bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening of Potential Molecular Targets for Proximal, Mid, and Distal Esophageal Cancers
Authors: Zhong Liping , Guo Zeying , Pan Yuefen , Zhu Xiaoyong , Chen Yurong
Published: June 2020

Objective: This study aimed to screen the potential molecular targets for proximal, mid, and distal esophageal cancers.Methods: The clinical data, RNA-seq data, and survival data for TCGA esophageal cancer were retrieved from UCSC Xena database. The samples with clinical information on the esophageal tumor central location were selected. Differential analyses on different groups (mid vs. proximal, distal vs. proximal, and distal vs. mid) were performed. Following the differentially expressed genes (DEGs) in three groups were analyzed, the common genes were subjected to survival analysis, miRNA prediction, and drug-gene analysis. The specific genes were annotated for functional and module analyses.Results: Six common genes, namely KCNA1, CCDC196, UNC5CL, CYP3A5, CA10, and REG3A, were analyzed among three comparison groups. The expression of CA10 and REG3A was significantly correlated in the prognosis of patients with esophageal cancer. The distal vs. mid groups screened 766 specific DEGs, and the mid vs. proximal group screened 99 specific DEGs. Functional analysis showed that the genes of distal vs. mid groups, including EDN3, CGA, CCR9, and GABRA2, as well as genes in the mid vs. proximal groups, including GCGR, OXTR, and MCHR2, were significantly enriched in neural functions. In the distal vs. proximal groups, there were 314 specific DEGs, including CYP2C8 and OXGR1.Conclusion: Six common genes may serve as the potential molecular targets for the treatment of all proximal, mid, and distal esophageal cancers.
An Open Source Chemical Structure Curation Pipeline using RDKit
Authors: Bento A Patrícia , Hersey Anne , Felix Eloy , Landrum Greg , Gaulton Anna , Atkinson Francis , Bellis Louisa J , De Veij Marleen , Leach Andrew R
Published: June 2020

BackgroundThe ChEMBL database is one of a number of public databases that contain bioactivity data on small molecule compounds curated from diverse sources. Incoming compounds are typically not standardised according to consistent rules. In order to maintain the quality of the final database and to easily compare and integrate data on the same compound from different sources it is necessary for the chemical structures in the database to be appropriately standardised.ResultsA chemical curation pipeline has been developed using the open source toolkit RDKit. It comprises three components: a Checker to test the validity of chemical structures and flag any serious errors; a Standardizer which formats compounds according to defined rules and conventions and a GetParent component that removes any salts and solvents from the compound to create its parent. This pipeline has been applied to the latest version of the ChEMBL database as well as uncurated datasets from other sources to test the robustness of the process and to identify common issues in database molecular structures. ConclusionAll the components of the structure pipeline have been made freely available for other researchers to use and adapt for their own use. The code is available in a GitHub repository and it can also be accessed via the ChEMBL Beaker webservices. It has been used successfully to standardise the nearly 2 million compounds in the ChEMBL database and the compound validity checker has been used to identify compounds with the most serious issues so that they can be prioritised for manual curation.
Identification of infrasonic and seismic components of tremors in single-station records: application to the 2013 and 2018 events at an isolated volcanic island, Ioto, Japan
Authors: Kurokawa Aika K. , Ichihara Mie
Published: June 2020

Infrasonic stations are sparse at many volcanoes, especially those on remote islands and those with less frequent eruptions. When only a single infrasound station is available, the seismic-infrasonic cross-correlation method has been used to extract infrasound from wind noise. However, it does not work with intense seismicity and sometimes mistakes ground-to-atmosphere signals as infrasound. This paper proposes a complementary method to identify the seismic component and the infrasonic component using a single microphone and a seismometer. We applied the method to estimate the surface activity on the isolated volcanic island, Ioto. We focused on volcanic tremors during the phreatic eruption on April 11, 2013, and during an unconfirmed event on September 12, 2018. We used the spectral amplitude ratios of the vertical ground motion to the pressure oscillation and compared those for the tremors with those for known signals generated by volcano-tectonic earthquakes and airplanes flying over the station. We were able to identify the infrasound component in the part of the seismic tremor with the 2013 eruption. On the other hand, the tremor with the unconfirmed 2018 event was accompanied by no apparent infrasound. We interpreted the results that the infrasound with the 2013 event was excited by the vent opening or the ejection of ballistic rocks, and the 2018 event was not an explosive eruption either on the ground or in the shallow water. If there was any gas (and ash) emission, it might have occurred gently undersea. As the method uses the relative values of on-site records instead of the absolute values, it is available even if the instrument sensitivity and the station site effects are poorly calibrated.
Neoadjuvant concurrent chemoradiotherapy followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery for low-lying rectal adenocarcinoma: a single center study
Authors: Lu Yen-Jung , Chen Chien-Hsin , Lin En-Kwang , Wu Szu-Yuan
Published: June 2020

