bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of Refugees and Their Mental Health in the Perspective of World, and the Particular Issue of Afghan Refugees in Pakistan
Authors: Anjum Ubair
Published: April 2020

The mental health of the refugees is a matter of interest from the global perspective, as the refugees are reported to have several kinds of mental illness because of their flee from their home countries which could ultimately provoke the circumstances of the host countries. Pakistan is amongst the top listed countries providing the refuge to the displaced people after Lebanon, Jordan and, Turkey. The refugees have been reported to have behavioral and mental issues because they had gone through the awful situations of being exiled from their own land. Pakistan is serving the refugees from decades on mandate of UNHCR, but has been victimized of worthy loss due to the extremists and terrorists hide in refugee camps, because of their psychopaths of criminality towards the host-nation. Pakistan still backed the Afghan refugees and declared to provide the nationality to those Afghan’s born in Pakistan. But, Pakistan doesn’t possess any certain act or policy concerning the Afghan refugee till now, the mandate of UNHCR has been following as well as the health facilities and betterments for refugees are accordingly. By unveiling the certain issue mental health of the refugees in general the recommendations has been presented as well as by focusing the matter of the Afghan Refugees the ultimate policy is devised to consider for betterment in state-backed by the evidence gathered contextually.
Medium-Term Budgetary Framework for Fiscal Efficiency: A Conceptual Analysis of Bangladesh Case
Authors: Bhuiyan Sanwar Jahan , - Shumshunnahar
Published: April 2020

Medium-Term Budgetary Framework (MTBF) is one of the most important policy reforms in the fiscal management of both developing and developed countries of the world. Over the last two decades, on advocacy and technical assistance of World Bank and IMF more than 132 countries of the globe successfully implemented this new form of performance-based budgetary mechanism. As a part of public finance management reform, Bangladesh first introduced MTBF in 2004 and piloted the process for FY 2005-2006 in four ministries successfully. From the FY 2011-12 MTBF has already been rolled out to all ministries and agencies of Bangladesh. The paper discusses the conceptual framework of MTBF that has been following in Bangladesh along with a very limited discussion of empirical evidence of achieving fiscal efficiency by some developing countries. The paper is based on secondary data. On reviewing the relevant literature, it is found that the MTBF mechanism is scientifically devised and logically organized where achieving fiscal discipline, allocative and operational efficiency are the main focus of it. The paper also explored that the new form of a budgetary framework is a radical shift from traditional and compliance-based budgetary system to performance-based, result-oriented, priority-focused budgetary mechanism. Finally, the paper places some empirical evidence on fiscal discipline, allocative and operational efficiency that has been achieved by MTBF or MTEF-adopting countries.
Financial Management Practices and Growth of Small and Medium-Scale Enterprises: The case of Kassena-Nankana West District
Authors: Adda Godfrey
Published: April 2020

The promotion of financial management practices and growth of Small and Medium-scale Enterprises (SMEs) can contribute significantly towards the sustained elevation of a nation for a better or more humane life. SMEs play a crucial role in addressing the impediments of poverty, inequality and job creation. Yet, many SMEs face numerous challenges ranging from the lack of capital, poor management skills and the application of best financial management practices.This paper explores SMEs’ financial management skills and practices in relation to their growth. The study used questionnaire to collect data from managers or owners of SMEs. Descriptive statistics was used to present the results of the data. Not only that but also, a multiple regression model was also used to test the correlation between financial management practices of SMEs and business growth. The results indicates a moderate correlation between the financial management practices of the SMEs and the growth of the enterprises. Based on the findings, it is recommended for targeted financial education programmes to help managers and owners of SMEs develop and adopt best financial management practices.
Opioid Prescribing Patterns in Orthopaedic Surgery Patients: the Effect of New York State Regulations and Institutional Initiatives
Authors: Lott Ariana , Hutzler Lorraine H. , Bosco Joseph A. , Lajam Claudette M.
Published: April 2020

Background:

The opioid epidemic in the United States is a public health crisis. As a result, regulatory agencies, including state governments, have enacted initiatives to decrease the use of opioids in the perioperative setting. The purpose of this study was to compare opioid utilization in orthopaedic surgery patients at discrete points after implementation of State regulatory and institution/physician-led initiatives to decrease opioid utilization in the perioperative period.

Methods:

We reviewed the electronic medication orders for all patients who underwent orthopaedic surgery procedures between September 2015 and June 2018 at our urban academic medical center. The outcome measures were the number of patients who were prescribed opioid medications, duration of prescription (days), and average milligram morphine equivalents prescribed. Patients were divided into three time cohorts to assess the effect of the NY State (NYS) policy and institutional initiatives to decrease opioid utilization.

Results:

A total of 20,483 patients met the inclusion criteria over all three time cohorts. After the initiation of the NYS 7-day supply legislation, there was a decrease in the average supply of opioids prescribed from 10.1 to 7.6 days and the average daily milligram morphine equivalent decreased from 67.9 to 56.7 mg (P < 0.0001). However, with the combination of physician education and surgeon-led institutional initiatives, the percentage of patients who were prescribed opioids decreased by over 10% (96% to 84%), with continued decrease in duration of prescription by 1.0 to 6.4 days (P < 0.0001).

