bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Thinking in a Pandemic: A Blueprint for Government-Led National Hygiene Communication Campaigns to Combat COVID-19
Authors: Curtis Valerie , Dreibelbis Robert , Sidibe Myriam , Cardosi Jason , Sara Jennifer , Bonell Chris , Mwambuli Kaposo , Ghosh Moulik Soma , White Sian , Aunger Robert
Published: May 2020

Whilst large-scale changes in population behaviour are required to reduce the transmission of the SARS-COV-2 pandemic virus, the emergency context is not conducive to the sort of careful communications planning that would normally be required to meet such a task. Rapid strategic communications planning in a pandemic by governments is, however, possible and necessary. Steps include setting up a dedicated communications task force, mobilising partners and resources, developing a creative brief and theory of change and overseeing the creation, testing, roll out and revision of content. In this short guide we argue that a minimum of strategic planning can be undertaken rapidly, and that good use can be made of simple principles of behaviour change, even during pandemics. Our aim here is to provide a blueprint that governments and their partners, especially in low-income settings, can follow to design, coordinate and resource national communications efforts to combat the COVID-19 pandemic.
New Fixed Point Results via (q,y)R-Weak Contractions with an Application
Authors: Imded Mohammad , Ali Based , Alfaqih Waleed M. , Sessa Salvatore
Published: May 2020

In this paper, inspired by Jleli and Samet [journal of inequalities and applications 38 (2014) 2 1–8] we introduce two new classes of auxiliary functions and utilize the same to define (q, y)R-weak 3 contractions. Utilizing (q, y)R-weak contractions, we prove some fixed point theorems in the setting 4 of relational metric spaces. We employ some examples to substantiate the utility of our newly proved 5 results. Finally, we apply one of our newly proved results to ensure the existence and uniqueness of 6 solution of a Volterra-type integral equation.
Simulation Metamodeling Approach to Complex Design of Garment Assembly Lines
Authors: Bongomin Ocident , Igadwa Mwasiagi Josphat , Oyondi Nganyi Eric , Nibikora Ildephonse
Published: May 2020

The today competitive advantage of Ready-made garment industries depends on the ability to improve the efficiency and effectiveness of resource utilization. Ready-made garment industries have long historically adopted fewer technological and process advancement as compared to automotive, electronics and semiconductor industries. Simulation modeling of garment assembly line system has attracted a number of researchers as one way for insightful analysis of system behaviour and improving its performance. However, most of simulation studies have considered ill-defined experimental design which cannot fully explore the assembly line design alternatives and does not uncover the interaction effects of the input variables. Simulation metamodeling is an approach to assembly line design which has recently been of interest to so many researchers. However, its application in garment assembly line design has never been well explored. In this paper, simulation metamodeling of trouser assembly line with 72 operations has been demonstrated. The linear regression metamodel technique with resolution-V design was used. The effects of five factors: bundle size, job release policy, task assignment pattern, machine number and helper number on the production throughput of the trouser assembly line were studied. The increase of 28.63% of the production throughput was achieved for the best factors’ setting of the metamodel.
Design of Nutrition Automation on Lactuca Sativa NFT Hydroponic Systems
Authors: Saputro Joko Slamet , Latifa Ulinnuha , Ramelan Agus
Published: May 2020

This research focus on preserved nutrition on lettuce plants, as well as automation of other parameters that affect plant growth in NFT type hydroponic systems such as temperature, water acidity (pH), water level and light intensity. The automation of this hydroponic system includes the provision of nutrients according to the needs of plants by utilizing EC sensors, keeping the temperature of the water in accordance with plant specifications as well as water levels that are maintained.

 
Modelling and Simulation of DC Motor Speed Control Using Fuzzy-PID Algorithm
Authors: Gideon Alfano Anrico , Maghfiroh Hari , Iftadi Irwan , B.A. Chico Hermanu , Adriyanto Feri
Published: May 2020

This paper discusses the simulation of the Fuzzy-PID hybrid algorithm as a method for controlling the speed of a DC motor compared to the usual PID method. Comparisons were also made to the membership functions used in the fuzzy logic fuzzification process. Membership functions that are used are triangular, trapezoidal, and gaussian shaped function with each having 3, 5, and 7 as the number of membership to be compared. The performance of this control is compared by looking at the results of the step unit responses and the ability in tracking signals. The simulation results show that the Fuzzy-PID algorithm is superior to the ordinary PID algorithm but slower on computation time. The results of the comparison in the fuzzification process shows that the more number used in membership function, the faster the response reaches the set point, while the difference in shape has little effect on the response. The best results are achieved by fuzzy triangle shaped function with 7 membership number.
Study Analysis of Voltage Drop in a Typical Office Building Lighting System: A Case Study of of FEM IPB Building Electrical Installation
Authors: Apribowo Chico Hermanu Brillianto , Faradiba Ghea , Adriyanto Feri , Listiyanto Oktavian
Published: May 2020

