bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuroinflammatory Remodeling of the Anterior Cingulate Cortex as a Key Driver of Mood Disorders in Gastrointestinal Disease and Disorders
Authors: Matisz Chelsea , Gruber Aaron
Published: September 2020

The brain reciprocally communicates with the rest of the body via neural, endocrine, immune, and other systems. This is crucial for coordinating the complex behavioral and physiological responses needed to cope with the many challenges of life. The Anterior Cingulate Cortex (ACC) is a key brain structure involved in assessing rewards and threats, as well as activating appropriate responses. This is a dynamic process that depends on evolving needs and challenges. Important challenges include illness or injury. These typically involve inflammation and pain, which evoke neuroinflammatory processes in the brain to drive sickness behaviours. In the short term, sickness behaviours are considered adaptive, as they promote convalescence (e.g. low mood; lethargy, fatigue, social withdrawal), and enhanced threat appraisal (e.g. anxiety) to combat increased risk/vulnerability associated with sickness. Chronic inflammation, however, appears to remodel the system to inappropriately activate threat-coping responses, resulting in depressive and/or anxious phenotypes. These mood disorders are particularly pronounced in diseases and disorders associated with gut dysfunction, which feature chronic inflammation and altered ACC function. We propose that chronic inflammation remodels ACC physiology such that it errantly predicts heightened danger based on a mental model (a.k.a ‘schema’) of the world. This evokes chronic activation of threat-coping systems, including endocrine signaling (e.g. adrenaline), and anxiety. Inflammation can be driven by brain systems involving ACC, leading to a feedback-cycle that self-reinforces pathological states. This theory accounts for a wealth of clinical and preclinical data that implicate the ACC in disorders of mood and gastrointestinal function, and reveals a key player in the gut-brain axis that may represent a novel therapeutic target.
The GRE in Public Health Admissions: Barriers, Waivers, and Moving Forward
Authors: Millar Jess
Published: September 2020

In the wake of COVID-19, there is an urgent need for a diverse public health work force to address problems presented or exacerbated by the global pandemic. Educational programs that create our work force both train and shape the makeup of access through graduate applications. The Graduate Record Exam has a number of standing issues, with additional barriers created by the pandemic. We trace the GRE waiver movement over several years, focusing on the gradual adoption in CEPH accredited programs and the rapid expansion of temporary waivers as a response to testing access. Going forward, we need to consider gaps in waivers during the pandemic and how this data can be used to shape our future use of the GRE.
Towards A New Model and Classification of Mood Disorders based on Risk Resilience, Neuro-Affective Toxicity, Staging, and Phenome Features Using the Nomothetic Network Psychiatry Approach
Authors: Maes Michael , Brum Juliana , Bonifacio Kamila , Barbosa Decio , Vargas Heber , Michelin Ana Paula , Nunes Sandra
Published: September 2020

Current diagnoses of mood disorders are not cross validated. The aim of the current paper is to explain how machine learning techniques can be used to a) construct a model which ensembles risk/resilience (R/R), adverse outcome pathways (AOPs), staging, and the phenome of mood disorders, and b) disclose new classes based on these feature sets. This study was conducted using data of 67 healthy controls and 105 mood disordered patients. The R/R ratio, assessed as a combination of the paraoxonase 1 (PON1) gene, PON1 enzymatic activity, and early life time trauma (ELT), predicted the high-density lipoprotein cholesterol – paraoxonase 1 complex (HDL-PON1), reactive oxygen and nitrogen species (RONS), nitro-oxidative stress toxicity (NOSTOX), staging (number of depression and hypomanic episodes and suicidal attempts), and phenome (the Hamilton Depression and Anxiety scores and the Clinical Global Impression; current suicidal ideation; quality of life and disability measurements) scores. Partial Least Squares pathway analysis showed that 44.2% of the variance in the phenome was explained by ELT, RONS/NOSTOX, and staging scores. Cluster analysis conducted on all those feature sets discovered two distinct patient clusters, namely 69.5% of the patients were allocated to a class with high R/R, RONS/NOSTOX, staging, and phenome scores, and 30.5% to a class with increased staging and phenome scores. This classification cut across the bipolar (BP1/BP2) and major depression disorder classification and was more distinctive than the latter classifications. We constructed a nomothetic network model which reunited all features of mood disorders into a mechanistically transdiagnostic model.
NILAI KARAKTER DALAM UNGKAPAN HIKMAH BERSUMBERKAN WACANA BERITA
Authors: Wardani Lupita Sari Pitra , Al-Ma’ruf Ali Imron , Prayitno Harun Joko
Published: September 2020

The purpose of this study is to describe the value of character education in wisdom expressions sourced from news discourse. This research utilizes descriptive qualitative approach. The data of research are in the form of phrase, words, and sentense in news discourse that contain wisdom expressions. The data source is news discourse that contain character value in expressions of wisdom. Data collection techniques utilized are observation and note taking. The object of this study is the expressions of wisdom sourced from news discourse. The data analysis method utilizes the referential identity method and the constituent analysis method. Data analysis uses content analysis method. The result of this study indicate that are various value of character education in expressions of wisdom in news discourse, namely the value of religiosity, professionalism, national defense, creativity, peace loving, fighting spirit, love of environment, love of the motherland, harmony, and honesty. The conclusion of this research is that news discourse contain multidisciplinary wisdom expressions, which can be used in character education for the nation's successors.

