bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent Development of Aminoacyl tRNA Synthetase Inhibitors for Human Diseases: A Future Perspective.
Authors: Kim Soong-Hyun , Bae Seri , Song Minsoo
Published: November 2020

Aminoacyl-tRNA synthetases (ARSs) are essential enzymes for translating amino acids for protein synthesis. Their function in pathogen-derived infectious diseases has been well established, which has led to development of small molecule therapeutics. The applicability of ARS inhibitors for other human diseases such as fibrosis has recently been explored in the clinical setting. There are active studies to find small molecule therapeutics for cancers. Studies on central nervous system (CNS) disorders are burgeoning as well. In this regard, we present a concise analysis of the recent development of ARS inhibitors based on small molecules from the discovery research stage to clinical studies as well as a recent patent analysis from the medicinal chemistry point of view.
The Role of APOBECs in Viral Replication
Authors: Xu Wendy K. , Byun Hyewon , Dudley Jaquelin P.
Published: November 2020

Apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like (APOBEC) proteins are a diverse and evolutionarily conserved family of cytidine deaminases that provide a variety of functions from tissue-specific gene expression and immunoglobulin diversity to control of viruses and retrotransposons. APOBEC family expansion has been documented among mammalian species, suggesting a powerful selection for their activity. Enzymes with a duplicated zinc-binding domain often have catalytically active and inactive domains, yet both have antiviral function. Although APOBEC antiviral function was discovered through hypermutation of HIV-1 genomes lacking an active Vif protein, much evidence indicates that APOBECs also inhibit virus replication through mechanisms other than mutagenesis. Multiple steps of the viral replication cycle may be affected, although nucleic acid replication is a primary target. Packaging of APOBECs into virions was first noted with HIV-1, yet is not a prerequisite for viral inhibition. APOBEC antagonism may occur in viral producer and recipient cells. Signatures of APOBEC activity include G-to-A and C-to-T mutations in a particular sequence context. The importance of APOBEC activity for viral inhibition is reflected in the identification of numerous viral factors, including Vif, which are dedicated to antagonism of these deaminases. Such viral antagonists often are only partially successful, leading to selection for viral variants.
Mast Cell Functions Linking Innate Sensing to Adaptive Immunity
Authors: Katsoulis-Dimitriou Konstantinos , Kotrba Johanna , Voss Martin , Dudeck Jan , Dudeck Anne
Published: November 2020

Although Mast cells are known as key drivers of type I allergic reactions, there is increasing evidence for their critical role in host defense. MCs do not only play an important role in initiating innate immune responses, but also influence the onset, kinetic and amplitude of the adaptive arm of immunity, or fine-tune the mode of the adaptive reaction. Intriguingly, MCs have been shown to affect T cell activation by direct interaction or indirectly by modifying properties of antigen-presenting cells, and can even modulate lymph node-borne adaptive responses remotely from the periphery. In this review, we provide a summary of recent findings that explain how MCs act as a link between the innate and the adaptive immunity, all the way from sensing inflammatory insult to orchestrating the final outcome of the immune response.
Efficient Resource Management for Deep Learning Applications with Virtual Containers
Authors: Zheng Wenjia
Published: November 2020

The explosion of data has transformed the world since much more information is available for collection and analysis than ever before. To extract valuable information from the data in different dimensions, various deep learning models have been developed in the past years. Although these models have demonstrated their strong capability on improving products and services in various applications, training them is still a time-consuming and resource-intensive process. Presently, cloud, one of the most powerful computing infrastructures, has been used for the training. However, how to manage cloud computing resources and to perform the training efficiently is still challenging current techniques. For example, general resource scheduling approaches, such as spread priority and balanced resource schedulers, actually do not work well with deep learning workloads. Besides, the resource allocation problem on a cluster can be divide into two subproblems: (1) local resource optimization: improve resource configuration for a single machine; (2) global resource optimization: improve the cluster-wide resource allocation. In this thesis, we propose two novel container schedulers, FlowCon and SpeCon, that are designed to address these two subproblems respectively and specifically to optimize performance of short-lived deep learning applications in the cloud. FlowCon focuses on resource configuration of single-node in a cluster, as show that it efficiently improves deep learning tasks completion time and resource utilization, and reduces the completion time of a specific job by up to 42.06\% without sacrificing the overall system time. SpeCon targets on cluster-wide resource configuration that speculatively migrate slow-growing models to release resources for fast-growing ones. Based on our experiments, SpeCon improves makespan for up to 24.7\%, compared to current approaches.
3D Trajectory Control of Flexible Manipulator
Authors: Sasaki Minoru , Maeno Daiki , Asango Jackline , Njeri Wweru , Matsushita Kojiro , Mulembo Titus
Published: November 2020