Conclusions:

The addition of institution-led initiatives and education programs to previously established government-led prescription limits produced a substantial reduction in the amount of opioids prescribed to orthopaedic surgery patients in the perioperative period. Although mandatory limits set by the state government resulted in a decreased amount of opioid medications being prescribed per patient, it was only after the introduction of educational programs and institution- and physician-led programs that perioperative patient exposure to opioids decreased.

Level of Evidence:

Level III
Practice Management During the COVID-19 Pandemic
Authors: Vaccaro Alexander R. , Getz Charles L. , Cohen Bruce E. , Cole Brian J. , Donnally Chester J.
Published: April 2020

On March 14, 2020, the Surgeon General of the United States urged a widespread cessation of all elective surgery across the country. The suddenness of this mandate and the concomitant spread of the COVID-19 virus left many hospital systems, orthopaedic practices, and patients with notable anxiety and confusion as to the near, intermediate, and long-term future of our healthcare system. As with most businesses in the United States during this time, many orthopaedic practices have been emotionally and fiscally devastated because of this crisis. Furthermore, this pandemic is occurring at a time where small and midsized orthopaedic groups are already struggling to cover practice overhead and to maintain autonomy from larger health systems. It is anticipated that many groups will experience financial demise, leading to substantial global consolidation. Because the authors represent some of the larger musculoskeletal multispecialty groups in the country, we are uniquely positioned to provide a framework with recommendations to best weather the ensuing months. We think these recommendations will allow providers and their staff to return to an infrastructure that can adjust immediately to the pent-up healthcare demand that may occur after the COVID-19 pandemic. In this editorial, we address practice finances, staffing, telehealth, operational plans after the crisis, and ethical considerations.
Recommendations for the Care of Pediatric Orthopaedic Patients During the COVID-19 Pandemic
Authors: Farrell Sarah , Schaeffer Emily K. , Mulpuri Kishore
Published: April 2020

The COVID-19 pandemic has necessitated modifications to pediatric orthopaedic practice to protect patients, families, and healthcare workers and to minimize viral transmission. It is critical to balance the benefits of alterations to current practice to reduce the chances of COVID-19 infection, with the potential long-term impact on patients. Early experiences of the pandemic from orthopaedic surgeons in China, Singapore, and Italy have provided the opportunity to take proactive and preventive measures to protect all involved in pediatric orthopaedic care. These guidelines, based on expert opinion and best available evidence, provide a framework for the management of pediatric orthopaedic patients during the COVID-19 pandemic. General principles include limiting procedures to urgent cases such as traumatic injuries and deferring outpatient visits during the acute phase of the pandemic. Nonsurgical methods should be considered where possible. For patients with developmental or chronic orthopaedic conditions, it may be possible to delay treatment for 2 to 4 months without substantial detrimental long-term impact.
Stent-Jack Technique for Ruptured Vertebral Artery Dissecting Aneurysm Involving the Origin of Posterior Inferior Cerebellar Artery
Authors: Terakado Toshitsugu , Nakai Yasunobu , Ikeda Go , Tsukada Kazuaki , Hanai Sho , Akutagawa Kazuki , Igarashi Haruki , Konishi Takahiro , Shiigai Masanari , Uemura Kazuya
Published: April 2020

We herein report a case of a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery that was treated using the stent-jack technique. After parent artery occlusion of the distal vertebral artery, stenting of the posterior inferior cerebellar artery was performed. Further coiling was needed because distal vertebral artery recanalization occurred due to transformation of the coil mass. The stent-jack technique for a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery is effective; however, careful attention to recanalization after stenting is needed due to transformation of the coil mass.
Blood Product Requirement in Childhood Acute Lymphoblastic Leukemia in Relation to Chemotherapy Regimens
Authors: Gudeloglu Elif , Albayrak Davut
Published: April 2020

Background: Along with lack of studies that systematically address the transfusion requirements and triggers in acute leukemia, no study to date has addressed the blood product use with respect to ongoing chemotherapy (CT) in pediatric acute lymphoblastic leukemia (ALL) patients. Objectives: This study was therefore designed to evaluate total erythrocyte, random platelet and apheresis platelet suspension requirement in pediatric ALL patients in relation to ongoing CT protocols. Methods: A total of 146 pediatric patients with ALL were included in this retrospective study. Data on patient demographics, CT protocol, amount and efficacy of blood product use (erythrocytes, apheresis platelet and random platelet), and survival during CT were retrieved from hospital records. Results: The average amount of erythrocytes, apheresis platelets and random platelets received by 146 ALL patients from the date of diagnosis were 14 (3 - 78) bags, 9 (1 - 97 bags and 11 (1 - 83) bags, respectively. Protocol 1b augmented was associated with the highest amount of erythrocyte use (P < 0.001), while no significant difference was noted in apheresis platelet and random platelet use with respect to CT regimens. Erythrocyte transfusion was associated with a more marked increase in hemoglobin (Hb), erythrocyte (RBC), leukocyte (WBC), lymphocyte and neutrophil counts as compared with apheresis platelet and random platelet infusions, while protocol 2 was associated with higher Hb (P = 0.017) levels after erythrocyte transfusion. Conclusions: Our findings indicate a great amount of blood product transfusion to be required in children with ALL under CT and emphasize the likelihood of transfusion need and efficacy of transfusion to alter with respect to ongoing CT regimen. The need in patients using augmented BFM protocol 1 b was highest, and albeit the need of blood and blood product transfusions vary within patients, the anticipated median need for blood products at diagnosis and at various blocks of treatment may be helpful for the blood banks, doctors of the respective pediatric hematology-oncology centers to plan as patients are treated.
Reliabilism and the Testimony of Robots
Authors: Wheeler Billy ,   Philosophy Documentation Center
Published: April 2020

