bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of XTFs on risk and return of households’ investment portfolios
Authors:   , Wanger Hans Philipp
Published: November 2021

In this doctoral thesis, XTFs are considered as plain-vanilla Exchange Traded Funds which pursue a passive investment approach and replicate a broad, internationally diversified market index. The thesis pursues two research goals. First, to investigate whether XTFs enhance risk and return of household portfolios when taking multiple relevant asset classes into account – not only stocks. Second, to examine whether employing XTFs in household portfolios is reasonable when including practical constraints and risk measures that reflect households’ actual investment situation and interpretation of risk more closely compared to previous literature. To meet these research goals, three empirical analyses are conducted. The analyses are built on the foundations of neoclassical finance theory, new institutional economics, market microstructure theory, financial intermediation, as well as behavioral finance and economics. For the empirical investigations, two data sets of the German central bank (Deutsche Bundesbank) are combined: The Panel on Household Finances-survey and the Securities Holdings Statistics-base. The thesis ends by discussing the empirical analyses' results, possible limitations to the findings' generalizability, and implications for different stakeholders.
The Difference of Despression Level Before and After Keroncong Music Therapy in the Elderly
Authors: Raufuddin Raufuddin
Published: November 2021

Introduction: coming to an old age a person will experience physical, psychological, and biological setbacks. Psychological deterioration which is often found in the elderly is depression (Purbowinoto, 2010). One of the non-pharmacological therapies that can be applied to reduce depression levels in the elderly is to use keroncong music therapy. The purpose of this study was to determine the differences in depression levels in the elderly before and after being given keroncong music therapy at UPTD Griya Werdha Jambangan Surabaya.Method: the method used was analytical pre-experimental research with pre testpost test design. The independent variable in this study was depression in the elderly, while the independent variable was keroncong music therapy. The population is 40 elderly with 36 samples in the UPTD Griya Werdha Jambangan Surabaya taken using purposive sampling techniques. The data was taken using a questionnaire. Data analysis used the Wilcoxon Rank Test statistical test.Results: from the results of the study, it was found that there was a difference in the levels of depressionin the elderly before and after being given keroncong music therapy at UPTD Griya Werdha Jambangan Surabaya with a significant value of = 0.0001 lower than p= 0.05 (p <α). Before the therapy or treatment, most of the elderly experienced depression levels with as many as 11 respondents (30.6%) and after the treatment most of them experienced depression level with as many as 16 respondents (44.4%).Conclusion: it could be concluded that there was a difference in levels of depression in the elderly before and after being given keroncong music therapy at UPTD Griya Werdha Jambangan Surabaya. For this reason, music therapy can be an option to decrease the depression level in the elderly at UPTD Griya Werdha Jambangan Surabaya.
NURSING CARE OF NEONATAL JAUNDICE IN HYPERBILIRUBINEMIA BABIES: A CASE REPORT
Authors: Tyas Anestasia Pangestu Mei , Nurvianti Siti Aisyah , Mardhika Amellia , Medawati Riris , Lutfiandini Cherlys Tin , Lestari Wahyu Agustin Eka
Published: November 2021

Introduction: Jaundice is a condition that is often found in the 24 hours after the birth of the baby due to hyperbilirubinemia. Hyperbilirubinemia can cause various complications and death if not treated properly and immediately. The knowledge and ability of nurses in providing nursing care for neonatal jaundice still need to be improved. This study aims to describe nursing care for neonatal jaundice in hyperbilirubinemia infants. Methods: This study uses a case study approach design through the nursing process with a sample of a hyperbilirubinemia baby with neonatal jaundice nursing problems. Data collection techniques were carried out through interviews, observations, physical examinations and documentation studies. Data analysis in this study uses narrative analysis. Results: The case report found jaundice on the skin, sclera, and mucosa. The nursing diagnosis in this study was neonatal jaundice associated with less than 7 days of age. The intervention provided in the form of phototherapy and breastfeeding education showed the result was not found jaundice on the skin, sclera, and mucosa after three days. Conclusion: The provision of phototherapy and breastfeeding education is effective in solving neonatal jaundice.
RESILIENCE OF ADOLESCENT POST-DISASTER ERUPTION OF MOUNT SEMERU: LITERATURE REVIEW
Authors: Rahmawati Primasari Mahardhika , Suhari Suhari , Astuti Anggia , Musviro Musviro
Published: November 2021

Introduction:Indonesia sits on an active continental plate, surrounded by a series of very active volcanoes called the ring of fire. These conditions make Indonesia very vulnerable to disasters. Mount Semeru was observed to have experienced at least 57 eruptions or eruptions. The resilience possessed by adolescents can affect when the post-eruption disaster strikes.Methods:The strategy to determine the selection of studies that have been found, the author uses a protocol and evaluation uses the PRISMA Checklist and is adjusted to the purpose of this literature review. Searching for literature sources in this literature review uses several databases including PubMed and Google ScholarResults:Resilience is very important for adolescents in post-mountain eruption disaster situations, adolescents who have resilience can survive and never give up in difficult circumstances, adapt to these conditions, and can rise. Most of the adolescents in post-disaster areas have moderate levels of resilience as much as 64% and as high as 63%. This can occur due to several factors, namely individuals, families, and communities. In addition, gender can also affect a person's resilience. Men are more resilient than women.Conclusion:The existence of sources of support from internal and external as well as knowledge about adolescent disasters can optimize youth resilience after the Semeru eruption disaster.
THE RELATIONSHIP OF KNOWLEDGE ABOUT COVID-19 WITH COMMUNITY PERCEPTIONS OF THE COVID-19 VACCINATION PROGRAM
Authors: Murtiyani Ninik , Yulianto Yulianto , Adhimah Lailatul
Published: November 2021

