bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Social and Cultural Changes Materials in Social Studies
Authors: Rindawati Rindawati , Abbas Ersis Warmansyah , Putra Muhammad Adhitya Hidayat
Published: September 2021

Perubahan sosial dan budaya tidak bisa dihindari dalam kehidupan masyarakat. Pada ranah pembelajaran IPS, konteks perubahan sosial dan budaya merupakan materi yang diajarkan pada kelas IX, dengan tujuan agar peserta didik dapat memahami perubahan sosial disekitarnya, dapat menyesuaikan diri maupun memecahkan masalah sosial sebagai dampak terjadinya berbagai perubahan sosial maupun budaya. Atas dasar hal itu, artikel ini bertujuan untuk mengidentifikasi materi perubahan sosial dan budaya pada mata pelajaran IPS di SMP kelas IX. Penelitian ini menggunakan pendekatan kualitatif dengan metode studi literatur. Penulis mengumpulkan data dan informasi dengan bersumber pada jurnal, buku, dan surat kabar. Penelusuran pustaka tidak hanya untuk langkah awal menyiapkan kerangka penelitian, tetapi sekaligus memanfaatkan sumber-sumber tersebut untuk pegumpulan data sampai dengan melakukan analisis dan penarikan simpulan. Dari berbagai studi literatur tersebut, maka pada bagian hasil penelitian diidentifikasi bahwa materi perubahan sosial budaya pada mata pelajaran IPS di SMP kelas IX memuat beberapa aspek, yaitu definisi, bentuk, pola perubahan, faktor pendorong, faktor penghambat dan sikap masyarakat terhadap perubahan sosial dan budaya.
Repeated Oral Administration of Flavan-3-ols Induces Browning in Mice Adipose Tissues Through Sympathetic Nerve Activation
Authors: Ishii Yuko , Muta Orie , Teshima Tomohiro , Hirasima Nayuta , Odaka Minayu , Fushimi Taiki , Fujii Yasuyuki , Osakabe Naomi
Published: September 2021

We previously found increases in uncoupling protein (Ucp)-1 transcription in brown adipose tissue (BAT) of mice following a single oral dose of flavan 3-ols (FL), a fraction of catechins and procyanidins. It was confirmed that these changes were totally reduced by co-treatment of adrenaline blockers. According to these previous results, FL possibly activates sympathetic nervous system (SNS). In this study, we confirmed the marked increase in urinary catecholamine (CA) s projecting SNS activity following a single dose of 50 mg/kg FL. In addition, we examined the impact of the repeated administration of 50 mg/kg FL for 14 days on adipose tissues in mice. In BAT, FL tended to increase the level of Ucp-1 along with thermogenic transcriptome factors, such as peroxisome proliferator-activated receptor γ coactivator (PGC)-1α and PR domain-containing (PRDM)1. Transcription of browning markers, such as CD137 and transmembrane protein (TMEM) 26 in addition to PGC-1α were increased in epididymal adipose (eWAT) by FL. A multilocular morphology with cell size reduction was shown in the inguinal adipose (iWAT), together with increasing the level of Ucp-1 following administration of FL. These results suggest that FL produces browning in adipose through activation of the SNS.
The System of Differential Equations Associated With Involutions
Authors: Dekhkonov Farrukh Nuriddin ugli
Published: September 2021

In this paper, we consider with a class of system of differential equations whose argument transforms are involution. In this an initial value problem for a differential equation with involution is reduced to an initial value problem for a higher order ordinary differential equation. Than either two initial conditions are necessary for a solution, the equation is then reduced to a boundary value problem for a higher order ODE.
Application of Strategic Entrepreneurship Approach in Franchise and Non-franchise Business: A Study in Non-Formal English Education in Indonesia
Authors: Wulandari Respati , Herlina Maria Grace
Published: September 2021

This study further examines the influence of entrepreneurship in the innovation of the non-formal English language education industry (English course) that is oriented towards the achievement of competitive advantage. Entrepreneurship is characterized by entrepreneurial leadership, entrepreneurial culture, and an entrepreneurial mindset. This research approach is undertaken with strategic entrepreneurship. The method used is a quantitative method that begins with an explorative study of the English course industry in DKI Jakarta. The results of the discussion of institutional course data using a franchise system in which entrepreneurial mindset has no significant effect on entrepreneurial leadership and innovation strategy, as well as entrepreneurial culture, has no significant impact on innovation strategy. On the other side, institutional course data using a non-franchise system found that entrepreneurial leadership has no significant effect and is inversely proportional to innovation strategy. This research provides a new repertoire of entrepreneurial fusion and its impact on organizational innovation so that competitive advantage can be achieved. The entrepreneurial typology and innovation of the research results are given in managerial implications as the contribution of this study.
Application in Payment to Support Small, Micro, and Medium Enterprise
Authors: Dewi Anggadini Sri , Dianti Putri Wulandari
Published: September 2021