We are becoming increasingly dependent on robots and other forms of artificial intelligence for our beliefs. But how should the knowledge gained from the “say-so” of a robot be classified? Should it be understood as testimonial knowledge, similar to knowledge gained in conversation with another person? Or should it be understood as a form of instrument-based knowledge, such as that gained from a calculator or a sundial? There is more at stake here than terminology, for how we treat objects as sources of knowledge often has important social and legal consequences. In this paper, I argue that at least some robots are capable of testimony. I make my argument by exploring the differences between instruments and testifiers on a well-known account of knowledge: reliabilism. On this approach, I claim that the difference between instruments and testifiers as sources of knowledge is that only the latter are capable of deception. As some robots can be designed to deceive, so they too should be recognized as testimonial sources of knowledge.
Prognostic value of Mastora obstruction score in acute pulmonary embolism
Authors: Račkauskienė Jolita , Gedvilaitė Vaida , Matačiūnas Mindaugas , Abrutytė Mažvilė , Danila Edvardas
Published: April 2020

Background. To evaluate the clinical significance of Mastora obstruction score in hemodynamically stable patients with acute pulmonary embolism (aPE). Materials and methods. One-hundred-and-six patients with newly diagnosed aPE, confirmed by computed tomography pulmonary angiography (CTPA), were included in the study and prospectively examined. aPE severity was assessed by using Mastora obstruction score. According to the Mastora index, patients were divided into “non-massive” and “massive” groups. The patients’ medical histories and blood laboratory data were collected, and instrumental tests were performed and analyzed. Results. Eighty-two (77%) of the patients had “non-massive” aPE. Cough (48%), fever (44%), and pleural effusion (48%) occurred significantly more often in the “non-massive” PE group, while syncope (42%) and right ventricular dysfunction (86%) were more frequent in the “massive” PE group. The probability of the right ventricular dysfunction was significantly higher in the presence of increased pulmonary artery pressure (Cramer’s V = 0.410; p < 0.0001) and respiratory failure (Cramer’s V = 0.247; p = 0.032). Increased CRP level was found in the majority of the patients (90%). D-dimer level
A comparative analysis of mathematical methods for homogeneity estimation of the Lithuanian population
Authors: Molytė Alma , Urnikytė Alina , Kučinskas Vaidutis
Published: April 2020

Background. Population genetic structure is one of the most important population genetic parameters revealing its demographic features. The aim of this study was to evaluate the homogeneity of the Lithuanian population on the basis of the genome-wide genotyping data. The comparative analysis of three methods – multidimensional scaling, principal components, and principal coordinates analysis – to visualize multidimensional genetics data was performed. The results of visualization (mapping images) are also presented. Materials and methods. The data set consisted of 425 samples from six ethnolinguistic groups of the Lithuanian population. Genomic DNA was extracted from whole venous blood using either the phenol-chloroform extraction method or the automated DNA extraction platform TECAN Freedom EVO. Genotyping was performed at the Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Lithuania, with the Illumina HumanOmniExpress-12 v1.1 and the Infinium OmniExpress-24. For the estimation of homogeneity of the Lithuanian population, PLINK data file was obtained using PLINK v1.07 program. The Past3 software was used to visualize the genotype data with multidimensional scaling and principal coordinates methods. The SmartPCA from EIGENSOFT 7.2.1 program was used in the principal component analysis to determine the population structure. Conclusions. Methods of multidimensional scaling, principal coordinate, and principal component for the genetic structure of the Lithuanian population were investigated and compared. The principal coordinate and principal component methods can be used for genotyping data visualization, since any essential differences in the results obtained were not observed and compared to multidimensional scaling. The Lithuanian population is homogenous whereas the points are strongly close when we use the principal coordinates or principal component methods.
Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report
Authors: Bužinskienė Diana , Mongirdas Matas , Mikėnas Saulius , Drąsutienė Gražina , Andreika Linas , Sakalauskaitė Indrė
Published: April 2020

