bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethanolic extract of black grapes (Vitis Vinifera) ameliorates overtraining-induced pancreatic β-cells and muscle damage
Authors: Siswanto Ferbian Milas , Pradhany Risha Catra , Yenniastoeti Boedi Prihatini , Pangkahila Alex
Published: December 2020

Overtraining is a high-volume, high-intensity, long-duration, and high-frequency training. The heavier physical training, the more oxygen needed for metabolism. Increasing oxygen usage causes an elevation of electron leakage in mitochondria;thus,produce a higher amount of reactive oxygen species (ROS). Antioxidant inhibits oxidative damage in a target molecule. Grapes contain a lot of antioxidants, such as polyphenols and anthocyanins. The purpose of this study was to examine the effect of ethanol extract of Balinese grapes (Vitis vinifera) on β-cells and muscle damage in overtraining-induced rats. This study was a completely randomized experimental study using a posttest only control group design. Samples were 36 male albino rats (Rattus norvergicus), aged 2.5-3 months, divided randomly into two groups. The control group (P0), 18 rats, were given overtraining and placebo of 2 ml distilled water; the treatment group (P1) 18 rats, were given overtraining and 25g/kg.BW ethanol extract of Balinese grapes. The result showed the average amount of pancreatic β-cells in the P0 group was higher than the P1 group (p< 0.001). In addition, the average level of creatine kinase was also higher in the P1 group than those of the P0 group (p<0,001). It can be concluded that the administration of ethanolic extract of Balinese grapes mitigates the damage on pancreatic β-cells and muscle cells induced with overtraining.
Identification of Worm Types that Infest Bali Cattle in Bolo District
Authors: Khoirani Kuntum , Lukman HY , Nikmaturayan Nikmaturrayan , Hosin Hosin
Published: December 2020

Bali cattle are the primary genetic resources of Indonesia. Besides beef cattle are used as breeds, they are also distributed to all regions in Indonesia. One of the requirements for good quality of beef cattle is to be free from parasitic diseases. Bima Regency is one of the areas of Bali cattle population centers in West Nusa Tenggara, but the Bali cattle maintenance system in Bima Regency is generally still extensive, certainly increasing the potential for diseases. The disease can cause economic losses, disrupt the health of livestock and the health of people who consume meat derived from parasitic-infected animals. This study used 50 stool samples of Bali cattle aged 5 to 12 months taken randomly. The sedimentation and flotation method was used to identify nematode worm eggs. The parameters observed were gastrointestinal parasitic morphology, and then the data were analyzed descriptively. It was found two types of parasites that infected bali cattle in Bolo Sub-district, Ascaris spp, and Trichuris sp. As caris spp infected as many as 72% of 50 bali cattle faecal samples, 72% were infected by Trichuris sp., and mixture of Ascaris spp and Trichuris spp infected 54 % of the sampled cattle. The improvement of cage management and cattle maintenance system are necessary to implement. Those are by taking into high-quality nutrition feeding, regular anthelminthic treatment, and avoiding the feeding of green forage to avoid worm infection and re-infection.
Does the Export of Agricultural Products Lead to Economic Growth in Cameroon?
Authors: NGOUWOUO Younchawou , TOURERE Zenabou , NTAVOUA Samuel Honoré
Published: December 2020

The purpose of this article is to analyze the impact of agricultural exports such as coffee, cotton and cocoa on economic growth in Cameroon. The main results obtained by the Generalized Moments Method show that the impact of cocoa and coffee exports is negative and that of cotton on economic growth is positive. The export of cocoa, the exchange rate and the stability of agricultural exports are respectively significant. To this end, farmers should be encouraged to form more cooperatives in order to have easy access to finance which permit to increase their production, the government should fund research activities to improve the quality of agricultural products sold abroad in order to be more competitive and finally to promote the strategy of diversification of export products.
The Use of Porous Titanium Coating and the Largest Possible Head Do Not Affect Early Cup Fixation
Authors: Tsikandylakis Georgios , Mortensen Kristian R.L. , Gromov Kirill , Troelsen Anders , Malchau Henrik , Mohaddes Maziar
Published: December 2020

Background:

Cups are more frequently revised than stems after uncemented total hip arthroplasty, which warrants the development of cup surfaces that provide long-lasting, stable fixation. Large heads have become popular with the aim of reducing dislocation rates, but they generate greater frictional torque that may compromise cup fixation. We aimed to investigate (1) if a novel porous titanium surface provides superior cup fixation when compared with a porous plasma spray (PPS) surface and (2) if the use of the largest possible head compromises cup fixation when compared with a 32-mm head.

Methods:

Ninety-six patients were randomized to receive either a cup with a porous titanium coating (PTC) or a cup with PPS. A second randomization was performed to either the largest possible (36 to 44-mm) or a 32-mm head in metal-on-vitamin-E-infused polyethylene bearings. Roentgen stereophotogrammetric analysis (RSA) examinations were obtained postoperatively at 3, 12, and 24 months. The primary outcome was proximal cup migration when comparing the 2 cup surfaces and also when comparing the largest possible head with the 32-mm head. The patients were followed for 2 years.

Results:

The median (and interquartile range) proximal cup migration was 0.15 mm (0.02 to 0.32 mm) for the PTC cup and 0.21 mm (0.11 to 0.34 mm) for the PPS cup. The largest possible head had a proximal cup migration of 0.15 mm (0.09 to 0.31 mm), and the 32-mm head had a proximal cup migration of 0.20 mm (0.04 to 0.35 mm). There were no significant differences between the cup surface (p = 0.378) or the head size (p = 0.693) groups.