Introduction: There are so many issues that affect information about the Covid-19 vaccine, such as safety and vaccines that have not been proven to be effective in preventing someone from being infected with Covid-19 again. Knowledge will also affect the public's perception of the Covid-19 vaccination program. Methods: The design of this study was a cross-sectional approach. with a population of 127 respondents and a sample of 96 people. The sampling method uses simple random sampling, data collection uses a questionnaire. The variables in this study are the dependent variable on perceptions of the Covid-19 vaccination program in the community and the independent variable on knowledge about Covid-19. Spearman Rho test with < 0.05. Result: respondents' knowledge (88.5%) is good. Respondents' perception of the COVID-19 vaccination program (90.6%) was positive. The results of the Spearman rho test showed = 0.018 < = 0.05. Conclusion: there is a relationship between knowledge about Covid-19 and the perception of the Covid-19 vaccination program in the community in Sumari Hamlet, Sumari Village, Sitsampeyan District, Gresik
Use of Electronic Resources Before and During the Pandemic in the Universitas Indonesia Library
Authors: Aswinna Aswinna , Rahmi Rahmi
Published: November 2021

Background of the study: COVID-19 impacts library activities. However, previous studies have not analysed the use of electronic resources (online database) before and during the pandemic, especially concerning higher education libraries in Indonesia.

Purpose: This study investigated electronic collections before (2019) and during the pandemic (2020) in the Universitas Indonesia Library.

Method: This study used a quantitative approach with descriptive analysis. Using online database usage logs from 2019 to 2020.

Findings: The study divided its online database comparisons into several clusters, including multi-disciplinary, health, science and technology, and social science and humanities. The findings show that the use of almost all electronic collections declined in 2020, especially the use of e-books and protocol collections. When grouped according to knowledge clumps, however, the use of electronic collections increase in 1) health and 2) social sciences and humanities. Use declined in 1) multi-disciplinary and 2) science and technology clusters.

Conclusion: This study recommends further research.
Development of School Library Collection at SDN 11 Central Singkawang
Authors: Kurniasari Muwazah Ulfah
Published: November 2021

Background of the study: Every education can provide educational information institutions that can be through the library. The library is an institution that has the main task as a provider of information both in print and electronic form. Collection development in a library is an activity that is very important and must be done, as is the case with libraries in schools. In general, the school library is needed in the school environment as a support for the success of the teaching and learning process

Purpose: This study aims to determine how the process in developing the existing collections at the SDN 11 Central Singkawang Library.

Method: This research was conducted using a qualitative descriptive method through direct interviews via whatsapp and telephone to the principal and an operator at SDN 11 Central Singkawang.

Findings: Based on the results of the study, it can be seen that, collection development consists of user analysis activities (community analysis), collection development policies, library material selection, acquisition, weeding library materials, and evaluation.

Conclusion: The school library of SDN 11 Central Singkawang has developed its collection according to procedures, although it has not been carried out optimally because it has not set a specific collection development policy.
Methods and algorithm for calculating the focal parameters of a hollow conical electron beam in high-voltage glow discharge electron guns with a focusing magnetic lens
Authors: Melnyk Igor , Tugay Sergey , Kyryk Volodymyr , Shved Iryna
Published: November 2021

The algorithm is considered for calculating the focal distance of a hollow conical electron beam generated by high-voltage glow discharge electron guns with magnetic focusing of the beam in the drift region, as well as a method for calculating the diameter of the focal ring and its thickness for such a beam. The proposed algorithm is based on the theory of electron drift in the field of a focusing magnetic lens and is designed using the methods of discrete mathematics and the minimax analysis. The obtained simulation results made it possible to establish the influence of the magnetic lens current on the focal diameter of a hollow conical electron beam and on its focal ring thickness. It is shown that the change in the focal parameters of a hollow conical electron beam can be effectively provided through the regulation of the magnetic lens current.
Analysis and review on fuzzy evaluation of the performance
Authors: Yu Junfeng , Yang Zijiang , Guo Jianping , Globa Larysa
Published: November 2021

In modern conditions a comprehensive analysis of development trends and their effectiveness in various areas of human activity increasingly requires the analysis of data accumulated in numerous documents stored on the global network. Such an analysis is based on annual results in many areas of research, time trends and keywords. This analysis has certain peculiarities: it requires an analysis of not always accurate numerical information, comparison of qualitative indicators, obtaining both qualitative and quantitative characteristics, as well as the use of reference information for researchers and decision makers in related fields. In this regard, in recent years, a fuzzy assessment based on fuzzy mathematics is increasingly used in all types of assessing the effectiveness of various activities. The paper deals with conducting a bibliometric study based on the Extended Science Citation Index (SCI-E) and fuzzy performance measures to understand research trends and areas of focus. This paper takes the relevant scientific papers in Web of Science database as the research object, and analyzes the research trends with the help of bibliometrics. The results show that the number of papers published in the world is on the rise. The number of papers published in China and Iran is higher than that in other countries and regions. However, the number of papers cited in the United States and Turkey is higher than that in other countries or regions. Islamic Azad University is the largest. The research topics focus on fuzzy sets, fuzzy logic, genetic algorithms and performance evaluation. The research hotspots before 2011 included expert systems, neuro-fuzzy systems, and pattern recognition. After 2011, the research hotspots became neural networks, fuzzy sets, and machine learning.
O consumo de alimentos ultraprocessados é determinante no desenvolvimento da obesidade
Authors: Santos Lopes Da Silva Leonardo , Pugliesi Abdalla Pedro , Gavassa De Araújo Rafael , De Freitas Batalhão Daniel , Rossini Venturini Ana Cláudia , Dos Santos Carvalho Anderson , Bohn Lucimere , Augusto Pinto Silva Mota Jorge , Roberto Lopes Machado Dalmo
Published: November 2021

