bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs and availability of medical specialists’ and allied health professionals’ visits in German nursing homes: a cross-sectional study of nursing home staff
Authors: Schröder Ann-Kristin , Fassmer Alexander Maximilian , Allers Katharina , Hoffmann Falk
Published: April 2020

Background

The medical care for nursing home residents is estimated to be partly inadequate in Germany. The aim of this study is to investigate the needs and utilization of general practitioners (GPs), medical specialists and allied health professionals.

Methods

A survey was sent to a nationwide random sample of 1069 nursing homes in Germany in January 2019. Nursing staff managers were asked about medical care. Regular nursing home visits by medical specialists and allied health professionals were defined as at least one contact per year to at least one nursing home resident.

Results

A total of 486 persons responded (45.5%). On average, nursing homes have contact to 8.6 (interquartile range: 4–10) different GPs. Almost 70% of respondents agreed that residents’ medical care should be coordinated by GPs. However, only 46.0% stated that specialist treatment should require GP referral. A high need was seen for care from physiotherapists (91.0%), neurologists or psychiatrists (89.3%), dentists (73.7%), and urologists (71.3%). Regarding the actual utilization of medical specialists and health professionals, most nursing homes have regular contact to physiotherapists (97.1%), psychiatrists or neurologists (90.4%), speech therapists (85.0%), and dentists (84.8%). Remarkable discrepancies between need and utilization were found for urologists and ophthalmologists.

Conclusion

There is large variance in the number of GPs per nursing home, and needs for medical specialists, especially urologists and ophthalmologists, seem unmet. Interprofessional collaboration between GPs, medical specialists and allied health professionals should be improved, and GPs should play a more coordinating role.
Engagement of private healthcare providers for case finding of tuberculosis and diabetes mellitus in Pakistan
Authors: Habib Shifa Salman , Rafiq Sana , Jamal Wafa Zehra , Ayub Shaikh Muhammad , Ferrand Rashida Abbas , Khan Aamir , Zaidi Syed Mohammad Asad
Published: April 2020

Background

The rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and associated with poor tuberculosis treatment outcomes, while tuberculosis is associated with worsening glycemic control. We investigated the performance of bi-directional TB and DM case finding approaches through a private-sector engagement model in Karachi, Pakistan.

Methods

Between July 2016 and July 2018, private health care providers were engaged to generate referrals for bi-directional TB and DM screening at private diagnostic and treatment centers in Karachi, Pakistan. Individuals diagnosed with TB underwent glycated hemoglobin (HbA1c) testing at the time of anti-tuberculous treatment initiation and at three -month follow up stage. All individuals with a history of diabetes or random blood sugar of greater than 200 mg/dl were screened for TB using a chest X-ray and Xpert MTB/RIF.

Results

A total of 6312 persons with tuberculosis were tested on HbA1c at treatment initiation, of whom 1516 (24%) were newly diagnosed with DM. About one third of those with HbA1c in the diabetic range (≥ 6.5%) at baseline were found to have a normal HbA1c (< 5.7%) result at 3-month follow-up. A total of 3824 individuals with DM, of whom 2396 (63%) were known cases and 1428 (37%) were newly identified with random blood sugar > 200 mg/dl, underwent chest x-ray and Xpert MTB/RIF testing, with 321 (13.4%) known and 54 (3.8%) new diabetics respectively identified with tuberculosis.

Conclusion

This study demonstrates a high yield of TB and DM through bidirectional screening and the feasibility of engagement of private sector in finding missing cases of tuberculosis and diabetes. Given the high prevalence of undiagnosed DM in individuals with TB tuberculosis patients, there is a need to scale-up DM screening within TB programmes. Increased awareness of the high risk of TB among individuals with DM is needed among private health providers and screening for TB among diabetics should be strongly considered.
Daily cost of consumer food wasted, inedible, and consumed in the United States, 2001–2016
Authors: Conrad Zach
Published: April 2020

Background

Consumer food waste in the United States represents substantial amounts of wasted nutrients, as well as needless environmental impact from wasted agricultural inputs, energy use, and greenhouse gas emissions. Efforts to reduce food waste at the consumer level are urgently needed to address the most prominent nutrition and environmental sustainability issues we now face. Importantly, individuals report that saving money is a salient motivator for reducing food waste, yet contemporary evidence on the consumer cost of wasted food is lacking. The objectives of this study are to 1) estimate the daily per capita cost of food wasted, inedible, and consumed 2) at home and away from home, and 3) by food group.

Methods

This study utilizes cross-sectional, nationally-representative data on food intake from the National Health and Nutrition Examination Survey (2001–2016), linked with nationally representative data on food waste from published literature, as well as data on food prices and food price inflation from multiple publicly-available sources. Survey-weighted procedures estimated daily per capita expenditure on food waste for 39,758 adults aged ≥20 y.

Results

Total daily per capita food expenditure was $13.27, representing 27% wasted, 14% inedible, and 59% consumed. The greatest daily food waste expenditures were observed for meat and seafood purchased for consumption outside of the home ($0.94, 95% CI: $0.90–0.99), and fruits and vegetables purchased for consumption in the home ($0.68, $0.63–0.73).