Conclusions:

Early cup fixation was not superior with the novel PTC cup; the use of the largest possible head (36 to 44 mm) did not compromise early cup fixation.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
DIŞ TİCARET İŞLEMLERİNDE BİLİŞİM SİSTEMLERİNİN ÖNEMİ
Authors: GÜLDÜREN Burcu , ÖZTOP Sezai
Published: December 2020

Bu çalışmanın amacı, uluslararası ticaret sektöründe faaliyet gösteren ve yoğun olarak dış ticaret işlemleri gerçekleştiren işletmeler tarafından kullanılan, bilişim sistemlerini ve yazılımlarını inceleyerek dış ticaret işlemleri açısından önemini tespit etmektir. Bu amaçla, İstanbul'daki 106 dış ticaret işletmesinde, görüşme tekniği kullanılarak bir araştırma gerçekleştirilmiştir. Araştırma kapsamında, işletmelerin dış ticaret, insan kaynakları ve/veya ticaret birimlerindeki yetkililer/çalışanlar ile görüşmeler yapılmıştır. Bu görüşmelerde verileri toplamak amacıyla, cevapları çoktan seçmeli 24 sorudan oluşan bir görüşme formu kullanılmıştır. Elde edilen verilerin analizinde ise SPSS 20 istatistik programı ve içerik analizi kullanılmıştır. Araştırmadan elde edilen bulgular doğrultusunda, uluslararası ticaret faaliyeti gerçekleştiren işletmeler tarafından kullanılan bilişim sistemlerinin dış ticaret işlemleri üzerinde ve dolayısıyla dış ticaret hacmi üzerinde önemli etkisi olduğu belirlenmiştir. Sonuç olarak, dış ticaret işlemlerinde bilişim teknolojisi ve sistemlerinin önemli bir kaldıraç görevi olduğu ve özellikle dış ticaret yazılımlarının işletmelerin dış ticaret işlemlerindeki başarısında önemli rol oynadığı görülmüştür.
DENETİM KALİTESİNİN BAĞIMSIZLIK İLKESİ VE ETİK İLİŞKİSİ BAĞLAMINDA İNCELENMESİ
Authors: SÜKLÜM Nurcan
Published: December 2020

Bağımsız denetim faaliyeti yürüten bağımsız denetim kuruluşları, işletmelerin finansal raporlarının muhasebe standartlarına uygun, tarafsız, doğru ve güvenilir bir şekilde hazırlanıp hazırlanmadığı ve işletmenin gerçek durumunu yansıtıp yansıtmadığının belirlenmesi konusunda önemli bir role sahiptir. Denetçinin bu noktada sorumluluğunu yerine getirmesi denetimin kaliteli olmasına katkıda bulunmaktadır. Denetimin kaliteli olması ise, Genel Kabul Görmüş Denetim Standartları’na uyulmasına bağlıdır. Bu noktada denetim faaliyetini yürüten denetçinin, bağımsızlık ilkesine ve etik kurallara uygun olarak hareket etmesi oldukça önemlidir. Bağımsız denetim kuruluşları hazırladıkları şeffaflık raporlarında bağımsızlık ve etik ilkelerine yer vermektedir. Bu çalışmada içerik analizi yöntemi kullanılmış ve Türkiye’de faaliyet gösteren bağımsız denetim kuruluşlarının hazırladıkları şeffaflık raporları, bağımsızlık ve etik ilkeleri açısından incelenmiştir. Çalışma sonucunda bağımsız denetim kuruluşlarının şeffaflık raporlarında, bağımsız denetim kalitesi açısından çok önemli uygulamalar olarak görülebilen bağımsız denetim ekibinin belirli sürelerle rotasyona tabi tutulması, denetim ekibinde yer alanlardan bağımsızlık taahhüdü alınması, yeni müşteri kabulünde bağımsızlık ve etik ilkelere dikkat edilmesi, bağımsızlık ve etik ilkelerin kalite kontrol sisteminde yer alması gibi uygulamaların nispeten fazla olduğu tespit edilmiştir. Ancak etik ve bağımsızlık ilkeleri ile ilgili eğitimler, rüşvetin engellenmesi, siyaset yasağı, disiplin politikaları gibi konularda sayının oldukça az olduğu tespit edilmiştir.
SAĞLIK ÇALIŞANLARININ SANAL KAYTARMA ETKİNLİKLERİ VE SÜRELERİ
Authors: BOSTAN Sedat , FİLİZ Mustafa
Published: December 2020