This paper describes the development of a controller that enables trajectory control and vibration control. The controller performance was verified the using a 3D 2-link, flexible manipulator. On trajectory control using inverse kinematics, it was confirmed that the deflection due to its own weight deteriorated the track following performance. The vibration component of the resonance frequency of the flexible manipulator was generated, and the tip position accuracy is deteriorated. Using the results of control experiments based on the inverse kinematics, the system is identified and then created an inverse system for simultaneous control of trajectory control and vibration control. The target trajectories were the three joint angles. Finally, it was demonstrated through experiments on actual manipulator, that the system could sufficiently follow the ideal trajectory and suppress link vibrations.
Groundbreaking Anticancer Activity of Highly Diversified Oxadiazole Scaffolds
Authors: Benassi Alessandra , Doria Filippo , Pirota Valentina
Published: November 2020

Nowadays, an increasing number of heterocyclic-based drugs found application in medicinal chemistry and, in particular, as anticancer agents. In this context, oxadiazoles, five-membered aromatic rings, emerged for their interesting biological properties. Modification of oxadiazole scaffolds represents a valid strategy to increase their anticancer activity, especially on 1,2,4 and 1,3,4 regioisomers. In the last years, an increasing number of oxadiazole derivatives, with remarkable cytotoxicity for several tumor lines, were identified. Structural modifications, that ensure higher cytotoxicity towards malignant cells, represent a solid starting point in the development of novel oxadiazoles-based drugs. To increase the specificity of this strategy, outstanding oxadiazole scaffolds have been designed to selectively interact with biological targets, including enzymes, globular proteins and nucleic acids, showing more promising antitumor effects. In the present work, we aim to provide a comprehensive overview of the anticancer activity of these heterocycles, describing their effect on different targets and highlighting how their structural versatility has been exploited to modulate their biological properties.
Mapping of the Canopy Openings in Mixed Beech-Fir Forest at Sentinel-2 Subpixel level Using UAV and Machine Learning Approach
Authors: Pilaš Ivan , Gašparović Mateo , Novkinić Alan , Klobučar Damir
Published: November 2020

The presented study demonstrates the bi-sensor approach suitable for rapid and precise up-to-date mapping of forest canopy gaps for the larger spatial extent. The approach makes use of UAV RGB images on smaller areas for highly precise forest canopy mask creation. Sentinel-2 was used as a scaling platform for transferring information from UAV to a wider spatial extent. The various approaches of the improvement of the predictive performance were examined: (I) the highest R2 of the single satellite index was up to 0.57, (II) the highest R2 using multiple features obtained from the single date, S-2 image was 0.624 and, (III) the highest R2 on the multi-temporal set of S-2 images, was 0.697. Satellite indices such as ARVI, IPVI, NDI45, PSSRa, MCARI, CI, RI, and NDTI were the dominant predictors in most of the ML algorithms. The more complex ML algorithms such as SVM, Random Forest, GBM, XGBoost, and Catboost that provided the best performance on the training set exhibited weaker generalization capabilities. Therefore, a simpler and more robust Elastic Net algorithm was chosen for the final map creation.
A Method for Assessing the Stability of Digital Automatic Control Systems (ACS) with Discrete Elements. Hypothesis and Simulation Results
Authors: Kodkin Vladimir , Baldenkov Alexander , Anikin Alexander
Published: November 2020

The article presents a new approach to the analysis of the stability of automatic systems with discrete links.In almost all modern automatic control systems, there are links that break signals in time. These are power controlled switches - transistors or thyristors operating in a pulsed mode and digital links in regulators.Time discretization significantly affects the stability of processes in the automatic control system. The theoretical analysis of such systems is rather complicated and requires a significant change in engineering approaches to analysis. In connection with the improvement of digital controllers and a significant increase in their performance, in recent years this problem has practically not been remembered. However, its mathematical "content" has not changed since the 80s of the 20th century, when discreteness began to play a major role among the problems hindering progress in automatic control systems, in terms of the transition to digital systems.In this paper, a new approach is proposed, which consists in interpreting the sampling operation by a link with the proposed frequency characteristic, which determines the suppression of input high-frequency signals. This link greatly simplifies engineering calculations and demonstrates the new capabilities of sampling systems. These possibilities include the rational distribution of digitalization resources - the number of bits and the sampling interval between the regulator channels, depending on the frequency range of the efficiency of these channels. Theoretical statements have been verified and confirmed by simulation. It is shown how this approach makes it possible to formulate new principles of construction of seemingly well-known controllers - PID controllers and variable structure systems (VSS).
al-Aṣwāt al-Mutaghayyirah fī Asmā’ al-Manāṭiq al-Indūnīsīyah ‘inda Naqlihā ilá al-‘Arabīyah: Dirāsah Fūnūlūjīyah
Authors: Jamil Muhammad
Published: November 2020