Design of electrical system in the Faculty of Economics and Management Bogor Agricultural Institute was based guidance consisting of PUIL, SNI, as well as provisions of modern security and technology and aesthetic beauty. Design is also based on the relevant IEC standards, specifically IEC 60364. In the electrical system, it is necessary to pay attention to the conductor and safety factor to minimize power losses and drop voltage. Losses on the customer side due to drop voltage besides damaging electrical equipment is customers only can have a voltage less than 220 V. The distance between load panel and main panel is directly proportional to the drop voltage value, much farther the load panel to the main panel, resulting greater drop voltage value produced. The calculation of drop voltage based on total load, length, and area of conductor. To overcome the problems that occurred in this case study, the conductor uses 1.25 times the nominal current as a safety factor. The selection area of conductor can be said to be quite good with the farthest drop voltage value from SDP-TR is 0.89%. The total amount of electricity in the building is 158.33 kVA, assuming that if there is an additional 5-10 years, the total electric power and 15% of the others SDP is 182.04 kVA.
DESIGN AND DEVELOPMENT OF FAST CHARGING BATTERY USING FUZZY LOGIC CONTROL TECHNIQUE
Authors: Nizam Muhammad , Ali Naji Abdalaziz
Published: May 2020

Battery charging is an important issue when it is associated with battery life and cycle performance. The aim of this research is to design and promote fast battery chargers using fuzzy logic control techniques (FLC) for LiFePO4 batteries have been developed. The proposed charger is controlled by voltage and current to activate the PWM duty. The results show that the proposed battery charger has the potential to accelerate charging up to 37% at the rate when charging 2C. This means it is faster than the existing filling. The charger proposed by the FLC method is also capable of charging LiFePO4 batteries with greater efficiency, which is 82%. It can be concluded that the FLC application method has better performance than the CC-CV method
Machining Tests to Evaluate Machine Tool Thermal Displacement in Z-Direction: Proposal to ISO 10791-10
Authors: Ibaraki Soichi ,   Department of Mechanical Systems Engineering, Hiroshima University 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8511, Japan, Okumura Rin
Published: May 2020

Thermal deformation is one of the contributors of critical errors of machine tools. ISO 10791-10 describes standardized tests to evaluate a machine tool’s thermal deformation; however, they do not include cutting operations. By repeatedly performing the same machining feature, one can observe the change in geometric accuracy, which is typically caused by the thermal influence of the environment or the heat generated by the machine tool. This paper proposes a simple machining test to evaluate a machine tool’s thermal displacement in the tool’s axial direction (Z-direction). Together with a technical committee of the Japan Machine Tool Builders’ Association, the authors proposed the revision of ISO 10791-10 in ISO/TC39/SC2 to add the present machining tests. This paper presents the test procedures and case studies as well as a comparison with an alternative machining test.
Identification Method of Error Motions and Geometric Errors of a Rotary Axis by R-Test
Authors: Kenno Takaaki , Sato Ryuta , Shirase Keiichi , Natsume Shigemasa , Spaan Henny ,   Department of Mechanical Engineering, Kobe University 1-1 Rokko-dai, Nada-ku, Kobe 657-8501, Japan,   P&C Ltd., Yokohama, Japan,   IBS Precision Engineering BV, Eindhoven, Netherlands
Published: May 2020

While evaluating the accuracy of high-precision machine tools, it is critical to reduce the error factors contributing to the measured results as much as possible. This study aims to evaluate both the error motions and geometric errors of the rotary axis without considering the influence of motion error of the linear axis. In this study, only the rotary axis is moved considering two different settings of a reference sphere, and the linear axes are not moved. The motion accuracy of the rotary axis is measured using the R-test device, both the error motions and geometric errors of the rotary axis are identified from the measurement results. Moreover, the identified geometric errors are verified for correctness via measurement with an intentional angular error. The results clarify that the proposed method can identify the error motions and geometric errors of a rotary axis correctly. The method proposed in this study can thus be effective for evaluating the motion accuracy of the rotary axis and can contribute to further improvement of the accuracy of the rotary table.
Calibration Method of Parallel Mechanism Type Machine Tools
Authors: Nagao Keisuke ,   Kanazawa Institute of Technology 7-1 Ohgigaoka, Nonoichi, Ishikawa 924-8501, Japan, Fujiki Nobuaki , Morimoto Yoshitaka , Hayashi Akio
Published: May 2020

This paper proposes a calibration method for a parallel mechanism type machine tool (XMINI, Exechon Enterprises L.L.C.). In this method, the kinematic parameters are calculated using forward kinematics and the least squares method from the results obtained by a coordinate measuring machine. By using an articulated arm coordinate measuring machine (AACMM), we can measure a wide space, and the measuring machine position do not have to be determined strictly. This paper provides a solution for the forward kinematics problem to identify the kinematic parameters. The results from the kinematic parameter calculation are evaluated using the experimental results from an actual machine.
Development of an Additive Manufactured Artifact to Characterize Unfused Powder Using Computed Tomography
Authors: Tawfik Ahmed ,   EPSRC Future Advanced Metrology Hub, University of Huddersfield Queensgate, Huddersfield, West Yorkshire HD1 3DH, United Kingdom, Bills Paul , Blunt Liam , Racasan Radu
Published: May 2020