Bu çalışmanın amacı, sağlık çalışanlarının mesai süreleri içerisinde iletişim teknolojilerini kullanarak yapmış oldukları sanal kaytarma nedenlerini ve sürelerini tespit etmek ve sanal kaytarmanın sağlık kurumlarına maliyeti konusunda bir farkındalık oluşturmaktır. Bu süreçte sanal kaytarma sürelerini ölçmeye yönelik bir ölçeğe sahip olmaktır. Araştırmanın evrenini Artvin Devlet Hastanesinde ve Arhavi Devlet Hastanesinde çalışmakta olan toplam 326 sağlık çalışanı, örneklemini ise ankete gönüllü katılmayı kabul eden 133 sağlık çalışanı oluşturmaktadır. Anketin ölçeği daha önceki çalışmalardan yararlanılarak geliştirilmiştir. Ölçek demografik değişkenler dışında on beş ifadeden oluşmaktadır. Ölçek faktör analiziyle geçerlenerek, Cronbach's Alpha katsayısıyla güvenirliği test edilmiş ve uygun bulunmuştur. Her maddeyle ve ortalamayla ilgili sanal kaytarma sürelerinin hesaplanmasında gruplanmış seriler için aritmetik ortalama hesaplanması tekniği kullanılmıştır. Elde edilen bulgulara göre örneklemdeki sağlık çalışanları normal hayatlarında ortalama kişi başı günlük 203 dakikasını, haftalık 1427 dakikasını sanal âlemde geçirmektedir. Bu sürenin ortalama 452 dakikasını (7,5 saat) haftalık mesai süresi içerisinde yapmaktadır. En fazla zaman alan sanal kaytarma faaliyetleri; kişisel sosyal medya araçlarını kullanma (54 dakika) ve dizi, film, maç vb. programları izleme (52 dakika) etkinliğidir. Çalışmada erkekleri kadınlara göre, lise mezunlarının diğer gruplara göre daha fazla sanal kaytarma yaptıkları görülmüştür.
BOOTSTRAP PANEL CAUSALITY TESTING OF TOURISM AND GDP NEXUS FOR UPPER-MIDDLE INCOME COUNTRIES
Authors: KOÇOĞLU Mustafa , DOYAR Bayram Veli
Published: December 2020

One of the sources that increases the income of the countries is tourism. Many studies show that there are causal associations between GDP and tourism in various countries and country groups. In this respect, the purpose of current paper is to explore the causal relationship between tourism and GDP in 33 upper-middle income countries. Therefore, bootstrap panel causality test of Emirmahmutoğlu and Köse (2011) to annual data from 1995 to 2018. This test is powerful both under cross-section dependency and independency, also when the number of observations is small. The findings reveal that a unidirectional causality from tourism to GDP for Grenada and South Africa; a unidirectional causality from tourism to GDP in Albania, Bulgaria, Dominic Republic, Ecuador, Jamaica, Peru and Sri Lanka; bidirectional causality between tourism and GDP in Armenia, Mauritius and North Macedonia; and no causality for remaining 21 countries.
SOSYAL İNOVASYON ALANINDAKİ YAYINLARIN GÖRSEL HARİTALAMA YÖNTEMİYLE BİBLİYOMETRİK ANALİZİ
Authors: GÜLMEZ Murat , OĞUZ Suzan , YALÇINTAŞ Deniz
Published: December 2020

Günümüzde teknolojik yenilik ve gelişmeler sonucu ortaya çıkan inovasyon, toplumları ve sosyal yaşamı doğrudan etkilemektedir. Bu etkileşim, sosyal inovasyon kavramının ortaya çıkmasına sebep olmuştur. Sosyal inovasyon, sosyal ilerlemeyi desteklemek amacıyla sosyal ve çevresel sorunlara etkili çözümler geliştirme ve uygulama sürecidir. Bu çalışmanın amacı, son yıllarda öne çıkan sosyal inovasyon kavramı ile ilgili yapılmış araştırmaları bibliyometrik analiz yöntemi ile incelemektir. Bu amaç doğrultusunda Web of Science veritabanında sosyal inovasyon kavramı kullanılarak 2010-2019 yılları arası baz alınarak tarama yapılmış ve toplamda 579 yayına ulaşılmıştır. Yayınlar, VOSviewer haritalama yöntemi ile görselleştirilmiştir. Analiz sonrası incelenen çalışmalarda en sık kullanılan anahtar kelimenin “sosyal inovasyon” olduğu, en fazla yayın yapan ve en fazla ortak yazarlığı olan yazarın Antonius Schröder olduğu ve en fazla atıf alan yazarın Frances R. Westley olduğu görülmektedir. Ayrıca en fazla yayın yapan ülkenin İspanya (90 yayın), en fazla atıf alan ülkenin ise İngiltere (915 atıf) olduğu bulgular arasındadır.
THE LONG MEMORY BEHAVIOR IN TIME-VARYING BETA: AN EMPIRICAL APPLICATION ON BIST
Authors: KESKİN Hüseyin , ÇELİK İsmail
Published: December 2020

The study aims to investigate the long memory behavior in time-varying beta, a systematic risk indicator, in İstanbul Stock Exchange (BIST) sub-indices. Using the data regarding BIST national indices, sub-indices and two-year benchmark bond interest rate between January 2009 and September 2019, the time-varying beta coefficient is determined with DECO-FIGARCH model, and the long memory behaviors of the beta coefficient are analyzed with GPH, Lo R / S and GSP tests. It is found that the beta coefficient of the three sub-indices (banking, financial and industrial) changes over time and the beta coefficient demonstrates long memory behavior (mean-reverting at a hyperbolic speed). It is indicated that the time-varying beta coefficients are forecastable and our findings contradict the weak-form of market efficiency.
Shape difference of mud clasts depending on depositional facies: application of newly modified elliptic Fourier analysis to hybrid event beds
Authors: Fukuda Sojiro , Naruse Hajime
Published: December 2020

