bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacogenetic (PGx) guided cancer pain management in an oncology palliative medicine (PM) clinic.
Authors: Patel Jai Narendra , Boselli Danielle , Symanowski James Thomas , Wodarski Stephanie , Turner ShRhonda , Slaughter Courtney , Waller Melissa , Baldassare Donna , Edwards Rebecca , Susi Beth , Greiner Rebecca , Edelen Connie
Published: November 2019

117

Background: About 30% of cancer patients presenting with pain have symptomatic improvement using conventional strategies within one month. PGx may help personalize opioid selection and improve cancer pain management. Methods: This is a pragmatic pilot trial investigating the feasibility and application of PGx testing to improve pain management in adults with uncontrolled cancer pain referred to an oncology PM clinic. PM providers assessed patients using Edmonton Symptom Assessment Scale at baseline and opioid therapy was initiated or modified. A buccal swab was obtained for genotyping single nucleotide polymorphisms in: COMT, CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, and OPRM1. The first assessment occurred within one week of baseline and a second within another week if intervention was required. PGx results were available before the first assessment and utilized, if applicable, throughout the one-month study period. Pain improvement rate (≥ 2-point reduction on a 0-10 scale) from baseline to final visit, was compared to historical control data by a one-sided exact binomial test of proportions. Results: Of 75 undergoing PGx testing, 52 were evaluable for the primary endpoint (54% female, 81% white, 17% black, median age 63, 75% stage 3 or 4 disease, median personalized pain goal 3 [0-6]). 56% had pain improvement compared to 30% in historical controls (p < 0.001). At final assessment, 35% met their personalized pain goal. Of 26 (50%) requiring opioid adjustments, 18 (69%) had an actionable genotype with a 61% pain improvement rate. The two most common genes for opioid adjustment were CYP2D6 (16/18; 89%) and COMT (8/18; 44%). The most common PGx-guided modification involved switching from a CYP2D6-metabolized drug (hydrocodone, oxycodone, tramadol) to a non-CYP2D6-metabolized drug (fentanyl, hydromorphone, methadone, morphine). Conclusions: PGx implementation in an oncology PM clinic was feasible and improved pain management. Half of those requiring opioid adjustments had an actionable genotype, with the largest impact from CYP2D6 polymorphisms. Future studies should focus on preemptive PGx testing to guide initial drug selection and confirm clinical utility in a randomized trial. Clinical trial information: NCT02542397.
Prospective, longitudinal study of risk factors for cancer-related distress in colorectal cancer survivors from prior to surgery until one year after surgery: Results from the ColoCare study.
Authors: Han Claire J , Gigic Biljana , Schneider Martin , Kulu Yakup , Peoples Anita Roselyn , Ose Jennifer , Koelsch Torsten , Jacobsen Paul B. , Colditz Graham A. , Figueiredo Jane C. , Grady William M. , Li Christopher I. , Shibata David , Siegel Erin M. , Toriola Adetunji T. , Ulrich Alexis B. , Ulrich Cornelia M. , Syrjala Karen L
Published: November 2019

146

Background: Although cancer-related distress is known to persist long after completion of colorectal cancer (CRC) treatment, factors related to distress are largely unexplored in CRC survivors. We examined changes over time and risk factors for distress in CRC patients over the first year after surgery. Methods: We included 212 CRC patients who consented pre-surgery, with data at 6 and 12 months post-surgery from the ColoCare Study in Heidelberg, Germany. Sociodemographic and lifestyle factors, social support and health-related quality of life (QOL) prior to surgery were evaluated as predictors of cancer-related distress. Distress was measured with the Cancer and Treatment Distress instrument (CTXD). Linear regression analyses examined associations between risk factors and distress. Results: Although overall mean of six distress subscales did not change from 6 to 12 months, distress subscale scores varied over time: health burden subscale score increased ( p < .001), while finances ( p = .004), medical demands ( p < .001), and identity ( p < .001) subscale scores decreased from 6 to 12 months. Uncertainty and family strain subscale scores did not change. Younger age, lower income, advanced cancer stage, poorer social support, and poorer baseline QOL scores predicted worse distress at 6 and 12 months. Conclusions: Cancer-related distress continues unresolved at 6 and 12 months post-surgery in this population of CRC survivors. Although some risk factors are difficult to alter, lack of social support may be modifiable and those at risk can be identified early after diagnosis. Screening for risk factors pre-surgery would allow for targeted interventions including strategies to improve resources for those with low support, thereby reducing long-term distress in CRC survivors.
Symptom monitoring and the uncertain threat of disease recurrence: A deductive thematic analysis with adolescent and young adult (AYA) cancer survivors.
Authors: Heathcote Lauren C , Loecher Nele , Spunt Sheri L. , Simon Pamela , Dahl Gary , Moiceanu Silvana , Cruanes Gael , Tutelman Perri , Schapira Lidia , Mueller Claudia , Chiu Bill , Simons Laura
Published: November 2019