Conclusions

The most cost-effective ways to reduce food waste at the consumer level are to focus waste reduction efforts on meat and seafood purchased for consumption outside of the home and fruits and vegetables purchased for consumption in the home. A number of strategies are available to help consumers reduce their food waste, which can increase their financial flexibility to purchase more healthy foods while simultaneously reducing environmental impact.
CBCT evaluation of inter- and intra-fraction motions during prostate stereotactic body radiotherapy: a technical note
Authors: Jmour Omar , Benna Marouan , Champagnol Pierre , Ben Mrad Majed , Hamrouni Anis , Obeid Layal , Lahmamssi Chaimaa , Bousarsar Amal , Vial Nicolas , Rehailia-Blanchard Amel , Sotton Sandrine , Lan Meiling , Langrand-Escure Julien , Vallard Alexis , Magné Nicolas
Published: April 2020

Background

In most clinical trials, gold fiducial markers are implanted in the prostate to tune the table position before each radiation beam. Yet, it is unclear if a cone-beam computed tomography (CBCT) should be performed before each beam to monitor a possible variation of the organs at risk (OARs) fullness, especially in case of recto-prostatic spacer implantation. The present study aimed at assessing the inter- and intra-fraction movements of prostate, bladder and rectum in patients implanted with a hyaluronic acid spacer and undergoing prostate stereotactic body radiotherapy (SBRT).

Methods

Data about consecutive patients undergoing prostate SBRT were prospectively collected between 2015 and 2019. Inter-and intra-fraction prostate displacements and volume variation of organs at risk (OARs) were assessed with CBCTs.

Results

Eight patients were included. They underwent prostate SBRT (37.5Gy, 5 fractions of 7.5Gy) guided by prostate gold fiducial markers. Inter-fraction variation of the bladder volume was insignificant. Intra-fraction mean increase of the bladder volume was modest (29 cc) but significant (p < 0.001). Both inter- and intra-fraction variations of the rectum volume were insignificant but for one patient. He had no rectal toxicity. The magnitude of table displacement necessary to match the prostate gold fiducial marker frequently exceeded the CTV/PTV margins (0.4 cm) before the first (35%) and the second arc (15%). Inter- and intra-fraction bladder and rectum volume variations did not correlate with prostate displacement.

Conclusion

Major prostate position variations were reported. In-room kV fiducial imaging before each arc seems mandatory. Intra-fraction imaging of the OARs appears unnecessary. We suggest that only one CBCT is needed before the first arc.

Trial registration

NCT02361515, February 11th, 2015.
Detection of alpha-1 antitrypsin deficiency: the past, present and future
Authors: Brantly Mark , Campos Michael , Davis Angela M. , D’Armiento Jeanine , Goodman Kenneth , Hanna Kathi , O’Day Miriam , Queenan John , Sandhaus Robert , Stoller James , Strange Charlie , Teckman Jeffrey , Wanner Adam
Published: April 2020

Background

Most patients with alpha-1 antitrypsin deficiency remain undiagnosed and therefore do not benefit from current therapies or become eligible for research studies of new treatments under development. Improving the detection rate for AATD is therefore a high priority for the Alpha-1 Foundation. A workshop was held on June 23, 2019 in Orlando, Florida during which stakeholders from the research, pharmaceutical, and patient communities focused on the topic of alpha-1 antitrypsin deficiency detection.

Results

A variety of detection strategies have been explored in the past and new approaches are emerging as technology advances. Targeted detection includes patients with chronic obstructive pulmonary disease, unexplained chronic liver disease, and family members of affected individuals. Newborn screening, electronic medical record data mining, and direct-to-consumer testing remain options for future detection strategies.

Conclusion

These meeting proceedings can serve as a basis for innovative approaches to the detection of alpha-1 antitrypsin deficiency.
Improving intraoperative temperature management in elective repeat cesarean deliveries: a retrospective observational cohort study
Authors: Hoefnagel Amie L. , Vanderhoef Kristen L. , Anjum Anwar , Damalanka Venkata , Shah Saurin J. , Diachun Carol A. , Mongan Paul D.
Published: April 2020

Background

Inadvertent perioperative hypothermia (< 36 °C) occurs frequently during elective cesarean delivery and most institutions do employ perioperative active warming. The purpose of this retrospective observational cohort study was to determine if the addition of preoperative forced air warming in conjunction with intraoperative underbody forced air warming improved core temperature and reducing inadvertent perioperative hypothermia during elective repeat elective cesarean delivery with neuraxial anesthesia.

Methods

We evaluated the addition of perioperative active warming to standard passive warming methods (preheated intravenous/irrigation fluids and cotton blankets) in 120 parturients scheduled for repeat elective cesarean delivery (passive warming, n = 60 vs. active + passive warming, n = 60) in a retrospective observational cohort study. The primary outcomes of interest were core temperature at the end of the procedure and a decrease in inadvertent perioperative hypothermia (< 36 °C). Secondary outcomes were surgical site infections and adverse markers of neonatal outcome.

Results

The mean temperature at the end of surgery after instituting the active warming protocol was 36.0 ± 0.5 °C (mean ± SD, 95% CI 35.9–36.1) vs. 35.4 ± 0.5 °C (mean ± SD, 95% CI 35.3–35.5) compared to passive warming techniques (p <  0.001) and the incidence of inadvertent perioperative hypothermia at the end of the procedure was less in the active warming group - 68% versus 92% in the control group (p <  0.001). There was no difference in surgical site infections or neonatal outcomes.