This study aims to determine whether e-Money boosts income in Small Micro Medium Enterprises. This study used descriptive quantitative method. Some people including SMEs entrepreneurs feel that making digital payments e-Money types are helpful in the transaction process because they are non-cash and can be keep in electronic devices minimizing risks of theft. E-Money or electronic money involved in the type of digital payment that involves the use of a computer network. The result of this paper is that E-money has many benefits for consumers, especially for MSMEs (Micro, Small, and Medium Enterprises) because its existence will shorten the time and cost of efforts to develop MSME businesses.
Analysis of Influence of Product Quality and Price on Buyer's Decision
Authors: Mukson  , Zaman Mohamad Badrun , Ikhwan Syariefull
Published: September 2021

The product's quality and price are two considerations that consumers weigh before making a purchase. With the Gebug milkfish micro, small, and medium enterprises (MSME), as many as 17 businesses in Losari District, Brebes Regency, this study aims to evaluate the impact of product quality and price on customer satisfaction. The participants in this study were 212 Losari District buyers of MSME milkfish products. With a total sample size of 34 consumers, this analysis used the random sampling technique. Quantitative analysis using a survey approach was used in this study. The price variable received a T-count value of 4,196 with a significance value of 0.001 less than 0.05 (0.001 0.05) based on the results of the t-test statistic, and the regression coefficient has a positive value of 0.715, so it can be inferred that the commodity price has a positive impact on buying decisions. The regression coefficient has a negative value of -0.148, and the T-test statistical results of the product quality variable obtained a t-value of -0.748 with a significant value of 0.459 greater than 0.05 (0.459 0.05) that the quality of a commodity has a positive impact on buying decisions. In this research, product quality and price influence buyer decisions for Gebug milkfish in Brebes Regency's Losari District. Since the regression coefficient is negative (-0.148), it can be inferred that product quality positively impacts buying decisions. In this research, product quality and price influence buyer decisions for Gebug milkfish in Brebes Regency's Losari District. Since the regression coefficient is negative (-0.148), it can be inferred that product quality positively impacts buying decisions. In this research, product quality and price influence buyer decisions for Gebug milkfish in Brebes Regency's Losari District.
Surgical Treatment of Osteochondral Lesions of the Tibial Plafond
Authors: Rikken Q.G.H. , Dahmen J. , Altink J.N. , Buck T.M.F. , Stufkens S.A.S. , Kerkhoffs G.M.M.J.
Published: September 2021

Background:

The literature on osteochondral lesions of the tibial plafond (OLTPs) is sparse. The aim of this study was therefore to provide an overview of clinical and radiological outcomes following treatment of OLTPs.

Methods:

We performed a systematic search of the MEDLINE, Embase, and Cochrane library databases. The review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and included all original articles on treatment outcomes for OLTPs. The methodological quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Baseline patient and lesion characteristics were pooled and weighted according to the number of lesions per study. The primary outcome was any clinical or patient-reported outcome measure pooled by treatment method when separable data were available. Secondary outcomes were complications, reoperation rates, radiological outcomes, and sport outcomes.

Results:

The search yielded 2,079 articles, of which 10 studies (1 prospective case series, 1 retrospective comparative study, and 8 retrospective case series) with a total of 175 patients were included. The overall methodological quality of the studies was low. All patients were treated surgically; 96% of the lesions were primary cases (i.e., first-time surgery) and 58% were solitary tibial lesions (i.e., no opposing talar lesion). Arthroscopic bone marrow stimulation was the most frequently used treatment strategy (51%), followed by cartilage transplantation (17%), chondrogenesis-inducing techniques (11%), osteochondral transplantation (3%), retrograde drilling (3%), and mixed (i.e., inseparable) treatments (15%). The clinical outcomes of the different surgical therapies were considered to be moderate to good. The pooled postoperative AOFAS (American Orthopaedic Foot & Ankle Society) score for bone marrow stimulation and osteochondral transplantation was 54.8 (95% confidence interval [CI], 49.5 to 85.0) (n = 14) and 85.3 (95% CI, 56 to 100) (n = 3), respectively. Overall, complications and reoperations were rarely reported. The pooled complication and reoperation rates could only be calculated for bone marrow stimulation and were 5% and 7%, respectively.

Conclusions:

Surgical interventions for OLTPs appear to yield moderate to good clinical outcomes. Bone marrow stimulation resulted in a moderate AOFAS score. Complications and reintervention rates were found to be low. The current evidence in the literature is limited because of the underreporting of clinical, radiological, and sport data and the heterogenous outcome scores reported.