This study aims to determine the change in the consonant phoneme that is found only in the Indonesian language which occurs in the Indonesian region when it is transliterated into the Arabic language. The research method uses a qualitative method of descriptive with review literature techniques. The data obtained from various regional names in Indonesia contained in the Arabic version of Google Maps and then grouped by certain criteria. Five consonant phonemes are only available in the Indonesian language and are not found in Arabic, such as: /c/,/g/,/p/,/η/, and /ñ/, so variations appear in the Indonesian transliteration symbols to the Arabic. The results showed that phoneme /c/ could be represented by the phoneme <س> <ك>, or grapheme <تش>, Phoneme /g/can be represented by the phoneme <غ> or <ج>, phoneme /p/ can be represented by the phoneme <ب> or <ف>, phonemes/η/or grapheme  can be represented by the grapheme <نج>, <نغ>, <نق>, or <نك>, for the phonemes /ñ/ or grapheme  can be represented by the grapheme <ني>. The phoneme changes are based on the proximity of articulation points. This research is a preliminary study to map the transcription symbol of Indonesian phonemes into Arabic.
Character education in English subject: Teachers' perceptions and strategies
Authors: Aghni Luluk Aulia , Vianty Machdalena , Petrus Ismail
Published: November 2020

Character education is a purposeful, proactive attempt to develop good character in students or, more simply, to teach students about the right and the wrong. In relation to character education, the purposes of this study were to find out teachers’ perceptions on character education and their strategies to implement it in the classroom. In addition, this study also investigated the teachers’ problems in implementing character education and their proposed solution. The participants of this study were two teachers of English at one of public senior high school in Palembang and the students from two classes which taught by the two teachers. The data of this study were collected through questionnaire, interviews, classroom observation and document review. The result of this study showed that the teachers agreed that character education was important to be applied during teaching and learning program through the strategies such as group discussion or individual assignment. Students’ personal characters and behaviors stated by the teachers as the problem in teaching the character education and having a communication with students and observing them during teaching and learning process were mention as the ways to solve the problem.
EFL learners’ phonemic awareness: A correlation between English phoneme identification skill toward word processing
Authors: Rokhman Miftakh Farid , Lintangsari Alies Poetri , Perdhani Widya Caterine
Published: November 2020

This research aims to find out the correlation between English phoneme identification skills and word processing. It applies the quantitative approach with correlation design. The participants are 100 of 3rd- semester students in English Language Education Program. The correlational result reveals that it has correlation with .382 degrees in phoneme identification skill toward blending skill with the significance level .000, and .359 degrees in phoneme identification skill toward segmentation skill with the significance level .000. Then, the correlation result of English phoneme identification skill toward word processing is .462 degree with its significance .000. By the result, awareness to identify phoneme by initial, medial, and final sound correlates to the blending and segmenting skills which influence the comprehension of word. The more the students are able to identify phoneme based on its sound, the more the students will be able to blend and segment phoneme. Lastly, the ability to identify English phonemes is proven to be a skill that supports EFL learners on their productive and receptive skills. Then being able to identify its phonemes will assist on recognizing and processing English words appropriately so that English language teaching can be associated with the use of phoneme-based instruction on its teaching process.

Highlights :

Ability to identify English phonemes is proven to be a skill that supports EFL learners on their English productive and receptive skills.

English phoneme identification skill contributes to blending and segmentation skill since phonemic awareness provides both decoding and encoding skill.
Designing pedagogical narrative stories: Delving deeper into problem-solving skills of pre-service English teachers
Authors: Ginting Aprilia Arnis , Kuswandono Paulus
Published: November 2020

Educating Pre-Service English Teachers (PSETs) to be ready to face challenges is a response to the fast changing globalized world. Hence, preparing future teachers to apply problem-solving skills in dealing with teachers’ challenges in the classroom is necessary. This study was intended to design a set of pedagogical narrative stories which enquire problem-solving skills of PSETs. The pedagogical narrative stories were designed as a supplementary material in micro teaching class to help PSETs understand the complex issues of teaching and learning process. This study was based on ADDIE model. The designed material product consists of six units of teachers’ real life in adapted stories. Each unit contains critical discussion and reflective activities namely: Story, Individual Reflection, Group Sharing, Class Discussion and Resolution. The final product was validated by subject matter expert who has credibility in writing English learning books. The validated outcome showed that the supplementary materials are appropriate for PSETs in micro teaching class. The finding is projected to construct positive awareness on the importance of problem-solving skills to enhance PSETs’ competence in dealing with classroom problems by answering questions more critically and reflectively. 