INTRODUÇÃO: O consumo de alimentos ultraprocessados (AUP) aumenta o risco para o desenvolvimento da obesidade, contudo, ainda não foi quantificado tamanho e impacto desse risco.  OBJETIVO: Determinar a magnitude do consumo de AUP na transição do estado nutricional de sobrepeso para a obesidade. MÉTODOS: Este estudo observacional foi conduzido a partir de dados de 15.024 adultos dos 18 aos 59 anos (Mulheres: 56%), do projeto Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) de 2019. O estado nutricional foi determinado mediante o índice de massa corporal (IMC). Valores de IMC entre 25 e 29.99 kg/m2 classificaram sobrepeso (n=9618) e quando ≥30kg/m2, era considerada a obesidade (n=5406). O consumo de AUP foi considerado baixo (<9 unidades/dia) ou elevado (≥10 unidades/dia). Os fatores de risco: idade, sexo, escolaridade, consumo <9 alimentos minimamente processados (AMP), inatividade física (≤150 min/semana de intensidade moderada a vigorosa), horas de tela por dia, consumo de álcool (sim/não), consumo semanal de tabaco (nº de cigarros/semana), pressão arterial elevada (sistólica >120mm/Hg e/ou diastólica >80mm/Hg) e hiperglicemia (≥126mg/dL) foram introduzidos no modelo de regressão logística binária para o cálculo das razões de chance (Odds Ratio [OR]). RESULTADOS: O consumo de ≥10 AUP aumentou em 37% a probabilidade de ocorrência de obesidade, independentemente dos demais fatores de risco: inatividade física (OR=+26,1%), tempo de tela (OR=+6,5%), consumo de ≥10 AMP (OR=-59%), ausência de níveis pressóricos elevados (OR=-52,6%), de hiperglicemia (OR=-29,6%) e maior escolaridade (OR=-2,1%). CONCLUSÃO: O tamanho do sucesso nas estratégias interventivas para a prevenção da obesidade agora é conhecido A intervenção efetiva envolve prioritariamente fatores como redução do consumo de AUP e aumento do consumo de AMP, com magnitude do impacto de 37% e 59%, respectivamente.
Sustained Effects of Muscle Calpain System Genotypes on Tenderness Phenotypes of South African Beef Bulls during Ageing up to 20 Days
Authors: Basson Annie , Strydom Phillip E. , van Marle-Köster Esté , Webb Edward C. , Frylinck Lorinda
Published: November 2021

The most important factor that determines beef tenderness is its proteolytic activity and the balance between calpain1 protease activity and calpastatin inhibition is especially important, while contributions could arise from calpain2 and possibly calpain3. These processes are however affected by the meat aging process itself. To determine whether genotypes in the calpaincalpastatin system can enhance tenderness throughout a 20 day aging period, South African purebred beef bulls (n=166) were genotyped using the Illumina BovineHD SNP BeadChip, through genebased association analysis targeting the cast, capn3, capn2 and capn1 genes. The WarnerBratzler shear force (WBSF) and myofibril fragment length (MFL) of Longissimus thoracis et lumborum (LTL) steaks were evaluated between d 3 d 20 of aging, with protease enzyme activity in the first 20 h postmortem. Although several of the 134 SNP associated with tenderness, only seven SNP in the cast, capn2 and capn1 genes sustained genetic associations, additive to agingassociated increases in tenderness for at least three of the four aging periods. While most genomic associations were relatively stable over time, some genotypes within SNP responded differently to aging, resulting in altered genomic effects over time. The level of aging at which genomic associations are performed is an important factor that determines whether SNP affect tenderness phenotypes.
Diagnostics of the readiness for self-improvement of the future teacher in the conditions of COVID-19
Authors: Bilyk Valentyna , Tkachov Artem , Tkach Ivanna
Published: November 2021

The society's need for competitive specialists capable of solving urgent issues requires focusing efforts on solving the most pressing problems in education in today's pandemic conditions. The psychological and pedagogical literature has repeatedly emphasized the need for self-improvement as a component of self-education of a person in general and a teacher in particular. One of the most important factors in the success of further professional activity is the formation of students' readiness for professional self-improvement. The issues of training future teachers remain topical, because both the intellectual, moral and spiritual development of children and youth, the socio-economic well-being of the country depend on their activities. Since the attention of specialists is focused on the personal potential of a person, the urgent is the problem of the formation of future teachers' readiness for self-improvement in the process of individualization of professional training pedagogical science. For this, the methods of theoretical research of profile sources were used, and also theoretical and ascertaining experiments were carried out. It is proved that the training of a future teacher  should be focused on the personality, the recognition of a person as the highest value in society, and providing conditions for personal self-improvement of the future teacher is one of the priority areas in the educational process of the university
ANALISIS PENERAPAN PRINSIP KEADILAN, AL-IHSAN, AL-MAS’ULIYAH, AL-KIFAYAH, DAN KEJUJURAN DALAM BISNIS RITEL (STUDI KASUS MBS MADIUN TEGUHAN JIWAN MADIUN)
Authors: Muhamad Abdulloh
Published: November 2021