Hybrid event beds are the deposits from sediment gravity flows that change their rheological behavior through their passage, entraining muddy sediments and damping turbulence. Muddy facies of hybrid event beds are often associated with abundant mud clasts which show a wide variety of size and shape. The variation of clast occurrence in hybrid event beds is expected to preserve the information of entrainment and transport processes of muddy sediments in submarine density currents. However, previous analyses of hybrid event beds have focused on describing the overall clast occurrence rather than the statistical size and shape analyses because traditional shape parameters are incapable of characterizing the complex shape of mud clasts. Here, a new quantitative grain-shape analysis of mud clasts is conducted and allows visualization of the spatial variation of clast size and shape, which suggests the wide variety of origin and transport systems of entrained mud clasts. This new method revises the traditional elliptic Fourier analysis, substituting Fourier power spectra (FPS) for traditional elliptic Fourier descriptors to overcome the mirror-wise shape problem. Further, principal-component analysis is shown to capture significant shape attributes more effectively than traditional shape parameters. The proposed method is applied to mud clasts in sediment-gravity-flow deposits in the lower Pleistocene Otadai Formation, central Japan. Results imply that there are distinctive shape and size differences of mud clasts that are strongly associated with depositional facies rather than the distance from the source. The clasts have a higher angularity than other facies in the debrite intervals in hybrid event beds. It is also shown that clasts in sandy, structureless facies have different characteristics in shapes based on elongation and convexity compared to laminated facies. Comparison between different shape-analysis methods demonstrates that none of the traditional methods are able to visualize these trends as effectively as the method presented herein. These results highlight the importance of the quantitative shape analysis of sediment grains and the effectiveness of FPS-based elliptic Fourier analysis.
Stepwise Treatment of Uterine Arteriovenous Malformation Complicated by a Giant Aneurysm: A Case Report
Authors: Garbuzov Vladislav , Khafizov Ravil , Gromov Dmitry , Kozlova Ekaterina
Published: December 2020

Uterine arteriovenous malformation (AVM) is a rare condition that threatens severe uterine bleeding. We present a patient with this pathology, who was hospitalized twice within 5 months in serious condition, because she refused a hysterectomy. Ultrasonography of the uterus detected a vascular formation, the nature of which could be identified only on computed tomography (CT) angiography. Afferent vessels were embolized twice, and after the condition was stabilized, we performed a hysterectomy. For a long time, there was no recurrence of bleeding. The foregoing allows us to recommend the described tactics for the diagnosis and treatment of uterine AVM in women in similar clinical situations.
Evaluation of Liver in Type 2 Diabetes Mellitus Using Unenhanced Computed Tomography
Authors: Osama Huda , Siddig Afraa , Gareeballah Awadia , Gameraddin Moawia , Osman Hanady Elyas
Published: December 2020

Background: Chronic liver disease occurs due to different etiologies. Most diabetic patients are unaware that the effective control of hyperglycemia might reduce complications and mortality rates. Fatty liver disease is considered a risk factor of hepatic cirrhosis and cancers. Methods and Results: We conducted a case-control study to assess the impact of type 2 diabetes mellitus (T2DM) on the liver using a CT scan. A total of 100 patients with T2DM and 96 non-diabetic patients as a control group were selected using a convenient sampling method. There was a significant difference in liver attenuation in diabetic and control groups. The CT attenuation values of the liver, pancreas, and spleen were significantly lower in patients with T2DM than in non-diabetics (P<0.001). There was a significant negative correlation between the duration of T2DM and CT attenuation of the liver, pancreas, and spleen (P<0.01). Conclusion: The CT attenuation of the liver was significantly lower in T2DM than in the non-diabetic patients, and liver attenuation decreased as the duration of T2DM increased.
Art Therapy for Treating Anxiety in Adolescents with Psychosomatic Diseases
Authors: Prokhorova Zhanna , Polyakov Vladimir , Rychkova Lyubov
Published: December 2020

The purpose of our study was to develop and test a program for treating anxiety and hostility in adolescents with psychosomatic diseases (PSDs) by means of art therapy. Methods and Results: This study included 20 patients with PSDs aged between 15 years and 17 years. The patients’ examination included clinical data analysis, using standard records, and testing, using a questionnaire to reveal the severity of psychopathological symptoms (SCL–90–R, adapted by Tarabrina et al. 1997) and the Bekhterev Institute Personality Questionnaire (BIPQ, 1980). Art therapy sessions were conducted from 11:00 a.m. till 1:00 p.m., which coincides with the transition in the daily rhythm of autonomic nervous system activity and is more suitable for the reserve capabilities of the body. The course consisted of 10 daily 1.5-hour procedures. The controlled study duration was 10±2 days. The examination showed that adolescents with PSDs had an above-normal "Anxiety" (ANX) indicator, according to the SCL-90-R method, and a high score for the "Anxious" type (AT) of attitude toward the disease, according to the Bekhterev Institute Personality Questionnaire (BIPQ). Conclusion: Art therapy for treatment of adolescents with PSD contributed to a normalization of their emotional state, helped them gain new experience in solving problems, and improved the quality of life.
Influence of Wrist Tapping on Alpha Rhythm Synchronization in Patients with Juvenile Myoclonic Epilepsy
Authors: Narodova Ekaterina , Shnayder Natalia , Karnaukhov Vladislav , Petrov Kirill , Narodova Valeriya
Published: December 2020