HIGHLIGHTS:

· Problem solving skills can support PSETs in dealing with unpredicted occurrences beyond mastering knowledge and teaching materials in class.

· Factual problems and guided reflections can provide PSETs with story engagement that is close to the real life of becoming teachers.

· Through reflective practices, PSETs have opportunities to evaluate and make meaning of their previous educational experiences to become decision makers.
Brain-based learning and high order thinking skills effect on students’ writing ability
Authors: Zuhriyah Mukminatus , Agustina Ria Kamilah
Published: November 2020

In this study, the researchers implemented brain-based learning (BBL) model and the use of the students’ high order thinking skills (HOTS) in the teaching and learning of writing. The aim of this study was to know whether or not there was an interaction effect between teaching models and students’ HOTS on the students’ writing ability. This experimental research used a 2x2 factorial design. Two classes of the fourth semester of English Language Department became the population and the sample in this study. The students in both of the classes were divided into the students with high and low HOTS. Then, the experimental class was taught writing by using BBL and the control class used guided writing. Next, the data got from the writing test were calculated by using a two-way ANOVA. The result showed that Fo interaction (10.160) was higher than Ft (4.15) at the level of significance α=0.05. It means that there was an interaction effect between teaching models and students’ HOTS on the students’ writing ability. The mean score of the students with high HOTS taught by using BBL (82.44) was the highest. This brings to the conclusion that BBL and HOTS had significant interaction effect on the students’ writing ability.

The skills of analyzing, evaluating and creating the students whose HOTS was high worked well when having discussion.
The students’ relaxed feelings in BBL class could help them to get information about what to be written in their texts more and more by having discussion.
Masculine and metrosexual: Indonesian actor’s clothing style on Instagram from the Foucauldian perspective
Authors: Putranto Teguh Dwi , Sugihartati Rahma , Isnaini Santi , Widodo Suko
Published: November 2020

This study seeks to explore the fashion styles of Indonesian actors on Instagram from Foucault’s perspective. Appearance is a demand that is not only aimed at women but also for men. Appearance is an important part, especially for men, so that also increases the metrosexual side. The enhancement of men’s appearance in clothing has increased metrosexuality. The metrosexual side has been viewed by society as indicating the waning masculine side of a man. Thus, some people believe that metrosexual men lose their identity entirely because excessive attention to appearance is associated with women identity. The method used in this study was the Krippendorff content analysis carried out on Joe Taslim’s Instagram account Instagram posts from October 2019 to February 2020. Joe Taslim, known as an Indonesian action actor, is a figure with a masculine appearance chosen in this study to represent a masculine men figure but still looks metrosexual. The results of this study indicate that Joe Taslim’s Instagram is used as a medium in creating fantasies about the men body metrosexual, which is run by the capitalist industry to create a masculine impression.
Reconstrução ilustrativa das feições pretéritas do estuário do rio tubarão através da vetorização de imagens Landsat 1
Authors: Domingos Marcelo
Published: November 2020

Imagens de satélite e software como QGIS veem sendo utilizados para análises de mudanças na paisagem em várias áreas do conhecimento. Neste contexto o presente trabalho buscou utilizar-se desta ferramenta para produzir uma reconstrução ilustrativa do estuário do rio tubarão no ano de 1975, através da vetorização de imagens Landsat1. Pode ser observado na reconstrução, feições que apontam para uma formação de delta interno, assim como mudanças no curso do rio tubarão. Ao final consegue-se concluir a eficácia da ferramenta assim como reconstrução das feições pretéritas estuarina da área estudada.
Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study. 
Authors: Yu Tong , Wu Jiu-Ping , Zhang Jun , Yu Hai-Chi , Liu Qinyi
Published: November 2020