In this era of globalization, many retail businesses are starting to develop, especially the types of minimarkets, the number of minimarkets making the competition heats up. This makes entrepreneurs rack their brains to create good strategies to attract consumer interest, including applying sharia principles in their operations. This study seeks to determine how the application of sharia principles to the retail business in the city of Madiun. This research uses case studies by making shop owners the primary data source of research, while secondary data is from supporting information related to research conducted either from observations or literature sources or relevant previous research. The results showed that the strategy of applying sharia principles in several aspects, namely, aspects of products, services, marketing, and distribution of profits to those in need is in accordance with Islamic sharia. The application of sharia principles also provides a special attraction for consumers, thereby increasing mini-market sales.

Di era globalisasi seperti sekarang ini mulai banyak berkembang bisnis ritel khususnya jenis minimarket, banyaknya minimarket membuat persaingan semakin memanas. Hal tersebut membuat para pengusaha memutar otak untuk membuat strategi yang baik guna menarik minat konsumen diantaranya adalah dengan menerapkan prinsip-prinsip syariah dalam operasionalnya. Penelitian ini berusaha mengetahui bagaimana prinsip-prinsip syariah yang diterapkan pada bisnis ritel yang ada di kota Madiun. Penelitian menggunakan studi kasus dengan menjadikan pemilik toko sebagai sumber data primer penelitian, sedangkan data sekunder dari informasi-informasi pendukung terkait penelitian yang dilakukan baik dari pengamatan maupun sumber-sumber pustaka ataupun penelitian terdahulu yang relevan. Hasil penelitian menunjukkan bahwa dengan strategi menerapkan prinsip-prinsip syariah dibeberapa aspek yaitu, aspek produk, pelayanan, pemasaran, dan penyaluran keuntungan kepada yang membutuhkan sudah sesuai dengan syariah Islam. Penerapan prinsip-prinsip syariah juga memberikan kesan baik dimata para konsumen sehingga meningkatkan penjualan minimarket.
Income, Coal Consumption, And The Environmental Kuznets Curve In Vietnam
Authors: Tran Nhan Dang , Sahu Naresh Chandra
Published: November 2021

While coal leads energy structure in a rapid growth economy like Vietnam, there exist efforts to increase the use of renewable energy and at the same time to reduce greenhouse gas emissions. This paper aims to investigate whether there is an inverted U environmental Kuznets curve (EKC) relation between income and coal consumption from 1984 to 2019 using the nonlinear autoregressive distributed lag (NARDL) framework. We find that the income elasticities of coal consumption are larger than unity and increase monotonically with income. It thus reveals that the income-coal consumption relationship resembles an upward-sloping curve instead of an inverted U-shaped curve. We also find that coal consumption reduces with the one percent increase in the share of renewable energy consumption by less than it increases with the one percent decrease in the share of renewable energy consumption. Despite this, it indicates that the substitution of renewable energy for coal seems more substantial with policy improvements. Moreover, we find that the quantity of coal consumed grows with positive oil price shocks. It suggests that rising oil prices play an undesirable role in reducing coal consumption and associated emissions. Finally, the study provides policy implications for interventions to achieve committed emission targets.
Energy Efficiency and Green Innovation and Its Asymmetric Impact on CO2 Emission in China: A New Perspective
Authors: Li Yue , Zhangchuan Chuan , Li ShiXiang , Usman Ahmed
Published: November 2021

Green innovation undoubtedly plays a significant role in creating employment opportunities, boosting green economic activity, and improving environmental sustainability. This study scrutinizes the effect of energy efficiency and green innovation on CO2 emissions in China over the 1992–2014 period using NARDL. Findings show that energy efficiency and green innovation contribute to reducing CO2 emissions in China. Energy efficiency and green innovation are also important asymmetric determinants of CO2 emissions. An increase in energy efficiency and green innovation lowers CO2 emissions, while a decrease in energy efficiency and green innovation increases CO2 emissions in China in the long run. Some policy measures are suggested to attain carbon neutrality.
Surgical Management of Lumbar Spinal Stenosis in Patients Over 80 : Is There an Increased Risk ?
Authors: rault frédérick , Briant Anaïs R , Gaberel Thomas , Kamga Hervé , Emery Evelyne
Published: November 2021