Background: The aim of this study was to assess the effect of wrist tapping (WT), according to the author's method, on the synchronization of alpha activity in healthy adults and patients with juvenile myoclonic epilepsy (JME). Methods and Results: The study included 71 people of working age, including 51 clinically healthy volunteers (median age - 39[21;56] years) and 20 patients with JME (median age 27[23;35] years). Under the influence of WT in a state of sensory deprivation, statistically significant changes in the alpha peak frequency (APF) (P<0.001) and alpha power (AP) (P<0.05) were found in healthy adults. In JME patients, there were statistically significant changes in the APF (P<0.05) and AP (P<0.05), as well as a statistically significant increase in the ARW (P<0.05) after WT. WT, according to the author's technique, allows reducing the severity of alpha rhythm synchronization and leads to a shift in the peak frequency of the alpha rhythm in the occipital leads towards the alpha-2 sub-frequency range and a decrease in AP in both healthy volunteers and JME patients. At the same time, the alpha range width in the occipital leads is statistically significantly increased in JME patients. Conclusion: The nature of the change in the alpha rhythm, in comparison with the control, indicates the phenomenon of resonance with the frequency of the WT rhythm. The WT effect testifies to the prospects of the clinical application of WT in JME, since it was previously shown that if the selected external frequencies enter into resonance with the neurons of the antiepileptic system, then an antiepileptic effect could be obtained.
The Results of Bacteriological Examination in Premature Infants with Neonatal Morbidity and Mortality
Authors: Orazmuradov Agamurad , Kostin Igor , Akhmatova Anastasiya , Damirov Kemer , Savenkova Irina , Arakelyan Gayane , Haddad Khalid , Lopatin Alexander , Kyrtikov Sergey , Lukaev Aleksey
Published: December 2020

The purpose of this study was to assess the results of bacteriological studies in children born prematurely and compare the received data with the detected neonatal morbidity. Methods and Results: Our study included 227 pregnant women at gestational age of 28-36 weeks 6 days, and their newborns. Depending on the gestational age, they were divided into 3 groups. Group 1 included 73 women at gestational age of 28-30 weeks 6 days; Group 2 included 81 women at gestational age of 31-33 weeks 6 days, Group 3 included 73 women at gestational age of 34-36 weeks 6 days. All women underwent an assessment of vaginal microcenosis and the quantitative and qualitative composition of the biotope of the cervical discharge; the newborns underwent bacteriological examination of the auricle, pharynx and anus. Analysis of the results of bacteriological studies shows a significant growth of microorganisms in newborns from mothers of Group 1. The analysis of morbidity among premature infants showed that in each group there were 2 or 3 diseases, mainly of an infectious nature. The main proportion of morbidity (congenital pneumonia and infections of the perinatal period, diseases of the urinary system, neonatal jaundice of premature infants and cerebral ischemia}.among newborns was found in Group 1, compared with Groups 2 and 3. The analysis of the results obtained showed that the low birth weight in preterm labor correlated with the growth of Staphylococcus epidermidis in the throat of newborns. Neonatal jaundice of premature newborns was characterized by 100% detection of Staphylococcus epidermidis and Serratia odorifera in the anus swabs, and Staphylococcus epidermidis in swabs from the pharynx and ear. Congenital pneumonia positively correlated with the growth of Staphylococcus epidermidis, E. coli, Candida spp, Enterococcus faecalis in the throat swab. The deceased children had a co-infection. Conclusion: Our study identified the main microorganisms affecting both perinatal morbidity and neonatal mortality: Staphylococcus epidermidis, Enterococcus faecalis, E. coli, Candida spp. It is necessary to note the frequent identification of E. coli strains resistant to the main antibacterial drugs.
Falls in Elderly Patients with Stroke
Authors: Abdelbasset Walid Kamal
Published: December 2020

The present review aims to identify the prevalence of falls, to describe the factors related to falls among elderly stroke patients, and to demonstrate the desired interventions to prevent falling among those patients. This review was conducted using PubMed, SCOPUS, Web of Science, and Medline to determine the incidence, risk factors, and favorable procedures to prevent and manage falls among elderly stroke patients. Falls lead to injuries, fractures, and impairments of the quality of life. Elderly stroke patients are more susceptible to falling than their healthy peers, which may result in greater restrictions on activity and mobility. Previous studies have documented the incredible prevalence of falls among the elderly who have suffered a stroke. Our study led to the conclusion that falls should be assessed to determine how to prevent and control them among elderly stroke patients. Physical therapy and rehabilitation modalities have a key role to play in improving the health status and prevent falling among those patients.
Growth, exclusion and vulnerability: evaluation of the socio-spatial transformation of post-apartheid Pretoria-Tshwane (South Africa)
Authors: Horn Andre
Published: December 2020

Apartheid left South African city regions with two major challenges: social integration at a city level and spatial integration at a regional level. The task to finds solutions to these problems was left to municipalities, the lowest level of the three trier government system introduced after 1994. This article critically evaluates the success of the post-apartheid municipal government of Pretoria-Tshwane to address the said challenges in the reorganization of the city region over a 25-year period. The paper starts with a reconstruction of the apartheid city to display its socio-spatial contrasts and to define the challenge of integration and compaction. The investigation is based on literature, census information and observation. The main finding is that the progress made with the integration of the city at both scales is being neutralized by demographic trends, choice of association, urban sprawl, uncertain management, the scale of aspirations, unrealistic expectations and, most of all, municipal incapacity. The failure of the local government of Pretoria-Tshwane to achieve the said goals points to the inefficiency of the current approach that obligates municipalities with the complete task to rectify the dichotomies of the apartheid city system within their regions.  It is advocated that additional governmental entities be implemented to support local governments with the planning and re-development of post-apartheid city-regions.
Deletion of Smad3 Protects Against Diabetic Myocardiopathy in db/db Mice 
Authors: Dong Li , Li Jian-Chun , Hu Zhong-Jing , Huang Xiao-Ru , Wang Li , Wang Hong-Lian , CW Ronald , Yang Si-Jin , LAN Hui-yao
Published: December 2020