Background. Posterior percutaneous endoscopic cervical discectomy (p-PECD) is an effective strategy for cervical diseases which working cannula ranges from 3.7 mm to 6.9 mm. However, no studies were performed to compare the clinical outcomes of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of unilateral CDH patients treated with p-PECD applying the 3.7mm endoscopic with those treated with the 6.9mm endoscopic. Methods. From January 2016 to June 2018, totally 28 consecutive patients presented with single-level CDH who received p-PECD using the 3.7mm or the 6.9mm endoscopic were enrolled. The indications for this study were as follows: (1) Unilateral cervical spondylotic radiculopathy with pain irradiated to upper extremity, (2) MRI and CT scan show that foraminal CDH located lateral to the edge of spinal cord, from C4–C5 to C7–T1, (3) Unilateral symptoms caused by foraminal stenosis, (4) Failure after conservative treatment for at least 6 weeks or neurological symptoms aggravated. The clinical outcomes, including the operation time, the hospitalization, the visual analogue scale (VAS) and the modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were performed during follow up.Results. The mean surgical duration of the 3.7mm endoscopic was 76.5 minutes compared with 61.5 minutes for 6.9mm endoscopic (P<0.05). Moreover, there was significant difference with regard to average identification time of “V” point (18.608±3.7607min vs. 11.256±2.7161min, p＜0.001) and mean removal time of overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p＜0.05) between 3.7mm endoscopic and 6.9mm endoscopic. The VAS and MacNab scores postoperatively of the two endoscopies were significantly improved compared with that before operation (p＜0.05).Conclusion. Both 3.7mm endoscopic and 6.9mm endoscopic are effective methods for CDH in selected patients, and there is no significant difference in clinical outcomes. 6.9mm endoscopic is superior to 3.7mm endoscopic in the efficiency of “V” point identification, overlying soft tissue removal and spinal cord injury prevention. Furthermore, 6.9mm endoscopy may be inferior to 3.7mm endoscopy in anterior decompression of foramina due to its large diameter, which needs to be further evaluated by a large number of randomized controlled trials.
The Bipolar Coagulation Forceps Prevented Salivary Fistula in Patients with Parotidectomy
Authors: Wu Kun , Zhu Keke , Ye Yingxi , Li Sainan , Wu Hanjiang , Zhang Sheng
Published: November 2020

Background: Salivary fistula is a relatively common complication in patients with parotidectomy. The purpose of this study was to investigate the effect of bipolar coagulation forceps in salivary fistulas.Method and Material: From March 2015 to June 2020, 177 patients for management of parotidectomy were recruit from the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital, Central South University. The patients were divided into experimental group and control group according to application of bipolar coagulation forceps or suture, respectively.Results: The draining output of experimental group was dramatically decreased compared to control group (p = 0.04). The duration of pressure dressing application in experimental group was significantly increased compared to control group (p = 0.0003). Moreover, the incidence of salivary fistula in experimental group (9.8%, 8/82) was notably lower than that in control group (34.7%, 33/95) (p < 0.0001). In logistic regression model for salivary fistula development, both of bipolar coagulation forceps (p = 0.0026) and draining output (p = 0.0186) associated with salivary fistula.Conclusion: Our findings indicated that bipolar coagulation forceps decreased the incidence of salivary fistula in parotidectomy patients. The bipolar coagulation forceps is a safe, effective, and convenient method to prevent salivary fistulas in parotidectomy patients.
A Mixed Method Study to Explore the Feasibility and Patient Satisfaction of Two Different Exercise Programs in Systemic Sclerosis Associated Microstomia
Authors: Sydow Ellinor , Severi Sabien , Elst Kristien Van der , Verschueren Patrick , Westhovens René , Lenaerts Jan , Langhe Ellen De
Published: November 2020

BackgroundSystemic sclerosis (SSc) is a severe autoimmune disease often leading to fibrotic cutaneous involvement of the face. Reduced oral aperture is associated with impaired food intake, oral hygiene and secondary dental problems. Stretching and oral augmentation exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore feasibility, patient satisfaction and effectiveness of two exercise programs in SSc-associated microstomia.MethodsAdult patients (<18 years) suffering from systemic sclerosis (fulfilling the ACR/EULAR 2013 criteria) and microstomia (maximal oral aperture <40mm) were randomized to two groups. Group A exercised with a passive jaw motion device (Therabiteâ), and Group B performed mouth-stretching exercises. Patients were expected to exercise for 10 minutes, 3 times/day for 3 months, completed an exercise diary and were contacted 4 times by telephone. Patients were evaluated at baseline, 3 months (period without intervention), 6 months (after 3 months of intervention) and at 9 months (post-intervention visit). At month 6 semi-structured one‐to‐one interviews were conducted, recorded, transcribed verbatim and analyzed using Qualitative Analysis Guide of Leuven (QUAGOL).ResultsWe included 6 women and 3 men, median age 60 years (range 40-75) and median disease duration 8 years (range 3-22). At 6 months, all patients in group A (n=4) and 4 in group B (n=5) improved with a median of 9mm (range 2-10) and 7mm (range 4-11), respectively. The proportion of executed to the planned number of exercises ranged between 63.7% and 98,9% in group A and between 48.5% and 97,4% in group B. Maintenance of the increase in oral aperture was noted in patients that continued to exercise daily. All 9 patients attended the interview that revealed three themes: drivers, challenges and perceived improvement. ConclusionBoth interventions improve maximal oral aperture. The adherence to therapy was high but none of the patients considered it feasible to continue practicing 3 times/day. Future studies are needed in order to define feasible long-term exercise programs.
Nexus Between Tuberculosis and Diabetic Mellitus, A Prospective Cohort Study.
Authors: Feleke Berhanu Elfu , Feleke Teferi Elfu , Kassahun Melkamu Beyene , Adane Wondemu Gebrekirose , Genetu Abere , Gebeyehu Melesse , Woldie Kibrete , Tekleab Yohannes , Shumete Abebe , Hunegnaw Samuel , Taye Tesfaye , Biadegelegn Fantahune
Published: November 2020