Additive manufacturing (AM) is recognized as a core technology for producing high-value components. The production of complex and individually modified components, as well as prototypes, gives additive manufacturing a substantial advantage over conventional subtractive machining. For most industries, some of the current barriers to implementing AM include the lack of build repeatability and a deficit of quality assurance standards. The mechanical properties of the components depend critically on the density achieved. Therefore, defect/porosity analysis must be carried out to verify the components’ integrity and viability. In parts produced using AM, the detection of unfused powder using computed tomography is challenging because the detection relies on differences in density. This study presents an optimized methodology for differentiating between unfused powder and voids in additive manufactured components, using computed tomography. Detecting the unfused powder requires detecting the cavities between particles. Previous studies have found that the detection of unfused powder requires a voxel size that is as small as 4 μm3. For most applications, scanning using a small voxel size is not reasonable because of the part size, long scan time, and data analysis. In this study, different voxel sizes are used to compare the time required for scanning, and the data analysis showing the impact of voxel size on the detection of micro defects. The powder used was Ti6Al4V, which has a grain size of 45–100 μm, and is typically employed by Arcam electron beam melting (EBM) machines. The artifact consisted of a 6 mm round bar with designed internal features ranging from 50 μm to 1400 μm and containing a mixture of voids and unfused powder. The diameter and depth of the defects were characterized using a focus variation microscope, after which they were scanned using a Nikon XTH225 industrial CT to measure the artifacts and characterize the internal features for defects/pores. To reduce the number of the process variables, the measurement parameters, such as filament current, acceleration voltage, and X-ray filtering material and thickness were kept constant. The VGStudio MAX 3.0 (Volume Graphics, Germany) software package was used for data processing, surface determination, and defects/porosity analysis. The main focus of this study is to explore the optimal methods for enhancing the detection of pores/defects while minimizing the time taken for scanning, data analysis, and determining the effects of noise on the analysis.
Indikator Atribut Sensori Kopi Specialty Asal Jawa Barat Berbasis Komponen Biokimia
Authors: Isnidayu Anandya Vanessa , Sukartiko Anggoro Cahyo , Ainuri Makhmudun
Published: May 2020

Assessing coffee sensory quality is generally carried out by panelists using cup testing with reference to the Specialty Coffee Association of America (SCAA) standards. A high level of sensitivity sensory is essential thus it must be done by trained panelists. Given the limitations of the method, a deeper study is required to obtain a standard of assessment of coffee sensory quality based on more reliable and precise analytical methods, one of which is biochemical components. This study was aimed to analyze the sensory quality and biochemical components of Arabica coffee and determine the indicators of sensory attributes based on those biochemical components. The study was conducted at two Arabica coffee-producing areas in West Java from May to September 2019. The biochemical components analyzed included caffeine, trigonelline, chlorogenic acid (CGA), sucrose, and lipid, while the sensory attributes assessed were aroma, flavor, aftertaste, acidity, body, balance, uniformity, sweetness, clean cup, and overall. The survey method with stratified and simple random sampling was used and followed by Two-way Anova and Partial Least Square analysis. Results showed variations in the biochemical content of coffee from the two areas. Lipid has a positive correlation with the aroma and flavor attributes, and negatively correlated with the body attribute. Caffeine has a negative correlation with the aftertaste attribute, whereas CGA has a negative correlation with the acidity attribute. Correlation between biochemical components with sensory attributes showed that the biochemical content acts as an indicator of sensory attributes.
Efektivitas Aplikasi Fungi Mikoriza Arbuskula dan Arang Hayati terhadap Pertumbuhan Benih Kakao
Authors: Rokhmah Dewi Nur , Sobari Iing , Sasmita Kurnia Dewi
Published: May 2020

Seedling is an important process in preparing cocoa plant material. The growing medium must have sufficient nutrition and physical properties to enable cocoa seeds to grow well. Arbuscular mycorrhizae fungi (AMF) and biological charcoal (biochar) added into growing media were expected to increase the growth of cocoa seeds. The study aimed to determine the effect of AMF and biological charcoal on the growth of cocoa seeds. The randomized complete block design (RBD) in factorial 2 factors with three replications was used in this study. The first factor was AMF application consisted of two levels, namely: M0 = without AMF and M1 = application of 10 g/seedling AMF (100 spores/seedling). The second factor was the biochar application consisted of 5 factors namely: B0 = no biochar, B1 = 2% rice husk biochar, B2 = 4% rice husk biochar, B3 = 2% albizia wood biochar, and B4 = 4% albizia wood biochar. The variables observed were the height of seedling, number of leaves and stem diameter at 3, 4, 5 and 6 month after planting (MAP), leaf chlorophyll content, weight of dry cocoa seedling, and nutrient content in seedling media. The result showed that the application of AMF significantly affected the height of seedling at 3, 4, 5 and 6 MAP. While the application of biochar significantly affected the height and number of leaves of cacao seedlings.
Peningkatan Efisiensi Media Pembentukan Embrio Somatik Kakao Melalui Penggunaan Gula Pasir
Authors: Ajijah Nur , Hartati Sri
Published: May 2020