Purpose
To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma.
Methods and materials:
A total of 23 patients with clinical stage II-III low-lying (from anal verge 0–8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U-test were used to make nonparametric comparisons.
Results
Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 minutes and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested were 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS.
Conclusion
Neoadjuvant CCRT followed by TaTME-SPLS can be a safe and an effective sphincter-preserving procedure with acceptable morbidity rate for Asian patients with low-lying rectal adenocarcinoma.
Febrile infants without respiratory symptoms or sick contacts: Are chest radiographs or RSV/influenza testing indicated?
Authors: Ozcan Ali , Laskowski Evelyn , Sahai Shashi , Levasseur Kelly
Published: June 2020

Objectives: Serious bacterial infection rates in febrile infants <60 days are about 8-11%. Less than 1% of febrile infants with no respiratory symptoms will have pneumonia however, chest radiography (CXR) rates remain between 30-60%. Rapid Respiratory Syncytial Virus (RSV) and influenza (flu) testing is common, however, there is not enough data to determine if febrile infants without any respiratory symptoms should be tested. The goal of this study is to determine the rate of positive CXR and RSV/flu results in febrile infants with no respiratory symptoms and no sick contacts. Methods: Well-appearing febrile infants between 7-60 days of age who presented to the pediatric emergency department (PED) from September 1 st , 2015 through October 30 th , 2017 were enrolled. Demographic data, respiratory symptoms, CXR findings and RSV/flu results were collected. SAS statistical software was used for analysis. Results: 129 infants met enrollment criteria. Of the 129 infants, 58 (45.0%) had no respiratory symptoms and no sick contacts. Of these 58, 36 (62%) received a CXR and none of them had any abnormal findings, 48 (83%) had RSV/flu testing, no patients tested positive for RSV and only one patient tested positive for flu. Costs of CXR and RSV/flu testing for this cohort was $19,788. Conclusion: The absence of positive CXRs in this patient population reinforces the current recommendations that CXR is not indicated. The low incidence of RSV/flu indicate that routine testing may not be necessary in this population especially outside of the flu season. Reduced testing could decrease overall costs to the healthcare system as well as radiation exposure to this population.
Construction of an RNA Binding Protein-based Model for Prognosis Prediction of Colorectal Cancer
Authors: li Ting , Hui Wenjia , Halike Halina , Gao Feng
Published: June 2020

Background: Colorectalcancer (CRC) is a prevalent gastrointestinal tumor with high incidence and mortality. Dysregulation of RNA binding proteins (RBPs) has been found in a variety of cancers and is related to oncogenesis and progression. This study aimed to develop and validate new biomarkers related to CRC prognosis by a series of bioinformatics analysis.Methods: We mined the gene expression data of 510 CRC samples from The Cancer Genome Atlas (TCGA) database, differentially expressed genes were screened and prognosis-related genes were identified. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out. A prognosis-related gene signature was constructed by univariate and multivariate Cox analysis. Kaplan–Meier curves and time-dependent receiver operating characteristic (ROC) curves were utilized to evaluate the signature,The test set was used to validate the RBPs risk score model.Survival analysis was carried out to determine the independent prognostic significance of the signature. A nomogram combined with the gene signature was constructed.Results: A total of 224 aberrantly expressed RBPs were obtained, comprising 78 downregulated and 146 upregulatedRBPs. 13 RBPs with p < 0.005 were revealed in univariateCox regression analysis of train group, then stepwise multivariate Cox regression was applied for constituting an eight- RBP (BRCA1, TERT, TDRD7, PPARGC1A, LUZP4, CELF4, ZC3H12C, PNLDC1) signature prognostic biomarkers. Further analysis demonstrated that high risk score for patients was significantly related to poor overall survival according to the model. The area under the time-dependent receiver operator characteristic curve of the prognostic model was 0.730 at 5 years. The signature-based risk score was an independent prognostic factor in CRC patients. We also established a nomogram based on eight RBPs and internal validation in the train set, which displayed a favorable discriminating ability for Colorectal cancer.Conclusions: The established eight-RBP signature may serve as a novel independent prognostic factor that could be an important tool to predict the prognostic outcome of CRC patients. However, the specific biological mechanism needs further verification.
Analysis of the expression and potential molecular mechanism of interleukin-1 receptor antagonist (IL1RN) in papillary thyroid cancer via bioinformatics methods
Authors: Xie Zhenyu , Li Xin , He YuZhen , Wu Song , Wang Shiyue , Sun Jianjian , He Yuchen , Lun Yu , Xin Shijie , Zhang Jian
Published: June 2020

Background: Interleukin-1 receptor antagonist (IL1RN) has been reported as a biomarker of many cancers. However, the biological function of IL1RN in papillary thyroid carcinoma (PTC) remains undetermined.Methods: We obtained IL1RN expression data from The Cancer Genome Atlas (TCGA) database. Enrichment analysis of coexpressed genes and IL1RN methylation analysis were performed via LinkedOmics. The correlations between IL1RN and immune infiltrates were investigated via ESTIMATE, TIMER and TISIDB. We analyzed the association of IL1RN expression with pancancer overall survival (OS) via Gene Expression Profiling Interactive Analysis (GEPIA).Results: IL1RN showed higher expression levels and lower methylation levels in PTC tissues than in normal tissues. Higher IL1RN expression was significantly associated with shorter progression-free survival (PFS), advanced tumor stage, tumor metastasis, increased incidence of BRAF mutations, and decreased incidence of N-RAS and H-RAS mutations. Genes coexpressed with IL1RN participate primarily in immune-related pathways. IL1RN expression was positively correlated with immune infiltration, tumor progression and poor overall survival for all cancers.Conclusions: IL1RN is a good prognostic and diagnostic biomarker for PTC. IL1RN may promote thyroid cancer progression through immune-related pathways. Methylation may act as an upstream regulator of IL1RN expression and biological function. Additionally, IL1RN was shown to have broad prognostic value in a pancancer cohort.
Are Fiscal Deficits Inflationary in Nigeria? Evidence From Cointegration With Structural Breaks
Authors: Fasanya Ismail , Fajobi Ayinke , Adetokunbo Abiodun
Published: June 2020