Keywords: Character Value, Wisdom, Discourse.

 

Abstrak

Penelitian ini bertujuan untuk memaparkan nilai pendidikan karakter pada ungkapan hikmah bersumberkan wacana berita. Penilitian ini adalah penelitian deskriptif kualitatif. Data berupa kata, frasa, serta kalimat yang ada pada wacana berita yang mengandung nilai karakter dalam ungkapan hikmah. Sumber data adalah wacana berita yang mengandung nilai karakter dalam ungkapan hikmah. Simak dan catat merupakan teknik analisis data yang digunakan dalam penelitian ini. Objek dalam penelitian ini adalah ungkapan hikmah yang bersumber dari wacana berita. Metode analisis data menggunakan padan referensial dan metode agih. Analisi data dengan menggunakan analisis isi. Hasil penelitian ini menunjukkan terdapat berbagai nilai pendidikan karakter dalam ungkapan hikmah dalam wacana berita yakni nilai religiusitas, profesionalisme, bela negara, kreativitas, cinta damai, semangat juang, cinta lingkungan, cinta tanah air, kerukunan, kejujuran. Simpulan dari penelitian ini adalah wacana berita banyak mengandung ungkapan hikamah multidisipliner yang dapat dijadikan sebagai pendidikan karakter bagi insan penerus bangsa.

Kata kunci: Nilai Karakter, Hikmah, Wacana.
Investigation of the Effect of Missing Data Handling Methods on Measurement Invariance of Multi-Dimensional Structures
Authors: IŞIKOĞLU Mehmet Ali , ATAR Burcu
Published: September 2020

The purpose of this study was to compare the missing data handling methods on measurement invariance of multi-dimensional structures. For this purpose, data of 10857 students who participated in PISA 2015 administration from Turkey and Singapore and fully responded to the items related to affective characteristics of science literacy was used. Data with different percentages of missing data (5%, 10%, and 20% missing data) were generated from the complete data set with missing completely at random (MCAR) mechanism. In all data sets, missing data was completed with listwise deletion (LD), serial mean imputation (SMI), regression imputation (RI), expectation maximization (EM), and multiple imputation (MI) methods. Measurement invariance of the construct being measured between countries on completed data sets was investigated with multiple-group confirmatory factor analysis (MG-CFA). Findings from each dataset were compared with reference values. In the results of the study, RI and MI methods in the data set with 5% missing, EM method in the data set with 10% missing, and MI method in the data set with 20% missing gave the more similar results to the reference values than the other methods.
Caracterización morfológica de cabras indígenas en el área de Laghouat en Argelia.
Authors: Laouadi M. , Tennah S. , Moula N. , Antoine-Moussiaux N. , Kafidi N.
Published: September 2020

El objetivo de este estudio es caracterizar fenotípicamente dos razas de cabras indígenas en el área de Laghouat (Argelia), y evaluar el efecto de la edad y el sexo sobre las características biométricas morfológicas. Se analizarón un total de 312 animales: 58 hembras de raza Mekatia y 254 de raza Arabia (44 machos y 210 hembras). Los resultados muestran que la raza Mekatia se caracteriza por el pelo corto (96.55%) mientras que Arabia muestra un pelo largo (100% para los machos, 92.38% para las hembras). La mayor parte de los animales de ambas razas eran multicolores (≥3 colores). Las orejas semi-pendulares fueron las más representadas en Mekatia (48.28%) mientras que en Arabia, las orejas pendulares fueron las dominantes (79.55% y 75.72% en machos y en hembras, respectivamente). Sobre los rasgos cuantitativos, ambas razas se clasifican como grandes. El efecto de la edad se muestra para más de la mitad de las mediciones con un aumento general del tamaño del animal con la edad (p
Doses subletais de glifosato em combinação com manganês foliar na produção de capim marandu
Authors: Da Cunha Codognoto L. , Telles Conde T. , Amorim Faria G. , Maltoni K.L.
Published: September 2020

A deriva do herbicida glifosato pode estimular crescimento e/ou rendimento produtivo em plantas não-alvo, caracterizando efeito hormese. Ainda, manifesta-se amarelecimento momentâneo em folhas novas, característico de deficiência nutricional. Deste modo, o trabalho teve por objetivo avaliar o efeito hormese por aplicação de glifosato em Urochloa brizantha cv. Marandu. Foi avaliada a resposta produtiva aérea (PMS) e radicular (MSR) da forrageira por aplicação foliar de sete doses subletais do equivalente ácido (e.a.) de glifosato (5,40, 10,80, 21,60, 43,20, 64,80, 86,40 e 108,00, g e.a. ha-1) e controle, sob ausência e presença de manganês (1000 g ha-1) à calda de pulverização, em quatro colheitas sequenciais, caracterizando esquema fatorial 8 x 2 x 4, com quatro repetições. As doses subletais de glifosato com adição de manganês à calda de pulverização reduziram o efeito herbicida, com persistência de PMS durante período experimental (4 cortes). Para doses sem adição de manganês à calda de pulverização, houve falência produtiva nos cortes 2, 3 e 4, para doses 86,40 e 108,00 g e.a. ha-1. A presença de manganês à calda de pulverização assegurou massa seca de raiz superior àquelas sem adição de manganês, sendo constatado efeito do herbicida nas doses igual e superiores a 43,60 g e.a. ha-1.
Cinética de degradación ruminal in situ de ensilado de rastrojo de maíz (Zea mays) con niveles crecientes de urea
Authors: Sánchez A. , Perea J. , Montenegro L. , Espinoza I. , Avellaneda J. , Barba C.
Published: September 2020