Conclusions

Perioperative active warming in combination with passive warming techniques was associated with a higher maternal temperature and lower incidence of inadvertent perioperative hypothermia with no detectable differences in surgical site infections or indicators of adverse neonatal outcomes.
ATLANTIS: a randomised multi-arm phase II biomarker-directed umbrella screening trial of maintenance targeted therapy after chemotherapy in patients with advanced or metastatic urothelial cancer
Authors: Fulton Ben , Jones Robert , Powles Thomas , Crabb Simon , Paul James , Birtle Alison , Chowdhury Simon , Hussain Syed , Morris Anna , Soulis Eileen , Morrison Paula
Published: April 2020

Background

Metastatic urothelial cancer (UC) is the eighth most common cause of cancer death in the UK. Standard first-line treatment, for most patients, is cytotoxic chemotherapy. Although UC is initially sensitive to chemotherapy, relapse is almost inevitable and outcomes are poor; median overall survival is 8 months. Therefore, there is an urgent need for novel therapies to improve outcomes for this patient group.

Methods

ATLANTIS is a randomised phase II umbrella-design screening trial of maintenance therapy in biomarker-defined subgroups of patients with advanced UC. The primary end point is progression-free survival, and the study involves over 30 UK cancer centres.

Discussion

ATLANTIS is the first study in the UK to employ a precision-medicine approach to patients with UC for maintenance treatment. Agents with a positive efficacy signal will proceed to randomised phase III trials to confirm the activity of novel, biologically stratified therapies in UC.

Registration

ATLANTIS trial EudraCT number 2015–003249-25. ISRCTN25859465.
Design and implementation of an intelligent monitoring system for household added salt consumption in China based on a real-world study: a randomized controlled trial
Authors: Xian Jinli , Zeng Mao , Zhu Rui , Cai Zhengjie , Shi Zumin , Abdullah Abu S. , Zhao Yong
Published: April 2020

Background

A high intake of salt is a major risk factor for cardiovascular diseases. Despite decades of effort to reduce salt consumption, the salt intake in China is still considerably above the recommended level. Thus, this study aims to design and implement an intelligent household added salt monitoring system (SALTCHECKER) to monitor and control added salt consumption in Chinese households.

Methods

A randomized controlled trial will be conducted among households to test the effect of a SALTCHECKER in Chongqing, China. The test modalities are the SALTCHECKER (with a smart salt checker and a salt-limiting WeChat mini programme) compared to a salt checker (with only a weighing function). The effectiveness of the system will be investigated by assessing the daily added salt intake of each household member and the salt consumption-related knowledge, attitude and practice (KAP) of the household’s main cook. Assessments will be performed at baseline and at 3 and 6 months.

Discussion

This study will be the first to explore the effect of the household added salt monitoring system on the reduction in salt intake in households. If the intelligent monitoring system is found to be effective in limiting household added salt consumption, it could provide scientific evidence on reducing salt consumption and preventing salt-related chronic diseases.

Trial registration

Chinese clinical trial registry (Primary registry in the World Health Organization registry network): ChiCTR1800018586. Date of registration: September 25, 2018.
Supporting caregivers of veterans with Alzheimer’s disease and traumatic brain injury: study protocol for a randomized controlled trial
Authors: Carnahan Jennifer L. , Judge Katherine S. , Daggy Joanne K. , Slaven James E. , Coleman Nicki , Fortier Emily L. , Suelzer Christopher , Fowler Nicole R.
Published: April 2020

Background

Patients with Alzheimer’s disease and related dementias (ADRD) and traumatic brain injury (TBI) and their caregivers require cognitive and behavioral symptom management, interdisciplinary care, support for caregivers, and seamless care coordination between providers. Caring for someone with ADRD or TBI is associated with higher rates of psychological morbidity and burden, social isolation, financial hardship, and deterioration of physical health. Tremendous need exists for primary care–based interventions that concurrently address the care needs of dyads and aim to improve care and outcomes for both individuals with ADRD and TBI and their family caregivers.

Methods

The Aging Brain Care Acquiring New Skills While Enhancing Remaining Strengths (ABC ANSWERS) study is a randomized controlled trial that tests the effectiveness of an intervention based on two evidence-based programs that have been developed for and previously tested in populations with ADRD, TBI, stroke, and late-life depression and/or who have survived an intensive care unit stay. This study includes 200 dyads comprised of a veteran with a diagnosis of ADRD or TBI and the veteran’s primary informal caregiver. Dyads are randomized to receive the ABC ANSWERS intervention or routine Veterans Health Administration (VHA) primary care with a standardized educational and resource information packet. Data collection occurs at baseline and three follow-up time points (3 months, 6 months, and 12 months). The primary outcome is caregiver quality of life (QoL). A secondary measure for the caregiver is caregiver burden. Secondary measures for both the veteran and caregiver include symptoms of depression and anxiety.

Discussion

The ABC ANSWERS intervention integrates common features of an evidence-based collaborative care model for brain health while concurrently attending to the implementation barriers of delivering care and skills to dyads. We hypothesize that caregivers in dyads randomized to the ABC ANSWERS program will experience higher levels of QoL and lower levels of depression, anxiety, dyadic strain, and caregiver burden at 12 months than those receiving usual VHA primary care.