In this paper, we model the relationship between fiscal deficit and inflation for Nigeria using annual data from 1980 to 2019. We employ the Linear ARDL approach and also account for structural breaks using the Bai and Perron (2003) test that allows for multiple structural changes in regression models.The paper finds that fiscal deficit is a major determinant of inflation along with other macroeconomic factors considered in the study. However, we observe that it may be necessary to pre-test for structural breaks when modelling the relationship between fiscal deficit and price level as it performs better than when structural events are not considered.The results imply that a fiscal management process that does not encourage increased revenue and reduce fiscal deficits in Nigeria will further worsen the level of inflation in the country.
Incidence and predictors of surgical site infection after distal femur fractures treated by open reduction and internal fixation: a prospective single-center study
Authors: Zhang Junzhe , Li Junyong , Zhao Kuo , Meng Hongyu , Zhu Yanbin , Zhang Yingze
Published: June 2020

Background: There remain limited data on the epidemiological characteristics and related predictors of surgical site infection (SSI) after open reduction and internal fixation (ORIF) for distal femur fractures. We designed this single-centre prospective study to explore and resolve these clinical problems.Methods：From October 2014 to December 2018, 364 patients with distal femur fractures were treated with ORIF and followed for complete data within one year. Receiver operating characteristic (ROC) analyses, univariate Chi-square analyses, and multiple logistic regression analyses were used to screen the adjusted predictors of SSI.Results: The incidence of SSI was 6% (22/364): 2.4% for superficial SSIs and 3.6% for deep SSIs. Staphylococcus aureus (methicillin-resistant S. aureus in 2 cases) was the most common pathogenic bacteria (7, 36.8%). In multivariate analysis, parameters independently associated with SSI were: Open fracture (OR: 7.27, p = 0.003), drain use (OR: 4.11, p = 0.037), and incision cleanliness (OR: 3.53, p = 0.002). An albumin/globulin (A/G) level ≥ 1.35 (OR: 0.23, p = 0.042) was an adjusted protective factor for SSI. Conclusions: The SSI after ORIF affected approximately one in 15 patients with distal femur fractures. We recommend that maintaining A/G levels higher than 1.35 is introduced during hospitalization and elaborative evaluation of drain use is conducted for reducing the risk of post-operative SSI. Trial registration: NO 2014-015-1, October 15, 2014. We registered our trial prospectively in October 15, 2014 before the first participant was enrolled. This study protocol was conducted according to the Declaration of Helsinki and approved by the Institutional Review Board. The ethics committee approved the Surgical Site Infection in Orthopaedic Surgery (NO 2014-015-1). Data used in this study were obtained from the patients who underwent orthopaedic surgeries between October 2014 to December 2018. Keywords : predictor, surgical site infection, distal femoral fracture, internal fixation surgery
I felt so much conflict instead of joy: An analysis of narratives from pregnant people in British Columbia who declined care recommendations
Authors: Stoll Kathrin , Wang Jessie J. , Niles Paulomi , Wells Lindsay , Vedam Saraswathi
Published: June 2020

Background
No Canadian studies to date have examined the experiences of people who decline care during pregnancy and birth. The current analysis bridges this gap by describing narratives from 892 people in British Columbia (BC) who refused a test or procedure that their care provider recommended.
Methods
In the Changing Childbirth in BC study, childbearing people designed a mixed-methods study that captured experiences of receiving maternity care, including novel items describing provider-patient interactions. We conducted a descriptive quantitative content analysis of 1540 open ended comments about declining care recommendations.
Results
Close to half of people who participated in the survey (n = 892; 46%) declined a test or procedure. Participants most commonly declined genetic or gestational diabetes testing, ultrasounds, induction of labour, pharmaceutical pain management during labour, and eye prophylaxis for the newborn. Some people reported that care providers accepted or supported their decision, and others described pressure and coercion from providers. These negative interactions resulted in childbearing people feeling invisible, disempowered and in some cases traumatized. Loss of trust in healthcare providers were also described by childbearing people whose preferences were not respected whereas those who felt informed about their options and supported to make decisions about their care reported positive birth experiences.
Conclusions
Declining care is common during pregnancy and birth and care provider reactions and behaviours greatly influence how childbearing people experience these events. Our findings confirm that clinicians need further training in person-centred decision-making, including respectful communication even when choices fall outside of standard care.
Relationship of attitudes toward uncertainty and preventive health behaviors with breast cancer screening participation
Authors: Satoh Miho , Sato Naoko
Published: June 2020

