bluuebunny/crossref_metadata_2025 huggingface dataset:
ASPECTOS ETNOBOTÂNICOS E POTENCIAL FARMACOLÓGICO DE PLANTAS LATICÍFERAS LOCALIZADAS NO SÍTIO SÃO VICENTE, MUNICÍPIO DE SANTANA DO MATOS, RIO GRANDE DO NORTE
Authors: Jucá Thiago Lustosa , Cunha Muciana Aracely da Silva , Cavalcante Edson Amaro , Ramos Márcio Viana
Published: December 2021

Considerando a imensa diversidade vegetal do semiárido potiguar e a subvalorização dos seus aspectos etnobotânicos, este trabalho teve o objetivo de fazer um registro das principais espécies laticíferas da flora nativa encontradas no sítio São Vicente. Buscou-se também fazer um registro da utilização dos látex dessas plantas na medicina tradicional. Das cinco espécies registradas, três são nativas da região: velame (Croton heliotropiifolius Kunth), favela (Cnidoscolus phyllacanthus [Müll. Arg.] Fern. Casas) e pinhão-bravo (Jatropha mollissima [Pohl] Baill.); enquanto outras duas são exóticas, flor-de-seda (Calotropis procera [Aiton] W.T.Aiton) e urtiga (Urtica dioica L.). As três espécies nativas são da família Euphorbeaceae e apresentam látex com aspectos distintos, cujos relatos de sua utilização constam na medicina popular, porém estão ausentes na literatura científica. O látex do pinhão-bravo mostrou ser o mais promissor, por apresentar relatos de propriedades antiofídicas in natura. Esses dados revelam um promissor potencial farmacológico dessas espécies, assim como um potencial de prospecção de moléculas bioativas.
Projeto Enem para Todos: extensão universitária para o estímulo de jovens ao ensino superior
Authors: Bazzo Manoella Gonçalves , Castro Cecilia Orellana
Published: December 2021

O projeto de extensão “Enem para Todos” teve como objetivo incentivar o ingresso de alunos egressos do Ensino Médio de escolas públicas do município de Santana do Araguaia - PA ao nível superior, por meio da oferta de cursinho popular preparatório para o ENEM, bem como fortalecer a extensão universitária do Instituto de Engenharia do Araguaia (IEA) na região. O curso ofertou aulas aos sábados, durante os meses de maio a outubro de 2017, com foco na área de Linguagens, Códigos e suas Tecnologias e Matemática e suas Tecnologias. Esse relato, além de apresentar o projeto de extensão “Enem para Todos”, expõe parte da experiência vivida como professora durante execução desse. A partir dessa experiência, observou-se que, ao final do primeiro ano de atividade, o projeto pode ser considerado algo pioneiro no município, sendo muito bem recebido pelo público ao qual esteve voltado. Notou-se ainda que existe uma grande carência de estímulo ao nível superior entre os jovens, sendo necessários mais projetos dessa natureza.
Caminhos da Extensão na UFRN: desafios e perspectivas do passado e do presente
Authors: Ximenes Maria de Fátima Freire de Melo , Araújo Magnólia Fernandes Florêncio de , De Souza Candida , Tinoco Breno Guilherme de Araújo
Published: December 2021

No artigo Caminhos da Extensão na UFRN: desafios e perspectivas do passado e do presente Maria de Fátima Freire de Melo Ximenes, Magnólia Fernandes Florêncio de Araújo, Candida de Souza e Breno Guilherme de Araújo Tinoco Cabral desenvolvem uma análise acerca do contexto histórico e social do papel da extensão na formação integral com base nos princípios da indissociabilidade ensino-pesquisa- extensão. O texto destaca grandes projetos institucionais de extensão da UFRN como promotores de interação dialógica e potencial de transformação social.
Identification of Glutamine Synthetase as a Contryphan-Bt Binding
Protein by His-Tag Pull-Down
Authors: Han Penggang , Liu Shangyi , Dai Xiandong , Fan Chongxu , Cao Ying , Chen Jisheng
Published: December 2021

Background:

Contryphan-Bt is a D-tryptophan-containing disulfide-constrained decapeptide
recently isolated from the venom of Conus betulinus. The molecular targets of contryphans
are controversial, and the identification of its interacting proteins may be of great importance.

Methods:

His-tag pull-down assays were performed to investigate intracellular binding proteins of
contryphan-Bt from rat brain lysate. Bt-Acp-[His]6, a contryphan-Bt derivative containing hexahistidine
tag, was synthesized and used as the bait. As a control, Acp-[His]6 was used to exclude nonspecific
bindings.

Results:

Glutamine synthetase was identified as a potential contryphan-Bt binding protein by pull--
down assays and subsequent LC-MS/MS. The binding of contryphan-Bt to glutamine synthetase
was confirmed and determined using microscale thermophoresis, with a Kd of 74.02 ± 2.8 μM.
The binding did not affect glutamine synthetase activity, suggesting that the interaction site was
distinct from the catalytic center.