Background: This work aimed to describe the clinical presentation of TB in patient with DM, to determine the effects of DM on TB treatment outcomes, to identify the effects of TB on glycemic control, and to describe the lipid profile of TB and DM patients. Methods: This prospective cohort study design was conducted. The data were collected from September 2018 to June 2020 using patient interviews, examining the patients, chart review, and collecting blood samples. Binary logistic regression was used to identify the determinants of TB treatment outcomes in the context of DM. Kaplan Meier survival curve was used to see the effects of DM on TB clinical response. Linear regression was used to identify the determinants of the HbA1c level during TB infection. Results: A total of 1092 study participants were included giving for the response rate at 93.81 %. Good TB treatment outcome was observed in 72.5 % of the patients [95 % CI: 69 % - 76 %]. The odds of good TB treatment outcomes were at 75 % lower in the presence of DM (AOR 0.25 [95 % CI: 0.08 – 0.73]). The median time of clinical response in TB and DM patients was 45 days interquartile range (IQR) of 8 days; the median time of clinical response in DM free TB patients was 9 days [IQR 2 days]. TB increased the HbA1c level of DM patients by 1.22 % (B 1.22 [95% CI: 1.11 – 1.34]). In six months period, 60 % of TB and DM patients had got 3 episodes of acute complications. Conclusion: DM significantly decreases the favorable treatment outcome of DOTS. TB predisposed DM patients for bad glycemic control and increased episodes of acute DM complications.
Optimal Application of Stereotactic Body Radiotherapy and Radiofrequency Ablation Treatment for Different Multifocal Hepatocellular Carcinoma Lesions in Patients With Barcelona Clinic Liver Cancer Stage A4–B1: A Pilot Study
Authors: Wang Feiqian , Numata Kazushi , Takeda Atsuya , Ogushi Katsuaki , Fukuda Hiroyuki , Nihonmatsu Hiromi , Hara Koji , Chuma Makoto , Tsurugai Yuichirou , Maeda Shin
Published: November 2020

BackgroundsIn clinical practice, many hepatocellular carcinoma (HCC) patients in Barcelona Clinical Liver Cancer (BCLC) stage A4–B1 can not receive curative treatment of liver transplantation, resection and RFA which were recommended options by liver cancer guidelines. Our aim is to study the feasibility of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) as curative treatment for different multifocal HCCs in BLCL stage A4–B1 patients. MethodsFrom September 2014 to August 2019, 39 multifocal HCC lesions (median diameter, 16.6 mm) from 15 patients (median age, 73.2 years) were retrospectively enrolled. Among them, 23 were treated by RFA and the other 16 by SBRT because of predictable insufficiency and/or risk for RFA performance. The indicators for evaluating this novel therapy were tumor response, prognosis (recurrence and survivals), and adverse effect (deteriorated laboratory test values and severe complications). ResultsMedian follow-up duration was 31.3 months (range: 15.1–71.9 months). The numbers of one-year complete response, stable disease, and disease progression were 11, 1, and 3, respectively. In total, eight and two patients had confronted intrahepatic and local recurrence, respectively. The one-year progression-free survival rate and local control rate were 80% (12/15 patients) and 97.4% (38/39 lesions), respectively. Median time to progression was 20.1 (2.8–45.1) months. The one- and two-year survival rates were 100%, and 88.9%, respectively. During one week to 3–5 months’ observation, no patient showed severe complications. Seven, four, and two patients had slight changes in white blood cells, platelet count, and albumin–bilirubin grade, respectively. ConclusionsFor patients with BCLC stage A4–B1, RFA and SBRT treatment for different multifocal HCCs may be a potential option because of their favorable prognosis and safety. However, before setting assured application in clinical practice, prospective, controlled, large-scale studies are needed to further confirm our conclusions.
Symptom Relief is the Most Significant Prognostic Factor for Unresectable Locally Advanced/Recurrent Pancreatic Cancer Receiving Chemoradiotherapy: Analysis of 65 Cases
Authors: Jiang Ting , Shen Jingxian , Liu Shuang , Liu Qing , Xiao Weiwei , Zhang Yujing
Published: November 2020