Background: Early detection of breast cancer is effective for prolonging survival, but the participation rate in breast cancer screening among target Japanese women remains low. This study examined the relationships between tendencies in decision-making under uncertainty conditions, health behaviors, demographics, and breast cancer screening participation in Japanese women.Methods: Data for women aged 40 years or older obtained in the 2017 Keio Household Panel Survey were analyzed. Participants answered questions about breast cancer screening attendance in the last year, risk aversion, time preference, health behaviors (e.g., smoking habit, alcohol consumption, and medical treatment received in the last year), and demographic variables. Responses were analyzed using chi-squared tests, t-tests, and logistic regression analysis. Variables were entered into the regression model if they were significantly associated with breast cancer screening participation in univariate analysis.Results: A total of 2,729 of 2,945 households responded to the questionnaire. Data from 708 questionnaires were analyzed. Among the respondents, 28.8% had participated in breast cancer screening in the past year. Factors found to significantly contribute to breast cancer screening participation included higher risk aversity (odds ratio [OR], 2.34; 95% confidence interval [CI] = 1.03-5.32; p = 0.043), medical treatment received in the last year (OR, 1.56; 95%CI = 1.06-2.30; p = 0.026), higher self-rated health (OR, 1.47; 95% CI = 1.18-1.83; p = 0.001), living above the poverty line (OR, 2.31; 95% CI = 1.13-4.72; p = 0.022), and having children (OR, 1.57; 95% CI = 1.02-2.42; p = 0.042). Factors not significantly associated with screening participation were smoker (OR, 0.20; 95% CI = 0.10-0.42; p < 0.000), alcohol drinker (OR, 0.56; 95% CI = 0.37-0.86; p = 0.007), self-employed (OR, 0.22; 95% CI = 0.10-0.46; p < 0.000), and unemployed (OR, 0.48; 95% CI = 0.26-0.90; p = 0.022). No significant relationship was observed between time preference and screening participation.Conclusions: The results indicate that women who recognize the actual risk of developing breast cancer or have high awareness of breast cancer prevention tend to participate in breast cancer screening. Barriers to screening participation are not working for an enterprise that encourages screening and low income.
Fear of COVID-19, psychological distress, work satisfaction and turnover intention among front line nurses 
Authors: Labrague CHS DM PhD Leodoro J. , Santos Janet De los
Published: June 2020

Aim: To examine the relative influence of fear of COVID-19 on nurses’ psychological distress, work satisfaction and intent to leave their organisation and the profession. Background: The emergence of COVID-19 has significantly impacted the psychological and mental well-being of frontline healthcare workers, including nurses. To date, no studies have been conducted examining how this fear of COVID-19 contributes to health, well-being and work outcomes in frontline nurses.Methods: This is a cross-sectional research design involving 261 frontline nurses in the Philippines. Five standardised scales were used for data collection. Results: Overall, the composite score of the fear of COVID-19 scale was 19.92. Job role and attendance of COVID-19-related training predicted fear of COVID-19. An increased level of fear of COVID-19 was associated with decreased job satisfaction, increased psychological distress, and increased organisational and professional turnover intentions.Conclusions: Frontline nurses who reported not having attended COVID-19-related training and those who held part-time job roles reported increased fears of COVID-19. Addressing the fear of COVID-19 may result in improved job outcomes in frontline nurses, such as increased job satisfaction, decreased stress levels and lower intent to leave the organisation and the profession. Implications for Nursing Management: Organisational measures are vital to support the mental health of nurses and address their fear of COVID-19 through peer and social support, psychological and mental support services (e.g., counselling or psychotherapy), provision of training related to COVID-19, and accurate and regular information updates.
The Kinetics of Humoral Response and its Relationship with the Disease Severity in COVID-19
Authors: Ren Lili , Zhang Lulu , Chang De , Guo Li , Wang Junwen , Wang Linghang , Hu Yongfeng , Chen Hong , Wu Chao , Wang Conghui , Wang Yingying , Wang Ying , Wang Geng , Yang Siyuan , Cruz Charles S Dela , Sharma Lokesh , Zhang Dingyu , Wang Jianwei
Published: June 2020

Coronavirus Disease 2019 (COVID-19) has caused global pandemic. Here we profiled the humoral response against SARS-CoV-2 by measuring immunoglobulin (Ig) A, IgM and IgG against nucleocapsid, spike proteins and IgM, IgG antibodies against receptor-binding domain (RBD) of the spike protein along with total neutralizing antibodies. We tested 279 plasma samples collected from 176 COVID-19 patients. We demonstrate more severe cases have a late onset in the humoral response compared to mild/moderate infections. All the antibody titers continue to rise in patients with COVID-19 over the disease course. However, these levels are mostly unrelated to the disease severity. The appearance time and titers of neutralizing antibodies showed significant positive correlation to the antibodies against spike protein. Our results suggest late onset of antibody response as a risk factor for disease severity, however there is a limited role of antibody titers in predicting disease severity of COVID-19.
WITHDRAWN: Effect of MgO on the Properties of Alumina-Graphite Based Refractory Including 20 wt% Non-Stabilized ZrO2
Authors: Abolfazli Maryam , Paydar Mohammad Hossein
Published: June 2020