Availability of inexpensive and efficient tissue culture methods is needed in the development of mass propagation methods. The efficiency can be obtained through the use of low cost media components such as granulated sugar. The study aimed to determine the efficiency of cacao somatic embryo development medium using granulated sugar and its effect on somatic embryo formation. The study was conducted at Tissue Culture Laboratory for Superior Seed Development, IAARD, Bogor, from March to October 2016. Formation and maturation of somatic embryos was conducted using DKW medium without growth regulators. The treatments tested were carbon sources in the media (laboratory grade sucrose; a mixture of sucrose and granulated sugar with a ratio of 3:1, 2:2 and 1:3; granulated sugar) and cacao genotypes (Sca 6 and ICCRI 4). The study used in a randomized complete block design in factorial 2 favtors with 8 replications, which consisted of 10 explants per experimental unit. The results showed that carbon sources and genotypes significantly affected somatic embryos formation, whereas the interaction effect was not significant. The use of granulated sugar 30 g/l produced approximately 35.3% of somatic embryo formation and 3.5 somatic embryos per explant, which is not significantly different from sucrose 30 g/l (31.1% and 4.1), whereas the mixture of sucrose and granulated sugar produced the lowest average percentage of somatic embryo formation and the number of somatic embryos per explant (20.3%, 18.8%, 17.8% and 1.5; 2.2; 2.8 respectively). The low-cost somatic embryogenesis method was successfully developed with an efficiency of 98.8% per liter of media.
Les biofictions à l’ère du numérique, ou profil de l’auteur posté par soi-même : les hypertextes d’Alain Farah et d’Alain Beaulieu
Authors: Pruteanu Simona Emilia
Published: May 2020

Visant à envisager les (nouveaux) objets de l’écrivain à l’ère numérique, ce travail prend pour exemple le cas des deux écrivains et professeurs en création littéraire québécois, Alain Farah et Alain Beaulieu. Cette étude de leurs profils numériques démontre comment le réel, le potentiel et la fiction s’imbriquent dans les sphères publiques, privées et académiques investies par le statut d’auteur assumé par les deux écrivains. L’investissement médiatique des écrivains a pour résultat l’apparition de nouvelles formes de paratexte tout en changeant les modalités de partage entre auteur et son public. L’article suit aussi les modalités de « mise en scène du soi » en tenant compte de la citation de l’artiste allemand Joseph Beuys qu’on retrouve sur les pages sociales d’Alain Farah aussi bien que dans ses entretiens : « Je souhaiterais m’en tenir à cela aussi longtemps que ce m’est possible : jouer encore et encore ce rôle, être tout ce qu’on peut dire de moi. »
Objets trouvés d’une reprouvée : les objets d’écriture de Louise Michel en Nouvelle-Calédonie
Authors: Narayana Valérie
Published: May 2020

Ce travail examine la correspondance d’exil de Louise Michel et y recense les objets qui permettent à la déportée de poursuivre ses projets d’écriture en Nouvelle-Calédonie​.  Ces quelques possessions rendent manifestes les conditions de précarité dans lesquelles écrit l’ancienne Communarde. Les lettres, en plus de montrer la fortune de ces objets, témoignent du minimalisme radical de la militante.  Cette qualité explique largement l’ascendant que Michel exerce sur ses camarades exilés avec qui elle partage biens et écrits. Parmi ces déportés, l’on compte Henry Bauër, fils naturel d’Alexandre Dumas. La singularité du caractère de Louise Michel éclaire également la correspondance entretenue avec Victor Hugo.  En plus de vers envoyés au poète, Michel expédie des objets naturels, sortes d’emblèmes de son regard sur le monde matériel.  Le tout est fragmentaire, résultat des pressions de la surveillance et des remous politiques; bref, ces textes épistolaires sont à l’image de la vie mouvementée de l’auteure.
Valoración de una intervención de fisioterapia acuática en niños con parálisis cerebral mediante la gross motor function measure. Un estudio de casos
Authors: Latorre García Julio , Rodríguez Doncel María Luisa , Sánchez López Antonio Manuel , Pozuelo Calvo Rocio , Aguilar Cordero María José
Published: May 2020