Se estudió el efecto de la inclusión de urea sobre la composición y cinética de degradación ruminal in situ en el ensilado de rastrojo de maíz. Se partió de cuatro de tratamientos al adicionar el 0, 1, 2 y 3% de urea a una mezcla de rastrojo de maíz con el 10% de melaza. Se elaboraron 128 microsilos (3 kg/unidad y 4 repeticiones por tratamiento). La apertura de los silos se realizó a los 7, 14, 21, 28, 35, 42, 49 y 56 días. Se determinó el contenido de la materia seca (MS), materia orgánica (MO), proteína bruta (PB), FND y FAD. La degradabilidad in situ se obtuvo mediante el método de Mehrez y Orskov y la degradabilidad de MS y PB mediante el análisis de los residuos con el método Kjeldhal. Los datos se analizaron con el procedimiento GLM y el test de Tukey (P±
Resistencia y resiliencia a las enfermedades en las razas de rumiantes locales: un enfoque en América del Sur
Authors: Soares Fioravanti M.C. , Silva Freitas T.M. , Moura M.I. , Lage Costa G. , Moraes Dias J. , Kim Pires Guimarães L. , Gómez M.M. , Landi V.
Published: September 2020

La pérdida de variabilidad genética de interés ha tomado importancia no sólo la producción, sino también porque puede tener un efecto negativo en la epidemiología de las enfermedades animales. La actividad ganadera puede presentar considerables pérdidas económicas periódicas debido a la eliminación de animales, la reducción de la productividad, la falta de expresión del potencial genético de los animales, los costes de tratamiento, la asistencia laboral y profesional, el cierre del comercio debido a los obstáculos sanitarios y la competencia con los mercados extranjeros. Por lo tanto, la resistencia a las enfermedades es un atributo deseado en la producción ganadera y la salud animal puede estar limitando en los sistemas de producción de ganado. Existe cierta confusión en la terminología: la resistencia se define como la capacidad del huésped para ejercer cierto grado de control sobre el ciclo de vida del patógeno, mientras que la tolerancia define el impacto de la infección en el rendimiento animal. Un concepto muy cercano a la tolerancia es la resiliencia, que se puede definir como mantener la capacidad productiva del animal frente a la infección. Existen numerosos informes que indican las razas locales como un importante reservorio de resistencia genética natural a las enfermedades como un proceso de adaptabilidad al medio ambiente. Refiriéndose a las principales enfermedades de los animales domésticos (tuberculosis, brucelosis, fiebre aftosa, etc.), numerosos genes han sido identificados y estudiados como biomarcadores de resistencia y tolerancia como los genes BOLA, CD, NOD y SLC11A1 entre los más importantes. Aunque el factor limitante para que los programas de reproducción incluyan resistencia a enfermedades genéticas es la necesidad de cuantificar los fenotipos de resistencia. Esto puede ser costoso y logísticamente difícil, y es una barrera significativa para la selección de la resistencia a las enfermedades. Por esta razón, las características de resistencia a la enfermedad son un objetivo atractivo para los estudios genómicos y generalmente son objeto de estos estudios.
Políticas culturales en Argentina: una revisión en el contexto del Instituto Nacional de Teatro y del Instituto Nacional de Cine y Artes Audiovisuales
Authors: Relats Patricia , Algán Raúl S.
Published: September 2020

Política y cultura son fuerzas en tensión constante que influyen en el campo de la gestión y la producción artística. Esta tensión ha sido configurativa en los Estado-nación latinoamericanos, en especial en la segunda mitad del siglo XX cuando la cultura ingresa como recurso en las órbitas de la gestión pública. Sin ser ajenos a esta cuestión, los gestores culturales, en específico los productores de cine y artes escénicas, son agentes cuya actividad se ve estrechamente condicionada por el interés público. Con la intención de realizar una aproximación a la relación entre cultura, identidad, política y sociedad, en el presente escrito se abordan las condiciones preliminares que contribuyeron a que en la década de los noventa del siglo XX Argentina tuviera su Instituto Nacional de Teatro y su Instituto Nacional de Cine y Artes Audiovisuales. El teatro y el cine como espejos de una Argentina siempre cambiante son catalizadores de lo cultural que es un tema de permanente revisión. Desde la conformación del Estado en el siglo XIX, pasando por la afluencia inmigratoria europea de comienzos del siglo XX, la cual portó con ella prácticas sociales específicas, hasta los consumidores culturales omnívoros contemporáneos, la cultura es objeto de disputa constante. En este sentido, se profundiza el abordaje incorporando algunas reflexiones sobre los procesos de censura y los proyectos de producción cultural independiente. Corona este recorrido las condiciones actuales de producción independiente y los entrecruzamientos entre lenguajes.
Gender Differences in the Effect of Medical Humanities Program on Medical Students' Empathy: A Prospective Longitudinal Study
Authors: Lwow Michal , Canetti Laura , Muszkat Mordechai
Published: September 2020