147

Background: Symptom monitoring plays an important role in both the physical and psychological challenges of surviving cancer. Anecdotally, cancer survival is characterized by uncertainty, symptom-related fear, and the interpretation of normal bodily sensations as symptomatic of cancer recurrence. This fear may lead to over-vigilance of benign bodily sensations, increasing anxiety and decreasing quality of life. Yet, there are few studies investigating how cancer survivors interpret and make sense of post-cancer symptoms. These studies are needed to guide considerations for clinical practice and the development of supportive interventions. Methods: We conducted in-depth semi-structured interviews with 18 AYA cancer survivors about how they interpret, manage, and respond to physical symptoms during survivorship. Participants were 15-25 years old. The sample was diverse in terms of disease history, ethnicity (8 Hispanic), and gender (9 females, 1 nonbinary). We conducted thematic analysis using a deductive coding scheme that was developed using our Cancer Threat Interpretation (CTI) theoretical model of cognitive, affective, and behavioral processes in post-cancer symptom perception. Results: AYA cancer survivors reported experiencing anxiety in the face of common physical sensations. These sensations were often interpreted as potential signs of recurrence or as late effects of treatment. Survivors most commonly reported worries about pain and fatigue, but also other sensations such as breathlessness. We coded participant transcripts into the following themes: biased attending towards symptoms, biased interpretations of symptoms as threatening, fear and worry about symptoms, and behavioral response to symptoms. In addition, we generated a new theme that was not previously captured in the CTI model: trust in the body. Conclusions: Knowing how to appraise and respond to symptoms such as pain is a challenge for AYA cancer survivors. This rich qualitative data provides support for the CTI model and suggests future directions. The results of this study can inform how clinicians talk to their patients about symptom monitoring after treatment ends.
Racial disparities in end-of-life care among Louisiana cancer decedents in a population-based study from 2011-2017.
Authors: Perry Laura M , Walsh Leah E. , Horswell Ronald , Miele Lucio , Chu San , Melancon Brian , Lefante John , Blais Christopher M. , Hoerger Michael
Published: November 2019

46

Background: Cancer patients’ comfort near the end of life is often undermined by unnecessary aggressive treatments. Furthermore, Black adults receive more aggressive end of life care compared to White adults. We hypothesized that these inequalities would be especially pronounced in Louisiana given regional trends of high cancer mortality coupled with inaccessibility to high quality cancer care. Methods: This was a retrospective analysis of end-of-life care using a Patient-Centered Outcomes Research Institute (PCORI)-funded PCORnet database in the Deep South, called Research Action for Health Network (REACHnet). Of 3,089,092 individuals included, 1,290 met eligibility criteria for the present study: 1) died in Louisiana with a metastatic cancer diagnosis between January 1, 2011 and December 31, 2017, 2) had at least one outpatient clinic visit within six months of death, and 3) self-identified as White or Black. In collaboration with the Louisiana Clinical and Translational Science (LA CaTS) Center, we extracted data on five validated indicators of aggressive care in the final 30 days of life: chemotherapy use, inpatient hospitalizations, ED admissions, ICU admissions, and mechanical ventilation. Hypotheses were analyzed using binary logistic regression to examine whether patient race (White vs. Black) was associated with receipt of each indicator of aggressive end-of-life care, while controlling for sex, age, number of comorbidities, and cancer type. Results: Patients were either White ( n = 875, 67.8%) or Black ( n = 415, 32.2%) adults, and the majority were ≥60 years old (72.4%). Most patients (85.0%) received at least one indicator of aggressive care in the last 30 days of life ( M = 1.91, SD = 1.23), most commonly inpatient hospitalizations (77.0%). Black individuals were more likely than White individuals to be hospitalized ( OR = 1.66, 95% CI: 1.21 to 2.27, p= .002) or admitted to the ED ( OR= 1.57, 95% CI: 1.16 to 2.13, p= .004) during their last month of life, but race was not associated with other indicators. Conclusions: Findings have implications for informing healthcare decision making near the end of life for patients, families, and clinicians in the Deep South.
Patient perspectives on participation in phase 1 clinical trials.
Authors: Smith Thomas J. , Williams Anna Cathy , Ferrell Betty R. , Borneman Tami R. , Chung Vincent , Koczywas Marianna
Published: November 2019

48

Background: Patients with solid tumors in Phase 1 clinical trials are at an important phase in the cancer trajectory. Understanding patients’ experiences can guide healthcare providers to provide optimum care. The main objectives of this study were to describe patient perspectives on participating in a Phase 1 trial, understand their disease status and treatment options and, to describe the impact of the disease and clinical trial participation on quality of life (QOL). Methods: Phase 1 patients (n = 30) who were participating in a larger randomized NCI-funded intervention trial (n = 470), were interviewed and tape recorded. The interviews were transcribed and content analysis methods were used to identify common themes. Results: Patients reported participating in the Phase 1 clinical trial because their doctors informed and encouraged them, they had no other treatment options if they wanted to live longer, or they wanted to help future cancer patients. Most patients believed that participation would improve or stabilize their illness and improve quality of life. They believed that when the clinical trial ended, there would be new treatments available. Participants reported that the physicians, nursing staff, social worker, and their families had been supportive. They reported that the treatment had been difficult on their families. Patients reported that compassion, cultural awareness, spiritual support, and the need for individual attention was important. There was little mention of end-of-life care or advance care planning. Conclusions: Patients participating in Phase 1 trials remain optimistic about treatment options while aware of their mortality. They have important needs for support to address quality of life concerns as well as better understanding their disease status, treatment options, and advance care planning for end of life care. Clinical trial information: NCT01828775.
Oncology practice changes during a multistep Oncology Care Model practice transformation project.
Authors: Wujcik Debra , Owenby Susan T. , Khushman Moh'd M. , Cameron Daniel , Butler Thomas Wayne , Tinnea Cathy , Cadden Austin , Young Pierce Jennifer , Pai Sachin Gopalkrishn
Published: November 2019