Background. Mature cystic teratomas (dermoid cysts) are the most common germ cell tumours with 10–25% incidence of adult and 50% of paediatric ovarian tumours. The aetiology of dermoid cysts is still unclear, although currently the parthenogenic theory is most widely accepted. The tumour is slow-growing and in the majority of cases it is an accidental finding. Presenting symptoms are vague and nonspecific. The main complication of a dermoid cyst is cyst torsion (15%); other reported complications include malignant transformation (1–2%), infection (1%), and rupture (0.3–2%). Prolonged pressure during pregnancy, torsion with infarction, or a direct trauma are the main risk factors for a spontaneous dermoid rupture that can lead to acute or chronic peritonitis. The diagnosis of mature cystic teratoma is often made in retrospect after surgical resection of an ovarian cyst, because such imaging modalities as ultrasound, computer tomography, or magnetic resonance imaging cannot yet accurately and reliably distinguish between benign and malignant pathology. Materials and methods. We present a report of a clinical case of a 35-years-old female, who was referred to the hospital due to abdominal pain spreading to her feet for three successive days. She had a history of a normal vaginal delivery one month before. Abdominal examination revealed mild tenderness in the lower abdomen; no obvious muscle rigidity was noted. Transvaginal ultrasound showed a multiloculated cystic mass measuring 16 × 10 cm in the pelvis. In the absence of urgency, planned surgical treatment was recommended. The next day the patient was referred to the hospital again, with a complaint of stronger abdominal pain (7/10), nausea, and vomiting. This time abdominal examination revealed symptoms of acute peritonitis. The ultrasound scan differed from the previous one. This time, the transvaginal ultrasound scan revealed abnormally changed ovaries bilaterally. There was a large amount of free fluid in the abdominal cavity. The patient was operated on – left laparoscopic cystectomy and right adnexectomy were performed. Postoperative antibacterial treatment, infusion of fluids, painkillers, prophylaxis of the thromboembolism were administered. The patient was discharged from the hospital on the seventh postoperative day and was sent for outpatient observation. Results and conclusions. Ultrasound is the imaging modality of choice for a dermoid cyst because it is safe, non-invasive, and quick to perform. Leakage or spillage of dermoid cyst contents can cause chemical peritonitis, which is an aseptic inflammatory peritoneal reaction. Once a rupture of an ovarian cystic teratoma is diagnosed, immediate surgical intervention with prompt removal of the spontaneously ruptured ovarian cyst and thorough peritoneal lavage are required.
Mexican pregnant women show higher depression and anxiety with rising age and in the case of being single
Authors: Salgado Irma Visoso , Mendoza Jayson Leonel Moncada , Zerón Hugo Mendieta
Published: April 2020

Background. Pregnancy is an important predisposition period to develop anxiety and depression, with a direct impact on the woman’s offspring. The aim of this study was to report the correlation between depression and anxiety in pregnant women and its association with the marital status and age. Materials. A descriptive, retrospective and cross-sectional study was conducted in the outpatient care of the Psychology Service at the “Mónica Pretelini Sáenz” Maternal Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2012 to March 2019. As routine, the Beck Depression Inventory (BDI-II) and the Beck Anxiety Inventory-Trait (BAIT), were applied to all women seeking attention at the HMPMPS. Only pregnant patients were selected for this study, with the women referred for the first time to the external Psychology Clinic as inclusion criteria. Pearson’s correlation coefficient and the frequency of cases for age, BDI-II, and BAIT were obtained using the IBM SPSS Statistics ® v.23 software. Results. The study included 2947 pregnant patients with a mean age of 28.6 ± 6.9 years. Of these, 2616 (88.8%) presented with mild anxiety, 269 (9.1%) with moderate, and 62 (2.1%) with severe anxiety. On the other hand, 2149 (72.9%) patients presented with minimal depression, 341 (11.6%) mild depression, 268 (9.1%) moderate depression, and 189 (6.4%) had severe depression. The correlations between age and BDI-II was –0.026 (P = 0.152), between age and BAI was –0.038 (P = 0.037), and between BAIT and BDI-II 0.650 (P ≤ 0.001). Conclusions. The age group with the highest frequency of depression and anxiety was from 20 to 29 years. The absence of a stable partner represented an important risk factor for anxiety and depression during pregnancy.
The questions of administrative-legal regulation of migration
Authors: Kurakin Aleksei Valentinovich , Kostennikov Mikhail Valer'evich , Saidov Zaurbek Aslanbekovich
Published: April 2020

This article explores the issues of legal regulation of migration processes, with attention paid to the fact that this issue carries a global character, since migration determines social and economic development of the country. Its various segments are highlighted which are logically interconnected and form a uniform migration process. The social and economic significance of migration and importance of legal regulation of such relations is proved. The article substantiates the thesis that the efficiency of legal regulation of migration relations is predefined by the quality of management in this sphere. The need is justified for a more flexible order of regulation of migration relations, and proposals are made on development of internal migration process. Attention is turned to the practical functionality of the principles of administrative-legal regulation of migration relations. The authors underline the causes preventing the intensification of the internal migration process, as well as substantiate the importance of the principles that constitute the the system of legal influence; thereupon, the work defines the system of principles of migration regulation.
Retromer subunit, VPS29, regulates synaptic transmission and is required for endolysosomal function in the aging brain
Authors: Ye Hui , Ojelade Shamsideen A , Li-Kroeger David , Zuo Zhongyuan , Wang Liping , Li Yarong , Gu Jessica YJ , Tepass Ulrich , Rodal Avital Adah , Bellen Hugo J , Shulman Joshua M
Published: April 2020