Objective: Previous studies have suggested that Medical students' empathy declines during medical school, especially during the clinical studies. The aim of this study was to examine. changes in medical students' empathy during their first clinical experience, and to determine the impact of gender and humanities curriculum on empathy changes. Methods: In this prospective longitudinal study, 262 4th year students from three consecutive classes were assessed. Empathy was assessed before and at 4th-year-end, using the Jefferson Scale of Physician Empathy-Student Version (JSPE-S). The three classes differed in humanities curriculum [limited Medical Humanities (MH(lim)) vs. extended Medical Humanities (MH(ext))], and in admission system [Personal Interview (PI) vs. multiple mini interviews (MMI)]. Results: Overall, there was a small but significant decrease in JSPE-S during the fourth year (114.40±11.32 vs. 112.75±14.19, p= 0.034). Among men there was a statistically significant decline in JSPE-S during the fourth year, and the MH(ext) (but not the MH(lim)) was associated with the decline (t(35) = 2.38, p = 0.023). Women students showed no decline in empathy during the fourth-year of studies, regardless of type of humanities program. In addition, women who participated in MH(ext) had a higher JSPE-S scores during the 4th -year as compared to women who participated in MH(lim). Conclusion: Pre-clinical humanities program was associated with a decline in empathy among men medical students during the fourth-year of medical studies. Gender differences in response to medical humanities programs require further study.
Acute effect of green tea catechins on uric acid metabolism after alcohol ingestion in Japanese men
Authors: Kawakami Yuka , Yasuda Arisa , Hayashi Motoki , Akiyama Misuzu , Asai Toshihiko , Hosaka Toshio , Arai Hidekazu
Published: September 2020

Objective: Alcohol consumption is associated with hyperuricemia and gout. Previous studies have indicated a role for green tea catechins in uric acid (UA) metabolism. This study aimed to elucidate the acute effect of green tea catechins in terms of enhancing urinary excretion of UA and xanthine/hypoxanthine (Xa/HX; UA precursors) after alcohol ingestion.Methods: In a randomized crossover study, ten healthy Japanese subjects consumed test meals, including a Japanese distilled spirit (Shōchū) with water (SW) or Shōchū with catechin-rich green tea (SC), each containing 20 g of alcohol. The SC contained 617 mg of catechin in total. Serum and urine UA and Xa/HX concentrations were measured. Blood samples were collected after 2.5 h, and urine samples were collected between 0 and 5 h after consuming the test meal.Results: Urine UA and Xa/HX excretions were significantly higher in the SC group than in the SW group. UA clearance and fractional UA excretion tended to increase more in the SC group than in the SW group. No significant differences in serum UA and Xa/HX concentrations were observed between two groups.Conclusions: It was concluded that green tea catechins can enhance the excretion of UA and Xa/HX, even though alcohol is ingested.
The development of Legal Framework on blood donation and blood safety of China in 24 years
Authors: Gao Dajun , Li Heng , Wang Kang
Published: September 2020

BackgroundThis study analyzes the regulations and developments in blood donation from 1996 to 2019 in China, and demonstrate the government’s efforts in improving blood safety.ResultsSince the implementation of the Blood Donation Law in 1998, the number of blood donors in China increased by 275% from 1998 to 2018 (from 4 million to 15 million). The principle of no-fault liability was proposed and has been applied since 2010 to the tort liability related to blood transfusion malpractice. In 2015, mutual blood donation accounts for 4.2% of the national collection. However, in some provinces of China, the percentage of mutual blood donation increased from 9.3% to 35.6% in 2016. The NHC cancelled mutual blood donation in March 2018. Nucleic acid amplification testing (NAT) has become a routine test item for screening blood since 2015.ConclusionsThe Chinese government institutionalized the voluntary non-remunerated donation principle, enacted regulations for the management of blood transfusion, and adopted advanced blood testing technology to sustain blood supply and ensure blood safety. In spited of increased blood donation, blood shortage persists. Quality and safety of blood collection can be further improved through the cancellation of mutual blood donation and incentive measures for voluntary non-remunerated donation of blood, which needs facilitation by governmental legislation.
On the move: Exploring Inuit and non-Inuit health service providers’ perspectives about family participation in care in Nunavik, a qualitative study.
Authors: Fraser Sarah Louise , Moulin Louise , Gaulin Dominique , Thompson Jennifer
Published: September 2020