Conclusions:

Glutamine synthetase was identified as a novel contryphan-Bt binding protein. This is
the first report in which the conopeptide binds to an intracellular protein.
Regulation of Homeostasis by Neuropeptide Y: Involvement in Food
Intake
Authors: Marcos Pilar , Coveñas Rafael
Published: December 2021

:

Obesity leads to several metabolic disorders and, unfortunately, current pharmacological
treatments for obesity are not very effective. In feeding mechanisms, the hypothalamus
and some neuropeptides play an important role. Many data show that neuropeptide
Y (NPY) is involved in these mechanisms. The aim of this review is to update
the physiological actions mediated by the orexigenic peptide NPY, via its receptors, in
the control of food intake and to review its involvement in food intake disorders. The relationships
between NPY and other substances involved in food intake mechanisms, hypothalamic
and extra-hypothalamic pathways involved in feeding and the potential pharmacological
strategies to treat obesity will be discussed. Some research lines, focused on
NPY, to be developed in the future are suggested. Neuropeptide systems are associated
with redundancy and then therapies directed against a single target are generally ineffective.
For this reason, other targets for the treatment of obesity are mentioned. It seems
that combination therapies are the best option for successful anti-obesity treatments: new
and more specific NPY receptor antagonists must be tested as anti-obesity drugs alone
and in combination therapies.
2D Materials-Based Aptamer Biosensors: Present Status and Way Forward
Authors: Sen Raj Kumar , Prabhakar Priyanka , Bisht Neha , Patel Monika , Mishra Shruti , Yadav Amit K. , Venu Divya V. , Gupta Gaurav Kumar , Solanki Pratima R. , Ramakrishnan Seeram , Mondal D.P. , Srivastava Avanish Kumar , Dwivedi Neeraj , Dhand Chetna
Published: December 2021

:

Current advances in constructing functional nanomaterials and elegantly designed
nanostructures have opened up new possibilities for the fabrication of viable field
biosensors. Two-dimensional materials (2DMs) have fascinated much attention due to
their chemical, optical, physicochemical, and electronic properties. They are ultrathin
nanomaterials with unique properties such as high surface-to-volume ratio, surface
charge, shape, high anisotropy, and adjustable chemical functionality. 2DMs such as
graphene-based 2D materials, Silicate clays, layered double hydroxides (LDHs), MXenes,
transition metal dichalcogenides (TMDs), and transition metal oxides (TMOs) offer
intensified physicochemical and biological functionality and have proven to be very
promising candidates for biological applications and technologies. 2DMs have a multivalent
structure that can easily bind to single-stranded DNA/RNA (aptamers) through covalent,
non-covalent, hydrogen bond, and π-stacking interactions, whereas aptamers have a
small size, excellent chemical stability, and low immunogenicity with high affinity and
specificity. This review discussed the potential of various 2D material-based aptasensor
for diagnostic applications, e.g., protein detection, environmental monitoring, pathogens
detection, etc.
Norepinephrine in Goal-Directed Fluid Therapy During General Anesthesia in Elderly Patients Undergoing Spinal Operation: Determining Effective Infusion Rate to Enhance Postoperative Functions
Authors: Wu Fan , Liang Tao , Xiao Wei , Wang Tianlong
Published: December 2021

Background and Objective:

Intraoperative hypotension is a common complication in general anesthesia that could result in different serious complications particularly in elderly patients. This Randomized Clinical Trial (RCT) aims to determine effective continuous infusion rate of norepinephrine to prevent intraoperative hypotension during spinal surgery under general anesthesia in elderly patients.

Methods:

This RCT was conducted on elderly patients (n= 108) undergoing general anesthesia for posterior lumbar spinal fusion. The patients were randomly divided into 0.030, 0.060, and 0.090 μg.kg-1.min-1 groups of norepinephrine infusion rates. The outcomes were assessed at entrance to operation room (T0), 15 mins after anesthesia induction (T1), 60 mins following surgery (T2), and immediately after surgery (T3). The intraoperative and postoperative complications and rehabilitation outcomes were comparatively assessed.

Results:

All three groups significantly reduced the incidence of delayed wound healing (0.030 vs. 0.060 vs. 0.090 μg.kg-1.min-1; 33.3% vs. 10% vs. 10%, P=0.024) and wound infection (26.7% vs. 6.7% vs. 6.7%, P=0.031). Intraoperative total fluid volume and colloids volume in the 0.030 group were significantly higher than 0.060 and 0.090 groups (P=0.005, P=0.003, and P=0.01, respectively). The 0.060 and 0.090 groups significantly increased mean-arterial-pressure than the 0.030 group at T2 and T3. Both 0.060 and 0.090 infusion rates significantly reduced intraoperative hypotension than 0.030 dosage (P=0.01 and P=0.003, respectively). The bradycardia incidence in the 0.090 group was significantly higher than the 0.030 (P=0.026) and 0.060 groups (P=0.038). The 0.060 group decreased the first intake by 1.4 hours (P=0.008) and first flatus by 1.1 hours (P=0.004) and postoperative hospital stay by 1 day (P=0.066).