In this study the effect of magnesium oxide in the range of 0 to 10 wt. % on the mechanical properties, corrosion rate, preventing carbon bond oxidation and microstructure of alumina-graphite (coarse-grained) refractory bodies including 20 wt. % of non-stabilized zirconia is investigated. The refractories were fabricated by mixing raw materials, where phenolic resin in the form of liquid was used as binder, and then granulation, cold isostatic pressing and firing at 1400 °C for 8 hours in a reducing atmosphere. Mechanical, physical and chemical properties of the fabricated refractories were evaluated by determining cold compressive strength, modulus of rupture and thermal shock resistance, bulk density, molten shock resistance, permeant linear change, oxidation and corrosion resistance. The results showed that in the presence of MgO, the zirconia grain size increases and it results in a decrease in bulk density that leads in more slag penetration and decreasing corrosion resistance. It has also revealed that addition of MgO to the base refractory leads to decreasing in cold crushing strength, modulus of rupture, and thermal shock resistance. It has been also proved that it causes an expansion during sintering process and results in positive permeant linear change.
Is Carbon Decoupling Likely to Happen in Africa: Evidence From Production and Consumption-based Carbon Emissions
Authors: Tenaw Dagmawe
Published: June 2020

Despite extensive studies made on decoupling between emissions and growth, evidences have shown no uniformity and vast majority of studies considered emissions generated at the point of production alone which do not explicitly account for emissions associated with international trade. Accordingly, this study examines the issue of decoupling between economic growth and carbon emissions in 25 African countries over 1990-2017, considering both production and consumption-based CO2emissions. Different panel data estimation techniques which allow for cross-sectional dependence, heterogeneity,endogeneity and serial-correlation issues are applied for empirical analysis.The study results invariably indicate some evidence of relative decoupling for production-based emissions, but no robust evidence of decoupling for consumption-related emissions. Primary energy intensity and population are found as the main driversof carbon emissions in Africa. Further, exports and imports have insignificant effects on territorial emissions, but significant and offsettingeffects on consumption-based emissions. After all, this study suggests toincorporate emissions generated fromconsumption activities in emissions-growth linkage as production-related emissionsalone would evidently be insufficient for decarbonizing economic growth.
Effects of three methods of breast milk expression on breastfeeding initiation, breast milk extraction and proportion of exclusive breastfeeding—an open label, randomized controlled trial
Authors: Zhou Yun , Ni Jiaying , Zhou Chenchen , Chen Ying , Little Julian , Zhang Lin
Published: June 2020

Background Direct breastfeeding hasmultiple health benefits. Some mothers need to express their breasts when directly breast feeding is unavailable after delivery . However, there is insufficient evidence regarding an effective method of breast milk expression in the absence of an infant's suction. We aimed to investigate the effects of different methods of breast milk expression on breastfeeding initiation, efficacy of breast milk extraction, and on the rate of exclusive breastfeeding at 6 months. Methods In this open-label, randomized controlled trial, the participants of mother-infant dyads separated immediately after birth for at least 6 hrs were recruited and randomly assigned (1:1:1) into three groups: (1) hand expression of breast milk; (2) sequential electrical breast pumping: and (3) simultaneous electrical breast pumping. The two primary outcome measures were the time required for initiation of breastfeeding and the milk volume expressed in a 10-minute session (direct breastfeeding in hand expression group) at 3 days and at 6 weeks; a secondary outcome was the proportion of exclusive breastfeeding at 4 and 6 months. Analysis was according to intention-to-treat. Results Between 2018 and 2019, we recruited 226 participants, of whom 154 were randomized. The time to breastfeeding initiation showed no difference between the three groups. At 3 days and at 6 weeks, the volume of breast milk produced by 10 minutes of sequential pumping or simultaneous pumping was less than that of hand pumping before direct breastfeeding, while the volume did not differ significantly between the two pumping groups. However, simultaneous breast pumping was more effective than sequential pumping both in volume and saving time in women who had established breastfeeding. The rate of exclusive breastfeeding at 4 months was 21.0%, and at 6 months 10.6%, and did not differ between the three methods of breast milk expression. Conclusions Hand expression, sequential breast pumping, or simultaneous breast pumping in absence of immediate infant suction after birth did not show differences on the time required to initiate breastfeeding, or on the rate of exclusive breastfeeding at 4 and 6 months. Trial registration This trial was registered with www.chictr.org.cn (ChiCTR1800018193) on 4 September 2018.
Review and Prospect of Tissue-agnostic Targeted Strategies in Anticancer Therapies
Authors: Peng Yu , Tao Hongxun , Gao Yuanqing , Yang Yuanyuan , Chen Zhiyong
Published: June 2020