Introduction:Management of lumbar spinal stenosis (LSS) represents the first cause of spinal surgery for the elderly and will increase with the aging population. Although the surgery improves quality of life, the procedure involves anaesthetic and operative risks. The aim of this study was to assess whether the postoperative complications rate was higher for elderly patients and to find confounding factors.Material and MethodsWe conducted a retrospective study including all LSS surgeries between 2012 and 2020 at the University Hospital of Caen. We compared two populations opposing patients aged over 80 with others. The primary endpoint was the occurrence of a severe complication (SC). Minor complications were the secondary endpoint. Comorbidities, history of lumbar spine surgery and surgical characteristics were recorded.Results996 patients undergoing surgery for degenerative LSS were identified. Patients over 80 were significantly affected by additional comorbidities: hypertension, heart diseases, higher age-adjusted comorbidity Charlson score, ASA score and use of anticoagulants. Knee-chest position was preferred for younger patients. Older patients underwent a more extensive decompression and had more incidental durotomies. 5.2% of patients presented SC. Age over 80 did not appear to be a significant risk factor for SC, but minor complications increased. Multivariate analysis showed that heart diseases, history of laminectomy, AA-CCI, and accidental durotomies were independent risk factors for SC.ConclusionSurgical management for lumbar spinal stenosis is not associated to a higher rate of severe complications for patients over 80 years of age. However, preoperative risk factors should be investigated to warn the elderly patients that the complications risk is increased although an optimal preparation is the way to avoid them.
Analyses of Changing Disease Patterns and Factors Related to Disease Outcomes in Patients with Crohn’s Disease after 7 Years of Follow-up: A Single-center Retrospective Study
Authors: Han Dong Yoon , Park So Hyun , Seo Mirinae , Park Seong Jin , Liu Zi-Xin , You Myung-Won
Published: November 2021

Background: The clinical spectrum and disease course of Crohn’s disease (CD) are heterogeneous and difficult to predict based on initial presentation. Aim: To analyze the long-term disease course and factors leading to poor prognosis of the disease.Methods: In total, 112 patients with CD who were initially diagnosed or treated at our institution were included. We analyzed their clinical data, disease characteristics according to Montreal classification, endoscopic and computed tomography (CT) examinations at initial visit, and 2-year, 5-year, and last follow-ups. We categorized the long-term disease course into four categories: remission, stable, chronic refractory, and chronic relapsing. Significant factors associated with a poorer prognosis were analyzed.Results: The median follow-up period was 107 (range, 61-139) months. Complicated disease behavior increased slightly (20.5% to 26.2%). Chronic refractory (19.6%) and relapsing (16.1%) courses were defined as unfavorable disease course. Two-year disease characteristics were significant factors for unfavorable disease course, and the combination of 2-year perianal disease and 2-year moderate-to-severe CT activity could predict unfavorable disease course with the highest accuracy (0.722, area under the curve 0.768, p<.0001). Conclusions: One-third of our CD patients showed an unfavorable disease course (35.7%) and 2-year disease characteristics were significant factors for an unfavorable disease course.
Case Report: Extracorporeal Membrane Oxygenation In Curing A Young Man Post-Operative of The Modified Fontan Operation
Authors: Guo Hebing , Tan Jianbo , Cui Yongchao , Xiong Haofeng , Li Chuansheng , Liu Yufeng , Sun Yao , Pu Lin , Xiang Pan , Zhang Ming , Hao Jingjing , Yin Ningning , Hou Xiaotong , Liu Jingyuan
Published: November 2021

Background: The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ hemodynamics. After successful operation, patients typically recover the ability to engage in general physical activity. The mortality of patients diagnosed with acute respiratory distress syndrome (ARDS) ranges from 17.3 to 41.4% among critically ill patients with H1N1 infection. As a better ventilatory strategy, extracorporeal membrane oxygenation (ECMO) provides gas exchange via an extracorporeal circuit, and is increasingly being used to improve respiratory and circulatory function. As is known to all, after the modified Fontan operation, circulation was different compared with patients who were not subjected to the procedure. But very few articles describe the special circulation about the case who was post-operative of the modified Fontan operation especially when it received the treatment of E-CMO. This study aims to describe a successful case using E-CMO in curing the influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation thirteen years ago. We want to explore the special cardiac structure and circulatory characteristics in this case.Methods: To report a successful case using extracorporeal membrane oxygenation in curing the influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation thirteen years ago. In this article, we describe a 23-year-old man, with a history of modified Fontan operation for the Tausing-Bing syndrome, admitted to ICU with severe acute respiratory distress syndrome as a result of influenza A infection. The man was initially treated by V-V ECMO, five days later was switched to V-V-A E-CMO. Results: As circulation and respiratory function gradually improved, the VV-A ECMO equipment was removed on May 1, 2018.The patient was successfully withdrawn from artificial ventilation on May 28, 2018, then discharged from hospital on May 30, 2018.Conclusion: After the modified Fontan operation, circulation was different compared with patients who were not subjected to the procedure. There were certainly many differences between the two sides when they received the treatment of E-CMO. As the special cardiac structure and circulatory characteristics, an individualized liquid management strategy was necessary and it might be better for them to choose an active cycle support earlier.
Comparative Study of Hemispherical Solar Still Using Different Novel Basin Materials With and Without Internal Reflector: Yield, Energy, Exergy, Water Quality and Cost Analysis
Authors: Attia Mohammed El Hadi , Hussein Ahmed Kadhim , Ramadoss Prabha , Vaithilingam Sivakumar , Afzal Asif , Younis Obai
Published: November 2021