Retromer, including Vps35, Vps26, and Vps29, is a protein complex responsible for recycling proteins within the endolysosomal pathway. Although implicated in both Parkinson’s and Alzheimer’s disease, our understanding of retromer function in the adult brain remains limited, in part because Vps35 and Vps26 are essential for development. In Drosophila, we find that Vps29 is dispensable for embryogenesis but required for retromer function in aging adults, including for synaptic transmission, survival, and locomotion. Unexpectedly, in Vps29 mutants, Vps35 and Vps26 proteins are normally expressed and associated, but retromer is mislocalized from neuropil to soma with the Rab7 GTPase. Further, Vps29 phenotypes are suppressed by reducing Rab7 or overexpressing the GTPase activating protein, TBC1D5. With aging, retromer insufficiency triggers progressive endolysosomal dysfunction, with ultrastructural evidence of impaired substrate clearance and lysosomal stress. Our results reveal the role of Vps29 in retromer localization and function, highlighting requirements for brain homeostasis in aging.
Chloride channels regulate differentiation and barrier functions of the mammalian airway
Authors: He Mu , Wu Bing , Ye Wenlei , Le Daniel D , Sinclair Adriane W , Padovano Valeria , Chen Yuzhang , Li Ke-Xin , Sit Rene , Tan Michelle , Caplan Michael J , Neff Norma , Jan Yuh Nung , Darmanis Spyros , Jan Lily Yeh
Published: April 2020

The conducting airway forms a protective mucosal barrier and is the primary target of airway disorders. The molecular events required for the formation and function of the airway mucosal barrier, as well as the mechanisms by which barrier dysfunction leads to early onset airway diseases, remain unclear. In this study, we systematically characterized the developmental landscape of the mouse airway using single-cell RNA sequencing and identified remarkably conserved cellular programs operating during human fetal development. We demonstrated that in mouse, genetic inactivation of chloride channel Ano1/Tmem16a compromises airway barrier function, results in early signs of inflammation, and alters the airway cellular landscape by depleting epithelial progenitors. Mouse Ano1-/-mutants exhibited mucus obstruction and abnormal mucociliary clearance that resemble the airway defects associated with cystic fibrosis. The data reveal critical and non-redundant roles for Ano1 in organogenesis, and show that chloride channels are essential for mammalian airway formation and function.
Regular Mindful Yoga Practice as a Method to Improve Androgen Levels in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Trial
Authors: Patel Vishesha , Menezes Heather , Menezes Christian , Bouwer Stephanie , Bostick-Smith Chevelta A. , Speelman Diana L.
Published: April 2020

Background

Holistic approaches are needed to complement existing therapies for polycystic ovary syndrome (PCOS), a common disorder affecting the health of reproductive-aged females.

Objective

To determine whether thrice-weekly mindful yoga practice improves endocrine, cardiometabolic, or psychological parameters in women with PCOS.

Methods

Thirty-one women with PCOS between the ages of 23 and 42 years and living in Erie County, Pennsylvania, were recruited for this randomized, controlled study arm, which was part of a larger 3-part investigation. Women were randomly assigned to either a mindful yoga intervention group or no intervention (control) group. Group classes were 1 hour, thrice weekly. Initial endocrine, cardiometabolic, and psychological measurements were compared with measurements taken after the 3-month intervention period. Measurements included free testosterone, dehydroepiandrosterone, androstenedione, body mass index, waist-to-hip ratio, fasting blood glucose and insulin levels, and anxiety and depression scores.

Results

Twenty-two women completed the 3-month intervention period, 13 in the mindful yoga group and 9 in the control group. Paired comparisons of pre- and postintervention parameters indicated that women who completed the mindful yoga intervention had significantly lower free testosterone levels (5.96 vs 4.24 pg/mL;P<.05) and dehydroepiandrosterone levels that trended lower. Improved testosterone may persist for several months after completion of a 3-month, thrice-weekly mindful yoga intervention. Additionally, improvements were seen in measures of anxiety and depression.

Conclusion

The improvements observed suggest that regular mindful yoga practice can be a useful complementary therapeutic option for women with PCOS, particularly for improving serum androgen levels, a hallmark feature of PCOS. This improvement occurred in the absence of weight loss and may persist even if there is a lapse in practice. (ClinicalTrials.gov No. NCT03383484)
A Rare Case of Primary Aortoduodenal Fistula
Authors: Bae Hyun Jin , Kim Byung-Wook , Kim Joon Sung
Published: April 2020

Aortoduodenal fistula is a rare but life-threatening condition that can cause gastrointestinal bleeding. Due to its rarity, it is often overlooked as a cause of gastrointestinal blood loss. Notably, the mortality rate of aortoduodenal fistula is nearly 100% in undiagnosed and untreated cases. We report a case of aortoduodenal fistula, which resulted in the patient’s death. This report highlights the importance of considering even extremely rare causes of gastrointestinal bleeding in the differential diagnosis in patients with such a presentation.
Accumulation of sequence variants in genes of Wnt signaling and focal adhesion pathways in human corneas further explains their involvement in keratoconus
Authors: Karolak Justyna A. , Gambin Tomasz , Rydzanicz Malgorzata , Polakowski Piotr , Ploski Rafal , Szaflik Jacek P. , Gajecka Marzena
Published: April 2020

Background

Keratoconus (KTCN) is a protrusion and thinning of the cornea, resulting in loss of visual acuity. The etiology of KTCN remains unclear. The purpose of this study was to assess the potential involvement of new genetic variants in KTCN etiology based on both the genomic and transcriptomic findings recognized in the same corneal tissues.