Background Literature on participation in health and social services suggests that youth, and more specifically Indigenous youth, are difficult to engage within health and social services. They are less likely to access services or to actively participate in decision-making regarding their personal care. Service providers play a crucial role in engaging youth based on the ways in which they seek, and maintain relationships with youthand their families. The way in which they do so will depend on various factors including their own perceptions of roles and relationships of the various people involved in the life of youth. This article analyzes Inuit and non-Inuit health and social service providers’ perspectives, experiences and expectations regarding the roles of a particular group of Indigenous youth, families and community in care settings in Nunavik, Quebec. Methods: A snowball sampling method was used to recruit participants. A total of 58 participants (39 non-Inuit and 19 were Inuit) were interviewed. All interviews focused on three broad areas: 1) participants’ current and past positions/roles; 2) participants’ perceptions of the clientele they work with; and 3) participants’ understanding of collaborations taking place within and between services (who works with whom) and community. Inductive applied thematic analyses were conducted on the entirety of relevant data and then verbatim of Inuit and non-Inuit were analyzed separately to explore similarities and differences in perceptions based on positionality. Results: We organized findings around three themes: I) The most commonly described interventions, II) different types of challenges to and within participation; and III) what successful participation can look like according to service providers. Participants speak of the challenges for families to go towards services as well as the challenges for services providers to go towards youth and families, including personal, organisational and historical factors. Conclusion: We adopt a critical lens to reflect on the key findings in order to tease out points of tension and paradoxes that might hinder the participation of youth and families and more specifically in a social context of decolonization and self-governance of services.
Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe
Authors: Chikwari Chido Dziva , Bernays Sarah , Dringus Stefanie , Simms Victoria , Weiss Helen A , Sibanda Edwin , Kranzer Katharina , Ncube Gertrude , Chikodzore Rudo , Webb Karen , Chirimambowa Trevor , Sithole Kenny , Ndondo Nonhlanhla , Apollo Tsitsi , Mutseta Miriam , Ferrand Rashida A
Published: September 2020

Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.
A comparative study of dementia knowledge, attitudes and perception of care approach among Chinese nursing and medical students
Authors: Wang Yao , Xiao Lily Dongxia , Huang Rong
Published: September 2020

Background Dementia care requires inter-disciplinary collaboration starting from formal health professional education. Yet, little is known about how undergraduate medical and nursing students perceive dementia care in China. The aim of this study was to investigate undergraduate medical and nursing students’ knowledge, attitudes and care approach of dementia in China. Methods A cross-sectional survey was conducted. Students enrolled in a 5-year Bachelor of Medicine Program and a 4-year Bachelor of Nursing Program from four universities with campuses across Eastern, Western, Southern and Northern China were recruited into the study. Three validated instruments, Alzheimer’s Disease Knowledge Scale (AKDS), Dementia Care Attitude Scale (DCAS) and Approach to Advanced Dementia Care Questionnaire (ADCQ), were used to measure students’ dementia knowledge, attitudes and perceived care approach. Data were collected using a self-administered survey. Results The number of medical and nursing students completing the survey was 526 and 467 respectively. The overall mean score of students’ dementia knowledge measured by the ADKS was 19.49 (SD=2.82) out of 30, students’ attitudes to dementia was 29.92(SD=3.35) out of 40, and students’ person-centred care approach of dementia was 5.42 (SD=2.20) out of 13. Students’ overall knowledge towards dementia was poor and the attitudes were generally positive. Medical students demonstrated higher dementia knowledge scores and showed less positive attitude scores than nursing students (p<0.05). Students would not apply a person-centered care approach. There were no statistically significant differences in the mean scores of ADCQ between nursing students and medical students. Conclusions Study results highlight the urgent need to implement an inter-disciplinary approach to increasing dementia education among Chinese medical and nursing students, and ensuring that students have adequate knowledge, attitudes and experience in the care of people with dementia.
Evaluation of OAR sparing and plan robustness of beam-specific PTV in lung cancer IMRT treatment
Authors: Chang Yu , Xiao Feng , Quan Hong , Yang Zhiyong
Published: September 2020

Purpose: Margins are employed in radiotherapy treatment planning to mitigate the dosimetric effects of geometric uncertainties for the clinical target volume (CTV). Here, we proposed a margin concept that takes into consideration the beam direction, thereby generating a beam-specific planning target volume (BSPTV) on a beam entrance view. The total merged BSPTV was considered a target for optimization. We investigated the impact of this novel approach for lung intensity-modulated radiotherapy (IMRT) treatment, and compared the treatment plans generated using BSPTV with general PTV. Methods and Materials: We generated the BSPTV by expanding the CTV perpendicularly to the incident beam direction using the 2D version of van Herk’s margin concept. The BSPTV and general PTV margin were analyzed using digital phantom simulation. Fifteen lung cancer patients were used in the planning study. First, all patient targets were performed with the CTV projection area analysis to select the suitable beam angles. Then, BSPTV was generated according to the selected beam angles. IMRT plans were optimized with the general PTV and BSPTV as the target volumes, respectively. The dosimetry metrics were calculated and evaluated between these two plans. The plan robustness of both plans for setup uncertainties was evaluated using worst-case analysis. Results: Both general PTV and BSPTV plans satisfied the CTV coverage. In addition, the BSPTV plans improved the sparing of high doses to target-surrounding lung tissues compared to the general PTV plans. Both Dmean of Ring PTV and Ring BSPTV were significantly lower in BSPTV plans (38.89Gy and 39.43Gy) compared to the general PTV plans (40.27Gy and 40.68Gy). The V20, V5, and mean lung dose of the affected lung were significant lower in BSPTV plans (16.20%, 28.75% and 8.93Gy) compared to general PTV plans (16.69%, 29.22% and 9.18Gy). In uncertainty scenarios, about 80% of target coverage was achieved for both general PTV and BSPTV plans. Conclusions: The results suggested that plan robustness can be guaranteed in both the BSPTV and general PTV plans. However, the BSPTV plan spared normal tissues, such as the lungs, significantly better compared to the general PTV plans.
The Serum Levels of Circulating Matrix Metalloproteinase MMP-9, MMP-2/TIMP-2 Complex and TIMP-1 do not Change Significantly During Normal Pregnancy.
Authors: Nissi Ritva , Santala Markku , Talvensaari-Mattila Anne
Published: September 2020