Level of Evidence:

TherapeuticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
A New Approach for Automatic Optimization of Complex Fracture Network in Shale Reservoirs
Authors: Wang Haibo , Zhou Tong , Li Fengxia
Published: September 2021

Shale gas reservoirs have gradually become the main source for oil and gas production. The automatic optimization technology of complex fracture network in fractured horizontal wells is the key technology to realize the efficient development of shale gas reservoirs. In this paper, based on the flow model of shale gas reservoirs, the porosity/permeability of the matrix system and natural fracture system is characterized. The fracture network morphology is finely characterized by the fracture network expansion calculation method, and the flow model was proposed and solved. On this basis, the influence of matrix permeability, matrix porosity, fracture permeability, fracture porosity, and fracture length on the production of shale gas reservoirs is studied. The optimal design of fracture length and fracture location was carried, and the automatic optimization method of complex fracture network parameters based on simultaneous perturbation stochastic approximation (SPSA) was proposed. The method was applied in a shale gas reservoir, and the results showed that the proposed automatic optimization method of the complex fracture network in shale gas reservoirs can automatically optimize the parameters such as fracture location and fracture length and obtain the optimal fracture network distribution matching with geological conditions.
A scoping review on the key elements and effects of cardiovascular disease management programmes based on community-based participatory research
Authors: Park Bohyun , Yang Juhyeon
Published: September 2021

Background. This scoping review aims to analyse the literature on community based participatory research (CBPR) -based cardio vascular disease (CVD) management programmes, examining the key elements of their development and implementation and exploring their effectiveness. Methods. This study is based on the scoping review methodology, consisted of six stages: 1) identifying the research question; 2) identifying relevant studies—search strategy; 3) study selection; 4) charting the data; 5) collating, summarising, and reporting the results; and 6) consultation exercise. The electronic databases used for the literature search were PubMed, Cochrane, and CINAHL. The search period was from 4 March to 3 April 2020. We selected studies that: 1) were published after 2000; 2) targeted community residents over the age of 18; and 3) proposed a CBPR-based CVD management programme, described its development process, or evaluated its effects based on its application. The data were extracted independently by two researchers according to the standardised form. Results. Among the key elements of such programmes, there were many cases in which community organisations played the leading role in establishing partnerships and cases in which a decision-making committee was formed. Regarding the application of the CBPR principles, community partners participated only in executing the research and not in the process of analyzing and interpreting research results. In addition, In all six RCT studies, the experimental groups showed significantly positive effects compared to the control groups. Conclusion. It is necessary to develop strategies to improve the criteria based on which CBPR principles cannot be implemented during the development and implementation of a CBPR-based CVD management programme. In addition, more attempts to verify the effectiveness of high-quality research methodology should be made when evaluating the effectiveness of programmes.
A Local Perspective: Experiences And Handling of Mental Health Burden During The COVID-19 Pandemic In Uganda.
Authors: Muzyamba Choolwe , Munyati Bob Mwiinga , Makova Ogylive , Mushibi Geofrey
Published: September 2021

BackgroundThe COVID-19 pandemic has increased the prevalence of mental health illness around the world. While research has espoused these realities from the context of western countries, however, similar evidence from low income countries like Uganda is still missing. This is despite the fact that scholars have pointed out that given inadequate funding, health facilities and personnel to treat people with mental health challenges, the impact of the COVID-19 pandemic could be severe. Further, it is still unclear how locals in low income countries like Uganda manage to cope with mental health challenges given the lack of adequate skilled response, especially during a pandemic that has increased the pressure on the healthcare system. Therefore, this study aims to fill this gap by investigating local people’s experience and handling of mental health burden during the COVID-19 pandemic n Uganda. Methods Qualitative primary data was collected from Uganda in November and December 2020. The sample selection involved a two-staged cluster sampling technique via the AfriSight online platform. Our study included a total of 1249 participants picked from the 4 different regions of Uganda. On the basis of this, thematic analysis was used to analyze the data. Results Our study revealed that the COVID-19 pandemic and its associated interventions contributed to the increasing mental health burden in Uganda. The four most pronounced forms of mental health illnesses included stress, anxiety, depression and traumatic disorders with the leading causes being closure of income-generating activities, fear of dying, sexual and domestic abuse. While a few people had access to skilled mantel health care, the majority of the people struggled to access this form of care. Skilled maternal care remained an attractive yet unattainable form of care for many. Thus, most people relied on various forms of local strategies that were feasible. ConclusionOur study revealed that Uganda was home to various local survival strategies that counter the inadequacies presented by the weak health care system. Particularly, a culture of reciprocity, family and community network forms important coping avenues for many left stranded by the lack of adequate skilled care. Thus, in the context of Uganda during the COVID-19 pandemic, it seemed more logical to promote scaling up feasibly and locally-available solutions rather than idealistically focusing on attractive yet unattainable forms of care.
Physician Reported Challenges to Medical Professionalism: A Qualitative Study of Clinicians From Northern China
Authors: Liu Yutong , Zhao Weiyue , Ding Ning , Li Honghe , Song Wenwen , Zhang Xu , Wang Bin , Wen Deliang
Published: September 2021