Introducción: El presente estudio, parte de una revisión bibliográfica anterior sobre las técnicas de tratamiento en piscina para los pacientes afectados de Parálisis Cerebral Infantil (PC). Al no encontrar diferencias significativas entre los distintos métodos y técnicas utilizados,  diseñamos un programa de ejercicios según el modelo del desarrollo psicomotor del niño sano, implementándolo y valorando su eficacia en el tratamiento de personas con esta patología  haciendo un uso de la hidroterapia orientado hacia los aspectos estructurales, funcionales y sociales en el proceso global de la rehabilitación. 
Objetivos: El objetivo de este estudio es valorar la evolución que se produce en la función motora gruesa en niños afectados de PC, después de seis meses de tratamiento.
Método: Se trata de un estudio longitudinal prospectivo sobre 12 pacientes con edades comprendidas entre 18 y 33 meses al comienzo, 9 niños y 3 niñas. El protocolo de tratamiento consiste en una sesión semanal de 30 minutos de los cuales, 20 se realizan íntegramente en piscina. Se evaluó mediante la Escala validada Gross Motor Function Measure (GMFM) antes de realizar hidroterapia y a los seis meses de iniciar la intervención. No se ha utilizado grupo control debido a que la diversa sintomatología propia de esta patología lo desaconseja. Cada paciente es su propio control entre el pre y post-test.
Resultados: Se observa una mejoría, estadísticamente significativa, en la escala global GMFM y en aspectos específicos de las subescalas: a) Tumbado y rodando, b) Sentado, c) Gateando y de rodillas, d) de pie, e) Andando, Corriendo, saltando.
Conclusiones: La hidroterapia promueve el desarrollo de habilidades motoras gruesas en niños afectados por PC. También contribuye a un desarrollo positivo en la curva GMFM normal y una mejora posterior a la intervención en los percentiles correspondientes.
Palabras clave: Hidroterapia, Quinesiología Aplicada, Encefalopatía crónica, Enfermedades del recién nacido.
First Insights on Value-Based Healthcare of Elders Using ICHOM Older Person Standard Set Reporting
Authors: Lee Wei-Ju , Peng Li-Ning , Lin Chi-Hung , Lin Shinn-Zong , Loh Ching-Hui , Kao Sheng-Lun , Hung Tzu-Shing , Chang Chia-Yun , Huang Chun-Feng , Tang Ting-Ching , Chen Liang-Kung
Published: May 2020

Background: Clinical guidelines for specific conditions fragment care provision for elders. The International Consortium for Health Outcomes Measurement (ICHOM) has developed a global standard set of outcome measures for comprehensive assessment of older persons. The goal of this study was to report value-based health metrics in Taiwan using this ICHOM toolset.Methods: The cross-sectional study of baseline data excerpted from a prospective longitudinal cohort, which recruited people ≥65 years old with ≥3 chronic medical conditions between July and December 2018. All participants received measurements of physical performance, anthropometric characteristics, health-related behaviors, Charlson Comorbidity Index, and Montreal Cognitive Assessment. The ICHOM toolset comprises three tiers: 1 includes frailty and having chosen a preferred place of death; 2 includes polypharmacy, falls, and participation in decision-making; and 3 includes loneliness, activities of daily living, pain, depression, and walking speed. These items were converted into a 0–10 point value-based healthcare score, with high value-based health status defined as ≥8/10 points. Results: Frequencies of individual ICHOM indicators were: frail 11.7%, chose preferred place of death 14.4%, polypharmacy 31.5%, fell 17.1%, participated in decision-making 81.6%, loneliness 26.8%, limited activities of daily living 22.4, pain 10.4%, depressed mood 13.0%, and slowness 38.5%. People with high disease severity (OR 0.40, 95% CI 0.21–0.76, p=0.005) or cognitive impairment (OR 0.49, 95%CI 0.27–0.87, p=0.014) were less likely to have high value-based healthcare status. Conclusions: The ICHOM Standard Set Older Person health outcome measures provide an opportunity to shift from a disease-centric medical paradigm to whole person-focused goals. This study identified advanced age, chronic disease and cognitive impairment as important barriers to achieving high value-based healthcare status.﻿
The prognostic values of m6A RNA methylation regulators in Uveal melanoma
Authors: Tang Jing , Wan Qi , Lu Jianqun
Published: May 2020