Due to the increasing prevalence of cancer year by year, and the complexity and refractory
nature of the disease itself, it is required to constantly innovate the development of new cancer treatment
schemes. At the same time, the understanding of cancers has deepened, from the use of chemotherapy
regimens with high toxicity and side effects, to the popularity of targeted drugs with specific targets, to
precise treatments based on tumor characteristics rather than traditional anatomical location classification.
In precision medicine, in the view of the specific cancer diseases and their biological characteristics,
there is a great potential to develop tissue-agnostic targeted therapy with broad-spectrum anticancer
significance. The present review has discussed tissue-agnostic targeted therapy based on the biological
and genetic characteristics of cancers, expounded its theoretical basis and strategies for drug development.
In addition, the feasible drug targets, FDA-approved drugs, as well as drug candidates in clinical
trials have also been summarized. In conclusion, the “tissue-agnostic targeted therapy” is a breakthrough
in anticancer therapies.
Improving Energy Efficiency in Internet of Things using Artificial Bee Colony Algorithm
Authors: Sivaram Murugan , Porkodi V. , Mohammed Amin Salih , Karuppusamy S. Anbu
Published: June 2020

Background:

With the advent of IoT, the deployment of batteries with a limited lifetime
in remote areas is a major concern. In certain conditions, the network lifetime gets restricted due to
limited battery constraints. Subsequently, the collaborative approaches for key facilities to reduce
the constraint demands of the current security protocols.

Objective:

This work covers and combines a wide range of concepts linked by IoT based on security
and energy efficiency. Specifically, this study examines the WSN energy efficiency problem among
IoT devices and security for the management of threats in IoT through collaborative approaches and
finally outlines the future. The concept of energy-efficient key protocols which clearly cover heterogeneous
IoT communications among peers with different resources has been developed. Because
of the low capacity of sensor nodes, the energy efficiency in WSNs has been an important concern.

Methods:

In this paper, we present an algorithm for Artificial Bee Colony (ABC) which reviews
security and energy consumption to discuss their constraints in the IoT scenarios.

Results:

The results of a detailed experimental assessment are analyzed in terms of communication
cost, energy consumption and security, which prove the relevance of a proposed ABC approach and
a key establishment.

Conclusion:

The validation of DTLS-ABC consists of designing an inter-node cooperation trust
model for the creation of a trusted community of elements that are mutually supportive. Initial attempts
to design the key methods for management are appropriate individual IoT devices. This gives
the system designers, an option that considers the question of scalability.
Digital Support for Patients Undergoing Bariatric Surgery: Narrative Review of the Roles and Challenges of Online Forums
Authors: Robinson Anna , Husband Andrew K , Slight Robert D , Slight Sarah P
Published: June 2020

Background

The internet has become an important medium within health care, giving patients the opportunity to search for information, guidance, and support to manage their health and well-being needs. Online forums and internet-based platforms appear to have changed the way many patients undergoing bariatric surgery view and engage with their health, before and after weight loss surgery. Given that significant health improvements result from sustained weight loss, ensuring patient adherence to recommended preoperative and postoperative guidance is critical for bariatric surgery success. In a patient cohort with high information needs preoperatively, and notoriously high attrition rates postoperatively, online forums may present an underutilized method of support.

Objective

The aim of this study was to conduct a narrative review focusing on the developing roles that online forums can play for patients with bariatric conditions preoperatively and postoperatively.

Methods

A literature search was conducted in October-November 2019 across 5 electronic databases: Scopus, EMBASE, PsycINFO, CINAHL, and MEDLINE. Qualitative or mixed methods studies were included if they evaluated patients undergoing bariatric surgery (or bariatric surgery health care professionals) engaging with, using, or analyzing online discussion forums or social media platforms. Using thematic analysis, themes were developed from coding patterns within the data to identify the roles and challenges of online forums for patients undergoing bariatric surgery.

Results

A total of 8 studies were included in this review, with 5 themes emerging around (1) managing expectations of a new life; (2) decision making and signposting; (3) supporting information seeking; (4) facilitating connectedness: peer-to-peer social and emotional support; and (5) enabling accessibility and connectivity with health care professionals.

Conclusions

Online forums could offer one solution to improving postoperative success by supporting and motivating patients. Future research should consider how best to design and moderate online forums for maximal effectiveness and the sharing of accurate information. The surgical multidisciplinary team may consider recommendations of online peer-support networks to complement care for patients throughout their surgical journey.
Clinician Perspectives and Design Implications in Using Patient-Generated Health Data to Improve Mental Health Practices: Mixed Methods Study
Authors: Wu Danny T Y , Xin Chen , Bindhu Shwetha , Xu Catherine , Sachdeva Jyoti , Brown Jennifer L , Jung Heekyoung
Published: June 2020

Background

Patient-generated health data (PGHD) have been largely collected through mobile health (mHealth) apps and wearable devices. PGHD can be especially helpful in mental health, as patients’ illness history and symptom narratives are vital to developing diagnoses and treatment plans. However, the extent to which clinicians use mental health–related PGHD is unknown.

Objective

A mixed methods study was conducted to understand clinicians’ perspectives on PGHD and current mental health apps. This approach uses information gathered from semistructured interviews, workflow analysis, and user-written mental health app reviews to answer the following research questions: (1) What is the current workflow of mental health practice and how are PGHD integrated into this workflow, (2) what are clinicians’ perspectives on PGHD and how do they choose mobile apps for their patients, (3) and what are the features of current mobile apps in terms of interpreting and sharing PGHD?

Methods

The study consists of semistructured interviews with 12 psychiatrists and clinical psychologists from a large academic hospital. These interviews were thematically and qualitatively analyzed for common themes and workflow elements. User-posted reviews of 56 sleep and mood tracking apps were analyzed to understand app features in comparison with the information gathered from interviews.