Background: Diabetic cardiomyopathy (DCM) is a common diabetic complication characterized by diastolic relaxation abnormalities, myocardial fibrosis, and chronic heart failure. Although TGF-b/Smad3 signaling has been shown to play a critical role in chronic heart disease, the role and mechanisms of Smad3 in DCM remain unclear. Methods: We generated Smad3 knockout (KO)-db/db, Smad3 wild-type (WT)-db/db, Smad3+/- db/db, and their littermate Smad3 KO/WT-db/m mice. The role of Smad3 in DCM including the left ventricular (LV) ejection fraction (EF), LV fractional shortening (FS), and LV Mass were determined and mechanisms of Smad3 in cardiac inflammation and fibrosis including Smad3-dependent microRNAs were investigated. Results: At the age of 32 weeks, Smad3WT-db/db mice developed moderate to severe DCM as demonstrated by a significant fall in LVEF, LVFS, and a marked increase in LV mass with progressive myocardial fibrosis and inflammation. In contrast, db/db mice lacking Smad3 (Smad3KO-db/db) were protected against the development of DCM with normal cardiac function without myocardial inflammation and fibrosis. Interestingly, db/db mice with deleting one copy of Smad3 (Smad3+/-db/db) did not show any cardioprotective effect. Mechanistically, we found that deletion of Smad3 from db/db mice largely protected cardiac Smad7 from Smurf2-mediated ubiquitin proteasome degradation, thereby inducing IkBa to suppress NF-kB-driven cardiac inflammation. In addition, deletion of Smad3 also altered Smad3-dependent miRNAs by upregulating cardiac miR-29b while suppressing miR-21 to exhibit the cardioprotective effect on Smad3KO-db/db mice. Conclusions: Smad3 is a key mediator in the pathogenesis of DCM. Results from this study imply that targeting Smad3 may be a novel therapy for DCM.
HER3 PET Imaging Identifies HER2+ Breast Cancers That Benefit From HER3 Inhibitor Addition  
Authors: Wehrenberg-Klee Eric , Sinevici Nicoleta , Nesti Sarah , Kalomeris Taylor , Austin Emily , Larimer Benjamin , Mahmood Umar
Published: December 2020

Background: Standard therapy for HER2+ breast cancers includes HER2 inhibition. While HER2 inhibitors have modestly improved outcomes, they have not had nearly the original anticipated therapeutic efficacy, with only a modest improvement in survival in both the metastatic and adjuvant setting. An important intrinsic resistance mechanism to HER2 inhibition in some breast cancers is dynamic upregulation of HER3. Increase in HER3 expression that occurs in response to HER2 inhibition allows for continued growth signaling through HER2:HER3 heterodimers, promoting tumor escape. We hypothesized that a non-invasive method to image changes in HER3 expression would be valuable to identify those breast cancers that dynamically upregulate HER3 in response to HER2 inhibition. We further hypothesized that this imaging method could identify those tumors that would benefit by further addition of a HER3 inhibitor. Methods: In cells treated with the HER2 inhibitor lapatinib, we evaluate changes in HER3 expression and viability. Mouse HER2+ breast cancer models treated with lapatinib were imaged with a peptide-based HER3-specific PET imaging agent (Ga-68-HER3P1) to assess for dynamic changes in tumoral HER3 expression and uptake confirmed by biodistribution. Subsequently, HER2+ cell lines were treated with the HER2 inhibitor lapatinib as well HER3-specific siRNA to assess for changes in viability and correlate with HER3 expression upregulation. For all statistical comparisons, p<0.05 was considered statistically significant. Results: Ga68-HER3P1 PET imaging of mice implanted with the HER2+ breast cancer cell lines MDA-MB453 or HCC-1569 prior to and after treatment with lapatinib demonstrated a significant increase in SUV in MDA-MB453 tumors only, consistent with in vitro findings. The addition of HER3 siRNA to lapatinib increased therapeutic efficacy in MDA-MB453 cells, but not in HCC-1569 cells. Conclusion: HER3 PET imaging can be used to visualize dynamic changes in HER3 expression that occur in HER2+ breast cancers with HER2 inhibitor treatment and identify those likely to benefit by the addition of combination HER3 and HER2 inhibition.
Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: An application of K-means clustering algorithm
Authors: Gesicho Milka , Were Martin , Babic Ankica
Published: December 2020

Background The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. The aim of this study is to conduct a comprehensive assessment of the reporting status for HIV indicators, from the time of DHIS2 implementation, using Kenya as a case study. Methods A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 to 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness facility reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters. Results Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups.Conclusions The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.
Study of Survivin: A Biomarker in Carcinoma Colon – An Original Study
Authors: Chandra Pratibha , Kinra Prateek
Published: December 2020

Background: Survivin, an anti-apoptotic protein has been of importance in colon carcinoma patient. Here we studied the prevalence of Survivin biomarker among cases of colon carcinoma and its relationship with other prognostic indicators.

Design: Tissue samples from 102 patients with colon carcinoma were studied. H&E stain and immunohistochemistry were performed and evaluated. Immuno-histochemistry expression was sought according to IRS Scoring System (Immunoreactivity Scoring) for stain intensity and percentage positive cells. Survivin expression was also correlated with age at diagnosis, gender, grade, nodal status, lympho-vascular and perineural invasion, resection margins, Tumor stage (TNM) and Group Stage.