Conclusion:

The 0.060 µg·kg-1·min-1 norepinephrine infusion combined with goal-directed fluid therapy exhibited adequate intraoperative management and postoperative outcomes.
Advanced Protein Drugs and Formulations
Authors: Benedini Luciano
Published: December 2021

:

Previously, the application of proteins was uncommon as therapeutically active molecules.
Some of the first applications of proteins as drugs have been insulin and vaccines for overcoming a
physiological deficiency and the prevention of diseases, respectively. Nowadays, proteins have many
applications, not only as drugs but also as drug delivery systems to be administered by different
routes. Due to their nature, the behavior of proteins varies while the conditions of the environment are
modified. For this reason, it is necessary to study their behavior for predicting the correct
manufacturing, storing, or combination with other possible molecules in a formulation or into the
body. The application of techniques for predicting the behavior of proteins in different environments
has led to associating this type of behavior into the body with the occurrence of diseases, such as
celiac disease or Alzheimer's disease. Thus, this work shows an overview of the main types of
proteins applied as active therapeutically molecules, proteins-based drug delivery systems, and
techniques for predicting their stability into the primary storing container and the body.
A Novel Nomogram for Predicting Prognosis after Mechanical Thrombectomy in Patients with Acute Ischemic Stroke
Authors: Sun Huiling , Zhou Feng , Zhang Guoxing , Hou Jiankang , Liu Yukai , Chen Xiangliang , Zhang Yuqiao , Wang Wei , Deng Qiwen , Shi Hongchao , Zhou Junshan
Published: December 2021

Background:

Mounting evidence has shown that mechanical thrombectomy (MT) improves
clinical outcomes for large vessel occlusions (LVOs) in patients with acute ischemic stroke
(AIS) of the anterior circulation. The present study aimed to provide a comprehensive analysis of
risk factors associated with clinical outcomes in AIS patients receiving MT.

Methods:

A total of 212 consecutive patients who underwent MT for AIS were enrolled in the present
study. Clinical characteristics were recorded at admission. Two endpoints were defined according
to the 3-month modified Rankin scale (mRS) score after AIS (good outcome, mRS 0-2; and
death, mRS 6). Additionally, we compared the clinical outcomes and safety of MT alone and bridging
therapy in AIS patients.

Results:

Of the 212 patients treated with MT, 114 (53.77%) patients had a good outcome and 31
(14.62%) died. The incidence of a worse outcome after MT was significantly elevated in males and
patients with high WBC counts, high admission blood glucose levels, high baseline NIHSS scores
and a long interval time from groin puncture to reperfusion in AIS patients treated with MT after
adjustment for covariates (P<0.05); these risk factors were further confirmed by our constructed nomograms.
In addition, we observed no significant benefit of bridging therapy compared to MT
alone in AIS patients.

Conclusion:

Our constructed nomogram based on male sex, admission WBC, admission blood glucose,
NIHSS, and the interval time from groin puncture to reperfusion predicts prognosis after mechanical
thrombectomy in patients with acute ischemic stroke.
The Emerging Role of Epigenetic Methylation in Kidney Disease
Authors: Wen Li , Yang Hong-liu , Lin Lin , Ma Liang , Fu Ping
Published: December 2021

:

Kidney disease has complex and multifactorial pathophysiology and pathogenesis.
Recent studies have revealed that epigenetic methylation changes, namely DNA
methylation, histone methylation and non-histone methylation, are strongly implicated in
various forms of kidney diseases. This review provides a perspective on the emerging role
of epigenetic methylation in kidney disease, including the effects of DNA methylation in
diverse promoter regions, regulation and implication of histone methylation, and recent
advances and potential directions related to non-histone methylation. Monitoring or targeting
epigenetic methylation has the potential to contribute to development of therapeutic
approaches for multiple kidney diseases.
Effects of Melatonin and Doxorubicin on Primary Tumor And Metastasis in Breast
Cancer Model
Authors: Tanriover Gamze , Dilmac Sayra , Aytac Gunes , Farooqi Ammad Ahmad , Sindel Muzaffer
Published: December 2021

Background:

Melatonin exerts oncostatic effects on breast cancer via immunomodulation and antioxidation.
Doxorubicin is an effective chemotherapeutic agent, but parallel studies also provide ample evidence of an
off-target effect of Doxorubicin in breast cancer patients.