Trial registration

ClinicalTrials.gov, NCT03397667. Registered on 12 January 2018.
Crimean-Congo hemorrhagic fever virus in tortoises and Hyalomma aegyptium ticks in East Thrace, Turkey: potential of a cryptic transmission cycle
Authors: Kar Sirri , Rodriguez Sergio E. , Akyildiz Gurkan , Cajimat Maria N. B. , Bircan Rifat , Mears Megan C. , Bente Dennis A. , Keles Aysen G.
Published: April 2020

Background

Recent reports have demonstrated the presence of Crimean-Congo hemorrhagic fever virus (CCHFV) genomic material inHyalomma aegyptiumticks feeding primarily on tortoises belonging to the genusTestudo. This raises the question if these ticks and their hosts play a role in the natural transmission dynamics of CCHFV. However, the studies are limited, and assessing the relevance ofH. aegyptiumin perpetuating the virus in nature, and a potential spillover to humans remains unknown. This study aimed to detect CCHFV inH. aegyptiumticks and their tortoise hosts in the East Thrace region of Turkey, whereH. aegyptiumis the most common human-biting tick and where a high density of tortoises of the genusTestudocan be found.

Methods

During the study period, 21 blood samples from different tortoises (2T. hermanniand 19T. graeca), 106 tick pools (containing 448 males, 152 females, 93 nymphs and 60 larvae) collected from 65 tortoises (5T. hermanniand 60T. graeca), 38 adult unfed questing ticks (25 males and 13 females, screened individually) and 14 pools (containing 8 nymphs and 266 larvae) of immature unfed questing ticks collected from the ground were screened for CCHFV genome by nested PCR and partial genomes sequenced.

Results

As a result of the screening of these 179 samples, 17 (9.5%) were detected as positive as follows: 2 of 21 blood samples (9.52%), 13 (containing 18 nymphs in 3 pools, and 52 males and 8 females in 10 pools) of 106 tick pools from tortoises (12.26%), and 2 of 38 adult questing ticks (5.26%). No positive result was determined in 14 pools of immature questing ticks.

Conclusions

Previous studies have shown that reptiles can participate in the transmission of arthropod-borne viruses, but they may contribute to different aspects of the disease ecology and evolution of tick-borne viral pathogens. Our results indicate the presence of CCHFV in questing and feedingH. aegyptiumticks as well as tortoise hosts. This may indicate that CCHFV circulates in a cryptic transmission cycle in addition to the primary transmission cycle that could play a role in the natural dynamic of the virus and the transmission to humans.
Patient satisfaction and quality of life in breast reconstruction: assessment of outcomes of immediate, delayed, and nonreconstruction
Authors: Siqueira Hianga Fayssa Fernandes , Teixeira Jorge Luiz de Almeida , Lessa Filho Reginaldo da Silva , Hora Evânia Curvelo , Brasileiro Filipe Ferreira , Borges Kênya de Souza , Brito Érika de Abreu Costa , Lima Marcela Sampaio , Marques Adriane Dórea , Moura Alex Rodrigues , Figueiredo Júnior Tarcizo Costa , de Oliveira Thiago Costa , Vasconcelos Ana Alice Santana , Lima Carlos Anselmo
Published: April 2020

Objectives

This study was conducted aiming to assess the quality of life and satisfaction of women who had mastectomy treated with and without breast reconstruction.

Results

A total of 81 women who had mastectomy were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of women who had mastectomy who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life.
Adaptive and separable multiary reversible data hiding in encryption domain
Authors: Yu Mingji , Liu Yuchen , Sun Hu , Yao Heng , Qiao Tong
Published: April 2020

To ensure the security of digital information, information needs to be stored and processed in the encryption domain during the cloud storage process, during which the user does not allow the cloud provider (CP) to access the image contents, and the CP must embed additional information in the image. Therefore, reversible data hiding in an encryption domain (RDHEI) has emerged. This paper presents an adaptive and separable multiary RDHEI method. First, the image is divided into two parts that consist of reference pixels and non-reference pixels. Next, we compute the prediction errors of the non-reference pixels, followed by a replacement of the original non-reference values with the computed prediction errors. Then, the entire image is encrypted with a specially designed stream cipher strategy so that the CP can embed additional information by modifying the prediction errors without knowing the original image. In addition, although our method vacates space before encryption, the CP can adaptively control the reserved space, unlike traditional RDHEI schemes which also vacate space before encryption. Because our method is separable, the embedded message can be extracted from both encryption and plaintext domains accurately. The experimental results demonstrate the efficacy of the proposed method.
Separation and stability of solutions to nonlinear systems involving Caputo–Fabrizio derivatives
Authors: Zhong Wenyong , Wang Lanfang , Abdeljawad Thabet
Published: April 2020

This work mainly investigates the separation and stability of solutions to nonlinear systems involving Caputo–Fabrizio fractional derivatives. An inequality ensuring the positivity of the fractional derivative at a given point is derived, by which the sufficient conditions for the separation of solutions are obtained. The comparison principle and the inequality for the fractional derivatives of convex functions are obtained, by which the approach of the convex Lyapunov functions is extended effectively to establish the criteria for the stability of solutions in the context of Caputo–Fabrizio fractional derivatives. Applications of the main results are illustrated by using examples.
Lateral Load Distribution for Hollow Slab Bridge: Field Test Investigation
Authors: Zhao Yu , Cao Xiaozhe , Zhou Yongjun , Wang Gangqiang , Tian Ruixin
Published: April 2020