Result and discussion: Survivin was expressed in high grade and stage tumors and showed significant association (p value= 0.002).  Survivin expression was positive in lymph node positive tumors and showed significant association (p value= 0.002).  Survivin was expressed in tumors with lympho-vascular and perineural invasion and showed significant association (p value= 0.02 and 0.001) respectively. Age at diagnosis showed significance of p=0.03 whereas Gender (Male/Female) and resection margins did not show any association with Survivin expression.

Conclusion: Survivin expression increases as the tumor grade worsens in colon cancer and is maintained in approximately all high group staged tumors (TNM Staging) along with tumors showing lymphovascular and perineural invasion. Gender does not have any association.
Microsatellite Instability in Endometrial Carcinoma.
Authors: Toor Sharanjit Singh , Kinra Prateek , Kumar Aman , Hothi Onkar Singh
Published: December 2020

Background: Endometrial carcinoma is the commonest gynaecological malignancy in the western countries with a standardised incidence of 8 per 100000 women. In India and Southeast Asia, the incidence of endometrial carcinoma is low but it is increasing due to increasing prevalence of obesity, diabetes, early menarche, late menopause, late marriage and declining birth rate. The study aimed to identify the role of microsatellite instability in endometrial carcinoma. Although MSI has been studied extensively in colorectal carcinoma there have been very few studies in southeast asian region regarding association of MSI and prognosis in endometrial carcinoma. To the best of our knowledge this is first study in India.

Method: A Descriptive study in which 40 patients of endometrial carcinoma were studied. MSI was detected using immunohistochemistry (MSH-1, PMS-2, MSH-2, MSH-6). Statistical Analysis was done using SPSS software and fisher exact test was used to calculate p value. p value less than.05% was considered significant.

Results: Overall prevalence of microsatellite instability was 40%. Microsatellite instability was associated with higher tumor grade, myometrial invasion>50% and presented in initial stages compared to microsatellite stable tumors.

Conclusion: Our study showed statistically significant association between microsatellite instability and Figo staging, tumor grade and myometrial invasion.
Parnaparin in surgery, vascular surgery and associated disciplines
Authors: Lavrentyev D. A. , Zotikov A. E.
Published: December 2020

Aliterature review is dedicated to the use of Parnaparin in various surgical specialties. Prevention and treatment of thromboembolic complications is the major indication for the use of Parnaparin. In the review, the authors dwell on comparative studies of the efficacy oflow molecular weight heparins and unfractionated heparin. They also discuss in detail pharmacokinetics and pharmacodynamics of Parnaparin, its structure and effect on hemostasis components. Due tolack of direct comparative studies of variouslow molecular weight heparins, the authors provide reviews based on the network meta-analysis, which allowed them to identify the advantages of a specificlow molecular weight heparin by indirect comparison.There are few direct comparative studies of variouslow molecular weight heparins in theliterature, which does not allow for an objective assessment of their advantages and disadvantages. The authors do not only provideliterature data on direct comparative studies, but also show data on indirect comparisons (network meta-analysis). They analysed the efficacy of Parnaparin and otherlow molecular weight heparins for the prevention of thromboembolic complications, treatment of deep vein thrombosis and post-thrombophlebitic syndrome. The issues of the efficacy of Parnaparin in chronic arterial insufficiency and use in acute coronary syndrome are highlighted separately. The final part of the review is concerned with a promising, butlittle-known area of prophylaxis of restenosis and prevention of atherosclerosis progression. Experimental studies have allowed us to state that Parnaparin is one of the most effectivelow molecular weight heparins as far as thromboembolic complications are concerned. Parnaparin significantly reduces frequency of DVT events and, at the same time, decreases major bleeding risk as compared with unfractionated heparin. No dose adjustment is required in obese patients. Dose adjustments are based not on body weight but on risk factors for thrombosis, and obesity is only one of them to be considered to choose a dose. Amonglow molecular weight heparins, Parnaparin is one of the most potent drugs that reduces the proliferative and migratory capacity of smooth muscle cells; however, further research is needed to assess the prospects of using Parnaparin for the prevention of restenosis.
Antithrombotic therapy for chronic ischemic heart disease: how to balance risk and benefit in different categories of patients?
Authors: Perepech N. B.
Published: December 2020

The review focuses on current guidelines for the use of medications that affect hemostasis in the treatment of patients with chronic ischemic heart disease (IHD). The review shows the important impact of negative outcomes of IHD on mortality from cardiovascular system diseases in the Russian Federation. The results of the most significant randomised clinical trials, which assessed the efficacy and safety of various antithrombotic therapy options in patients with various clinical manifestations of IHD, as well as methodological methods for individual assessment of ischemic and hemorrhagic risks, were discussed. Theoretically, the use of anticoagulants in combination with antithrombocytic drugs to reduce the risk of atherothrombotic complications in the phase of the stable course of the IHD is justified. The results of the COMPASS study, which proved the positive effect oflow-dose addition of rivaroxaban to acetylsalicylic acid on the risk of cardiovascular events, cardiovascular death and death from all causes in patients with chronic IHD with maintained sinus rhythm, are reviewed in detail. Discussions were held on how to determine the optimal duration of double antithrombocytic therapy in patients with IHD after percutaneous coronary intervention (PCI), taking into account individual values of ischemic and hemorrhagic risks. Long-term antithrombotic therapy schemes for patients with chronic IHD and atrial fibrillation (AF) that have not been exposed to PCI are presented, as well as current recommendations on how to choose the best antithrombotic therapy scheme for patients with IHD that have been exposed to PCI depending on the risk of stent thrombosis and the risk of bleeding. It has been substantiated that active differentiated antithrombotic therapy should be widely used in everyday practice, which, provided that ischemic and hemorrhagic risks are adequately assessed, creates a real prospect of reducing mortality from IHD and circulatory system diseases in general.
Chromogenic anti-Xa test: the ratio between heparin activity units and concentration of apixaban and rivaroxaban
Authors: Titaeva E. V. , Dobrovolsky A. B.
Published: December 2020