Objective: Matrix metalloproteinases (MMPs) are important regulators of vascular and uterine remodeling. Normal pregnancy is associated with increased MMP activity. Measurements of the plasma levels on MMPs have not been consistent between studies in complicated pregnancies. We have examined MMP-9, MMP-2 and their respective tissue inhibitors TIMP-1 and TIMP-2 in different time points in the sera of 13 women with normal pregnancy. Results: The serum levels of MMP-9 and TIMP-1 were stable throughout pregnancy. The level of MMP-2/TIMP-2 complex was slightly increased after week 15 without statistical significance. The serum levels of MMP-9, MMP-2/TIMP-2 and TIMP-1 on different time points during normal pregnancy are poorly studied and further measurements of the plasma levels of MMPs and the correlation with MMP levels in the placenta and other maternal tissues are needed.
Predictors of Smoking Preventive Behavior based on Empowerment Components among Male Students of High Schools,Iran
Authors: Didarloo Alireza , Rezapour Baratali , Sharafkhani Naser
Published: September 2020

Background:Smoking among adolescents and young adults is one of the most important preventable health problems. The etiology of smoking is one of the most important activities in designing prevention programs.The aim of this study was to detemine effective components of empowerment on smoking preventive behavior(SPB) in high school students in Urmia.Methods:This descriptive-analytical study carried out on 422 high school students. The data collection tool of this study was a valid and reliable researcher-made questionnaire containing demographic charectheristics, items related to various components of empowerment, and items related to the SPB. Data were analyzed using descriptive and inferential statistical methods (frequency, mean, standard deviation, Pearson correlation coefficient and linear regression) in SPSS software with version 22.Results:The results showed that 10.42% of students were active smokers and 40.75% of them had the experience of smoking. The results also showed that there exists a positive and significant between among problem solving skill (r=0.394, p<0.001), self-efficacy(r=0.340, p<0.001), self-esteem(r=0.310, p<0.001) and attitude(r=0.333, p<0.001) with the SPB. In addition, a negative and significant correlation was shown between group dependence(r=-0.313, p<0.001) with the SPB. Overall, the components of empowerment were able to explain 26.5% of the variance in SPB. Among components, problem solving skills solely explained 15.5% of variance of SPB.Conclusion: The present study suggests that the study results can be useful for researchers and health planners who want to design and implement appropriate health interventions to prevent and control smoking in students.
Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin receptor blockers (ARBs) may be safe for COVID-19 patients
Authors: Wang Wenjun , Zhao Xiaohui , Wei Wei , Fan Weiwang , Gao Kai , He Shengxiu , Zhuang Xijing
Published: September 2020

Background: To investigate the effects of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blockers (ARBs) administration to hypertension patients with the coronavirus disease 2019 (COVID-19) induced pneumonia.Methods: We recorded the recovery status of 67 inpatients with hypertension and COVID-19 induced pneumonia in the Raytheon Mountain Hospital in Wuhan during February 12, 2020 and March 30, 2020. Patients treated with ACEI or ARBs were categorized in group A (n = 22), while patients who were not administered either ACEI or ARBs were categorized into group B (n = 45). We did a comparative analysis of various parameters such as the pneumonia progression, length-of-stay in the hospital, and the level of alanine aminotransferase (ALT), serum creatinine (Cr), and creatine kinase (CK) between the day when these patients were admitted to the hospital and the day when the treatment ended.Results: These 67 hypertension cases counted for 33.17% of the total COVID-19 patients. There was no significant difference in the usage of drug treatment of COVID-19 between groups A and B (p > 0.05). During the treatment, 1 case in group A and 3 cases in group B progressed from mild pneumonia into severe pneumonia. Eventually, all patients were cured and discharged after treatment, and no recurrence of COVID-2019 induced pneumonia occurred after the discharge. The length of stays was shorter in group A as compared with group B, but there was no significant difference (p > 0.05). There was also no significant difference in other general parameters between the patients of the groups A and B on the day of admission to the hospital (p > 0.05). The ALT, CK, and Cr levels did not significantly differ between groups A and B on the day of admission and the day of discharge (p > 0.05). Conclusions: To treat the hypertension patients with COVID-19 caused pneumonia, anti-hypertensive drugs (ACEs and ARBs) may be used according to the relative guidelines. The treatment regimen with these drugs does not need to be altered for the COVID-19 patients.
E-cigarette Use for Smoking Reduction and Cessation in a Four-year Follow-up Study Among Young Swiss Men: Some may Benefit, but they are Few.
Authors: Gmel Gerhard , Wicki Matthias , Marmet Simon , Studer Joseph
Published: September 2020