Distribution factors (DFs) for one typical cross-section as specified in the AASHTO LRFD specification can be varied when the bridge parameters such as span length, loading lanes and skew are changed. The diversity between design and actual DFs may be varied as the bridge parameters changed. To study this diversity, this paper presents an evaluation of lateral load DFs for prefabricated hollow slab bridges. The response of the bridge was recorded during the field test. This field test was divided into two stages: a concentrated force loading test on the prefabricated girder that settled on the bridge supports before the girders were connected transversely and a vehicle loading test after the girders were connected transversely. The instruments used to record the response of the bridge were strain gauges and dial indicators. The measured data in the multi-stages of the field test could be used to calibrate the support condition of the bridge and transverse connection between adjacent girders in the finite element model (FEM) using beam and plate elements. From the FEM, DFs for this hollow slab bridge were determined and compared with the DFs in the AASHTO LRFD specification. A parametric study using the calibrated FEM was then used to investigate the effect of various parameters including span length, skew and bridge deck thickness on the DFs. It was found that AASHTO LRFD specification is conservative compared with the analysis in the FEM, while this conservatism decreased as the span length and skew of the hollow slab bridge increased.
Association of abdominal fat with metabolic syndrome components in overweight women: effect of menopausal status
Authors: Numao Shigeharu , Katayama Yasutomi , Nakata Yoshio , Matsuo Tomoaki , Nakagaichi Masaki , Tanaka Kiyoji
Published: April 2020

Background

The association between abdominal fat distribution and metabolic syndrome (MetSyn) components by menopausal status has yet to be explicated. The purpose of this study was to examine a cross-sectional association between abdominal fat compartments and MetSyn components in pre- and post-menopausal overweight Japanese women.

Methods

Of 212 overweight Japanese women, 76 pre-menopausal overweight (BMI ≥ 25) women (PreM age, 42.1 ± 5.9 years) and 87 post-menopausal overweight women (PostM: age, 56.2 ± 4.5 years) were analyzed in this study. Measurements were taken for body mass index (BMI), abdominal compartments [visceral fat (VF), subcutaneous fat (SF), superficial subcutaneous fat (SSF), and deep subcutaneous fat (DSF)], serum high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol, triglycerides (TG), and fasting plasma glucose (FPG). Abdominal compartments were assessed using computed tomography.

Results

No significant differences were found for BMI, SF, SSF, or DSF between the PreM and PostM. Despite this, the PreM had a significantly smaller VF area than that of the PostM. However, the difference in VF area disappeared when age was adjusted for. VFA significantly correlated with HDLC, TG, and FPG independently of menopause status.

Conclusions

These results suggest that the effect of menopause status on the association between VF and MetSyn components is negligible. Abdominal subcutaneous fat compartments were not associated with MetSyn components in overweight women regardless of menopausal status.
Pre-pubertal bipolar disorder: origins and current status of the controversy
Authors: Duffy A. , Carlson G. , Dubicka B. , Hillegers M. H. J.
Published: April 2020

Background

Evidence from epidemiological, clinical and high-risk studies has established that the peak period of risk for onset of bipolar disorder spans late adolescence and early adulthood. However, the proposal of the existence of a pre-pubertal form of bipolar disorder manifesting in early childhood created substantial debate. In this narrative review, the literature and contributing factors pertaining to the controversy surrounding the proposed pre-pubertal bipolar disorder subtype are discussed. The resolution of the debate and lessons learned are highlighted.

Main body

In the mid 1990s US researchers proposed that chronic irritability and explosive temper in pre-pubertal children with pre-existing ADHD and/or other learning and developmental disorders might represent a variant of mania. A number of factors contributed to this proposal including severely ill children with no diagnostic home given changes in the ADHD DSM diagnostic criteria and over-reliance on symptoms and structured interviews rather than on a clinical assessment incorporating developmental history, social context and clinical course. Prospective studies of children at high familial risk did not support the proposed pre-pubertal bipolar phenotype; but rather provided convergent evidence that bipolar disorder onset in adolescence and early adulthood not uncommonly preceded by sleep and internalizing symptoms and most often debuting as depression in adolescence (after puberty). Epidemiological studies of population and hospital discharge data provided evidence that the pre-pubertal bipolar phenotype was largely a US driven phenomenon.

Conclusions

Psychiatric diagnosis is particularly challenging given the current lack of objective biomarkers. However, validity and utility of clinical diagnoses can be strengthened if all available predictive information is used to formulate a diagnosis. As in other areas of medicine, critical information required to make a valid diagnosis includes developmental history, clinical course, family history and treatment response—weighed against the known trajectories of classical disorders. Moreover, given that psychiatric disorders are in evolution over childhood and adolescence and symptoms, in of themselves, are often non-specific, a thorough clinical assessment incorporating collateral history and psychosocial context is paramount. Such an approach might have avoided or at least brought a more timely resolution to the debate on pre-pubertal mania.
Absolute quantification of terpenes in conifer-derived essential oils and their antibacterial activity
Authors: Allenspach Martina Delia , Valder Claudia , Steuer Christian
Published: April 2020