BackgroundPancreatic cancer is the fourth leading cause of cancer-related death throughout the world. For local advanced and recurrent pancreatic cancer (LAPC/LRPC), chemoradiotherapy (CRT) is a main choice which may prolong their survival and ease patients’ symptoms.MethodsWe constructed a database of 65 patients with LAPC/LRPC treated from June, 2004 to February, 2018. We used log-rank test to evaluate the different overall survival (OS) rates of all factors involved, and used cox regression model to find out independent prognostic factors for these patients.ResultsThe median OS time for 65 eligible patients was 23.6 months. 47 (72.3%) and 18 (27.7%) patients had unresectable LAPC and LRPC, and median OS time was 17.2 and 40.7 months (P= 0.02), respectively. The mean biological effective dose (BED) to gross tumor volume (GTV) was 64.8Gy (46.7-85.5 Gy). 11(16.9%) and 54(83.1%) patients had BED> 72 Gy and BED≤ 72 Gy, and their mOS was 31.8 and 21.9 months (P= 0.08), respectively. Simultaneous dose boost to interval GTV (GTVin) was applied to 23 patients (35.4%). Patients with large GTV volume (≥ 109.2 cm3) may benefit from radiation dose boost (mOS: 27.6 vs. 5.3 months, P= 0.004). Patients with symptom relief including relief of pain, jaundice, and/or diarrhea had higher OS rates than those without response (mOS: 25.7 vs. 13.2 months, P< 0.01) and multivariate cox regression analysis suggested symptom relief was the most significant prognostic factor for OS (HR= 0.44, 95%CI 0.35-2.36, P= 0.02).ConclusionCRT with simultaneous integrated boost of radiation dose may bring survival benefit for LAPC/LRPC patients with bulk tumor. Symptom relief is the most significant prognostic factor for LAPC/LRPC patients after comprehensive CRT.
Outcome of Early Stage Merkel Carcinoma Treated by Exclusive Radiation: A Study of 53 Patients.
Authors: DUBOIS Manon , Rached Henry Abi , Escande Alexandre , Dezoteux Frédéric , Darloy Franck , Jouin Anaïs , Kyheng Maeva , Labreuche Julien , Dziwniel Veronique , Mirabel Xavier , Mortier Laurent
Published: November 2020

PurposeEarly stage Merkel cell carcinoma (MCC) is a rare and aggressive primary skin cancer. The standard of care for MCC is broad excision and adjuvant external beam radiation therapy (EBRT). However, for some patients, anesthesia is contraindicated, while others run the risk of serious aesthetic sequelae. In such cases, exclusive radiotherapy is an interesting alternative to surgery. Though limited data is available, this study evaluates exclusive radiotherapy for MCC, using data from the largest retrospective study to date. MethodsAll patients who were followed in our center between 1989 and 2019 for histologically proven early stage MCC were included in the study. They were treated either by surgery with a 2-cm clear margin followed by adjuvant radiotherapy (RT) or by exclusive RT. Survival rates with adjuvant and exclusive EBRT were analyzed using Cox model and Fine & Gray model depending on the type of survival. P-value < 0.05 was considered significant ResultsEighty-four patients treated for MCC were included. Fifty-three of them (63.1%) were treated by exclusive RT, and 31 (36.9%) had surgical excision followed by adjuvant RT. Local relapse rate was 13.7% (95%CI 8.0-43.7) in the RT monotherapy group (group A) and 25.8% (95%CI 10.3-56.2) in the surgery + RT group (group B) (p = 0.42). No statistical difference was found for nodal relapse (p = 0.81), metastatic relapse (p = 0.10), disease free survival (p = 0.83) or overall survival (p = 0.98). ConclusionOur study suggests that exclusive radiotherapy for early Merkel cell carcinoma leads to a similar oncological outcome as combined treatment, with fewer aesthetic sequelae. The approach is interesting for elderly patients with comorbidities or patients for whom surgery would cause significant functional or aesthetic sequelae.
Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China
Authors: Zhang Xi , Rao Huaxiang , Wu Yuwan , Huang Yubei , Dai Hongji
Published: November 2020

Background: Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.Methods: The number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).Results: Compared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR=135.08, 95% CI: 128.36-142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR=423.51, 95% CI: 240.96-722.32) for SARS. Fewer secondary clusters were identified after the "Wuhan lockdown". The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.Conclusions: COVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.
Extensively drug-resistant Alcaligenes faecalis infection
Authors: Huang Chienhsiu
Published: November 2020