Methods

Corneal tissues derived from five unrelated Polish individuals with KTCN were examined using exome sequencing (ES), followed by enrichment analyses. For comparison purposes, the datasets comprising ES data of five randomly selected Polish individuals without ocular abnormalities and five Polish patients with high myopia were used. Expression levels of selected genes from the overrepresented pathways were obtained from the previous RNA-Seq study.

Results

Exome capture discovered 117 potentially relevant variants that were further narrowed by gene overrepresentation analyses. In each of five patients, the assessment of functional interactions revealed rare (MAF ≤ 0.01) DNA variants in at least one gene from Wnt signaling (VANGL1, WNT1, PPP3CC, LRP6, FZD2) and focal adhesion (BIRC2, PAK6, COL4A4, PPP1R12A, PTK6) pathways. No genes involved in pathways enriched in KTCN corneas were overrepresented in our control sample sets.

Conclusions

The results of this first pilot ES profiling of human KTCN corneas emphasized that accumulation of sequence variants in several genes from Wnt signaling and/or focal adhesion pathways might cause the phenotypic effect and further points to a complex etiology of KTCN.
Proteomic profiling analysis of postmenopausal osteoporosis and osteopenia identifies potential proteins associated with low bone mineral density
Authors: Huang Dageng , Wang Yangyang , Lv Jing , Yan Yuzhu , Hu Ya , Liu Cuicui , Zhang Feng , Wang Jihan , Hao Dingjun
Published: April 2020

Postmenopausal osteoporosis (PMOP) is a major global public health concern and older women are more susceptible to experiencing fragility fractures. Our study investigated the associations between circulating proteins with bone mineral density (BMD) in postmenopausal women with or without low BMD (osteoporosis and osteopenia) using a tandem mass tag (TMT) labeling proteomic experiment and parallel reaction monitoring testing. Across all plasma samples, we quantitatively measured 1,092 proteins, and the OP and normal control (NC) samples were differentiated by principal component analysis and a partial least squares-discrimination analysis model based on the protein profiling data. The differentially abundant proteins between the low BMD and NC samples mostly exhibited binding, molecular function regulator, transporter and molecular transducer activity, and were involved in metabolic and cellular processes, stimulus response, biological regulation, immune system processes and so forth. TMT analysis and RRM validation indicated that the expression of protein Lysozyme C (P61626) was negatively related to BMD, while the expression of proteins Glucosidase (A0A024R592) and Protein disulfideisomerase A5 (Q14554) was positively related to BMD values. Collectively, our results suggest that postmenopausal women with low BMD have a different proteomic profile or signature. Protein alterations may play an important role in the pathogenesis of PMOP, and they may act as novel biomarkers and targets of therapeutic agents for this disease.
Modified Goal Programming Model for Limited Available Budget Allocation for Equipment Procurement under Inflation Condition
Authors: Ojo O. O. , Farayibi P. K. , Akinnuli B. O.
Published: April 2020

Equipment procurement budget is of a great challenge in manufacturing industries by reasons of its multi-objectives, insufficient funds, and inflation problems. Solutions were proffered to these problems by identifying the strategic decisions required in equipment procurement (machine, accessories, spare parts and miscellaneous costs). Procurement changes from year to year based on equipment industrial needs. Hence eleven (11) scenarios for procurement but this study focused on a scenario where all the decisions are needed for procurement. This problem is multi-objective decision problem where there is need for multi-objective decision tool for its solution, therefore a goal programming tool was adopted and improved by integrating inflation model into it to be able to solve inflation problems. International Brewery Ilesha, Nigeria was used as case study for the model’s application to evaluate its performance. The strategic decisions deviated above or positively by 0.4604, 4.1311 and 2.3760 for machines, spare-parts and miscellaneous costs respectively while accessories cost was not deviated. Therefore, the procurement cost for Machines, Accessories, Spare-parts and Miscellaneous costs would be (N 166,015,000; $ 461,152.77), (N 127,968,000; $ 355,466.67), (N 548,075,000; $ 1,522,430.56), (N 271,091,500; $ 753,031.94). US Dollar exchange rate was at N 360 to a Dollar as at the time of this research. This multi-criteria decision tool will find its application useful in small, medium and large scale industries that equipment procurement budget affects their production.v
Assessment of Technical Vocational Education Programs of Davao Del Sur School of Fisheries
Authors: Zamora-Sereguine Roname
Published: April 2020

Aims: The study generally assessed the Technical Vocational Education Program of Davao del Sur School of Fisheries.

Study Design: Quantitative-descriptive correlation.

Place and Duration of Study: The study was conducted at the Davao del Sur School of Fisheries in Davao del Sur, The Philippines. The study was conducted for 10 months.