Objective:

Combinatorial use of doxorubicin and melatonin has not been comprehensively analyzed in breast cancer
models. We hypothesized that the anti-oxidative, anti-proliferative and anti-inflammatory effects of melatonin could
ameliorate the off-target effects of doxorubicin in breast cancer patients and enhance the anti-tumoral effects of
doxorubicin. The goal of the study is to test this hypothesis in cancer cell lines and xenografted mice.

Methods:

The effects of Melatonin and doxorubicin on the cell viability were evaluated in 4T1-Brain Metastatic Tumor
(4TBM). Furthermore, the effects of melatonin and doxorubicin on the primary tumors and systemic metastasis
were evaluated in the xenografted mice. Lung and liver tissues were removed and metastasis analyses were performed.
The levels of p65, phospho-STAT3, CD11b+, GR1+, Ki67, and cleaved caspase-3 proteins were determined with immunohistochemistry
and western blot analysis. We examined the effects of melatonin and Melatonin+Doxorubicin
combination therapy on 4TBM cells.

Results:

Our results showed that doxorubicin inhibited the proliferation of metastatic breast cancer cells while melatonin
did not affect cells. Tumor growth and metastasis were markedly suppressed in melatonin alone and in combination
with doxorubicin. The expression of CD11b+ and GR1+ proteins, which are indicators of myeloid-derived suppressor
cells (MDSCs), were noted to be reduced in both primary tumor and metastatic tissues in melatonin and doxorubicin
groups.

Conclusion:

The combination of melatonin with doxorubicin reduced primary tumor growth and distant metastasis.
Based on these results, melatonin is a promising candidate for combinatory use with conventional chemotherapeutics
for breast cancer treatment.
Dietary Intake and Nutritional Status of Javanese Women in Rice Producing Areas: a Comparison between Lactating and Non-lactating Women
Authors: Fahmi Ilmia , Purwestri Ratna C , Lauvai Judith , Barati Ziba , Bell Whelma , Wirawan Nia Novita
Published: December 2021

Maintaining optimal maternal nutrition is essential for the motherâ€™s health and the childâ€™s growth and development. Throughout the lactating period, maternal nutrition is significant due to the childâ€™s high nutritional needs. Therefore, an increase in food consumption is necessary. This research aimed to analyze the dietary intake and nutritional status of lactating and non-lactating women living in rice-producing areas in Central Java, Indonesia. A cross-sectional study was conducted from December 2014 to February 2015 in Demak Regency. As many as 375 participants were recruited and analyzed in this study. The results showed that the mean BMI-score of non-lactating mothers was higher than that of breastfeeding mothers (p=0.039). However, the nutritional status between the two groups of women was not significantly different. Significantly more lactating women consumed dark green leafy-colored vegetables (68.8%) and other vegetables (59.2%) than the non-lactating mothers (54.4%, p=0.065 and 36.8%, p=0.001, respectively). Regarding the selected macro and micronutrient intakes, statistically significant differences between the two groups of women could not be proven. In short, dietary intake between women within the different physiological statuses and BMI categories showed that they consumed around the same amount of macro-and micronutrient intakes and food groups, except for the high vegetable consumption among lactating women.
Resistencia del frijol al ataque del gorgojo pardo Acanthoscelides obtectus (Say, 1831) (Coleoptera: Chrysomelidae) en la zona Norte de Sinaloa
Authors: Armenta-López Arturo Rafael , Lugo-García Gabriel Antonio , Sánchez-Soto Bardo Heleodoro , Romero-Félix Celia Selene , Cortez-Mondaca Edgardo , Nava-Pérez Eusebio
Published: December 2021

El frijol es un producto básico en la alimentación de los mexicanos, pero su comercialización y establecimiento es afectado por el gorgojo pardo (A. obtectus), ya que es una plaga grave cuando la semilla está almacenada. En la última década, en Sinaloa, México, se establecieron nuevas variedades de fríjol con características agronómicas valiosas, como la alta productividad y calidad del producto cosechado; sin embargo, es indispensable determinar la resistencia o alta tolerancia de estos cultivares al ataque de este insecto. Debido a esto, se determinó la resistencia de seis cultivares de frijol (Aluyori, Azufrasin, Azufrado Higuera, Azufrado Noroeste, Azufrado Regional 87 y Janasa) cultivados en el centro y norte del estado de Sinaloa, al ataque y daño del gorgojo pardo Acanthoscelides obtectus (Say, 1831). Se compararon seis cultivares con cuatro repeticiones. El cultivar Aluyori presentó mayor resistencia con sólo el 18 % de semilla, escaso número de adultos emergidos (37) y mínima disminución de la capacidad germinativa (2.33 %). Por el contrario, el más susceptible fue Janasa con los siguientes valores: 51.75 %, 131.5 y 24.75 %, respectivamente. Por lo anterior, se recomienda la utilización de Aluyori y Azufrado Higuera para reducir el impacto negativo de la plaga, aunque se recomienda seguir con la experimentación de los materiales contenidos en los bancos de germoplasma para la futura liberación de nuevos cultivares.
The Negative Impacts of Chalets Operation on the Peninsular Malaysia Marine Park Islands
Authors: Yusoff Zeenat Begam , Zakariya Khalilah , Che Haron Roziha , Sapian Abdul Razak , Asif Nayeem , Shakir Hayder Jawad
Published: December 2021