88

Background: Treatment of lung cancer has seen a paradigm shift in recent years. While the availability of newer treatment options such as targeted therapy and immunotherapy have provided new hope for better outcomes, this has added to the cost of care. Participation in the Center for Medicare Services’ Oncology Care Model (OCM) provides opportunities for oncology practices to identify practice transformation (PT) change strategies that result in improved quality of care (QOL) and cost savings. Methods: A lung cancer PT team convened to facilitate changes that improve patient outcomes and decrease costs at an OCM organization. The year-long project included clinical treatment updates, quantitative and qualitative assessments, and data sharing. Practice changes focused on biomarker driven treatment selection, nurse navigation to better manage symptoms and decrease emergency department (ED) visits and hospitalizations, and earlier advanced care planning (ACP) discussions. Surveys were completed by oncology physicians and nurse practitioners at baseline (n = 9) and end of the project (n = 7). Results: After education, there were more correct responses in 3 of 6 knowledge questions and providers noted less concern about performance status or co-morbidities when prescribing immunotherapy. Providers noted fewer barriers with biomarker documentation; self-reported confidence in 4 questions of biomarker selection was unchanged. Providers reported increased participation of nurse navigators to impact ED visits and hospitalizations over time. Documentation of ACP discussions increased, 42% (8/19) to 56% (13/23), but did not reach statistical significance due to sample size. Although providers reported changes toward earlier ACP discussions, 1 in 3 still wait until performance status declines to initiate discussion. Conclusions: Systematic PT can improve quality of patients care and measures used in value-based care reimbursement models. Providers need ongoing education, practice feedback, and organizational support to effect positive practice changes. In addition, new strategies to increase provider ability to initiate end of life discussions need to be explored.
Pectoral and pelvic girdle rotations during walking and swimming in a semi-aquatic turtle: testing functional role and constraint
Authors: Mayerl Christopher J. , Capano John G. , Moreno Adam A. , Wyneken Jeanette , Blob Richard W. , Brainerd Elizabeth L.
Published: November 2019

Pectoral and pelvic girdle rotations play a substantial role in enhancing stride length across diverse tetrapod lineages. However, the pectoral and pelvic girdle attach the limbs to the body in different ways and may exhibit dissimilar functions, especially during locomotion in disparate environments. Here, we test for functional differences between the forelimb and hind limb of the freshwater turtle Pseudemys concinna during walking and swimming using X-Ray Reconstruction of Moving Morphology (XROMM). In doing so, we also test the commonly held notion that the shell constrains girdle motion in turtles. We found that the pectoral girdle exhibited greater rotations than the pelvic girdle on land and in water. Additionally, pelvic girdle rotations were greater on land than in water, whereas pectoral girdle rotations were similar in both environments. These results indicate that although the magnitude of pelvic girdle rotations depends primarily on whether the weight of the body must be supported against gravity, the magnitude of pectoral girdle rotations likely depends primarily on muscular activity associated with locomotion. Furthermore, the pectoral girdle of turtles rotated more than has been observed in other taxa with sprawling postures, showing an excursion similar to that of mammals (∼38°). These results suggest that a rigid axial skeleton and internally positioned pectoral girdle have not constrained turtle girdle function, but rather the lack of lateral undulations in turtles and mammals may contribute to a functional convergence whereby the girdle acts as an additional limb segment to increase stride length.
Comparing perineuronal nets and parvalbumin development between blackbird species with differences in early developmental song exposure
Authors: Cornez Gilles , Langro Justin , Cornil Charlotte A. , Balthazart Jacques , Lynch Kathleen S.
Published: November 2019

Brood parasitic songbirds are a natural system in which developing birds are isolated from species-typical song and therefore present a unique opportunity to compare neural plasticity in song learners raised with and without conspecific tutors. We compared perineuronal nets (PNN) and parvalbumin (PV) in song control nuclei in juveniles and adults of two closely related Icterid species (i.e. blackbirds): brown-headed cowbirds (Molothrus ater; brood parasite) and red-winged blackbirds (Agelaius phoeniceus; non-parasite). The number of PV cells per nucleus was significantly higher in adults compared to juveniles in HVC and RA, whereas no significant species difference appeared in any region of interest. The PNN per nuclei was significantly higher in adults compared to juveniles in HVC, RA and Area X but only RA exhibited a significant difference between species. PV cells surrounded by PNN (PV+PNN) also exhibited age-related differences in HVC, RA and Area X but RA was the only region in which PV+PNN exhibited significant species differences. Furthermore, a significant interaction existed in RA between age and species with respect to PNN and PV+PNN, revealing RA as a region displaying differing plasticity patterns across age and species. Additional comparisons of PNN and PV between adult male and female cowbirds revealed that males have greater numbers of all three measures in RA compared to females. Species-, sex- and age-related differences in RA suggest species differences in neural plasticity are related to differences in song production rather than sensitivity to song learning despite stark contrast in early exposure to conspecific male tutors.
Biofunctional Molecules Inspired by Protein Mimicry and Manipulation
Authors: Muraoka Takahiro
Published: November 2019

This account focuses on synthetic approaches to develop functional molecules on the basis of mimicry and manipulation of proteins. Proteins are one of the central molecules serving vital functions and maintaining biological homeostasis. The sophisticated roles and dynamic functions found in proteins provide lots of useful clues to develop synthetic functional molecules. This account describes the development of synthetic supramolecular ion channels made of multiblock structures that can switch ion transportation in response to external stimuli by mimicking ligand-gated and mechano-responsive transmembrane proteins. Multiblock amphiphiles also perform membrane budding and self-assembly in a bilayer. This account also describes functionalization of poly(ethylene glycol) by structuring, which allows for controlling the thermal properties and protein aggregation suppression. The thermal response of poly(ethylene glycol) is also effective in a solid state to develop crystals showing thermal polymorphic transitions.
Exercise Training Reduces Reward for High-Fat Food in Adults with Overweight/Obesity
Authors: BEAULIEU KRISTINE , HOPKINS MARK , GIBBONS CATHERINE , OUSTRIC PAULINE , CAUDWELL PHILLIPA , BLUNDELL JOHN , FINLAYSON GRAHAM
Published: November 2019

Purpose

There is increasing evidence that exercise training may facilitate weight management via improvements in homeostatic appetite control, but little is known about how exercise training affects food reward and susceptibility to overeating.