The present work deals with the experimental investigation of Hemispherical Solar Still (HSS) using different basin materials with and without Internal Reflector (IR). Three solar stills such us HSS with Steel Basin (HSS-SB), HSS with Zinc Basin (HSS-ZB), HSS with Copper Basin (HSS-CB) was fabricated. Experiments was conducted with and without IR. It was found that, the productivity of the HSS-CB (4.99 kg/m2/day) was better than HSS-ZB (4.26 kg/m2/day) and both of them were better than HSS-SB (3.64 kg/m2/day). Also, It was found that the productivity of the HSS-CB&IR (5.67 kg/m2/day) was better than HSS-ZB&IR (5.04 kg/m2/day), and both of them were better than the HSS-SB&IR (4.28 kg/m2/day). The results revealed that use of IR improves the yield of HSS from 12 to 15.6%. Also thermal and exergy efficiency of the HSS was improved by 14.4 to 20% and 21.1 to 25.4% using IR than the without IR. Furthermore, recovery period and water quality analysis has been carried out. The recovery period of HSS-SB, HSS-ZB, HSS-CB, HSS-SB&IR, HSS-ZB&IR and HSS-CB&IR are 43, 38, 33, 36, 32 and 29 days, respectively.
Women’s Perception of and Readiness To Adopt a Sustainable Healthy Diet: A Cross-Sectional Survey in Enugu City, Nigeria
Authors: Ogbuabor Daniel Chukwuemeka , Ogbuabor Alphonsus Ogbonna
Published: November 2021

Background

Perceived benefit of and readiness to adopt sustainable healthy diets (SHDs) is under-investigated in low-resource countries. We assessed women’s perceived benefit of and readiness to adopt SHDs and their associated factors in Enugu Metropolis, Nigeria.
Methods

A household cross-sectional survey of childbearing women (n = 450) was conducted in January and February 2021 using a questionnaire assessing food choice motives, perceived benefit, and readiness to adopt SHDs. Readiness to adopt SHDs was grouped into pre-contemplation and contemplation (PC/C), preparation and relapse (P/R), and action and maintenance (A/M).
Results

About 79% and 60% of women have high perception and adopted SHDs respectively. Perceived benefit of SHD was associated with younger age (β = -0.20, ρ < 0.05), low education (β = -0.19, ρ < 0.05), and poor wealth quintile (β = -0.57, ρ < 0.001). PC/C was predicted by low perceived benefit (OR = 10.07, 95% CI: 4.78-21.22, ρ < 0.001), low education (OR = 2.51, 95% CI: 1.25-5.04, ρ = 0.010), and taste (OR = 3.96, 95% CI: 1.61-9.75, ρ = 0.003). PR was predicted by low perceived benefit (OR = 3.92, 95% CI: 1.99-7.73, ρ < 0.001), low education (OR = 1.82, 95% CI: 1.00-3.29, ρ = 0.049). A/M was related to younger age (OR = 0.48, 95% CI: 0.27-0.84, ρ = 0.010, PR), and health (OR = 0.14, 95% CI: 0.06-0.36, ρ < 0.001, PC/C) and (OR = 0.17, 95% CI: 0.08-0.35, ρ < 0.001, P/R).
Conclusions

Adoption of SHDs need to improve in Enugu, Nigeria. We identified the factors that should inform dietary guidelines and campaigns to increase women's adoption of SHDs.
The National Economic Burden of Rare Disease in United States in 2019
Authors: Yang Grace , Cintina Inna , Pariser Anne , Oehrlein Elisabeth , Sullivan Jamie , Kennedy Annie
Published: November 2021

Background: To provide a comprehensive assessment of the total economic burden of rare diseases (RD) in the U.S. in 2019.We followed a prevalence-based approach that combined the prevalence of 379 RDs with the per-capita direct medical and indirect costs, to derive the national economic burden by patient age and type of RD. To estimate prevalence and the direct medical cost of RD, we used claims data from three sources: Medicare 5% Standard Analytical File, Transformed Medicaid Statistical Information System, and Optum claims data for the privately insured. To estimate indirect and non-medical cost components, we worked with the rare disease community to design and implement a primary survey.Results: There were an estimated 15.5 million U.S. children (N=1,322,886) and adults (N=14,222,299) with any of the 379 RDs in 2019 with a total economic burden of $997 billion, including a direct medical cost of $449 billion (45%), $437 billion (44%) in indirect costs, and $111 billion (11%) in non-medical costs. The top drivers for excess medical costs associated with RD are hospital inpatient care and prescription medication; the top indirect cost categories are labor market productivity losses due to absenteeism, presenteeism, and forced early retirement.Conclusions: Our findings highlight the scale of the RD economic burden and call for immediate attention from the scientific communities, policy leaders, and other key stakeholders such as health care providers and employers, to think innovatively and collectively, to identify new ways to help improve the care, management, and treatment of these often-devastating diseases.
Prevalences of Antibiotic-Resistant and Multidrug Resistant Bacteria in Urine Cultures from Inpatients with Spinal Cord Injuries and Disorders: An 8-Year, Single-Center Experience
Authors: Šámal Vladimir , Paldus Vít , Fáčková Daniela , Mečl Jan , Šrám Jaroslav
Published: November 2021