A simple, robust, and precise method for the absolute quantification of the terpenes α-pinene, camphene, β-pinene, 3-carene, limonene, bornyl acetate, β-caryophyllene, and borneol was developed using gas chromatography coupled to a flame ionization detector (GC-FID) and validated according to the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use. The GC-FID method shows high accuracy (91–105%) and low imprecision (< 7.6%) for all terpenes at quality control (QC) low, medium, and high level. The curves are linear with strong correlation (R2 ≥ 0.999) for all terpenes. Additionally, the relative response factor (RRF) for each terpene is calculated. The method was validated in terms of specificity, linearity, accuracy, precision, LOD, LOQ, stability tests, and carry-over. The method was successfully applied to quantify the selected terpenes in conifer-derived essential oils (CEOs). The total amount of terpenes ranged from 6.3 to 11.8 mM. Additionally, the CEOs were screened in vitro for the antibacterial activity against E. coli and S. aureus using the broth microdilution method to determine the minimum inhibitory concentration (MIC). All the CEOs showed antibacterial activity in the concentration from 0.3 to 50 μg/mL (S. aureus) and 1.2 to 50 μg/mL (E. coli), respectively. CEO14 showed the most effective antibacterial activity of the entire tested CEOs (MIC values 0.3 μg/mL (S. aureus); 1.2 μg/mL (E. coli)). Our results suggest that the terpenoid profile should be considered for a comprehensive evaluation of the antibacterial activity, as none of the single compounds seems to be fully responsible for antibacterial activity.
Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
Authors: Horino Taichi , Hiyoshi Yukiharu , Miyamoto Yuji , Yoshida Naoya , Baba Hideo
Published: April 2020

Background

The recurrence of endoscopically resected intramucosal colorectal cancer (CRC) is quite rare, and data regarding metastasis in intramucosal tumors are still lacking. We herein report a case of presacral lymph node recurrence of intramucosal rectal cancer after curative endoscopic resection.

Case presentation

A 53-year-old man underwent endoscopic mucosal resection (EMR) for rectal intramucosal adenocarcinoma. Thirty-nine months after the procedure, follow-up computed tomography (CT) revealed a swollen anterior sacral lymph node with an abnormal fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET). He underwent laparoscopic low anterior resection (LAR) and was discharged on postoperative day 11 without any complications. The pathological examination confirmed solitary lymph node metastasis (moderately differentiated adenocarcinoma) without a residual tumor in the rectal epithelium. We diagnosed him with lymph node metastasis of rectal cancer. Pathological examination of the resected lymph node confirmed moderately differentiated adenocarcinoma. He has not experienced any re-recurrence in the 6 months since surgery.

Conclusions

This is a rare case of local lymph node recurrence of intramucosal rectal cancer after successful EMR that was salvaged with surgery. Surveillance after successful endoscopic resection of rectal cancer using both endoscopy and CT is necessary.
Coexisting schwannoma of the gallbladder and sarcoidosis: a case report
Authors: Tajiri Takuya , Hayashi Hiromitsu , Higashi Takaaki , Yamao Takanobu , Takematsu Toru , Uemura Norio , Yamamura Kensuke , Imai Katsunori , Yamashita Yo-ichi , Baba Hideo
Published: April 2020

Background

Schwannomas originate from Schwann cells, which are constituents of peripheral nerve sheaths, and can occur anywhere in the body at any age. Most occur in soft tissues such as subcutaneous tissues and muscles, occurrence in the abdominal cavity being relatively rare. In particular, schwannomas of the gallbladder are extremely rare. We herein report a rare case of a schwannoma that coexisted with systemic sarcoidosis and presented as a steroid-resistant mass in the gallbladder wall.

Case presentation

A 40-year-old woman was found to have thickening of the gallbladder wall during a routine medical examination and was referred to our hospital, where she was found to have granular shadows in the lungs; mediastinal, cervical, intraperitoneal, and inguinal lymphadenopathy; parotid gland enlargement; and an erythematous skin rash. She was diagnosed as having systemic sarcoidosis by transbronchial lung biopsy and bronchoalveolar lavage. All her systemic mass lesions except for the one in the gallbladder resolved or became smaller with steroid treatment. The steroid-resistant gallbladder lesion showed enhancement on contrast-enhanced computed tomography and was shown by endoscopic ultrasonography to be a 30-mm-diameter gallbladder wall lesion. We performed laparoscopic cholecystectomy, which resulted in diagnosis of the steroid-resistant tumor as a schwannoma. Five months after surgery, the patient’s prednisolone dosage had been gradually reduced to 5 mg/day and she was doing well with no evidence of recurrence.

Conclusion

Resection of a steroid-resistant tumor resulted in diagnosis of schwannoma, enabling reduction in the patient’s steroid dosage for sarcoidosis.
Protein Antioxidant Capacity from Moringa Oleifera Fresh and Commercialised Leaf
Authors: Zulkifli Z.A. , Rahmat Z.
Published: April 2020

ABSTRACT: Moringa oleifera is one of the most reported medicinal plants with various health benefits while its commercialised leaf in dried and powdered form is currently a blooming herbal product in the market. Apart from some profiling work, the protein from M. oleifera that tops other plants was never focused. Since protein is an essential nutrient and could interact with a substrate or another protein, its role in the pharmacological activity is highly anticipated. Hence, this study was done to highlight on the antioxidant ability of protein and comparing it with crude extract from fresh and commercialised Moringa’s leaf via Ferric Reducing Antioxidant Power (FRAP) and 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical assay. Interestingly, the protein extract from commercialised leaf of M. oleifera elucidated significantly higher antioxidant activity compared to other samples. It had the highest reducing power (±SEM) of 2381.88±25.16 (mM Fe2+/g) and even highest radical scavenging activity of 46.26±0.2 (%RSA). Thus, the protein contained in this blooming product would benefit its consumers. Plus, instead of relying solely on the crude extract, detailed study on the mechanism of the protein extracts on its therapeutic properties is highly anticipated.
APPLICATION OF THE ANALYTIC HIERARCHY PROCESS FOR MANAGEMENT OF SOIL EROSION IN OMAN
Authors: Al-Rahbi Alia Khalfan Hamdoon , Abushammala Mohammad F.M. , Qazi Wajeeha A.
Published: April 2020