Methods

This study examined changes in food reward and eating behavior traits after a supervised 12-wk exercise intervention (10.5 MJ·wk−1) in inactive individuals with overweight/obesity (exercisers; n = 46, 16 men/30 women; mean (SD) body mass index, 30.6 (3.8) kg·m−2; and mean (SD) age, 43.2 (7.5) yr) compared with nonexercising controls (n = 15; 6 men/9 women; mean (SD) body mass index, 31.4 (3.7) kg·m−2; and mean (SD) age, 41.4 (10.7) yr). Liking and wanting scores for high-fat relative to low-fat foods were assessed with the Leeds Food Preference Questionnaire before and after consumption of an isoenergetic high-fat or high-carbohydrate lunch. Eating behavior traits were assessed using the Three-Factor Eating Questionnaire and Binge Eating Scale.

Results

A week–group interaction indicated that wanting scores decreased from baseline to postintervention in exercisers only (M
∆Pre–Post = −4.1, P = 0.03, ηp
2 = 0.09, 95% confidence interval [CI], −7.8 to −0.4), but there was no exercise effect on liking. There was also a week–group interaction for binge eating, which decreased in exercisers only (M
∆Pre–Post = −1.5, P = 0.01, ηp
2 = 0.11; 95% CI, −2.7 to −0.4). A small reduction in disinhibition was also apparent in exercisers (M
∆Pre–Post = −0.7, P = 0.02, ηp
2 = 0.10; 95% CI, −1.3 to −0.1).

Conclusions

This study showed that 12 wk of exercise training reduced wanting scores for high-fat foods and trait markers of overeating in individuals with overweight/obesity compared with nonexercising controls. Further research is needed to elucidate the mechanisms behind these exercise-induced changes in food reward.
SEDIMEN DAN MANFAATNYA
Authors: . Helfinalis
Published: November 2019

SEDIMENT AND ITS BENEFITS. Sediment deposition is a form of compact material that accumulates on the surface or near the surface of the earth, under conditions of low pressure and temperature. Sediment is generally a product of old rock destruction which is transported and distributed by water or wind currents. Sediments are the result of chemical or biochemical precipitation of the solution. Learning the distribution of sediment on the seabed is desperately needed and very useful, for the initial phase to lay the wire and pipe lines on the sea, consider topography of sea (bathimetry), sedimentary texture and ocean currents. Clays are considered unfavorable for the laying of construction pole as a result of clay having a high volume change potential. Clay will undergo expansion when water increases and shrinkage occurs when the water content is less. Rock sediments of sand and limestone are useful for building materials.
Relationship Between Recreational Marijuana Use and Bowel Function in a Nationwide Cohort Study
Authors: Adejumo Adeyinka Charles , Flanagan Ryan , Kuo Braden , Staller Kyle
Published: November 2019

OBJECTIVES:

Although the endogenous cannabinoid system modulates bowel function, our understanding of the impact of recreational marijuana (MJ) use on bowel motility is limited. This study examines the effect of MJ on self-reported bowel function among a large cohort of US adults.

METHODS:

We identified adults (age: 20–59 years) who completed both the drug use and bowel health questionnaires in the National Health and Nutrition Examination Survey over a 6-year period from 2005 to 2010 (n = 9,645). Constipation and diarrhea were defined according to stool form (Bristol Stool Form Scale) and/or frequency criteria. Adjusted odds ratios (AORs) for likelihood of constipation or diarrhea were estimated in a multinomial logistic model according to MJ use status.

RESULTS:

Overall, constipation prevalence was lower among those with recent MJ use compared with those with past/never use (7.5% vs 10.2%, P = 0.03). Recent MJ use was associated with a 30% decreased odds of constipation (crude odds ratio: 0.71 [0.56–0.98], P = 0.005), which persisted after stepwise adjustment for age and other demographic factors including sex, ethnicity, education, body mass index, and socioeconomic status (AOR: 0.64 [0.49–0.83], P = 0.001); comorbidities, substance use (alcohol, tobacco, heroin, and cocaine), constipating medications, general health condition, rigorous physical activity, and emotional disturbances (AOR: 0.68 [0.48–0.93], P = 0.016); and diet (AOR: 0.68 [0.52–0.89], P = 0.006). There was no association between recent MJ use and diarrhea.

DISCUSSION:

In a nationally representative sample of community-dwelling US adults, recent MJ use was associated with decreased odds of constipation, counter to the known physiologic effects of cannabinoids on colonic motility.
O PAPEL DA GEOGRAFÍA PARA A FORMAÇÃO PROFISSIONAL PARA O SUS FORMAR PARA EL EL SUS: ¿DÓNDE, EN QUÉ, CUÁNTOS?
Authors: Rojas Luisa Basilia Iñiguez
Published: November 2019

Para ser coherentes con la proclama de este simposio, “más SUS más geografía”, intentaré penetraren el tema que me han asignado, y que agradezco los organizadores. Cuando desde fuera, desde lejos, observamos la trayectoria   de la formación de profesionales para el SUS de Brasil, notamos la profusión de esfuerzos que incluyen numerosas instancias, aparatos legales, estrategias políticas que han producido innúmeros documentos organizativos como portarias, relatorios, Programas, cursos con diferentes objetivos y materiales docentes. No hay dudas de que a lo largo de tres décadas se ha hecho MUCHO.
DIÁLOGOS E INTERFACES DA ABORDAGEM GEOGRÁFICA NA EDUCAÇÃO PROFISSIONAL DE NÍVEL TÉCNICO EM SAÚDE
Authors: Monken Maurício
Published: November 2019