Results

The results showed that PGHD have been part of the workflow, but its integration and use are not optimized. Mental health clinicians supported the use of PGHD but had concerns regarding data reliability and accuracy. They also identified challenges in selecting suitable apps for their patients. From the app review, it was discovered that mHealth apps had limited features to support personalization and collaborative care as well as data interpretation and sharing.

Conclusions

This study investigates clinicians’ perspectives on PGHD use and explored existing app features using the app review data in the mental health setting. A total of 3 design guidelines were generated: (1) improve data interpretation and sharing mechanisms, (2) consider clinical workflow and electronic health record integration, and (3) support personalized and collaborative care. More research is needed to demonstrate the best practices of PGHD use and to evaluate their effectiveness in improving patient outcomes.
Analysis of Benzodiazepine Prescription Practices in Elderly Appalachians with Dementia via the Appalachian Informatics Platform: Longitudinal Study
Authors: Bhardwaj Niharika , Cecchetti Alfred A , Murughiyan Usha , Neitch Shirley
Published: June 2020

Background

Caring for the growing dementia population with complex health care needs in West Virginia has been challenging due to its large, sizably rural-dwelling geriatric population and limited resource availability.

Objective

This paper aims to illustrate the application of an informatics platform to drive dementia research and quality care through a preliminary study of benzodiazepine (BZD) prescription patterns and its effects on health care use by geriatric patients.

Methods

The Maier Institute Data Mart, which contains clinical and billing data on patients aged 65 years and older (N=98,970) seen within our clinics and hospital, was created. Relevant variables were analyzed to identify BZD prescription patterns and calculate related charges and emergency department (ED) use.

Results

Nearly one-third (4346/13,910, 31.24%) of patients with dementia received at least one BZD prescription, 20% more than those without dementia. More women than men received at least one BZD prescription. On average, patients with dementia and at least one BZD prescription sustained higher charges and visited the ED more often than those without one.

Conclusions

The Appalachian Informatics Platform has the potential to enhance dementia care and research through a deeper understanding of dementia, data enrichment, risk identification, and care gap analysis.
A Double Triage and Telemedicine Protocol to Optimize Infection Control in an Emergency Department in Taiwan During the COVID-19 Pandemic: Retrospective Feasibility Study
Authors: Lin Chien-Hao , Tseng Wen-Pin , Wu Jhong-Lin , Tay Joyce , Cheng Ming-Tai , Ong Hooi-Nee , Lin Hao-Yang , Chen Yi-Ying , Wu Chih-Hsien , Chen Jiun-Wei , Chen Shey-Ying , Chan Chang-Chuan , Huang Chien-Hua , Chen Shyr-Chyr
Published: June 2020

Background

Frontline health care workers, including physicians, are at high risk of contracting coronavirus disease (COVID-19) owing to their exposure to patients suspected of having COVID-19.

Objective

The aim of this study was to evaluate the benefits and feasibility of a double triage and telemedicine protocol in improving infection control in the emergency department (ED).

Methods

In this retrospective study, we recruited patients aged ≥20 years referred to the ED of the National Taiwan University Hospital between March 1 and April 30, 2020. A double triage and telemedicine protocol was developed to triage suggested COVID-19 cases and minimize health workers’ exposure to this disease. We categorized patients attending video interviews into a telemedicine group and patients experiencing face-to-face interviews into a conventional group. A questionnaire was used to assess how patients perceived the quality of the interviews and their communication with physicians as well as perceptions of stress, discrimination, and privacy. Each question was evaluated using a 5-point Likert scale. Physicians’ total exposure time and total evaluation time were treated as primary outcomes, and the mean scores of the questions were treated as secondary outcomes.

Results

The final sample included 198 patients, including 93 cases (47.0%) in the telemedicine group and 105 cases (53.0%) in the conventional group. The total exposure time in the telemedicine group was significantly shorter than that in the conventional group (4.7 minutes vs 8.9 minutes, P<.001), whereas the total evaluation time in the telemedicine group was significantly longer than that in the conventional group (12.2 minutes vs 8.9 minutes, P<.001). After controlling for potential confounders, the total exposure time in the telemedicine group was 4.6 minutes shorter than that in the conventional group (95% CI −5.7 to −3.5, P<.001), whereas the total evaluation time in the telemedicine group was 2.8 minutes longer than that in the conventional group (95% CI −1.6 to −4.0, P<.001). The mean scores of the patient questionnaire were high in both groups (4.5/5 to 4.7/5 points).