BackgroundDespite efforts to promote professionalism among physicians, many studies have confirmed the ongoing prevalence of unprofessional behaviours in medicine and alluded to the challenges to professionalism that physicians may encounter. Physicians may regularly witness unprofessional events and may even participate in unprofessional practices. Therefore, the current study aims to identify common challenges to professionalism and physicians’ priorities when coping with such challenges，in hopes of shedding light on the East Asian environment with respect to physician professionalism. MethodsFive focus groups were conducted with a total of 49 clinical physicians from two tertiary hospitals in Shenyang, the largest city in northern China. Socio-demographic data were obtained through a brief questionnaire, and participants were de-identified after being linked to verbal data from the focus groups. Focus group interviews were audio-recorded and later transcribed and subjected to an inductive thematic analysis.ResultsA content analysis of the focus groups demonstrated that common professionalism challenges could be classified into five categories, namely: patients and their families (38%), society (22%), peers or teams (21%), institutions (13%), and education (n = 6%). Physicians failed to find current remediation measures, such as, discussing with supervisors, or reporting challenges to hospital or health authorities very effective.ConclusionsThe current study suggests that challenges from patients and their families contributed the most to professionalism challenges in the hospitals in northern China. In terms of the systematic reform of medical education and the healthcare delivery system, health authorities and hospital administrators should aim at addressing challenges to physician professionalism by building up a protective atmosphere.
Kinetic Analysis of Crude Enzyme Extract Produced Via Solid State Fermentation of Banana Pseudo Stem Waste
Authors: Subash Mira Chares , Perumalsamy Muthiah
Published: September 2021

Banana Pseudo stem waste after each harvest contributes about 70–80 Milli Tons Per hector. The banana pseudo stem will be thrown as waste biomass after each harvest as it is unstable for the upcoming harvest. The biggest challenge in banana cultivation is the utilization of biomass of banana pseusostem waste into valuable products. In this study, Xylano-pectinase enzyme extract was produced from banana pseudo stem waste under solid-state fermentation by Enterobacter cloacae PMC04. The highest pectinase and xylanase activities obtained using banana pseudo stem as carbon source were 124.62 U/ml and 173.81 U/ml respectively. Thermodynamics stated that range 40-50oC were considered to be the optimal temperature for xylano-pectinase enzyme production and subsequent degumming of banana fibers. The crude enzyme extract were then used in the degumming of banana fibers for textile application. Textile processing of banana fiber necessitates the removal of hemicellulose substance which can be achieved by crude xylano-pectinase enzyme. It was found that crude xylano-pectinase was efficient in the removal of hemicellulose substance from the fibers. Results obtained from this study demonstrate that the proposed bioprocess could be successfully applied for the degumming of banana fibers sustainably.
Diagnostic Biomarker KIF23 is Associated With Immune Infiltration in Gastric Cancer
Authors: Bai Maoshu , Liu Xin
Published: September 2021

Background: Kinesin family member 23 (KIF23), an index of tumor proliferation, can serve as a prognostic marker in numerous tumors. However, the relationship between KIF23 expression and immune infiltration and the diagnostic value of KIF23 remain unclear in GC (gastric cancer). This study aimed to explored the diagnostic value of KIF23 and its interactions with tumor-infiltrating immune cells in GC by bioinformatics analysis. Mothods: The relationship between clinicopathologic features and KIF23 expression was also analyzed using the Wilcoxon rank-sum test and logistic regression. And the expression level of KIF23 was validated by IHC and GEO databases, which was consistent with informatics results. Receiver operating characteristic (ROC) curves were generated to evaluate the value of KIF23 as a binary classifier using the area under the curve (AUC value).Results: High expression of KIF23 was significantly associated with longer overall survival and progression-free survival in GC. The mutations of KIF23 in GC were analyzed using cBioPortal and the Catalogue of Somatic Mutations in Cancer database. Enrichment analysis of co-expressed genes and KIF23 analysis was performed using LinkedOmics. By using STRING and GeneMANIA databases, we investigated the protein-coding genes related to KIF23 and its co-expression genes in GC tissues. Then, the relationship between KIF23 expression and immune infiltration in GC was investigated using Timer and GEPIA. We found that KIF23 might be used as a potential diagnostic biomarker in GC. Subsequently, KIF23 expression level was correlated with the infiltration levels of CD8 + T cells, macrophages, neutrophils, and more obviously with B cells and dendritic cells. In addition, KIF23 expression was significantly associated with T cell exhaustion (CTLA-4 and GZMB). KIF23 expression showed correlations with the infiltration of diverse immune markers in GC. Conclusions: Our findings suggest KIF23 can serve as a marker for immune infiltration and diagnostic in GC, making it a potential treatment of target.
Regression of Liver Fibrosis and Hepatocellular Carcinoma Development After HCV Eradication With Oral Antiviral Agents; A Prospective Multi-center Study
Authors: Yoo Hae Won , Park Jun Yong , Kim Sang Gyune , Jung Young Kul , Lee Sae Hwan , Kim Moon Young , Jeon Dae Won , Jang Jae Young , Lee Jin Woo , Kwon Oh Sang
Published: September 2021