Background:Alcaligenes faecalis is usually causes opportunistic infections in humans. Alcaligenes faecalis infection is often difficult to treat due to its increased resistance to several antibiotics. The results from a clinical study of patients with Alcaligenes faecalis infection may help improve patients’ clinical care. Methods:We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 to December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past three months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.Results:Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, nine cases of diabetic foot infection, eight cases of pneumonia, seven cases of acute pyelonephritis, three cases of bacteremia, and nine cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within three months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The best sensitivity rate to A. faecalis was 66.7% for three antibiotics (imipenem, meropenem, and ceftazidime) in 2019. Two antibiotics (ciprofloxacin and piperacillin/tazobactam) sensitivity rates to A. faecalis were less than 50%.Conclusions:The most frequent Alcaligenes faecalis infection sites, in order, are the bloodstream, urinary tract, skin and soft tissue, and middle ear. The susceptibility rate of Alcaligenes faecalis to commonly used antibiotics is decreasing. Extensively drug-resistant Alcaligenes faecalis infections have emerged.
Identifying research priorities for Health Professions Education Research in Sub-Saharan Africa using a modified Delphi method
Authors: Schalkwyk Susan C van , Kiguli-Malwadde Elsie , Budak Jehan Z , Reid Michael JA , De Villiers Marietjie Rene
Published: November 2020

Background: Recent increases in health professions education (HPE) research in sub-Saharan Africa (SSA), though substantial, have predominantly originated from single institutions and remained uncoordinated. A shared research agenda can guide the implementation of HPE practices to ultimately influence the recruitment and retention of the health workforce. Thus, the authors aimed to generate and prioritise a list of research topics for HPE research (HPER) in SSA. Methods: A modified Delphi process was designed to prioritise a shared agenda. Members of the African Forum for Research and Education in Health (AFREhealth) technical working group (TWG) were asked to first list potential research topics. Then, members of the same TWG and attendees at the annual AFREhealth academic symposium held in Lagos, Nigeria in August 2019 rated the importance of including each topic on a 3-point Likert scale, through two rounds of consensus seeking. Consensus for inclusion was predefined as ³ 70% of respondents rating the topic as “must be included.”Results: Health professions educators representing a variety of professions and 13 countries responded to the survey rounds. Twenty-three TWG members suggested 26 initial HPER topics; subsequently 90 respondents completed round one, and 51 completed round 2 of the modified Delphi. The final list of 12 research topics which met predetermined consensus criteria were grouped into three categories: (1) creating an enabling environment with sufficient resources and relevant training; (2) enhancing student learning; and (3) identifying and evaluating strategies to improve pedagogical practice.Conclusions: Establishing research priorities for HPE is important to ensure efficient and appropriate allocation of resources. This study serves as a reminder of how the prevailing context within which HPE, and by implication research in the field, is undertaken will inevitably influence choices about research foci. It further points to a potential advocacy role for research that generates regionally relevant evidence.
Health and support service needs of individuals with disability from culturally and linguistically diverse backgrounds: a scoping review protocol
Authors: Pho Jacqueline Nhu Quynh , Tan Aidan Christopher , Chaudhary Katrina , Hines Sonia , Ellison Caroline , Isaac Vivian , Lim David
Published: November 2020

Background: All individuals should have the right to engage meaningfully in occupations that meet their aspirations and life goals as well as promote their health and wellbeing. For individuals with disability, meaningful engagement in occupations is supported by timely, effective and adaptive health and support services. However, research has revealed multiple barriers preventing utilization of these services by individuals with disability from culturally and linguistically diverse (CALD) backgrounds. This review aims to identify gaps and solutions in health and support services of individuals with disability from CALD backgrounds to meaningfully engage in occupations.Methods: A scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A detailed search strategy will be used to search CINAHL, PubMed, Embase, Scopus, PsycInfo, JBI and Cochrane Library, as well as grey literature in Trove, Mednar and OpenGrey from January 1974 onwards. Two reviewers will independently screen all citations and full-text articles for eligibility against specific inclusion and exclusion criteria. Potential conflicts will be resolved through discussion. Data will be extracted and presented in a diagrammatic or tabular form accompanied by a narrative summary. Discussion: The scoping review will present the health and support service needs of individuals with disability from CALD backgrounds and will extend the current reviews as it focuses the engagement in meaningful occupation. Findings from this review have the potential to inform local policy discussions and practice-based disability care.Systematic review registration: Open Science Framework (osf.io/hw2fb).
Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study
Authors: Nakamura Eishin , Matsunaga Shigetaka , Ono Yoshihisa , Takai Yasushi , Seki Hiroyuki
Published: November 2020

Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD.Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.