The level of soil degradation worldwide is alarming due to its potential for causing serious problems such as threatening food security. The sultanate of Oman faces the problem of soil erosion which also disturbs waterways, infrastructure and agriculture. The problem of soil erosion has become increasingly apparent in Oman and is due to inappropriate land management. This occurs particularly with dams where sedimentation is a common issue and in the aflaj water systems. Currently, there are no appropriate methods being practiced that would overcome the problem of soil erosion in Oman, and no specific studies are available that discuss suitable methods for soil protection in Oman. Therefore, this study is an initiative to overcome the problem of soil erosion in Oman by proposing the best soil erosion protection method using the Analytic Hierarchy Process (AHP). In order to achieve this goal, this study reviews different methods of preventing soil erosion and the factors governing their selection. The important and controlling factors were considered in an AHP model to rank the soil erosion protection methods. Based on the AHP model, pairwise comparisons were conducted with the help of 15 experts from different sectors including authorities responsible for soil conservation in Oman, decision-making governmental departments and research institutes. The results of the AHP analysis indicated that the most suitable soil erosion protection method, based on the considered factors, is erosion control fences, followed by protection of the gully head and revetment. As no previous studies on suitable methods for soil conservation in Oman exist, this study bridges the gap by providing valuable information on the best soil protection methods that could help soil conservation authorities in Oman as they decide about possible future strategies.The study also indicated that the AHP model is a suitable guiding framework for decision-making because it involves a group of experts for the selection of soil protection methods based on the situation in Oman.
A COMBINED MULTI-OBJECTIVE SIMULATION-OPTIMIZATION AND AHP APPROACH: A HEALTHCARE CASE STUDY
Authors: Dehghanimohammadabadi Mohammad , Kabadayi Nihan
Published: April 2020

Quality of care is crucial for patients' satisfaction and safety in healthcare centers. The majority of hospitals attempt to implement facility-wide improvements to ensure high-quality care delivery. This study aims to propose a combined Simulation-Optimization and MCDM approach to accurately assess the impact of quality improvement initiatives on different facets of healthcare systems. In this framework, first, the importance (weights) of the different healthcare criteria is determined by health providers’ using an AHP approach. Then, the weights provided by AHP are applied in a simulation-optimization environment to determine the most efficient action with the most desirable quality of care. Simulation provides a platform to examine the effectiveness of different improvement efforts and calculate their impact on the system performance measures.
Consideraciones de Diseño para Intercambiar Electrónicamente Recursos Académicos Digitales a Nivel Interinstitucional
Authors: Suárez-Murcia Angie Carolina , Sierra-Alean Diego Alejandro , Barón-Velandia Julio
Published: April 2020

Para el intercambio o préstamo de recursos educativos a nivel interinstitucional tanto las entidades públicas como privadas cuentan con procedimientos y especificaciones propios, siendo común el largo periodo requerido para la aprobación de un préstamo y la necesidad de trasladarse a dicha institución para realizar la consulta según la disponibilidad de horario definida. El objetivo de este trabajo es presentar un diseño de software que permita la transacción de recursos académicos entre dos entidades educativas, esto con el fin de reducir tiempos en la ejecución del proceso. La implementación del modelo se basa en las etapas propuestas del método científico y el proceso unificado, aplicando especificaciones de negociación electrónica definidas en ebXML, para definir mediante acuerdos y perfiles condiciones de uso del recurso solicitado. Al poner en funcionamiento el modelo de software se acortan los tiempos de la ejecución del proceso de negocio de varios meses a un par de minutos al realizarse todo el intercambio por medios electrónicos, además de la comunicación sin limitaciones geográficas, lo que favorece tanto a estudiantes como a entidades para el intercambio de propiedad intelectual de manera remota.
Retardo en Redes Inalámbricas Colaborativas
Authors: Hernández-Suárez Cesar Augusto , Giral-Ramírez Diego Armando , Pedraza-Martínez Luis Fernando
Published: April 2020

La radio cognitiva es una tecnología que hace un uso eficiente del espectro y permite a los usuarios secundarios utilizar las oportunidades espectrales de las bandas licenciadas, pero sin interferir con las comunicaciones de los usuarios primarios. El objetivo de este artículo es analizar y comparar el desempeño de dos algoritmos de toma de decisiones multicriterio: Topsis y Vikor, con diferentes niveles de colaboración entre usuarios secundarios. Los dos algoritmos se evalúan y comparar con respecto al retardo durante una transmisión de información de 9 MB. La comparación se realizó bajo cuatro escenarios distintos, de acuerdo con la clase de servicio y el nivel de tráfico, para la banda de frecuencia GSM. De acuerdo con los resultados alcanzados el algoritmo Topsis tiene un mejor desempeño en los diferentes escenarios y niveles de colaboración.
La estadística en los medios de comunicación como detonante del miedo en estudiantes Universitarios Colombianos
Authors: Riaño-Vargas Angie , Rocha-Salamanca Pedro
Published: April 2020