Purpose: We prospectively investigated the changes of liver stiffness (LS) and the occurrence of hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) eradication using direct antiviral agents (DAA) over three years.Method: LS measurement using transient elastography and serum fibrosis surrogate markers before treatment and at 48, 96, 144 weeks after starting direct-acting antivirals (DAA) according to the protocol were evaluated. Patients were also compared with historical cohort treated with pegylated interferon (peg-IFN).Result: Sustained viral response (SVR) was observed in 95.8%. LS value in the patients achieving SVR significantly decreased over time (19.4 ± 12.9 kPa [baseline], 13.9 ± 9.1 kPa [48 weeks], 11.7 ± 8.2 kPa [96 weeks], 10.09 ± 6.23 [144 weeks], all p < 0.001). With matched analysis, the decrease in LS value was significantly larger in DAA group than peg-IFN group at both 48 weeks (29% vs. 9%) and 96 weeks (39% vs. 17%). The incidence of HCC was not significantly different between DAA and peg-IFN groups (5.5% vs. 5.4%) at 144 weeks.Conclusion: HCV eradication with DAA can lead to improvement of liver stiffness over time. The regression of fibrosis was greater in the group with DAA than peg-IFN.
Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness
Authors: Jarrar Mu’taman , Al-Bsheish Mohammad , Aldhmadi Badr , Albaker Waleed , Meri Ahmed , Dauwed Mohammed , Minai Mohd
Published: September 2021

Background
Patient safety and quality are concerns of healthcare systems, and several reforms and efforts have focused on this concern. Person-centeredness and nurse work environment are key elements for providing high quality and safe patient care, as structural and process factors. Limited existing studies suggest a mediation role of person-centeredness from a nursing perspective. Accordingly, this study aim to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety.
Methods
A quantitative cross-sectional survey collected data from 1,055 nurses working in medical and surgical units in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics.
Results
A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-hour shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-hour shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned for more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety.
Conclusion
Medical and surgical nurses working in a healthy environment had a high level of person-centeredness, which is, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and preventing patient harm.
Training Visual Pattern Recognition in Ophthalmology Using a Perceptual and Adaptive Learning Module
Authors: Ahmad Tessnim R. , Ashraf Davin C. , Kellman Philip J. , Krasne Sally , Ramanathan Saras
Published: September 2021

Background: To evaluate the efficacy of a perceptual and adaptive learning module (PALM) for teaching the identification of five optic nerve findings.Methods: In this prospective trial at a single academic institution, second- through fourth-year medical students were randomized, by class, to the PALM or a video didactic lecture. The PALM presented the learner with a short classification task consisting of an optic nerve image with all five possible findings. Learner accuracy and response time were used to guide the sequencing of successive classification tasks. Mastery for each finding was defined as three consecutive correct identifications within a target response time of eight seconds. The lecture intervention was a narrated video designed to simulate the related part of a traditional medical school didactic lecture. Accuracy and fluency on a pre-test, post-test, and delayed test (one month after the learning intervention) were compared within and between groups using the t-test. Cohen’s d was used to estimate effect size.Results: Eighty-three students participated. Accuracy and fluency improved significantly (P < 0.001) from pre-test to immediate post-test for both the PALM (accuracy d = 2.94, fluency d = 3.39) and lecture (accuracy d = 2.32, fluency d = 1.06). At the delayed test, PALM performance remained significantly (P < 0.001) greater than the pre-test in both accuracy (d = 0.89) and fluency (d = 1.16), while lecture performance remained greater in accuracy only (d = 0.44, P = 0.02). The PALM induced greater improvements than the lecture in both accuracy and fluency on the immediate post-test and delayed test.Conclusions: The PALM is an effective modality for training identification of common optic nerve findings.
Distance education (E-learning) as an effective tool to improve nurses’ perception and knowledge of developmental care of preterm infants: A quasi-experimental study
Authors: Jalali Shala , fouruzi Mansooreh Azizzadeh , Mehdipour-Rabori Roghayeh , Bagherin Behnaz , Roy Kallista , Jamalli Zahra , Nematollahi Monirsadat
Published: September 2021

Background: Providing developmental care for preterm infants admitted to the neonatal intensive care unit (NICU) is of special importance. To implement developmental care accurately, NICU nurses must have a proper understanding and sufficient knowledge in this field. This study aimed to investigate the effect of distance education on perception and knowledge of neonatal developmental care in nurses working in neonatal intensive care units. Methods: This quasi-experimental study was conducted using a pretest-posttest design with two groups. The participants were 60 nurses working in neonatal intensive care units who were selected using convenience sampling. The instruments used to collect the data were the Demographic Information Questionnaire, the Developmental Care Knowledge Scale, and the Developmental Care Perception Scale. The data were collected before and one month after the intervention. The participants in the intervention group received developmental care training using an electronic file uploaded in Navid Learning Management System, while the members of the control group received no intervention. The collected data were analyzed using SPSS V25 software. All statistical tests were performed at the significance level of 0.05 (P = 0.05). Results: The results of paired samples t-test showed there was no statistically significant difference between the mean scores of perception and knowledge of developmental care before and after the intervention in the control group (p> 0.05). However, the difference in the pre-intervention and post-intervention scores was statistically significant for the participants in the intervention group (p<0.001). Moreover, the results of the independent samples t-test showed that the mean scores of perception and knowledge of developmental care between the two groups before the intervention was not statistically significant (p= 0.67)). The results of univariate analysis of covariance also showed that there was a statistically significant difference between the mean score of perception and knowledge of developmental care between the two groups after the intervention (p=0.05).Conclusion: The results of this study showed that distance education for the developmental care of premature infants plays an effective role in the perception and knowledge of nurses working in the neonatal intensive care unit. Therefore, the development of e-learning packages for developmental care and their availability for nurses can be a step to improve the quality of nursing care for infants admitted to the NICU.
Integrated Geochemical And Mineralogical Investigation of Soil From The Volcanic Fogo Island (Cape Verde): Implications For Ecological And Probabilistic Human Health Risks
Authors: Pinto Marina M.S. Cabral , Saha Narottam , Ordens Carlos M , Pitta-Groz Denise , Carlos Gelson , Dinis Pedro , Marques Rosa , Prudêncio Isabel , Rocha Fernando , Silva Eduardo Ferreira da
Published: September 2021