Introduction. The direct oral anticoagulants (DOC) therapy does not require alaboratory control; however, it may be required to determine the anticoagulationlevel to choose a treatment strategy if alarge bleeding is developing or emergency surgery is needed.The objective of this experimental study was to investigate the relationship between the residual factor Xa (FXa) activity, anti-Xa activity units oflow molecular weight heparins (LMWH), and the apixaban and rivaroxaban plasma concentrations in a chromogenic anti-Xa assay.

Material and methods. Concentrated DOC solutions were prepared by extracting apixaban and rivaroxaban from crushed tablets using methanol and dimethyl sulfoxide, respectively. The resulting solutions were added to the donor plasma pool until final inhibitor concentrations are achieved in the range from 10 to 100 ng/ml plasma. Anti-Xa activity was determined using an STA-compact analyser and the Liquid anti-Xa reagent kit, an analysis protocol, and calibrators designed to control the LMWH therapy. The effect on the thrombin formation dynamics was investigated using the thrombin generation test (TGT) and the PPR reagent as a trigger (final concentrations of tissue factor are 5 pM, and those of phospholipids are 4 μM). TGT curves were analysed using the Thrombinoscope program.Results. It was shown that in the anti-Xa activity test version designed to control the LMWH therapy, there is a high correlation (R2 > 0.98) between thelogarithm of the residual factor Xa activity and the content of apixaban and rivaroxaban in the range from 10 to 80 ng/ml. Rivaroxaban shows about 1.5 times more anti-Xa activity than apixaban at equal concentrations. It was also shown that apixaban and rivaroxaban at doses equal both in concentration and in anti-Xa activity differ in their effect on the thrombin formation dynamics and thrombin inactivation in the TGT.Conclusion. In the LMWH anti-Xa activity test version, the measured range of apixaban and rivaroxaban includes 30 ng/ml and 50 ng/ ml concentrations taken as “cut-off points” to determine the treatment tactics in emergency cases. However, thelack of certified DOC calibratorslimits the use of this test in clinical practice.
Copper-zeolite integrated stormwater biofilter for nutrient removal – the impact of intermittent wetting and drying conditions
Authors: Li Yali , Deletic Ana , McCarthy David T.
Published: December 2020

A large-scale column study was conducted to examine the sediment and nutrient removal performance of stormwater biofilters that contained layers of novel copper-zeolite filter media. The filters were exposed to stormwater under varied dosing frequency over 33 weeks and were assessed for their hydraulic performance and their efficiency in removing sediment and nutrients. The non-vegetated sand filters with layers of copper-zeolite media (SCu filters) achieved consistently good removal of total phosphorus (87%) despite the challenging dry-wet cycles, and the effluent concentration met a long-term irrigation guideline (0.05 mg/L). The same design achieved 51% removal of total nitrogen above the Australian runoff quality load reduction targets (45%). Incorporation of Leptospermum continentale into the copper-zeolite filters (LCCu-T) maintained the phosphorus removal (86%) and led to a slight increase in total nitrogen removal (57%). Both designs maintained good water permeability (200 mm/h at the end of the last wet period). Copper-zeolite played a mixed role in the system: enhancing nutrients removal through precipitation and ion exchange, maintaining high water permeability, limiting the advantages of vegetation on nutrient removal. Future studies should refine biofilter design and vegetation selection to augment the performance of copper-zeolite filters by integrating the advantages of vegetation on nutrient removal.
Culturally inclusive water urban design: a critical history of hydrosocial infrastructures in Southern Sydney, Australia
Authors: Coyne Taylor , Zurita Maria de Lourdes Melo , Reid David , Prodanovic Veljko
Published: December 2020

Historic relationships between communities and waterscapes are complex and often explained solely in technical terms. There is a key need to understand how human-centered developments have shifted the use of river spaces over time, and how these changes reflect on the values of rivers and surrounding cultures. In this paper, we develop a critical analysis of the historically changing relationship between urban communities and water infrastructures using the Georges River catchment in Sydney, Australia. Our focus was on bringing together past and current perspectives, engaging with the formation of diverse hydrosocial behaviors entangled with water infrastructures. Using post-settlement historical documents, maps, journals, and newspaper articles, we trace shifts in hydrosocial perspectives over time, mapping six distinct historic phases. In our study, we offer a shift from the main paradigms currently influencing the development of urban water infrastructures, moving away from the dominant technical propositions of systems designed purely for the management and treatment of stormwater. Drawing on our analysis, we propose a new urban water design concept: Culturally Inclusive Water Urban Design (CIWUD). This presents an advancement on current framework to include a consideration of people's connections and uses of urban waterscapes, as well as a shift towards democratic space design.