Background: The aim of this study was to identify gene signatures and prognostic values of m6A methylation regulators in uveal melanoma (UM).Methods: The RNA sequencing dataset and corresponding clinical information were downloaded from TCGA and GEO database. Based on the expression of m6A RNA methylation regulators, the patients were further clustered into different groups by applying the “ClassDiscovery” algorithm. Best survival analysis was performed to select prognostic m6A regulators and multivariate cox regression analysis was applied to constructed m6A regulators signature. The association between mutations and m6A regulators was assessed by Kruskal−Wallis tests and clinical characteristics were examined by using chi-square test.Results: Totally, we identified two molecular subtypes of UM (C1/2) by applying consensus clustering to m6A RNA methylation regulators. In contrast to the C1 subtype, the C2 subtype associates with a better prognosis, have higher percentage of subtype 1 and lower percentage of Monosomy 3 which have been regarded as the well established prognostic markers for UM. The malignant hallmarks of mTORC1 signaling, oxidative phosphorylation, interferon-a response and apoptosis signaling are also significantly enriched in the C1 subtype. Moreover, a 3-m6A regulators signature was constructed by multivariate cox regression analysis method, which closely correlated with chromosome 3 status, subtype 1 of UM and can robustly predict patients’ overall survival time.Conclusions: m6A RNA methylation regulators take a crucial role in the potential malignant progression and prognostic value of UM and might be regarded as a new promising biomarker for UM prognosis and treatment strategy development.
Effect Of Smoking On Treatment Outcome Among Tuberculosis Patients In Malaysia; A Multicenter Study
Authors: Khan Amer Hayat , Sulaiman Syed Azhar Syed , Hassali Mohamed Azmi , Khan Kashif Ullah , Ming Long Chiau , Mateen Umer , Malik Obaid Ullah
Published: May 2020

Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. The current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients. Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form. Results: Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smokers, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with extrapulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) all showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smokers' group, while 4004 (79.7 %) patients were non-smokers. The proportion of deaths (6.6%, n=283), defaulters (6.6%, n=284) and treatment interruptions (4.7%, n=204) was higher in the smokers' group.Conclusions: Smoking has a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings indicate that smoking cessations are an effective way to decrease treatment failure and drug resistance.
Setting up a nurse-led model of care for management of Hypertension and Diabetes Mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study
Authors: Frieden Marthe Marie , Zamba Blessing , Mukumbi Nisbert , Mafaune Patron Titsha , Makumbe Brian , Irungu Elizabeth , Moneti Virginia , Isaakidis Petros , Garone Daniela , Prasai Madhu Janina
Published: May 2020

Background: In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context-adapted, cost-effective service delivery models are now required as a matter of urgency. We describe the experience of setting up and organising a nurse-led Diabetes Mellitus (DM) and Hypertension (HTN) model of care in rural Zimbabwe, a low-income country with unique socio-economic challenges and a dual disease burden of HIV and NCDs. Methods: Mirroring the HIV experience, we designed a conceptual framework with 9 key enablers: decentralization of services, integration of care, simplification of management guidelines, mentoring and task-sharing, provision of affordable medicines, quality assured laboratory support, patient empowerment, a dedicated monitoring and evaluation system, and a robust referral system. We selected 9 primary health care clinics (PHC) and two hospitals in Chipinge district and integrated DM and HTN either into the general out-patient department, pre-existing HIV clinics, or an integrated chronic care clinic (ICCC). We provided structured intensive mentoring for staff, using simplified protocols, and disease-specific education for patients. Free medication with differentiated periodic refills and regular monitoring with point of care (POC) glycosylated haemoglobin (HbA1c) were provided. Results: Nurses in 7 PHC facilities and one hospital developed sufficient knowledge and skills to diagnose, initiate treatment and monitor DM and HTN patients, and 3094 patients were registered in the programme (188 with DM only, 2473 with HTN only, 433 with both DM and HTN). Major lessons learned from our experience include: the value of POC devices in the management of diabetes; the pressure on services of the added caseload, exacerbated by the availability of free medications in supported health facilities; and the importance of leadership in the successful implementation of care in health facilities.Conclusion: Our experience demonstrates a model for nurse-led decentralized integrated DM and HTN care in a high HIV prevalence rural, low-income context. Developing a context-adapted efficient model of care is a dynamic process. We present our lessons learned with the intention of sharing experience which may be of value to other public health programme managers.
The level of bilirubin and the risk of ischemic stroke: a systematic review and dose-response meta-analysis of real-world studies
Authors: Wang Xiao , Zhou Yang , Ye Xiaofei , Liu Fangchen , Zhu Xi , Wu Danhong , Zhong Ping
Published: May 2020