Volcanic regions are associated with increased environmental and human health risks due to elevated concentrations of potentially toxic elements (PTEs). Fogo Island, Cape Verde, experienced recent volcanic eruptions, which raised questions about local soils' potential to pose such risks. To better understand the local mineralogy and geochemistry, and environmental and probabilistic human health risks, we (i) investigate the distribution of selected PTEs in 140 soil samples covering different geologic units, (ii) determine major associations between minerals and geological units, (iii) calculate the potential ecological risk, and (iv) model human health risks based on Monte Carlo simulations. The results show that the soils overlaying the older pre-caldera units yield higher contents of secondary minerals (phyllosilicates and Fe-oxides), with relative enrichment of PTEs. The soils covering more recent units are enriched with primary minerals (feldspar and pyroxene) and show elevated concentrations of Pb. This study suggests that As, Pb, Cd and Hg pose ‘considerable’ to ‘very high’ ecological risks. Based on probabilistic health risk simulation, ingestion is identified as the dominant pathway of PTEs exposure. Metal(oid)s are unlikely to cause a non-carcinogenic health risk, although As may pose a cancer risk for children. This research also provides health and environmental authorities with a tool to manage such risks.
Novel Breast Specimen Orientation Approach through 3D Visualizations for Relocating Inadequate Margins based on the Surgical Clips: Feasibility Study.
Authors: Doremalen Rob F.M. van , Lipman Kevin B.W. Groot , Riet Esther van 't , Torrenga Hans , Smits Maria M. , Heijden Ferdinand van der
Published: September 2021

Purpose: The current breast specimen orientation method after breast-conserving surgery is potentially inaccurate due to deformability and mobility of the extracted breast tissue. This complicates targeted relocation during re-excision or radiation. Therefore, we propose a new 3D-visualization method to communicate the breast specimen orientation to instantly provide an intuitive overview of the resection margins in relation to the surgical clips on the wound bed.Methods: In 15 female patients undergoing breast-conserving surgery, the surgeon labeled the surgical clips on the specimen and the wound bed. During pathologic assessment, after inking, a 3D scan was made of the specimen. Tumor tissue was annotated on the histological image and transposed to the respective location inside the 3D model. The transposed resection margins with respect to the labeled surgical clips were calculated and visualized. Intuitivity of the visualization was tested (face validity) as well as the quality of displayed resection margins and labeled clips.Results: Average face validity score for 3D-visualization was between ‘++’ and ‘+’ for surgeons and between ‘+’ and ‘+/-’ for pathologists. Average difference between computed resection margins and reported histologic margins was 1 mm. In 8 cases not all clips could be labeled in situ. In 5 cases not all labeled clips could be retrieved by pathology. Conclusion: The visualizations appeared valuable in interdisciplinary communications. The displayed resection margins approximated the reported margins. Consistent accurate surgical clip labelling proved challenging.
Circulating Exosomal miR-17-92 Cluster Serves as a Novel Non-Invasive Diagnostic Marker for Gastric Cancer Patients
Authors: Liu Fei , Han Ye , Li Dongbao , Zhou Jun , Xu Jingjing , Chen Weichang
Published: September 2021