Methodology: This study used the universal sampling for both sets of respondents; the teachers of TVE program and the Grade 10 students. There were 32 teachers and 322 students participated in the study. The Technical Vocational Education program was assessed in terms of library facilities and internet connectivity, Science laboratory facilities, TVE laboratory facilities and the use of information and communication technology. These were correlated to the academic performances of the students.

Results: The findings of the study showed that in terms of population, 322 students were enrolled in the TVE program; majority of these students took the food processing technology course that comprised 39.45%. In terms of teachers’ qualification, 32 were Bachelor of Art or Bachelor of Secondary Education graduates. There were 18 out of 32 teachers who were teaching in TVE programs and the rest taught in other related courses. For qualification to teach in the Program, one- third of the total faculty was handling fish culture, while two third was teaching outside the flagship courses. In the assessment of the support learning facilities, the library, internet connectivity, science and laboratory facilities were described as “moderately adequate”; the TVE laboratory facilities was described as “very adequate”. In the assessment of the ICT in instruction, it was described as “very effective”. The study found significant relationship between the academic performance of the TVE students and the support learning facilities and between the academic performance of the TVE students and the used of information and communication technology (ICT) in learning.

Conclusion: The school needs to maintain its support learning facilities and information and communication technology so that it can produce more competent TVE students. However, the school may look into industry partners so that actual application of students’ theoretical knowledge may be put into action. Moreover, tracer study may also be conducted to find the competitiveness and employability of the graduates.
Viability and Vigor in Jackfruit Seed (Artocarpusheterophyllus) Subjected to Different Substrates
Authors: Borges Igor Eduardo Martins , Cardeal Indira Rayane Pires , Abreu Jennifer Monique Martins de , Barros Daniella Inácio , Nunes Helber Veras , Nunes Bruno Henrique di Napoli , Ribeiro Evandro Alves , Santos Juliana Lopes dos , Oliveira Liomar Borges de
Published: April 2020

The use of substrates is a good option and should present some important characteristics, such as availability of acquisition and transportation, absence of pathogens, richness in essential nutrients, suitable pH, texture and structure. However, each species exhibits different behavior on the same substrate, it is necessary to scientifically verify which substrate or combination of these allows obtaining seedlings with higher physiological quality. The experiment was conducted in a greenhouse at the Federal Institute of Education, Tocantins Science, and Technology, Gurupi/TO. Jackfruit seeds (Artocarpus heterophyllus) were used, directly removed from the fruits that were collected in the same period. The highest root length value was obtained when the seeds were sown in the substrates: BS (13.9 cm), HW + WS + BS (14.6 cm), PP + Sawdust + BS (13.8 cm) and CS (17 cm), intermediate value on the WS substrate (11.9 cm) and low on CS + BM + WS (6.6 cm). It was also observed that the highest length value of shoot was obtained in BS substrates (20.7 cm), HW + WS + BS (18.2 cm), PP + Sawdust + BS (16,5 cm) CS (16.4 cm) and low on the WS substrates (12.9 cm) and CS + BM + WS (7.2 cm). Regarding the first emergency count and emergence of seedlings, depending on the different substrates, once again stood out the BS substrates (65% and 85%) and CS (68.3% and 98.3%). The CS provided the highest values of viability and vigor in jackfruit seeds, followed by the Substrate BS.
Mortality in Patients With Gout Treated With Allopurinol: A Systematic Review and Meta‐Analysis
Authors: Hay Charles A. , Prior James A. , Belcher John , Mallen Christian D. , Roddy Edward
Published: April 2020

Objective

Urate‐lowering therapy (predominantly allopurinol) is highly effective as a treatment for gout, but its wider long‐term effects remain unclear. This systematic review and meta‐analysis aimed to ascertain the association between mortality and the use of allopurinol in patients with gout.

Method

Medline, Embase, CINAHL, and the Cochrane Library were searched from inception to August 2018. Articles eligible for inclusion used a cohort design and examined cardiovascular or all‐cause mortality in patients diagnosed with gout and prescribed allopurinol. Information on study characteristics, design, sample size, and mortality risk estimates were extracted. Article quality was assessed using the Newcastle‐Ottawa Scale. Included articles were described in a narrative synthesis and, where possible, risk estimate data were pooled.

Results

Four articles reported a hazard ratio (HR) risk estimate for all‐cause mortality in patients with gout using allopurinol, and 2 of these also reported cardiovascular mortality. Two articles found allopurinol to be protective in patients with gout, 1 found no statistically significant association, and 1 found no statistically significant effect of escalation of allopurinol dosage on all‐cause or cardiovascular‐related mortality. Data pooling was possible for all‐cause mortality and found no association between allopurinol use in patients with gout and all‐cause mortality compared to patients with gout not using allopurinol (adjusted HR 0.80 [95% confidence interval 0.60–1.05]).