The popularity of marine tourism put intense pressure on the island's environment. Limited studies were conducted to determine the negative impacts caused by chalets operation. Study aim is to investigate the adverse effects caused by the chalet’s operation on the Tioman and Perhentian Island. The objectives are to identify operation activities and the negative impact caused by the operation. The study was conducted by adopting qualitative method. The findings indicate solid waste disposal, groundwater extraction, and sewage disposal are destroying the marine environment in many ways. Several recommendations were provided to reduce the negative impacts.
Keywords: Chalet operation; Negative impacts; Island environment; Marine tourism
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i18.2953
Addressing Offshore Tax Evasion Challenges in the Rising of Digitalization Economy
Authors: Omar Nadia , Md Amin Wan Liza , Abdul Raof Nurazlina
Published: December 2021

Countries worldwide have lost billions of dollars in tax revenue due to tax evasion on income from offshore bank accounts. The increasing challenge in a rising digital economy, has brought about significant economic and social disruption, necessitating advanced measures to combat offshore tax evasion. Hence, this paper aims to provide an overview and critical analysis of the digital approaches taken globally to curb offshore tax evasion strategies used by individual and multinational corporations. This paper employs library-based doctrinal study and comparative legal analysis in a descriptive, analytic provision, and prescriptive manner.
Keywords: Offshore Asset, Tax Evasion, Digital Economy, Law Reform
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i18.3019
Investigating the Impact of Saudi QoL Program on Neighbourhoods’ Public Spaces: Riyadh neighbourhoods
Authors: Mostafa Lobna
Published: December 2021

“Humanization of Neighborhoods Initiative” was launched in 2020, under the QoL program aiming at improving and adapting public spaces in the city of Riyadh into pedestrian-friendly ones and fewer cars' dependent which can help accomplish the Saudi Vision 2030.
This research aims at investigating the reflections of the QoL program on the urban and social life in Riyadh neighborhoods focusing on the streets to promote social activities and walkability into a prime physical activity in neighborhoods.The research follows mixed methods; a qualitative approach is in the literature review and quantitative analysis in the research survey. It provides recommendations for city planners for developing pedestrian infrastructure.
Keywords: Saudi Vision 2030, Quality of Life, QoL, Public Space, walkability, community design, Placemaking
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i18.3024
Determining Controllability Level of Project Issues in Malaysian Landscape Architectural Projects
Authors: S.Muthuveeran Adam Aruldewan , Mohd Tahir Osman , Hassan Mohd Azren , Ramli Hidayati
Published: December 2021

The study aims to examine current project issues and the level of controllability in Malaysian landscape architecture projects. The data collection fieldwork was conducted via a semi-structured interview with twenty-four landscape architect professionals in the Klang Valley region. Content and thematic analysis were used to analyse the collected data. Found that project issues are controllable if the project can anticipate and treat them in advance. Nonetheless, issues continue to occur due to insufficient action taken in response to predicted issues affecting project outcomes. The study recommends developing a process for systematically forecasting, evaluating, and treating future issues.
Keywords: landscape architecture; project issues; controllability; Malaysia
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i18.3053
Public Awareness of British Pillboxes in Bachok, Kelantan from a Heritage Tourism Perspective
Authors: Hashim Nur Athmar , Muhammad Siti Aisyah , Tengku Anwar Tengku Fauzan , Zahar Iwan , Shuhaimi Nur Farhana
Published: December 2021

The British pillboxes built in Kelantan in 1941 during World War II, although damaged, continue to attract tourists. However, they have considerably less impact on residents, with the exception of war veterans, and there are plans to relocate the pillboxes in Bachok. The present study uses a range of methods to analyze the structures and to evaluate community awareness of them: field observation and setting coordinates for all pillboxes, taking photographs to consolidate data, and administering a questionnaire to 100 respondents. The results show that these monuments can be an economic resource and can help to raise awareness of historical value in relation to the formation of Malaysia.
Keywords: British Pillbox, Bachok coast, Heritage tourism, Kelantan.
eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v6i18.3087
The Safety of Oral Telomerase Activator in UV-Induced Skin Cancer with A Review of Telomerase in Aging and Skin Carcinogenesis
Authors:   Department of Dermatology, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, 10029, USA, Burke Karen E. , Zhou Xueyan ,   Department of Dermatology, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, 10029, USA,Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA, Wang Yongyin ,   Department of Dermatology, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, 10029, USA, Wei Huachen ,   Department of Dermatology, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, 10029, USA,Department of Clinical Research, Medtronic Diabetes, 18000 Devonshire St., Northridge, CA 91325, USA
Published: December 2021