Gastric cancer (GC) is one of the most common malignant tumors with a leading cause of cancer-related mortality worldwide. Exosomal miRNAs are considered as promising non-invasive biomarkers for the diagnosis of malignant tumors. In this study, we aimed to investigate the expression of exosomal miR-17-92 cluster and develop a potential biomarker for the diagnosis of GC. Exosomal RNAs were extracted and the expression profile of miR-17-92 cluster was detected using quantitative polymerase chain reaction (qRT-PCR). The ROC (receiver-operating characteristic) curve and AUC (area under the ROC curve) analysis were used to explore the diagnostic utility of miRNAs. Statistical was used to analyze the expression of serum exosomal miR-17-92 cluster with the clinical pathological parameters of GC patients. The results showed that the expressions of four members of the exosomal miR-17-92 cluster in the serum samples of GC patients were significantly upregulated compared with those of healthy controls. The AUC for serum exosomal miR-17, miR-18, miR-19a and miR-92 was 0.750 (95%CI=0.626-0.874, sensitivity=84.7%, specificity=70.0%), 0.736 (95%CI=0.590-0.881, sensitivity=88.9%, specificity=65.0%), 0.700 (95%CI=0.562-0.838, sensitivity=62.5%, specificity=80.0%), 0.689 (95%CI=0.567-0.811, sensitivity=45.8%, specificity=90.0%), respectively. The AUC for the newly combined panel consisting of miR-17, miR-18, miR-19a and miR-92 was 0.808 (95%CI=0.680-0.937), with sensitivity of 90.3% and specificity of 70.0%, which showed much higher clinical diagnostic value for GC than any of the four alone or any pair. Besides, the AUC for the newly developed panel consisting of the two traditional tumor biomarkers including CEA (carcinoembryonic antigen) and CA19-9 (carbohydrate antigen 19-9) and the four miR-17-92 cluster members was 0.881 (95%CI, 0.765-0.998) with sensitivity of 91.7% and specificity of 90.0%, which showed the greatest powerful clinical diagnostic value for GC. Moreover, the elevated exosomal miR-17-92 expressions were closely correlated with tumor size, tumor depth, lymph node metastasis, distant metastasis and TNM stage of GC patients. In conclusion, our findings revealed that circulating exosomal miR-17-92 cluster may be used as a novel potential non-invasive biomarker to improve the diagnostic efficiency in GC.
Mathematical Modeling of the Impact of Rehabilitation Centers on Illicit Drug Usage
Authors: Baba Isa , Sambo Saudatu Baba
Published: September 2021

This paper presents a mathematical model that studies the importance of treatment at rehabilitation centers intending to show the impact of the rehabilitation centers in minimizing illicit drug usage. We consider the global stability of endemic equilibrium using the properties of Volterra-Lyapunov matrices. Numerical simulations were carried out to show the impact of rehabilitation centers on illicit drug users.
Comprehensive Identification of Trem2 as a Key Factor in Promoting the Progression of Hepatocellular Carcinoma and Predicting Prognosis
Authors: Han Sheng , Wang Ziyi , Yu Wenjie , Jia Chenyang , Jiao Chenyu , Chen Xuejiao , Li Xiangdong , Zhang Yu , Xia Nan , Ni Yong , Pu Liyong
Published: September 2021

BackgroudsTrem2 is a core member of the Triggering recptor expressed on myeloid cell family, and its role in response to pathological damagewas first discovered in Alzheimer’s disease. Recently, the role of Trem2 played in tumor progression has been highlighted. However, the specific role and related mechanisms of trem2 in HCC (hepatocellular carcinoma) are still ambiguous.MethodsThe 371 HCC data sets in the TCGA cohort combined with the TIMER2.0 online database were used to verify the potential role and prognostic value of trem2 in HCC.TIMER2.0 online database,immunohistology, immunofluorescence, Western Blot and other methods are applied to identify the correlation between Trem2 and HCC patient samples.Animal models of bile duct ligation, intraperitoneal injection of CCL4 and feeding of CDAHFD60 were used to verify the potential mechanism of trem2 to regulate HCC.ResultsTrem2 is significantly overexpressed in HCC and is an independent risk factor predicts the poor prognosis of HCC patients. Trem2 mainly regulates the progression of HCC in response to the mutations of TP53 and CTNNB1, which also suggests that Trem2 plays an important role in tumor pathological metabolism. Since HCC patients often accompanied by different degrees of liver fibrosis, we suspect that Trem2 may promotes the progression of HCC by regulating liver fibrosis.ConclusionOur research highlights the status of trem2 in the tandem or independent events of HCC's pathological metabolism, immune checkpoint coordination, and liver fibrosis. We predict that targeting Trem2 combined with immune checkpoint inhibitors may be an effective treatment for HCC with rich immune and metabolic microenvironment.
Novel One-Step Nucleic Acid Amplification (OSNA) Application in Prostate Cancer. What Can We Learn from its Usage in Other Cancer Entities? A Systematic Review
Authors: Cuadras Mercè , Planas Jacques , Celma Ana , Regis Lucas , de Torres Inés M. , Semidey M. Eugenia , Trilla Enrique , Morote Juan
Published: September 2021

Background: Lymph node (LN) status is a key prognostic factor in the decision-making process of prostate cancer (PCa) management. Sectioning and haematoxylin and eosin (H&E) staining technique remain the gold standard for the evaluation of LN metastases despite some limitations, especially low sensitivity in detecting an accurate tumour burden within the LN, as well as a subjective and time-consuming result. One-step nucleic acid amplification (OSNA) quantifies mRNA copies of cytokeratin 19 (CK19) in a fast, objective, automated, and reproducible way, raising a general interest to explore its utility for lymphatic metastasis identification in different malignancies.Methods: To present the latest evidence related to the detection of LN metastases in several tumours by using OSNA compared with the conventional H&E method, a systematic review of articles published since March 2021 was conducted using PubMed, Cochrane Library, and Web of Science databases. References from primary papers and review articles were checked to obtain further potential studies. Our procedure for evaluating records identified during the literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria.Results: Twenty five studies were included. LN from six different groups of tumours: breast, gastrointestinal, gynecological, lung, head and neck and prostate cancers has been assessed. OSNA was compared with post-operative formalin-fixed paraffin-embedded tissue sections with H&E staining as the reference standard. Contingency tables were created, and concordance rate, sensitivity, specificity and predictive values were reported. Seventeen studies analysed the discordant cases using different techniques.Conclusion: OSNA method has a high diagnostic accuracy for the detection of LN metastases in several CK19 expressing tumours. Available evidence encourages its usage in PCa patients to improve LN staging and prognosis.
The Development and Psychometric Validation of the Japanese Version of the Home Healthcare Nurses’ Job Satisfaction: A Cross-Sectional Study Among Japanese Home Healthcare Nurses
Authors: MORI Yoko , SASAKI Miki , OGATA Yasuko , TOGARI Taisuke
Published: September 2021