Conclusion

There was no significant association between all‐cause mortality and allopurinol use in people with gout. However, the number of included studies was small, suggesting that further studies are needed.
Collagen Stiffness and Architecture Regulate Fibrotic Gene Expression in Engineered Adipose Tissue
Authors: Di Caprio Nikolas , Bellas Evangelia
Published: April 2020

Adipose tissue (AT) has a dynamic extracellular matrix (ECM) surrounding adipocytes that allows for remodeling during metabolic fluctuations. During the progression of obesity, AT has increased ECM deposition, stiffening, and remodeling, resulting in a pro‐fibrotic dysfunctional state. Here, the incorporation of ethylene glycol‐bis‐succinic acid N‐hydroxysuccinimide ester (PEGDS) allows for control over 3D collagen hydrogel stiffness and architecture to investigate its influence on adipocyte metabolic and fibrotic function. Upon stiffening and altering ECM architecture, adipocytes did not alter their expression of key adipokines, leptin, and adiponectin. However, they do increase actin cytoskeletal fiber formation, pro‐fibrotic gene expression, ECM deposition, and remodeling within a stiffer, 3D collagen hydrogel. For example, COL6A3 gene expression is upregulated approximately twofold, resulting in increased deposition of pericellular collagen VI alpha 3 surrounding adipocytes. Furthermore, inhibition of actin contractility results in a reversal of pro‐fibrotic gene expression and ECM deposition, indicating that adipocytes are mediating mechanical cues through actin cytoskeletal networks. This study demonstrates that ECM stiffness and architecture plays a critical regulatory role in adipocyte fibrotic function and contributes to the overall pro‐fibrotic dysfunctional state of AT during the progression of obesity and AT fibrosis.
A Mixed Lithium‐Ion Conductive Li2S/Li2Se Protection Layer for Stable Lithium Metal Anode
Authors: Liu Fanfan , Wang Lifeng , Zhang Zhiwen , Shi Pengcheng , Feng Yuezhan , Yao Yu , Ye Shufen , Wang Haiyun , Wu Xiaojun , Yu Yan
Published: April 2020

Constructing artificial solid‐electrolyte interphase (SEI) on the surface of Li metal is an effective approach to improve ionic conductivity of surface SEI and buffer Li dendrite growth of Li metal anode. However, constructing of homogenous ideal artificial SEI is still a great challenge. Here, a mixed lithium‐ion conductive Li2S/Li2Se (denoted as LSSe) protection layer, fabricated by a facile and inexpensive gas–solid reaction, is employed to construct stable surface SEI with high ionic conductivity. The Li2S/Li2Se‐protected Li metal (denoted as LSSe@Li) exhibits a stable dendrite‐free cycling behavior over 900 h with a high lithium stripping/plating capacity of 3 mAh cm−2 at 1.5 mA cm−2 in the symmetrical cell. Compared to bare Li anode, full batteries paired with LiFePO4, sulfur/carbon, and LiNi0.6Co0.2Mn0.2O2 cathodes all present better battery cycling and rate performance when LSSe@Li anode is used. Moreover, Li2Se exhibits a lower lithium‐ion migration energy barrier in comparison with Li2S which is proved by density functional theory calculation.
“Looping In” Mechanics: Mechanobiologic Regulation of the Nucleus and the Epigenome
Authors: Dai Eric N. , Heo Su‐Jin , Mauck Robert L.
Published: April 2020

Cells respond to physical cues in their microenvironment. These cues result in changes in cell behavior, some of which are transient, and others of which are permanent. Understanding and leveraging permanent alteration of cell behavior induced by mechanical cues, or “mechanical memories,” is an important aim in cell and tissue engineering. Herein, this paper reviews the existing literature outlining how cells may store memories of biophysical cues with a specific focus on the nucleus, the storehouse of information in eukaryotic cells. In particular, this review details mechanically driven adaptations in nuclear structure and genome organization and outlines potential mechanisms by which mechanical memories may be encoded within the structure and organization of the nucleus and chromatin.
Somatosensory, Light‐Driven, Thin‐Film Robots Capable of Integrated Perception and Motility
Authors: Wang Xiao‐Qiao , Chan Kwok Hoe , Cheng Yin , Ding Tianpeng , Li Tongtao , Achavananthadith Sippanat , Ahmet Selman , Ho John S. , Ho Ghim Wei
Published: April 2020

Living organisms are capable of sensing and responding to their environment through reflex‐driven pathways. The grand challenge for mimicking such natural intelligence in miniature robots lies in achieving highly integrated body functionality, actuation, and sensing mechanisms. Here, somatosensory light‐driven robots (SLiRs) based on a smart thin‐film composite tightly integrating actuation and multisensing are presented. The SLiR subsumes pyro/piezoelectric responses and piezoresistive strain sensation under a photoactuator transducer, enabling simultaneous yet non‐interfering perception of its body temperature and actuation deformation states. The compact thin film, when combined with kirigami, facilitates rapid customization of low‐profile structures for morphable, mobile, and multiple robotic functionality. For example, an SLiR walker can move forward on different surfaces, while providing feedback on its detailed locomotive gaits and subtle terrain textures, and an SLiR anthropomorphic hand shows bodily senses arising from concerted mechanoreception, thermoreception, proprioception, and photoreception. Untethered operation with an SLiR centipede is also demonstrated, which can execute distinct, localized body functions from directional motility, multisensing, to wireless human and environment interactions. This SLiR, which is capable of integrated perception and motility, offers new opportunities for developing diverse intelligent behaviors in soft robots.