Os séculos XX e XXI empreenderam profundas transformações nos modos de viver de sociedades, resultado do intenso processo de globalização da economia com expansão e incorporação massiva de processos técnicos em redes de cadeias produtivas e de finanças em todos os lugares do planeta, com apropriação de recursos locais e intensificação de fluxos de circulação e de troca de informações, materialidades e pessoas (GONDIM e MONKEN, 2016).
POLÍTICAS PÚBLICAS NA GESTÃO DE RISCO DE DESASTRES: UM OLHAR PARA ALÉM DA RESPOSTA À EMERGÊNCIA NO SISTEMA ÚNICO DE SAÚDE
Authors: E Silva Eliane Lima
Published: November 2019

Desastres são eventos cada vez mais frequentes que se apresentam como uma ameaça à vida das pessoas, provocando impactos diretos e indiretos, mensuráveis e imensuráveis, então, falar sobre saúde em situações de desastres é um desafio. Esse tema nos leva a diversas ponderações das quais, considerando o cenário brasileiro, quero convidá-los a refletir sobre:

quais os impactos potenciais que os desastres “naturais” podem trazer para a saúde das pessoas e para os serviços de saúde?

as políticas públicas envolvidas nessa temática têm contribuído para o estabelecimento de uma agenda de redução do risco de desastres e para a redução do risco que esses desastres representam para a saúde humana?

há consonância entre as decisões setoriais na implementação de políticas públicas e as medidas de redução do risco de desastres?

há perspectivas sobre a adoção de medidas para a redução do risco atual e futuro que os desastres representam no Brasil?

Todos esses pontos subsidiam uma complexa análise cercada de incertezas. Assim, vale fazer uma reflexão sobre a relação entre desastres e saúde e conhecer a estratégia de gestão de risco de desastres e a preparação e resposta à emergência em saúde pública por desastres no Sistema Único de Saúde, que será o desafio a ser apresentado neste texto.
Preliminary Feasibility of a Peer-supported Diabetes Medication Adherence Intervention for African Americans
Authors: Shiyanbola Olayinka O. , Tarfa Adati , Song Ariana , Sharp Lisa K. , Ward Earlise
Published: November 2019

Objectives: African Americans (AAs) have higher rates of medication nonadherence compared to non-Hispanic whites. In this study, we determined the preliminary feasibility of an 8-week intervention focused on improving culturally-informed illness and medication beliefs, self-efficacy,
and medication adherence. Methods: We used purposeful sampling to recruit 8 peer ambassadors (PAs), individuals constituting the advisory board of AAs adherent to their medicines, and 7 peer buddies (PBs), assessed as non-adherent to their diabetes medicines. PAs and PBs were paired.
They completed 2 group educational sessions together and one follow-up phone call to PBs by PAs. Results: PAs were mostly female (N = 5, 63%), mean age of 55 years (± 8.3). Similarly, PBs were mostly female (N = 6, 86%), mean age of 56 years (± 6.3). Follow-up interviews
with PBs revealed that they liked discussing medication management strategies and diabetes management resources, sharing their diabetes experiences with their PA and connecting with them over the phone. All PBs reported a positive, trusting relationship between them and their PAs. Conclusions:
This study demonstrates AAs with diabetes medication adherence challenges are receptive to a peer support mechanism to address culturally informed beliefs and enhance patient-provider communication and self-efficacy.
BARONG USING Optimalisasi Seni Pertunjukan sebagai Obyek Pariwisata Budaya Using
Authors: Pramono Putro Muhammad Agung , Soepeno Bambang , Nirmala P Rully Putri
Published: November 2019

Barong Using is a performance art which is native to the Using community. Barong Using is used as a sacred necessity for clean village rituals. Rituals are held twice a year. The Ider Earth Ritual on the 2nd of Shawwal and the moon village salvation ritual were recited. The cultural development of bringing the art of barong performance functions as a sacred and profane need. There are efforts to optimize the art of barong performance by the use of tourism. The problems contained in this study are related to discussing (1) the history of Barong Kemiren's performance in which it examines ritual processions with socio-cultural values; and (2) efforts to optimize the art of barong performance later using communities in 1996-2018 as the use of tourism. The research method used is the historical research method by using a cultural anthropology approach to study cultural change and using structural functionalism theory to analyze the shift in barong function socially as a result of tourism. The results of this discussion, the optimization of the art of barong performance is packaged in the interrelationships of the five pillars that support the development of tourism and creative industries, namely, the state, art and ritual actors, supporting communities, industry, and religious leaders. These pillars can provide the right input so that a good response emerges from entrepreneurs, bureaucrats, cultural practitioners, and practitioners of traditional and ritual arts. Now the art of barong performance has undergone many changes starting from the structure of performances and interludes which accompany.
CaV1.2 and CaV1.3 voltage-gated L-type Ca2+ channels in rat white fat adipocytes
Authors: Fedorenko Olena A , Pulbutr Pawitra , Banke Elin , Akaniro-Ejim Nneoma E , Bentley Donna C , Olofsson Charlotta S , Chan Sue , Smith Paul A
Published: November 2019