The supplement telomerase activator TA-65 (purified from Astragalus membranaceus) has been shown to retard cellular senescence, boost the aging immune system, and retard age-related symptoms. Lengthened telomeres retard aging, but because cancers often maintain longevity by lengthening telomeres, dietary telomerase activator might possibly increase tumorigenesis. This study investigated whether oral TA-65 effects the timing of onset and/or the incidence of skin cancers induced by UVB-irradiation and whether that possible effect is different if the oral supplementation is begun only after tumors are first detected clinically or if supplementation is begun before initiation of tumors as well as during and after the inciting UVB exposure. Three groups of ten Skh:1 hairless, nonpigmented mice exposed to UVB for twenty weeks were given (1) no supplementation, (2) TA-65 supplementation starting when the first UV-induced skin cancers were clinically observed, after which the UV exposure was terminated, and (3) TA-65 supplementation before, during, and after UV exposure (as more tumors subsequently appeared). Except for two time points when Group 3 had borderline or statistically more tumors ≥ 2mm per mouse, overall, there was no statistically significant difference in the time of onset, the incidence, or the tumor load of skin cancers with TA-65 with either timing, confirming the safety of this anti-aging supplement in this model of the most frequent human malignancy.
An Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) for Individuals With Coronary Heart Disease: Development and Usability Testing Analysis
Authors: Chen Yuling , Ji Meihua , Wu Ying , Wang Qingyu , Deng Ying , Liu Yong , Wu Fangqin , Liu Mingxuan , Guo Yiqiang , Fu Ziyuan , Zheng Xiaoying
Published: December 2021

Background

Death and disability from coronary heart disease (CHD) can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system.

Objective

The aim of this study was to develop an Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of iCARE.

Methods

We developed iCARE based on a user-centered design approach, which included 4 phases: (1) function design, (2) iterative design, (3) expert inspections and walkthroughs of the prototypes, and (4) usability testing with end users. The usability testing of iCARE included 2 stages: stage I, which included a task analysis and a usability evaluation (January to March 2019) of the iCARE patient app using the modified Health Information Technology Usability Survey (Health-ITUES); and stage II (June 2020), which used the Health-ITUES among end users who used the app for 6 months. The end users were individuals with a confirmed diagnosis of CHD from 2 university-affiliated hospitals in Beijing, China.

Results

iCARE consists of a patient app, a care provider app, and a cloud platform. It has a set of algorithms that trigger tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For stage I usability testing, 88 hospitalized patients (72% [63/88] male; mean age 60 [SD 9.9] years) with CHD were included in the study. The mean score of the usability testing was 90.1 (interquartile range 83.3-99.0). Among enrolled participants, 90% (79/88) were satisfied with iCARE; 94% (83/88) and 82% (72/88) reported that iCARE was useful and easy to use, respectively. For stage II usability testing, 61 individuals with CHD (85% [52/61] male; mean age 53 [SD 8.2] years) who were from an intervention arm and used iCARE for at least six months were included. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 89% (54/61) were satisfied with the use of iCARE, 93% (57/61) perceived it as useful, and 70% (43/61) as easy to use.

Conclusions

This study developed an intelligent, individualized, evidence-based, and theory-driven app (iCARE) to improve patients’ adherence to health behaviors and medication management. iCARE was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of CHD.

Trial Registration

Chinese Clinical Trial Registry ChiCTR-INR-16010242; https://tinyurl.com/2p8bkrew
Effects of Person-Centered Care Using a Digital Platform and Structured Telephone Support for People With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Randomized Controlled Trial
Authors: Ali Lilas , Wallström Sara , Fors Andreas , Barenfeld Emmelie , Fredholm Eva , Fu Michael , Goudarzi Mahboubeh , Gyllensten Hanna , Lindström Kjellberg Irma , Swedberg Karl , Vanfleteren Lowie E G W , Ekman Inger
Published: December 2021

Background

Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are characterized by severe symptom burden and common acute worsening episodes that often require hospitalization and affect prognosis. Although many studies have shown that person-centered care (PCC) increases self-efficacy in patients with chronic conditions, studies on patients with COPD and CHF treated in primary care and the effects of PCC on the risk of hospitalization in these patients are scarce.

Objective

The aim of this study is to evaluate the effects of PCC through a combined digital platform and telephone support for people with COPD and CHF.