El artículo expondrá algunos resultados relacionados con el estudio y comprensión del sesgo de la disponibilidad en el campo de la Educación Estadística desde una perspectiva crítica social. Se diseñó y aplicó en un grupo de control y tratamiento un instrumento de indagación que consistía en un conjunto de preguntas sobre los miedos que sienten estudiantes universitarios en relación con el cambio climático, la seguridad social, la estabilidad económica, la violencia e inseguridad; y que pueden ser exacerbados por los medios de comunicación.
Quantum evolution as a usual mechanical motion of peculiar continua
Authors: Samarin Alexey Yur'evich
Published: April 2020

Квантовая частица рассматривается как сплошная среда, обладающая рядом специфических свойств. Эти свойства сформулированы так, чтобы основные постулаты традиционной квантовой механики были прямым следствием механического движения такой сплошной среды. Представлено детерминистическое описание процесса взаимодействия квантовой частицы с измерительным прибором при измерении координаты. Показана природа возникновения случайности в процессе измерения и выведено правило Борна для пространственной плотности вероятности. Волновая функция интерпретируется как специфическая объемная сила, с которой сплошная среда квантового объекта воздействует на измеритель, а квантовое волновое уравнение выводится из уравнения непрерывности для этой среды. Предложенный подход к представлению микроявлений позволяет исключить ограничения, связанные с принципом неопределeнности, и описывать динамику процессов недоступных для рассмотрения методами квантовой механики.
Adsorpsi Ion Logam Natrium dan Kalium dengan Karbon Aktif Merck dan Norit
Authors: Siahaan Parsaoran
Published: April 2020

Telah dilakukan penelitian adsorpsi karbon aktif merck dan norit terhadap ion iogam natrium dan kalium yang kemudian dibandingkan dengan adsorsi terhadap metilena biru. Untuk mempelajari kemampuan adsorpsi karbon aktif juga telah ditentukan luas permukaan dan distribusi pori. Luas permukaan kaibon aktif merck dan norit masing-masing adaiah 762,7286 m2/g dan 9,2756 m2/g. Karbon aktif merck dan norit mengadsorpsi metilena biru masing-masing sebesar 4,700 ppm dan 4,467 ppm pada konsentrasi larutan metilena biru 5,0 ppm. Karbon aktif merck dapat mengadsorpsi ion logam kalium sebesar 1,106 ppm (pada konsentrasi larutan 3 ppm), tetapi tidak dapat mengadsorpsi ion logam natrium. Karbon aktif norit dapat mengadsorpsi ion logam natrium sebesar 0,703 ppm (pada konsentrasi larutan 3 ppm) tetapi tidak dapat mengadsorpsi ion logam kalium
Isomerisasi Metil Eugenol dengan Beberapa Macam Katalis dan Media
Authors: Fachriyah Enny
Published: April 2020

Eugenol dapat diisolasi dari minyak cengkeh. Selanjutnya dengan metode Williamson disintesis metil eugenol. Diperoleh hasil 78,65 %, titik didih 110-110,5°C/7 mmHg, indeks bias 1,5300. Isomerisasi metil eugenol dikerjakan dengan 4 macam katalisator, yakni Na-metoksida, Na-etoksida, Na-isopropoksida dan Na-butoksida dalam media berturut-turut metanol, etanol, isopropanol dan butanol. Hasil isomerisasi diamati dengan kromatografi gas. Dengan katalisator Na-butoksida memberikan hasil terbaik pada suhu reaksi 121°C dan waktu 5 jam. Pemurnian hasil dilakukan dengan distilasi fraksinasi dengan pengurangan tekanan menggunakan kolom vigriux panjang 25 cm, diameter dalam 1,5 cm, diperoleh fraksi dengan titik didih 112,5°C/3 mmHg, indeks bias 1,5650. Kemurnian hasil diuji dengan kromatografi gas. Uji dengan 1H-NMR memberikan 3JCH3 = 7 Hz, menguatkan dugaan bahwa hasil isomerisasi adalah cis metil isoeugenol. Selain 1H-NMR, analisis dengan IR dan MS juga dikerjakan
Kandungan Cadmium pada Perairan dan Ikan Bandeng (Chanos chanos, Forskal) di Wilayah Pantai Sekitar Muara Sungai Babon Semarang, Jawa Tengah, Indonesia
Authors: Suprapti Nanik Heru
Published: April 2020

Penelitian ini bertujuan untuk mengetahui kandungan Cadmium pada perairan dan pada ikan Bandeng di sekitar muara sungai Babon Semarang Pengambiian sampel menggunakan metoda acak sistematik. Dalam menganalisa kandungan Cadmium didasarkan pada kriteria kualitas air dari Pedoman Penetapan Baku Mutu Lingkungan sesuai keputusan Menteri Lingkungan Hidup Indonesia dan Indek Faktor Konsentrasi. Hasil penelitian menunjukkan bahwa kandungan Cadmium pada perairan dan Ikan Bandeng melebihi batas ambang yang ditentukan Sifat akumulatif Cadmium pada ikan Bandeng di daerah penelitian termasuk dalam kategori sifat akumulatif rendah