L-type channel antagonists are of therapeutic benefit in the treatment of hyperlipidaemia and insulin resistance. Our aim was to identify L-type voltage-gated Ca2+ channels in white fat adipocytes, and determine if they affect intracellular Ca2+, lipolysis and lipogenesis. We used a multidisciplinary approach of molecular biology, confocal microscopy, Ca2+ imaging and metabolic assays to explore this problem using adipocytes isolated from adult rat epididymal fat pads. CaV1.2, CaV1.3 and CaV1.1 alpha1, beta and alpha2delta subunits were detected at the gene expression level. The CaV1.2 and CaV1.3 alpha1 subunits were identified in the plasma membrane at the protein level. Confocal microscopy with fluorescent antibodies labelled CaV1.2 in the plasma membrane. Ca2+ imaging revealed that the intracellular Ca2+ concentration, [Ca2
+]i was reversibly decreased by removal of extracellular Ca2+, an effect mimicked by verapamil, nifedipine and Co2+, all blockers of L-type channels, whereas the Ca2+ channel agonist BAY-K8644 increased [Ca2+]i. The finding that the magnitude of these effects correlated with basal [Ca2+]i suggests that adipocyte [Ca2+]i is controlled by L-type Ca2+ channels that are constitutively active at the adipocyte depolarized membrane potential. Pharmacological manipulation of L-type channel activity modulated both basal and catecholamine-stimulated lipolysis but not insulin-induced glucose uptake or lipogenesis. We conclude that white adipocytes have constitutively active L-type Ca2+ channels which explains their sensitivity of lipolysis to Ca2+ channel modulators. Our data suggest CaV1.2 as a potential novel therapeutic target in the treatment of obesity.
On experimental investigation of the web-based stock-exchange model
Authors: Mockus Jonas , Katin Igor , Katina Joana
Published: November 2019

In this paper, the updated model USEGM simulating the stock exchange is investigated. The updated model includes the transaction costs to reflect the reality better. To represent users that prefer linear utility functions, USEGM adds the new models which minimize absolute prediction errors to the traditional ones minimizing square deviations. However, the main objective of USEGM is not forecasting, but simulation of financial time series that are affected by predictions of the participants. The model has been compared with actual financial time series.
Notes on the historical conceptual streams for mathematics and physics teaching
Authors: Pisano Raffaele
Published: November 2019

Based on recent researches of mine concerning history and epistemology of sciences (physics and mathematics) one side and foundations of sciences within my physics and mathematics teaching other side, in this paper I briefly discuss and report the role played by history of science within physics and mathematics teaching. Some case-study on the relationship between mathematics, physics and logics in the history and teaching process are presented, as well.
Option pricing in Heston model by means of weak approximations
Authors: Lenkšas Antanas , Mackevičius Vigirdas
Published: November 2019

We apply weak split-step approximations of the Heston model for evaluation of put and call option prices in this model.
Numerical study of a toxin and antibody interaction inside the cell
Authors: Katauskis Pranas , Malakauskaitė Silvija
Published: November 2019

A nonlinear mathematical model decribing toxin penetration into cell from the extracellular domain and its interaction with an antibody placed inside the cell is studied. The protective properties of the antibody against the toxin are investigated numerically choosing the model parameters in case of the well-mixed solution assumption.
The Euler–Mascheroni constant in school
Authors: Mačys Juozas Juvencijus , Sušinskas Jurgis
Published: November 2019

It is demonstrated how the Euler–Mascheroni constant  $\gamma$ can be defined quite simple in the school. Two approaches are considered: the first one using logarithms and derivatives, and the second one using only elementary knowledge of sequences.
On the Nash equilibrium in the inspector problem
Authors: Sabaliauskas Martynas , Mockus Jonas
Published: November 2019

Inspector problem represents an economic duel of inspector and law violator and is formulated as a bimatrix game. In general, bimatrix game is NP-complete problem. The inspector problem is a special case where the equilibrium can be found in polynomial time. In this paper, a generalized version of the Inspector Problem is described with the aim to represent broader family of applied problems, including the optimization of security systems. The explicit solution is provided and the Modified Strategy Elimination algorithm is introduced.
Catastrophe model in nonlinear dynamical systems and working groups
Authors: Butkevičiūtė Eglė , Landauskas Mantas , Bikulčienė Liepa
Published: November 2019

This paper employs catastrophe theory which analyzes changes in dynamical systems depending on two or more parameters at the same time. The main purpose of this work is to investigate the dynamics of the swallowtail catastrophe depending on the values of parameters. This catastrophe could be used as a model of leadership emergence in working groups. The best model of collected data has been found by using the particle optimization algorithm.
Feller chains and random functions
Authors: Kazakevičius Vytautas
Published: November 2019

We prove that each Feller transition probability is the one-dimensional distribution of some stochastically continuous random function. We also introduce the notion of a regular random function and show, on one hand, that every random  function has a regular modification, and on the other hand, that the composition of independent regular stochastically continuous random functions is stochastically continuous as well.
Analysis of genetic risk assessment methods
Authors: Tiešis Vytautas , Lančinskas Algirdas , Marcinkevičius Virginijus
Published: November 2019

Chronic non-communicable diseases are caused by a combination of multilocus genetic risk factors. The genetic risk assessment companies, e.g. Navigenics and 23andMe, calculate a lifetime risk of a disease by the use of strong assumptions on the total impact of the multiple SNPs genotype. The object of the paper is to compare such risk assessment methods. The theoretical disease model that describes both environmental and genetic factors has been used for evaluation of assessment methods. The system of nonlinear equations for tuning model’s parameters to real statistical parameters of the disease has been developed. The Receiver Operating Characteristic curve has been used to evaluate the quality of the methods as predictive tests.
Derivative parameters of electroencephalograms and their measurement methods
Authors: Misiukas Misiūnas Andrius Vytautas , Meškauskas Tadas , Samaitienė Rūta
Published: November 2019