Methods

A multicenter randomized trial was conducted from 2018 to 2020. A total of 222 patients were recruited from 9 primary care centers. Patients diagnosed with COPD, CHF, or both and with internet access were eligible. Participants were randomized into either usual care (112/222, 50.5%) or PCC combined with usual care (110/222, 49.5%). The intervention’s main component was a personal health plan cocreated by the participants and assigned health care professionals. The health care professionals called the participants in the intervention group and encouraged narration to establish a partnership using PCC communication skills. A digital platform was used as a communication tool. The primary end point, divided into 2 categories (improved and deteriorated or unchanged), was a composite score of change in general self-efficacy and hospitalization or death 6 months after randomization. Data from the intention-to-treat group at 3- and 6-month follow-ups were analyzed. In addition, a per-protocol analysis was conducted on the participants who used the intervention.

Results

No significant differences were found in composite scores between the groups at the 3- and 6-month follow-ups. However, the per-protocol analysis of the 3-month follow-up revealed a significant difference in composite scores between the study groups (P=.047), although it was not maintained until the end of the 6-month follow-up (P=.24). This effect was driven by a change in general self-efficacy from baseline.

Conclusions

PCC using a combined digital platform and structured telephone support seems to be an option to increase the short-term self-efficacy of people with COPD and CHF. This study adds to the knowledge of conceptual innovations in primary care to support patients with COPD and CHF.

Trial Registration

ClinicalTrials.gov NCT03183817; http://clinicaltrials.gov/ct2/show/NCT03183817
Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
Authors: Militello Lisa , Sobolev Michael , Okeke Fabian , Adler Daniel A , Nahum-Shani Inbal
Published: December 2021

Background

Given the interrelated health of children and parents, strategies to promote stress regulation are critically important in the family context. However, the uptake of preventive mental health is limited among parents owing to competing family demands.

Objective

In this study, we aim to determine whether it is feasible and acceptable to randomize digital prompts designed to engage parents in real-time brief mindfulness activities guided by a commercially available app.

Methods

We conducted a 30-day pilot microrandomized trial among a sample of parents who used Android smartphones. Each day during a parent-specified time frame, participants had a 50% probability of receiving a prompt with a message encouraging them to engage in a mindfulness activity using a commercial app, Headspace. In the 24 hours following randomization, ecological momentary assessments and passively collected smartphone data were used to assess proximal engagement (yes or no) with the app and any mindfulness activity (with or without the app). These data were combined with baseline and exit surveys to determine feasibility and acceptability.

Results

Over 4 months, 83 interested parents were screened, 48 were eligible, 16 were enrolled, and 10 were successfully onboarded. Reasons for nonparticipation included technology barriers, privacy concerns, time constraints, or change of mind. In total, 80% (8/10) of parents who onboarded successfully completed all aspects of the intervention. While it is feasible to randomize prompt delivery, only 60% (6/10) of parents reported that the timing of prompts was helpful despite having control over the delivery window. Across the study period, we observed higher self-reported engagement with Headspace on days with prompts (31/62, 50% of days), as opposed to days without prompts (33/103, 32% of days). This pattern was consistent for most participants in this study (7/8, 87%). The time spent using the app on days with prompts (mean 566, SD 378 seconds) was descriptively higher than on days without prompts (mean 225, SD 276 seconds). App usage was highest during the first week and declined over each of the remaining 3 weeks. However, self-reported engagement in mindfulness activities without the app increased over time. Self-reported engagement with any mindfulness activity was similar on days with (40/62, 65% of days) and without (65/103, 63% of days) prompts. Participants found the Headspace app helpful (10/10, 100%) and would recommend the program to others (9/10, 90%).

Conclusions

Preliminary findings suggest that parents are receptive to using mindfulness apps to support stress management, and prompts are likely to increase engagement with the app. However, we identified several implementation challenges in the current trial, specifically a need to optimize prompt timing and frequency as a strategy to engage users in preventive digital mental health.
Artificial Intelligence Education Programs for Health Care Professionals: Scoping Review
Authors: Charow Rebecca , Jeyakumar Tharshini , Younus Sarah , Dolatabadi Elham , Salhia Mohammad , Al-Mouaswas Dalia , Anderson Melanie , Balakumar Sarmini , Clare Megan , Dhalla Azra , Gillan Caitlin , Haghzare Shabnam , Jackson Ethan , Lalani Nadim , Mattson Jane , Peteanu Wanda , Tripp Tim , Waldorf Jacqueline , Williams Spencer , Tavares Walter , Wiljer David
Published: December 2021

Background

As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education.

Objective

With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs’ curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs’ effectiveness.

Methods

After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career).

Results

Of the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective.

