan , Ansari Meraj , Chakraborty M , Meetei T
Published: December 2020

Management of soil micronutrients for better crop produce needs sound understanding of their status and causes of variability. This is more relevant for acid soils developed in the mountain ecosystem of Eastern Himalaya (Northeast India). We assessed the status, and the effect of land use systems along wide altitudinal gradients (14 m to 4090 m masl) on soil properties and plant available micronutrient concentrations (DTPA extractable Fe, Mn, Cu and Zn) across the region. Soils of the region varied widely in micronutrient concentrations: Fe from 0.665 to 257.1 mg kg-1 while Mn, Cu and Zn from traces to 93.4, 17.1 and 34.2 mg kg-1, respectively. On conversion of evergreen forests (EF) to upland agriculture (Shifting-SC and Settled-SA) and plantation (PH), Mn, Cu and Zn concentrations decreased significantly (p <0.05) from 30.5, 1.74 and 2.13 mg kg-1 to 6.44-17.8, 0.68-0.81 and 1.06-1.42 mg kg-1, respectively. Grass land (GL) recorded the highest Zn concentration (3.0 mg kg-1) while Mn (24.9 mg kg-1) and Cu (1.16 mg kg-1) concentrations were comparable with lowland paddy agriculture (LP) but higher than upland agriculture. Degradation of EF to scrub land (SL) recorded the lowest Mn (5.91 mg kg-1), Cu (0.59 mg kg-1), and Zn (0.68 mg kg-1) concentrations. The Fe concentration was however, comparable among EF, GL, LP and SC (40.1-52.2 mg kg-1) but increased in degraded SL (+73%) over EF (48.7 mg kg-1). Micronutrient concentrations among the land uses were inconsistent and followed the order: (i) Fe: SL>PH>LP>EF>GL>SC>SA, (ii) Mn: EF> GL> LP> PH> SC> SA>SL; (iii) Cu: EF>GL>LP>SC>SA=PH>SL; and (iv) GL>EF>LP>SC>SA>PH>SL. Four micronutrients responded differently and followed a non-linear, 6th – order polynomial trend along the altitudinal gradients (<500 m to 4100 m masl). Peak concentrations of Fe, Mn, and Cu were recorded at 1001-2000 m elevation while Zn was recorded at > 4000 m masl. Altitude mediated positive influence on soil properties including micronutrient concentrations were observed only in non-cultivated land uses (EF and GL) with an exception to lowland agriculture. Three key soil properties namely pH, clay and organic carbon contents contributed significant variation (54-64%) in micronutrients in the soils of the region.
Ocean Warming and Acidification Modify Top-Down and Bottom-Up Control in A Tropical Seagrass Ecosystem
Authors: Listiawati Vina , Kurihara Haruko
Published: December 2020

Seagrass ecosystems are classified as one of the most productive ecosystems in coastal waters providing numerous of ecological functions, however various anthropogenic stressors including climate change are impacting these vulnerable habitats. Here, we investigated the independent and combined effects of ocean warming and ocean acidification on plant-herbivore interactions in a tropical seagrass community. Direct and indirect effects of high temperature and high pCO2 on the physiology of the tropical seagrass Thalassia hemprichii and sea urchin Tripneustes gratilla were evaluated. Productivity of seagrass was found to synergistically increase under the combination of high temperature and high pCO2, while sea urchin physiology including feeding rate decreased particularly under high temperature. The present study indicated that future climate change will affect the botom-up and top-down balance leading to a shift to a seagrass-dominated ecosystem, which potentially decrease biodiversity as well as ecosystem functions and services of tropical seagrass meadows.
HSF1 Promotes the Development of Endometriosis by Up-regulating PFKFB3 Expression
Authors: wang yixin , xiu jing , yang tingting , ren chune , yu zhenhai
Published: December 2020

BackgroundEndometriosis is a chronic hormonal inflammatory disease characterized by the presence of endometrial tissue (glands and stroma) outside the uterus. Endometriosis seriously affects the physical health of women of childbearing age, often causes infertility, and affects the body and mind of patients and their families.MethodsWe examined the effect of HSF1 on endometriosis through cell count, scratch and clone formation experiments. We used real-time quantitative PCR and western blotting to detect the effect of HSF1 on mRNA and protein of endometriosis cells. Collect the cell culture medium and Glucose levels and lactate levels were determined using a glucose (GO) assay kit and a lactate assay kit. Furthermore, we established a mouse model of endometriosis, and the effect of HSF1 on endometriosis was observed by inhibiting HSF1 with KRIBB11 in the mice.ResultsHSF1 is highly expressed in endometriosis and plays an indispensable role in endometriosis development in both cell and animal studies. We found that HSF1 promotes endometriosis development and glucose consumption and lactic acid production. Further research showed that HSF1 functions in endometriosis by up-regulating PFKFB3, a key enzyme in glycolysis. And the HSF1 inhibitor KRIBB11 can abrogate all of the above experimental effects both in vivo and in vitro. ConclusionsOur study shows that HSF1 plays a significant role in the occurrence and development of endometriosis, which may become a new target for the treatment of endometriosis and provide a new idea for the clinical treatment of endometriosis.