Conclusions

The implementation of the double triage and telemedicine protocol in the ED during the COVID-19 pandemic has high potential to improve infection control.
Hybrid Wind-Solar Power Plants
Authors: Kuznetsov P. N. , Cheboxarov V. V. , Yakimovich B. A.
Published: June 2020

Приведен анализ известных подходов к созданию гибридных ветро-солнечных энергетических установок. На примерах показано, что размещение фотоэлектрических преобразователей на роторах ветрогенераторов, существующих конструкций является неэффективным решением по ряду факторов. Представлено описание конструкции гибридной ветро-солнечной установки, разработанной ООО «НТЦ «Солнечная энергетика», с вертикальным ротором Дарье и фотоэлектрическими преобразователями, расположенными на общей опорной конструкции, позволяющей получить положительный синергетический эффект от использования двух возобновляемых источников энергии. Приведены достоинства данного решения, одними из которых является повышение энергетической эффективности фотоэлектрических преобразователей за счет интенсификации теплоотвода от поверхности фотоэлементов ветровым потоком от ротора Дарье, эффективное использование площади и стабильность выдачи электроэнергии.Приведены преимущества использования гибридных установок, работающих от возобновляемых источников энергии, в частности ветро-солнечных установок. Описаны возможные пути снижения негативных последствий, вызванных нестабильным характером выработки электроэнергии такими установками.Описаны результаты проведенных работ, направленных на повышение энергетической эффективности ротора ветроустановки и фотоэлектрических преобразователей за счет установки оптимального угла лопастей и фотоэлектрических модулей. Результатами моделирования показано, что максимальное значение коэффициента использования ветра достигается при установке лопастей под углом 38°, а оптимальный угол установки фотоэлектрических модулей для г. Севастополя составляет 34°. Приведены оценочные расчеты энергетических параметров комбинированной ветро-солнечной установки.
Panorama de un pensamiento
Authors: Paláu Castaño Luis Alfonso
Published: June 2020

Christian GodinTraducción del francés al español de Luis Alfonso Paláu-Castaño

Aquiles es el héroe de los pies ligeros en Homero. Hermes calzado con sandalias aladas tiene los pies más ligeros aún. Es esta liviandad mercuriana la que se percibe en las obras de Michel Serres con textos que uno cree comprender y que sin embargo parecen siempre huir, textos a imagen de lo que buscan significar: las nubes. Pero nuboso no significa nebuloso. Como su patrono, la obra de Serres puede leerse en todos los sentidos sin cambiar de sentido.
Reseña de la película Desobediencia o cómo entrenar gallos de pelea de Juan Pablo Ortiz “Tuchi” (2018)
Authors: Ortiz Tobón Sergio Elías
Published: June 2020

Este texto surge de dos fuentes principales: la primera y primordial es la de haber hecho parte del proyecto en la lectura del guion, y haber vivido esta idea interpretando al “Comandante Segundo” en la película Desobediencia o cómo entrenar gallos de pelea (Ortiz, 2017); la segunda está inscrita dentro de una investigación desarrollada en la Maestría en Sociología de la Universidad Nacional; la cual a través del análisis de diferentes formas de resistencia ante la compleja realidad en la que habita la sociedad, encontró que una de las formas de resistir encuentra la desobediencia como mecanismo de respuesta ante lo que se cree injusto, y se impone de manera agresiva por encima de los ideales y conceptos que se gestan en el individuo y la comunidad (Ortiz, 2019).
Exílio e nostalgia em "A noite da espera", de Milton Hatoum
Authors: Sarmento-Pantoja Tânia , Costa Carlos Carneiro
Published: June 2020

O estudo analisa o romance A noite da espera, de Milton Hatoum, com o objetivo de compreender algumas questões ligadas à constituição do narrador e o tema da nostalgia, levando em conta os conflitos sociais brasileiros da década de 70, mais especificamente aqueles ligados à ditadura militar e a experiência do exílio.
Como sobreviver na sociedade líquida?
Authors: Pereira Diego
Published: June 2020

Última obra de Umberto Eco (1932-2016), “Pape Satàn Aleppe: crônicas de uma sociedade líquida” (2017), ou, em italiano, sua versão original, “Pape Sàtan Allepe: cronache di uma societá liquida” (2016), reúne algumas de suas crônicas publicadas na coluna que mantinha, desde 1985, na revista L’Espresso — todas correspondentes a “[...] breves anotações e divagações sobre os mais variados temas [...] — em geral, inspirados na atualidade” (ECO, 2017[2016], p. 7). O próprio título de sua coluna, uma alusão às “caixinhas de fósforos Minerva”, cujo interior “oferecia dois espaços em branco, nos quais era possível tomar notas” (ECO, 2017[2016], p. 7), sugere esse objetivo. De lá para cá, boa parte dessa produção foi recuperada pelo autor em quatro compilações: algumas daquelas originalmente publicadas entre 1985 e o início da década de 90 encontram-se em Il secondo diario minimo (1992); entre a década de 90 e o início dos anos 2000, em La Bustina di Minerva (2001) e A passo di gambero (2006); e, entre 2000 e 2015, no livro objeto desta resenha, não por acaso publicado sob o título principal Pape Satàn Aleppe (2016). Essas palavras, extraídas de um verso d’A Divina Comédia, servem a Eco (2017[2016]) justamente por seu significado difuso, também explorado no poema dantesco: “confundem as ideias e podem se prestar a qualquer diabrura” (ECO, 2017[2016], p. 8). E, conforme ele mesmo confessa, a citação traduz sua “coletânea que [...] é desconexa, vai do galo ao asno [...] e reflete a natureza líquida destes quinze anos [2000-2015]” (ECO, 2017[2016], p. 8) — a costura que permite o alinhavo dessas suas crônicas, agora republicadas.