The derivative parameters of electroencephalogram (EEG): baseline, upslope, downslope and width of EEG spikes are analysed in this work. Automatic methods of their measurement are presented. Validation of discussed parameters against their possible range (provided by neurologists) lets us to exclude some falsely positively detected spikes thus improving accuracy of the spike detection algorithm. These parameters might have some correlation between them and diagnosis of the  atients.
Why do we teach the mathematics that we do?
Authors: Norvaiša Rimas
Published: November 2019

Due to the changes of education system the school mathematics in Lithua-nia have acquired the elements of commercial-administrative mathematics of ancient times. Among other consequences the opportunities of school children to achieve the standards of mathematical reasoning are limited.
İlkokulda STEM: Öğrencilerin Kariyer İlgileri ve Tutumları
Authors: AZGIN Ali Oktay , ŞENLER Burcu
Published: November 2019

Bu çalışmanın amacı, ilkokul 3. ve 4. sınıf öğrencilerinin STEM kariyer ilgilerinin ve STEM’e yönelik tutumlarının bazı değişkenler açısından incelenmesidir. Çalışma nicel araştırma yöntemlerinden tarama deseni ile tasarlanmıştır. Çalışmanın örneklemini Ege Bölgesi’nde yer alan bir ilde öğrenim görmekte olan 758 öğrenci oluşturmuştur. İlkokul öğrencilerinin STEM kariyer ilgilerini belirlemek amacıyla STEM Kariyer İlgi Ölçeği, STEM’e yönelik tutumlarını belirlemek amacıyla ise STEM Tutum Ölçeği kullanılmıştır. Çalışmada elde edilen veriler bağımsız t-testleri ve tek yönlü varyans analizi testleri ile analiz edilmiştir. Bu analizler sonucunda öğrencilerin STEM kariyer ilgileri ile STEM’e yönelik tutumlarının öğrencilerin cinsiyetlerine, ebeveynlerinin eğitim düzeyine ve bilgisayar/internete sahip olma durumlarına göre farklılaştığı tespit edilmiştir.
La cadena de seguridad y control en servicios web
Authors: Cieza Mostacero Segundo Edwin
Published: November 2019

El presente trabajo busca deï€nir y explicar las diferentes perspectivas de la seguridad en la informaciÃ³n de los Servicios Web, teniendo como base los conceptos, protocolos, servicios, normatividad y soluciones informÃ¡ticas (basado en caso de estudio ) en el aÃ±o 2016 que permiten veriï€car la operatividad de un servicio web.
GestiÃ³n de mantenimiento para mejorar la disponibilidad de la ï€‚ota vehicular de la empresa DÃ­az Acarreos Generales S.A.C.
Authors: GarcÃ­a Urraca Kevin Johny
Published: November 2019

En el presente trabajo se realizarÃ¡ una gestiÃ³n de mantenimiento para La empresa DÃ­az Acarreos Generales S.A.C. (DAG), la cual tiene como ï€nalidad aumentar los indicadores de sus unidades de la ruta Trujillo â€“ Piura Se comenzÃ³ recopilando informaciÃ³n de trabajos con relaciÃ³n al tema, tambiÃ©n se buscÃ³ informaciÃ³n teÃ³rica de los tipos de mantenimiento, vehÃ­culos entre otros, luego se procediÃ³ a elaborar una ï€cha de registro de las unidades para obtener sus indicadores de Disponibilidad, Conï€abilidad y Mantenibilidad, luego se hizo un anÃ¡lisis de criticidad de las partes mÃ¡s crÃ­ticas, despuÃ©s de obtener a estos elementos se elaboraron documentos de inspecciÃ³n y trabajos. Luego se elaborÃ³ un plan de mantenimiento teniendo en cuenta las necesidades que poseen estas unidades, se simulo este plan en un programa de mantenimiento llamado PROMODEL, al obtener datos de la simulaciÃ³n se compararon los indicadores iniciales con los simulados dando como resultado el aumento de los indicadores de Disponibilidad, Conï€abilidad y Mantenibilidad, seguidamente se hizo el cÃ¡lculo de retorno de inversiÃ³n, dando como resultado que el proyecto es factible y sustentable.

Palabras clave: GestiÃ³n de Mantenimiento, Disponibilidad, Plan de Mantenimiento, SimulaciÃ³n, Retorno de InversiÃ³n.
DiseÃ±o y simulaciÃ³n de una cÃ¡mara de microclimas para el laboratorio de la empresa Vitapro â€“ Trujillo
Authors: Vera John
Published: November 2019

En este trabajo se expone el diseÃ±o de una cÃ¡mara de microclimas a una temperatura mÃ¡xima de 30Â°C y una temperatura mÃ­nima de 0Â°C para la empresa de VITAPRO â€“ Trujillo. Para el desarrollo las necesidades de la empresa que se estipularon en las entrevistas. Seis conceptos de cÃ¡mara fueron analizados mediante una matriz de selecciÃ³n para brindar con el diseÃ±o final. Luego se estimÃ³ la humedad relativa con modelos matemÃ¡ticas con respecto a la temperatura. La velocidad tÃ©rmica con respecto al tiempo - temperatura y finalmente la carga tÃ©rmica y las toneladas de refrigeraciÃ³n para finalmente proceder a la selecciÃ³n de equipos; todo esto se hizo mediante una GUI (Interfaz grÃ¡fica de usuario) desarrollada en MatlabÂ®. La cÃ¡mara microclimas obtuvo el rango de 30-80% de humedad relativa con respecto a la temperatura de 0-30Â°C y una velocidad tÃ©rmica Ã³ptima, pero con un rango mÃ¡ximo de 60 minutos tanto para calentar o refrigerar. Se obtiene la eficiencia del sistema cumpliÃ©ndose COPt>COPr, tambiÃ©n se obtiene la carga tÃ©rmica de 1.2 kW y lo que es la potencia de la maquinaria de 1.8 kW, por lo mismo que son 2.4 hp y 0.5 toneladas de refrigeraciÃ³n. La metodologÃ­a de diseÃ±o GUI-MatlabÂ®, fue de mucha ayuda para el diseÃ±o paramÃ©trico tÃ©rmico, HR y velocidad tÃ©rmica porque se logrÃ³ obtener los resultados esperados, se espera una buena rentabilidad del producto (VAN 3903 y TIR 29%).