BackgroundRandomised controlled trials have shown some benefits to using e-cigarettes (ECs) to facilitate smoking reduction and cessation, but real-world observational studies have rarely confirmed this. The present study looked at EC use and smoking during a four-year longitudinal study of young men. It compares general population findings with a subgroup of individuals with a good prognosis for quitting smoking. MethodsThe smoking habits of 5353 young men at t1 (average 21.3 years old) were defined as either never-smoker, ex-smoker, initiates, relapsed smoker or persistent smoker. At follow-up (t2), smoking status was analysed using logistic regression, differences in the number of cigarettes smoked by persistent t1/t2 smokers were analysed using mixed linear models and the number of quit attempts was analysed using negative binomial models. ResultsAt the general population level, EC use had no beneficial effects on reducing or ceasing smoking. Non-smokers (never- and ex-) and smokers at t1 were more likely to be smokers at t2 if they had begun to use ECs (e.g. among persistent smokers OR=4.56, 95% CI [2.75, 7.58]), but not-significantly so if they had already used ECs at t1. Among smokers at t1, almost daily EC use at t1 was associated with a non-significant reduction in smoking at t2 (OR=0.74, 95% CI [0.33, 1.65]), but occasional EC use significantly increased smoking at t2 (OR=3.05, 95% CI [2.29, 4.06]). Both daily and occasional EC use increased smoking at t2 among t1 non-smokers. T2 smokers made more attempts to quit when using ECs at t2 (IRR=1.53, 95% CI [1.26, 1.85]). Beneficial effects were found among a subgroup of EC users with a good prognosis for quitting (using nicotine liquids and at least 2nd generation ECs, motivation to quit and daily EC use at t2, but not t1). ConclusionSome smokers may have benefitted from using ECs, but they were few. At the general population level, ECs are not predominantly used in a way, which might optimise reducing or ceasing smoking. Therefore, the public health effect on the general population of using ECs may be questionable, as may policy measures to facilitate EC use.
Comparison of prognostic impact of anatomic location of the pancreas on postoperative pancreatic fistula in laparoscopic and open gastrectomy
Authors: Kinoshita Jun , Yamaguchi Takahisa , Saito Hiroto , Moriyama Hideki , Shimada Mari , Terai Shiro , Okamoto Koichi , Nakanuma Shinichi , Makino Isamu , Nakamura Keishi , Tajima Hidehiro , Ninomiya Itasu , Fushida Sachio
Published: September 2020

Background: Postoperative pancreatic fistula (POPF) is a serious complication after gastric cancer surgery. The current study aimed to investigate the significance of the anatomic location of the pancreas as a predictor for POPF in both laparoscopic gastrectomy (LG) and open gastrectomy (OG). Methods: In total, 233 patients with gastric cancer were assessed retrospectively. We measured the maximum vertical (P-L height; PLH) and horizontal length (P-L depth; PLD) between the upper border of pancreas and the root of left gastric artery on a preoperative CT in the sagittal direction. The maximum length of the vertical line between the surface of the pancreas and the aorta (P-A length), previously reported as prognostic factor of POPF, was also measured. We investigated the correlations between these parameters and the incidence of POPF in LG and OG groups. Results: Among the patients in this study, 118 underwent OG and 115 underwent LG. In LG, the median PLH and P-A length in patients with POPF were significantly longer compared with those without POPF (p=0.026, 0.034, respectively), but not in OG. There was no significant difference in the median PLD between the patients with or without POPF in both LG and OG. The multivariate analysis demonstrated that PLH (odds ratio [OR] 4.19, 95% confidence interval [CI] 1.57–11.3, P=0.004) and P-A length (OR 4.06, 95%CI 1.05–15.7, P=0.042] were independent factors for predicting POPF in LG. However, intraoperative blood loss (OR 2.55, 95%CI 1.05–6.18, P=0.038) was extracted as an independent factor in OG. The median amylase level in the drained fluid (D-Amy) were significantly higher in patients with high PLH(≥12.4 mm) or high P-A length (≥45 mm) compared with those with low PLH or low P-A length in LG. However, there were no differences in the D-Amy levels by PLH or P-A length in OG patients. Conclusions: The anatomic location of the pancreas is a specific and independent predictor of POPF in LG but not in OG. PLH is a simple parameter that can evaluate the anatomic position of the pancreas, and it may be useful for preventing POPF after LG.
Can social capital play a role in contracting services of family doctors in China? Reflections based on an integrative review.
Authors: Xu Xinglong , Antwi Henry Asante , Zhou Lulin , Mustafa Tehzeeb , Boafo-Arthur Ama
Published: September 2020