Background: Bilirubin, a marker of hepatic and hematological diseases in clinical practice, is not only a waste end-product but also an antioxidant that may protect against diseases associated with oxidative stress. Numerous epidemiological studies have shown an inverse relationship between the serum total bilirubin (TBIL) level and the risk of ischemic stroke (IS). However, markedly elevated TBIL levels may exert neurotoxic effects. Based on this, we conducted a dose-response meta-analysis to quantify the relationship between blood TBIL and IS as well as between TBIL and all types of stroke (AS) in the physiological range of bilirubin.Methods: PubMed, Embase, Web of Science, and Cochrane Central databases were searched up to March 2019. Additional studies were identified by reviewing references and contacting authors. Categorical and dose-response meta-analyses were performed to quantify the relationship between TBIL and IS. The primary outcome was ischemic stroke, and the secondary outcome was all types of stroke.Results: Nine observational studies (seven publications) involving 110,032 participants and 3710 stroke cases were included for analysis. The average OR of IS for every 1 µmol/L increment in TBIL level was 0.978 (95% CI: 0.957–0.999). The summary OR of AS for every 1 µmol/L increment in TBIL level was 0.974 (95% CI: 0.956–0.992). Subgroup analysis based on gender showed a negative dose-response relationship between the circulating TBIL level and IS or AS in males, but not in females.Conclusions: The present study found a negative dose-response relationship between the circulating TBIL level and the risk of IS or AS within physiologic range of serum TBIL in males. Moderately elevated blood TBIL levels might be associated with a diminished prevalence of IS. Every 1 µmol/L increment in serum TBIL level was associated with a 2.2% decrease in the risk of IS and a 2.6% decrease in the risk of AS. However, due to the limitations in the number of included studies and their quality, large-scaled prospective cohort studies are needed to confirm the conclusion of the current analysis.Trial registration: This study was registered at PROSPERO (https://www.crd. york.ac.uk/PROSPERO/[CRD42017075988]).
Microglia depletion fails to abrogate inflammation-induced sickness in mice and rats
Authors: Vichaya Elisabeth G. , Malik Sajida , Sominsky Luba , Ford Bianca G. , Spencer Sarah J. , Dantzer Robert
Published: May 2020

Background: Production of inflammatory mediators by reactive microglial cells in the brain is generally considered the primary mechanism underlying the development of symptoms of sickness in response to systemic inflammation.Methods: Depletion of microglia was achieved in C57BL/6 mice by chronic oral administration of PLX5622, a specific antagonist of colony stimulating factor-1 receptor, and in rats by a knock-in model in which the diphtheria toxin receptor was expressed under the control of the endogenous fractalkine receptor (CX3CR1) promoter sequence. After successful microglia depletion, mice and rats were injected with a sickness-inducing dose of lipopolysaccharide according to a 2 (depletion versus control) x 2 (LPS versus saline) factorial design. Sickness was measured by body weight loss and decreased locomotor activity in rats and mice, and reduced voluntary wheel running in mice. Results: Chronic administration of PLX5622 in mice and administration of diphtheria toxin to knock-in rats depleted microglia and peripheral tissue macrophages. However, it did not abrogate the inducible expression of proinflammatory cytokines in the brain in response to LPS and even exacerbated it for some of the cytokines. In accordance with these neuroimmune effects, LPS-induced sickness was not abrogated, rather it was exacerbated when measured by running wheel activity in mice. Conclusions: These findings reveal that the sickness-inducing effects of acute inflammation can develop independently of microglia activation.
No evidence for amyloid pathology as a key mediator of neurodegeneration post-stroke - a seven-year follow-up study
Authors: Hagberg Guri , Ihle-Hansen Hege , Fure Brynjar , Thommessen Bente , Ihle-Hansen Håkon , Øksengård Anne Rita , Beyer Mona K. , Wyller  , Müller Ebba Gløersen , Pendlebury Sarah T. , Selnes Per
Published: May 2020

Background: Cognitive impairment (CI) with mixed vascular and neurodegenerative pathologies after stroke is common. The role of amyloid pathology in post-stroke CI is unclear. We hypothesize that amyloid deposition, measured with Flutemetamol (18F-Flut) positron emission tomography (PET), is common in seven-year stroke survivors diagnosed with CI and, further, that quantitatively assessed 18F-Flut-PET uptake after seven years correlates with amyloid-β peptide (Aβ₄₂) levels in cerebrospinal fluid (CSF) at one year, and with measures of neurodegeneration and cognition at seven years post-stroke. Methods: 208 patients with first-ever stroke or transient Ischemic Attack (TIA) without pre-existing CI were included during 2007 and 2008. At one- and seven-years post-stroke, cognitive status was assessed, and categorized into dementia, mild cognitive impairment or normal. Etiologic sub-classification was based on magnetic resonance imaging (MRI) findings, CSF biomarkers and clinical cognitive profile. At seven years, patients were offered 18F-Flut-PET, and amyloid-positivity was assessed visually and semi-quantitatively. The associations between 18F-Flut-PET standardized uptake value ratios (SUVr) and measures of neurodegeneration (medial temporal lobe atrophy (MTLA), global cortical atrophy (GCA)) and cognition (Mini-Mental State Exam (MMSE), Trail-making test A (TMT-A)) and CSF Aβ₄₂ levels were assessed using linear regression. Results: In total, 111 patients completed 7-year follow-up, and 26 patients agreed to PET imaging, of whom 13 had CSF biomarkers from one year. Thirteen out of 26 patients were diagnosed with CI seven years post-stroke, but only one had visually assessed amyloid positivity. CSF Aβ₄₂ levels at one year, MTA grade, GCA scale, MMSE score or TMT-A at seven years did not correlate with 18F-Flut-PET SUVr in this cohort.Conclusions: Amyloid binding was not common in 7-year stroke survivors diagnosed with CI. Quantitatively assessed, cortical amyloid deposition did not correlate with other measures related to neurodegeneration or cognition. Therefore, amyloid pathology may not be a key mediator of neurodegeneration seven years post-stroke.Trial registration: Clinicaltrials.gov (NCT00506818). July 23, 2007. Inclusion from February 2007, randomization and intervention from May 2007 and trial registration in July 2007.
Clinical, Functional and Radiographic Outcomes of Primary Total Hip Arthroplasty between Direct Anterior Approach and Posterior Approach: a Systematic Review and Meta-analysis
Authors: Peng Linbo , Zeng Yi , Wu Yuangang , Zeng Junfeng , Liu Yuan , Shen Bin
Published: May 2020