Palabras clave: Microclimas, Matlab, paramÃ©trico.
Estudio de reemplazo de turbinas a contrapresiÃ³n por motores elÃ©ctricos en el Ã¡rea de molienda para mejorar la cogeneraciÃ³n de energÃ­a elÃ©ctrica de la empresa CaÃ±a Brava
Authors: Reyes Escobedo HÃ©ctor Eli
Published: November 2019

En el presente proyecto se determinÃ³ el estudio de reemplazo de turbinas a contrapresiÃ³n por motores elÃ©ctricos de inducciÃ³n para mejor el uso de energÃ­a elÃ©ctrica en la empresa caÃ±a brava. RealizÃ¡ndose un balance de masa y energÃ­a para determinar la eficiencia de la caldera y planta termoelÃ©ctrica actual. Se calculo la nueva red de tuberÃ­as en mejora para la alimentaciÃ³n de vapor a las turbinas de contrapresiÃ³n, se dimensiono los generadores elÃ©ctricos trifÃ¡sicos y conductores elÃ©ctricos en media tensiÃ³n para el transporte de energÃ­a al transformador, el cual fue tambiÃ©n dimensionado y seleccionado. Se dimensionÃ³ los motores elÃ©ctricos jaula de ardilla, variadores de velocidad para tener mejor controlabilidad de los molinos y picadoras y conductores elÃ©ctricos en baja tensiÃ³n. El incremento de la eï€ciencia de caldera es de 8.08% y 3.78% de la planta termoelÃ©ctrica en condiciones de mejora. El excedente de energÃ­a elÃ©ctrica para la venta al SEIN es de 1.45MW, obteniendo un ingreso anual de 2133936 N.S./aÃ±o, si el precio preferencial a travÃ©s de Osinergmin es de 60 $/MWh. El periodo de retorno de la inversiÃ³n es 0.33 aÃ±os, a una tasa de 15% obteniendo un VAN igual a $10343191 y un TIR de 304%.

Palabras clave: CogeneraciÃ³n, eï€ciencia, inducciÃ³n, planta termoelÃ©ctrica, variador.
Estudio tÃ©cnico econÃ³mico de instalaciÃ³n de condensador industrial y torre de enfriamiento para optimizar la operaciÃ³n del turbogenerador Escher Wyss en la empresa azucarera el Ingenio S.A.
Authors: Larrea SagÃ¡stegui Lucius Francisco
Published: November 2019

La presente investigaciÃ³n se realizÃ³ con el objetivo de realizar un estudio tÃ©cnico econÃ³mico de instalaciÃ³n de condensador industrial y torre de enfriamiento para optimizar la operaciÃ³n del turbogenerador Escher Wyss en la empresa azucarera el Ingenio S.A. La investigaciÃ³n es aplicada, pre experimental y se realizÃ³ en base a la informaciÃ³n obtenida del anÃ¡lisis documental de la empresa, para corroborar la informaciÃ³n se realizaron balances energÃ©ticos en estado actual, luego se procediÃ³ a calcular los nuevos parÃ¡metros de funcionamiento del turbogenerador Escher Wyss para generar los 5 MW de potencia, posteriormente se calculÃ³ el ï€‚ujo mÃ¡sico de agua y la capacidad necesaria  para el nuevo condensador industrial y torre de enfriamiento a implementar, tambiÃ©n se tuvo que redimensiono el sistema de distribuciÃ³n de vapor sobrecalentado, vapor saturado y lÃ­quido saturado, se dimensionaron los conductores de media y baja tensiÃ³n, culminado con el anÃ¡lisis econÃ³mico de la investigaciÃ³n; obteniendo los siguientes resultados: El rendimiento actual del ciclo termodinÃ¡mico es de 14% y el ï€‚ujo mÃ¡sico de vapor para generar los 5MW de energÃ­a elÃ©ctrica en el turbogenerador Escher Wyss es de 17.853 Kg/s; el ï€‚ujo mÃ¡sico de agua de condensaciÃ³n que necesita el condensador industrial es 718.122 kg/s; el condensador industrial a fabricar serÃ¡ de tipo carcasa y tubos, con una capacidad de 48787.406 KW y la torre de enfriamiento seleccionada serÃ¡ una SICREA el modelo COOLPACK SR2920/OU-7T-C70.34 de 50938 KW. Concluyendo que el estudio tÃ©cnico econÃ³mico de instalaciÃ³n de un condensador industrial y torre de enfriamiento para optimizar la operaciÃ³n del turbogenerador Escher Wyss es factible en todos los aspectos debido a que se eliminarÃ¡ la dependencia de energÃ­a elÃ©ctrica del SEIN, generarÃ¡ grandes ingresos econÃ³micos para la empresa con la venta del excedente de la misma, contribuye con el ahorro de combustible en las calderas y su periodo de retorno de inversiÃ³n es de tan solo 3.6 meses.

Palabras clave: Condensador industrial, turbogenerador, torre de enfriamiento.