Background
Patients, especially inpatients, with spinal cord lesions and disorders (SCI/D) have an elevated risk of recurrent urinary tract infections with multidrug resistant (MDR) bacteria. This study evaluated antimicrobial resistance and the prevalence of multidrug resistance and determined the risk factors for multidrug resistance.
Methods
In this retrospective cohort study, urine culture results were used to calculate the antimicrobial resistance rate and the incidence of infection with MDR bacteria in the SCI/D population. MDR was defined as acquired nonsusceptibility to at least one agent from three or more antimicrobial categories. The cohort included 402 inpatients from 2013 to 2020, with 1385 urine isolates. We included only the first isolate, and duplicate isolates, defined as positive cultures of the same strain within 14 days, were excluded from the evaluation.
Results
The most common MDR strains were Klebsiella spp. (29%) and Escherichia coli (24%). MDR isolates were detected in 50% of the samples and extended spectrum beta-lactamase (ESBL)-producing isolates in 26%, while carbapenem resistance was found in 0.1%. Significantly higher rates of infection with MDR bacteria were identified in the groups of patients with indwelling urethral/suprapubic catheters (p=0.003) and severity score C1-C4/AIS A-C (p=0.01). We identified age (OR: 0.99, 95% CI; 0.98-0.99, p=0.000), male sex (OR: 1.55, 95% CI; 1.16-2.06, p=0.003), management with urethral/suprapubic catheters (OR: 2.76, 95% CI; 2.04-3.74, p=0.000), and spontaneous voiding (OR: 1.84, 95% CI; 1.03-3.29, p=0.038) as independent predictors of multidrug resistance in our study population.
Conclusions
We identified a high antibiotic resistance rate and an increasing prevalence of infection with MDR bacteria in the SCI/D inpatient population. Particular attention should be given to bladder management, with an emphasis on minimizing the use of indwelling catheters.
Inhibition of hemozoin-induced neuroinflammation by medicinal plants used for the treatment of malaria in Southwest Nigeria: implications for cerebral malaria
Authors: Olajide Olumayokun , Iwuanyanwu Victoria
Published: November 2021

This study aimed to investigate some antimalarial plants for effects on neuroinflammation. Freeze-dried infusions of the plants were investigated for effects on hemozoin-induced neuroinflammation in BV-2 microglia and levels of inflammatory mediators measured. Alstonia boonei (stem bark), Anacardium occidentale (stem bark), Azadiractha indica (leaves), Enantia chlorantha (stem bark), Khaya senegalensis (stem bark), Mangifera indica (stem bark), and Nauclea latifolia (stem bark) produced significant (p<0.05) reduction in TNFα, IL-6, IL-1β, MCP-1, RANTES and iNOS/NO production in BV-2 microglia stimulated with a synthetic hemozoin (400 µg/mL). Further experiments showed that pre-treatment with 50 µg/mL of A. boonei, A. indica, A. occidentale, E. chlorantha and M. indica prior to hemozoin stimulation resulted in inhibition of NF-κB activation by >40%, while E. chlorantha, K. senegalensis and N. latifolia produced weak activities. Pretreatment with A. indica (50 µg/mL) produced the highest inhibition (58.6%) of hemozoin-induced increased NLRP3 protein expression, while A. occidentale (50 µg/mL), M. indica (50 µg/mL) and A. boonei (50 µg/mL) reduced expression by 54.1%, 49.2% and 47.1%, respectively. Hemozoin-induced increased caspase-1 activity was reduced by A. boonei, A. occidentale, A. indica, E. chlorantha, and M. indica. These results suggest that A. boonei, A. occidentale, A. indica and M. indica produced strong inhibition of hemozoin-induced neuroinflammation through mechanisms involving NFκB and NLRP3 inflammasome activation, while moderate activities were produced by E. chlorantha, K. senegalensis and N. latifolia. The outcome of the study provides pharmacological evidence for the potential benefits of the plants as herbal treatments of cerebral malaria symptoms.
A 500,000-Person Experiment Evaluating the Impact of Geographically-Targeted, High-Payoff Vaccine Lotteries
Authors: Milkman Katherine , Gandhi Linnea , Ellis Sean , Graci Heather , Gromet Dena , Mobarak Rayyan , Buttenheim Alison , Duckworth Angela , Pope Devin , Stanford Ala , Thaler Richard , Volpp Kevin
Published: November 2021

Lotteries have been shown to motivate behavior change in many settings. However, the value of large-scale, geographically-targeted lotteries as a policy tool for changing the behaviors of entire populations is a matter of heated debate. In mid-2021, we implemented a pre-registered, city-wide experiment in Philadelphia to test the effects of three, high-payoff (up to $50,000) geographically-targeted lotteries designed to motivate adult residents of Philadelphia to get vaccinated against COVID-19. All Philadelphia residents ages 18 and older were eligible for inclusion in each drawing but, if selected, could not accept a prize unless they had received at least one dose of a COVID-19 vaccine. In each drawing, residents of a randomly selected “treatment” zip code received half of the 12 lottery prizes (boosting their chances of a win to 50-100x those of other Philadelphians). This experimental design makes possible a causal estimate of the impact of vastly increasing people’s odds of winning a vaccine lottery. We estimate that the first treated zip code, which drew considerable media attention, may have experienced a small bump in vaccinations compared to control zip codes: vaccinations rose by an estimated 61 per 100,000 people (an 11% increase). Pooling results from all three zip codes treated over the course of our six-week experiment, however, we do not detect any overall benefits. This unsustained effect may be because media attention waned, salience of the lottery declined, or attitudes about vaccination became increasingly entrenched over time. Further, our 95% confidence interval provides an upper bound on the overall benefits of treatment in our study of 9%. Given that lotteries of this scale cost hundreds of thousands of dollars to implement, the lack of a substantial benefit from this experiment strengthens the policy case for other, more impactful ways to encourage health behavior change.
Treatment Goals for Achondroplasia: A Qualitative Study with Parents and Adults
Authors: McGraw Sarah A. , Henne Jeff , Nutter James , Larkin Adelpha Abrahamson , Chen Er
Published: November 2021