Background: The purpose of this systematic review and meta-analysis was to compare the direct anterior approach and posterior approach for primary total hip arthroplasty in terms of the clinical, functional and radiographic outcomes.Methods: We searched the PubMed and EMBASE databases and Cochrane Library from their inception to November 1, 2019. We searched for previously published articles and meta-analyses of randomized controlled trials.Results: A total of 7 randomized controlled trials with 600 participants met the inclusioncriteria. Among these patients, 301 and 299 were included in the DAA and PA groups, respectively. The DAA was associated with a longer surgery by a mean duration of 13.74 min (95% CI 6.88 to 20.61, p < 0.0001, I2=93%). The postoperative early functional outcomes were significantly better in the DAA group than in the PA group, such as the Visual Analogue Scale (VAS) score at 1 day postoperatively (MD=-0.65, 95% CI -0.91 to -0.38, p < 0.00001, I2=0%), VAS score at 2 days postoperatively (MD=-0.67, 95% CI -1.34 to -0.01, p =0.05, I2=88%) and Harris Hip Score (HHS) at 6 weeks postoperatively (MD=6.05, 95% CI 1.14 to 10.95, p =0.02, I2=52%). There was no significant difference between the DAA and PA groups in the length of the incision, hospital length of stay (LOS), blood loss, transfusion rates or complication rates. We found no significant difference between the two groups regarding late functional outcomes, such as the VAS score at 12 months postoperatively or the HHS scores at 3, 6, and 12 months postoperatively. A significant difference in the radiographic outcomes was not detected.Conclusions: The DAA requires a longer surgery time than does the PA in primary total hip arthroplasty. The DAA yields better early functional recovery than does the PA. There was no significant difference between the two groups in terms of other clinical, complication-related, late functional or radiographic outcomes. The evidence on the superiority of the DAA is insufficient and needs to be studied further.
Antimicrobial practices among small animal veterinarians in Greece: a survey
Authors: Valiakos George , Pavlidou Eleni , Zafeiridis Christos , Tsokana Constantina N , Vilas Victor J Del Rio
Published: May 2020

Background The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece.Methods A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics.Results The majority of respondents’ report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents prefer to adopt the empirical treatment while waiting the laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections. Conclusions Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.
Serum amyloid A 1 protein isoforms induce Rheumatoid Arthritis
Authors: Leung Elaine Lai-Han , Lai Huan-Ling , Li Run-Ze , Pan Hu-Dan , Jiang Ze-Bo , Li Ying , Duan Fu-Gang , Xu Jia-Hui , Zhang Yi-Zhong , Shi A-Xi , Wei Chun-Li , Zhang Fang-Yuan , Yao Xiao-Jun , Liu Liang
Published: May 2020

The authors have withdrawn this preprint due to author disagreement.
A review of multi-dimensional diagnosis of Alport syndrome in 22 children in Northeast China
Authors: Zhang Li , Sun Bai-chao , Zhao Bing-gang , Ma Qing-shan
Published: May 2020

Background Alport syndrome (AS) is progressive hereditary nephritis due to different gene mutations. Affected individuals usually develop hematuria during childhood with gradual deterioration of renal functions. We adopted multi-dimensional methods to diagnose Alport syndrome in order to decrease the misdiagnosis.Methods Twenty-two children were diagnosed and managed by the Department of Pediatric Nephrology of Jilin University First Hospital between January 2017 and January 2020 through multi-dimensional methods. Information collected included age of onset, age at diagnosis, clinical manifestations, family history (FH), renal pathology and their genotype. Results All patients presented with hematuria with various degrees of proteinuria in some patients. While three children suffered from hearing loss, none of the children in the cohort had any visual problem or renal failure. Besides five patients estimated as Stage 2, the remain seventeen cases were at Stage 0. Renal biopsy were obtained in eighteen patients and fourteen of them showed glomerular basement membranes (GBM)-specific abnormalities. Thirteen children had mutations of the collagen IV genes. Conclusion Combined with the importance of early diagnosis and economic factors, we adopted multi-dimensional methods to improve the diagnosis of Alport syndrome and estimate the risk of progression. We also reviewed the therapy progress.