Conclusions

This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction.
The Effects of Intravenous Iron Infusion on Preoperative Hemoglobin Concentration in Iron Deficiency Anemia: Retrospective Observational Study
Authors: Nicholls Guy , Mehta Rajan , McVeagh Karen , Egan Matthew
Published: December 2021

Background

An iron infusion pathway using Ferrinject (ferric carboxymaltose) was implemented at Southend University Hospital for preoperative surgical patients with iron deficiency anemia undergoing major surgery. This was based on a treatment algorithm proposed by Munting and colleagues according to the international consensus statement on perioperative management of anemia and the UK National Institute for Health and Care Excellence (NICE) guidelines. These guidelines state that intravenous iron is indicated when oral iron is poorly tolerated or ineffective, there is insufficient time to surgery, or due to a functional iron deficiency.

Objective

The objective of this study was to evaluate the change in adult hemoglobin (Hb) concentration (g/L) after Ferrinject infusion at the time of surgery.

Methods

Data were retrospectively collected on all surgical patients that received an iron infusion preoperatively for iron deficiency anemia from July 2019 to April 2020. Nonsurgical, obstetric, and pediatric patients, and those without a postinfusion Hb level measurement were excluded. Data collected included the Hb, ferritin, and transferrin levels pre and postinfusion; correct dose of intravenous iron received; and any adverse reactions noted.

Results

Thirty-two surgical patients with iron deficiency anemia received intravenous iron between July 2019 and April 2020 prior to surgery. The average pre and post iron infusion Hb concentration across the cohort was 97 g/L and 114 g/L, respectively (18% increase; P=.001). Two (6%) patients had a posttransfusion Hb level ≥130 g/L prior to surgery after infusion. Nine patients had both a pre and postinfusion ferritin level recorded, which showed an increase from 12 ng/mL preinfusion to 94 ng/mL postinfusion (P=.02). Twenty-three (72%) patients did not receive the full dose of intravenous iron based on their Hb level and weight. Twenty-four (75%) patients received an iron infusion >2 weeks prior to surgery and the other 8 (25%) patients received the infusion <2 weeks before their surgery. There was an average increase in Hb of 22% (21 g/L, 95% CI 13-28) and 5% (5 g/L, 95% CI 1-10), respectively, across the two groups (P=.03). There were no documented adverse reactions to intravenous iron.

Conclusions

Intravenous iron is an effective intervention to improve the Hb concentration in patients with iron deficiency anemia despite the majority of patients not receiving the full dose based on their baseline Hb level and weight. Increasing the interval time between infusion and surgery was associated with a greater increase in Hb, with only a minimal increase observed if given less than 2 weeks prior to surgery.
The Clinical Utility of a Handheld Elastic Scattering Spectroscopy Tool and Machine Learning in the Diagnosis and Referral Management of Skin Cancer by Primary Care Physicians
Authors: Tepedino Kelly , Thames Todd
Published: December 2021

Background

Elastic scattering spectroscopy (ESS) is a noninvasive optical biopsy technique that can distinguish between normal and abnormal tissue in vivo. The handheld device measures ESS spectra of skin lesions and classifies lesions with an output of “Investigate Further” or “Monitor.” The algorithm was trained and validated with over 11,000 spectral scans from over 3500 skin lesions. The device performance was also evaluated in an associated clinical study.

Objective

The aim of this paper was to establish whether the use of a handheld ESS tool can improve the detection of skin malignancies by evaluating clinical performance while emulating a real-world telemedicine clinical care setting.

Methods

The associated clinical study examined an independent test set of 332 lesions in a prospective multicenter study that compared algorithm performance to biopsy results for diagnosing malignant lesions. A total of 50 cases were randomly selected from the study data base (25 malignant and 25 benign lesions). Device performance on these lesions had a 96% sensitivity. High-resolution digital images and the patient’s clinical information including prior skin cancer history, risk factors, and physical examination results were available for evaluation. A total of 57 primary care physicians participated in this study in 2 phases, the first phase with their standard-of-care diagnostic and the second phase regarding their evaluation with the device output. The physicians were educated on the ESS device before evaluating the cases in a random order. Case evaluation included the physician reporting their diagnosis, management decision, and confidence level without the device output in the first phase and with the device output in the second phase. The results were evaluated for sensitivity and specificity with confidence intervals.

Results

The diagnostic sensitivity of the readers without and with the use of the handheld ESS device increased significantly from 67% to 88% (P<.001). There was no significant difference in specificity at 40% and 53% (P=.05). The management sensitivity of the readers increased significantly with and without the use of the device, which, respectively, was 94% (91%-96%) and 81% (77%-85%) (P<.001), suggesting that the use of the device may reduce false negatives by 68%. Specificity was comparable for management decisions (P=.36) at 31% compared to 36% without the device.

Conclusions

The use of the handheld ESS device significantly improved diagnostic and management sensitivity over standard-of-care, with comparable specificity. While telemedicine has shown promise in many fields, studies have shown that in-person skin evaluation is superior to telemedicine evaluations; however, integration with this type of tool has the potential to improve early detection.