Background: Achondroplasia is characterized by disproportionate short stature accompanied by other changes to the musculoskeletal system. Individuals with this condition typically experience a variety of medical complications. Pharmacologic treatments are being developed for the treatment of achondroplasia. It is important to understand the goals for pharmacologic treatment among those affected by achondroplasia and factors that shape these views. Methods: This qualitative study is based on semi-structured interviews with 19 parents of children with achondroplasia and 5 adults with achondroplasia in the United States. We employed thematic analysis using an iterative process to identify themes across the interviews. Results:Participants had two goals for pharmacologic treatment of achondroplasia: ameliorating complications associated with the condition and increasing stature to overcome functional limitations and psychosocial challenges. Complications of particular concern were chronic pain and surgeries to repair spinal, ENT, and neurological sequelae. Increased height would enhance independence, fitting in socially, and avoiding social stigma. Despite many challenges, parents and adults with achondroplasia expressed that they found ways to adapt and emphasized satisfaction and the positive aspects of their lives. Concerns about medical treatment included fear of loss of their identity as a little person. Conclusions:This study offers evidence about how individuals affected by achondroplasia think about pharmacologic treatment of this condition, including both the benefits of ameliorating complications and increasing height. The findings can offer practical insights for parents of children considering treatment, treating physicians and decision makers evaluating coverage decisions for treatment of achondroplasia.
Clinico-Epidemiological Characteristics of Children with Cystic Fibrosis: A Tertiary Care Experience
Authors: Sarkar Probir Kumar , Akand Nabila , Tahura Sarabon , Kamruzzaman Md , Akter Johora , Zaman Khandakar Ashikur , Farhana Tanzila , Hossain Md Mosharaf , Alam Md Jahangir , Khan Md. Abdullah Saeed , Hasan Mohammad Jahid
Published: November 2021

Background: Cystic fibrosis (CF) is considered to be rare among individuals from Bangladesh. The objective of the study was to delineate the clinico-epidemiological characteristics of pediatric cystic fibrosis cases.Method: This observational study included pediatric patients (up to 14 years of age) with a clinical diagnosis of CF. Data were collected within the period from February 2021 and October 2021. Written informed consent was obtained from the accompanying parent. Clinical and epidemiological characteristics were analyzed on the basis of demographic data, medical history, laboratory tests, and outcome information. Data analysis was done with SPSS 26.Result: A total of 50 patients (66% male) with a mean age of 39.7 ±30.75 (SD) months were included. Twenty-eight patients (57.14%) had siblings with CF, and 41.67% of parents had a history of consanguineous marriage. The majority of them were stunted (86%) and underweight (86%), and half of them had wasting (54%). Median disease duration was 12 months (range: 2 – 72). Cough (100%) and purulent sputum (100%) were the predominant respiratory symptoms, while failure to thrive (98%) and bulky offensive stools (86%) were prime gastrointestinal symptoms. Among the signs, malnutrition (94%), short stature (72%), digital clubbing (64%), and bronchiectasis (40%) were most frequent. Pulmonary hypertension (48%, n=24) was the most common comorbidity identified in the study participants. In hospital, mortality was 16% (n=8). Digital clubbing, bronchiectasis, pancreatic insufficiency, and abnormal liver function tests were significantly higher in the patient who died.Conclusion: Children with cystic fibrosis most commonly present with undernutrition and respiratory symptoms. Failure to thrive was almost a global phenomenon. Pulmonary hypertension was the most common complication found in echocardiography.
Outcome of Life-Threatening Arrhythmias Among Patients Presenting in an Emergency Setting at a Tertiary Hospital in Accra-Ghana
Authors: Doku Alfred , Asare Bernard Yeboah-Asiamah , Osei Richard , Owoo Christian , Djagbletey Robert , Akamah Joseph , Aniteye Ernest , Ahadzi Dzifa
Published: November 2021

Background Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems. In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care systems. Little is known about life-threatening arrhythmia, and their outcomes in SSA. The aim of this study was to examine the outcomes and types of arrhythmias among haemodynamically unstable patients presenting at a tertiary hospital in Accra-Ghana.Method This was a retrospective case series study conducted at the Korle-Bu Teaching Hospital (KBTH), Accra-Ghana. Medical records of patients who presented with or developed haemodynamically unstable arrhythmias within 24 hours of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical data including outcomes of patients were collected. Descriptive statistics was used, and results presented in frequency table.Results A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias were the commonest arrhythmias found among the patients (70%). Approximately, 52.5% of patients had structural heart diseases (52.5%) whereas 27.5% had no apparent underlying cause or predisposing factor. Cardioversion (44.8%), commonly electrical (31.0%), and pacemaker implantation (34.5%) were the common initial interventions. Majority of the patients (88.1%) survived and were discharged home. Conclusion Tachyarrhythmias are the most common haemodynamically unstable arrhythmias seen among patients presenting emergently in a leading tertiary hospital in Ghana. The high survival rate observed was likely due to the presence of specialists on duty in our facility. This outcome cannot be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical entities.