Background: The family doctors’ contract service problem is not about government management alone, but an interaction of a complex social environment. Consequently, the effect of contracted services of family doctors not only depends on policy incentives but also needs to win the participation, acknowledgement, and confidence of community residents. The purpose of this integrative review is to examine whether there is any significant evidence that social capital in the form of social networking groups and other forms of social groups have any positive impact on the acceptance and the effectiveness of family doctors' contractual services.Method: Research on qualitative, quantitative and hybrid methods published in peer-reviewed journals on the social capital role in the process of contract service of family doctors were eligible for inclusion. In view of the increasing attention paid to the contract service effect of family doctors during this period, a 10-year time scale was selected to ensure full coverage of relevant literature in the same period. In total, 809 articles were determined in the database retrieval results which were downloaded and transferred to the Mendeley reference application software.Results: Twelve articles met the inclusion criteria for this integrative review and the quality of the included studies were assessed using the published criteria for the critical appraisal of quantitative and qualitative research methods. Majority of the articles assessed reported that there was evidence of a positive link between social support, especially a sense of belonging and the presence of regular family doctors. The influencing factors of patients' contract behavior of studies conducted in China were social interaction of social capital, acceptance of the first contact in the community, year of investigation, and exposure to the public. Conclusion: The family doctor system should take the community as the carrier, integrate various social resources, improve the doctor-patient relationship, cultivate social network groups in the community, and accelerate the development of community construction, social capital (social network groups) can guide residents to use family doctor services to maintain health. Social capital can also help residents have a regular and reliable family doctor.
Real-time determination of earthquake focal mechanism via deep learning
Authors: Kuang Wenhuan , Yuan Congcong , Zhang Jie
Published: September 2020

An immediate report of the source focal mechanism with full automation after a destructive earthquake is crucial for timely characterizing the faulting geometry, evaluating the stress perturbation, and assessing the aftershock patterns. Advanced technologies such as Artificial Intelligence (AI) has been introduced to solve various problems in real-time seismology, but the real-time source focal mechanism is still a challenge. Here we propose a novel deep learning method namely Focal Mechanism Network (FMNet) to address this problem. The FMNet trained with 787,320 synthetic samples successfully estimates the focal mechanisms of four 2019 Ridgecrest earthquakes with magnitude larger than Mw 5.4. The network learns the global waveform characteristics from theoretical data, thereby allowing the extensive applications of the proposed method to regions of potential seismic hazards with or without historical earthquake data. After receiving data, the network takes less than two hundred milliseconds for predicting the source focal mechanism reliably on a single CPU.
Across kingdom biased CYP-mediated metabolism via small-molecule ligands docking on P450 oxidoreductase
Authors: Jensen Simon , Thodberg Sara , Parween Shaheena , Moses Matias , hansen Cecilie , Thomsen Johannes , Sletfjerding Magnus , knudsen Camilla , Giudice Rita , Lund Philip , castano patricia , Bustamante Yanet , Jørgensen Flemming , Pandey Amit , Laursen Tomas , Møller Birger , Hatzakis Nikos
Published: September 2020

Metabolic control is mediated by the dynamic assemblies and function of multiple redox enzymes. A key element in these assemblies, the P450 oxidoreductase (POR), donates electrons and selectively activates numerous (>50 in humans and >300 in plants) cytochromes P450 (CYPs) controlling metabolism of drugs, steroids and xenobiotics in humans and natural product biosynthesis in plants. The mechanisms underlying POR-mediated CYP metabolism remain poorly understood and to date no ligand binding has been described to regulate the specificity of POR. Here, using a combination of computational modeling and functional assays, we identified ligands that dock on POR and bias its specificity towards CYP redox partners. Single molecule FRET studies revealed ligand docking to alter POR conformational sampling, which resulted in biased activation of metabolic cascades in whole cell assays. We propose the model of biased metabolism, a mechanism akin to biased signaling of GPCRs, where ligand docking on POR stabilizes different conformational states that are linked to distinct metabolic outcomes. Biased metabolism may allow designing pathway-specific therapeutics or personalized food suppressing undesired, disease related, metabolic pathways.
From Anaerobic to Aerobic Treatment: Upcycling of Digestate as a Moisturizing Agent for in-vessel Composting Process
Authors: Chaher Nour El houda , Hemidat Safwat , Chakchouk Mehrez , Nassour Abdallah , Hamdi Moktar , Nelles Michael
Published: September 2020

In Tunisia, there are crucial challenges facing both urban and rural areas, the most prominent of which are the production of organic waste, the need for waste treatment, the demand for water and energy and the need for a circular economy. To this end, the study was designed to develop a technical concept on closed cycle ‘biowaste to bioenergy’ treating, basically food waste (FW) through combined biological processes. In this approach, the generated digestate from FW anaerobic reactors was used successfully as a moisturizing agent for FW in vessel-composting. Four types of digestate were examined to be used as moisturizing agent (MA). The selection of the appropriate MA was achieved based on technical criteria ; moisture content (MC), C : N ratio and heavy metals concentrations. The findings showed that the digestate obtained from anaerobic co-digestion of food waste and wheat straw (D1) was the most efficient AD-effluent to be added. In terms of composting process performance, the thermophilic phase of the amended reactor (A1) lasted 16 days and reached higher temperatures of about 72°C, while the unamended one (A1) was characterized by a thermophilic temperature of around 66°C indicating that the end-products were of a pathogen-free compost. When it comes to the physico-chemical factors examined demonstrating that the biological conditions were sufficiently developed. The findings showed overall decreasing profiles during the composting period for moisture, C : N ratio as well as nitrification index (NI). From the quality-point of view, it was found that heavy metal concentrations had lower limits than those values set by German standards. Moreover, all the compost samples appeared to be stable and classified as class IV and V end-product.