Background: High-quality and attractive work environments and nurses’ intention to stay are highly related to the job satisfaction of home healthcare nurses. Accordingly, a reliable and valid tool is required to assess home healthcare nurses’ job satisfaction for evaluating and improving the work environment and clinical practice of home healthcare. This study aimed to develop and examine the Japanese version of the Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS-J).Methods: The Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS) was translated into Japanese, and a backward-translation was performed until equivalence between the original and backward-translated the HHNJS was confirmed. Subsequently, a mail survey was conducted among 409 home healthcare nurses from 154 home healthcare agencies in Japan. We evaluated construct validity through confirmatory factor analysis (CFA), and criterion-related validity and internal consistency were also tested.Results: The CFA revealed, a second-order seven-factor structure and adequate internal consistency, although, the fit of the data to the factor structure was moderate. As per the goodness-of-fit indices of the final model of the CFA, the comparative fit index was 0.89 and root mean square error of approximation was 0.06. This newly translated scale can be used to assess the job satisfaction of home healthcare nurses within Japan.Conclusions: The HHNJS-J evaluated acceptable reliability and validity among Japanese home healthcare nurses and had application in clinical practice in Japan.
Different Features of Metabolic Connectivity Map and Granger Causality Method in Revealing Directed Dopamine Pathways: A Pilot Study Based on Integrated PET/MR
Authors: Wang Lei , Wei Longxiao , Jin Long , Li Yunbo , Wei Yixin , He Wei , Shi Le , Sun Qinli , Li Wei , Li Qiang , Li Yongbin , Wang Yarong , Yuan Menghui
Published: September 2021

Granger causality (GC) analysis and metabolic connectivity map (MCM) are two effective connectivity (EC) methods commonly used in functional brain researches. Although they have a common basis in central neurophysiology, their differences in depicting EC are not clear because of absenting data acquired simultaneously and exactly aligned. Integrated positron emission tomography and magnetic resonance image (PET/MR) technology makes this available. Using the “Monash rs-PET/MR” dataset obtained from the OpenNeuro database, we first conducted GC and MCM analysis of the brain dopamine reward circuit, a well-known system mainly consisting of the bilateral Orbital Frontal Cortex (OFC), Caudate (CAU), Nucleus Accumbens (NAc), Thalamus (THA) and Substantia Nigra (SN). Then, we validated their ability of describing EC to priori knowledge. The significance of each directed pathways within group were tested through one-sample t-test (for MCM) or Wilcoxcon test (for GC), the significance level was set at p<0.05 after FDR correction. Three types of connections were found: the cortico-nucleus (long-range), the nucleus-nucleus (neighborhood) and the symmetrical connections. GC revealed long-range connections including OFC-CAU and OFC-NAc; MCM revealed neighborhood connections including NAc-CAU, SN-THA, and THA-CAU, the symmetrical connections including the bilateral NAc, CAU, THA, as well as OFC-CAU. Thus, different patterns in directional networks of dopamine reward circuit revealed by GC and MCM. GC predominated at aspects of cortico-nucleus bidirected connections, while MCM of directed connections among close regions and symmetrical regions. This study implicates that research involving in effective connections should choose an appropriate analysis method according to the study purpose.
The First Case Treated with Larotrectinib of a Novel TMTC2-NTRK3 Fusion Undifferentiated High-Grade Pleomorphic Sarcoma of the Chest
Authors: Bai Chujie , Zhang Lu , Wang Yaohui , Guo Taiyan , You Xia , Fan Zhengfu
Published: September 2021

Undifferentiated high-grade pleomorphic sarcoma (UPS) is a rare soft tissue sarcoma (STS) of mesenchymal origin, particularly the extremities and retroperitoneum, meanwhile it has been reported in almost all parts of the body. UPS is highly invasive and has a poor prognosis due to its clinical manifestations of painless mass and deep tumor site, which are usually found at an advanced stage. Patients with UPS tend to have a lower 5-year survival rate than patients with other types of STS. Recently, NTRK fusions were detected in many cancer types, such as thyroid cancer, colorectal cancer, non-small cell lung cancer, soft tissue tumors, uterine sarcomas, and melanomas. However, the mutation frequency of NTRK fusion in all cancers is only 0.1-1%. Targeted therapy with NTRK inhibitors, such as Larotrectinib and Entrectinib, leads to a response in most patients with NTRK1/2/3 gene fusion-positive tumors. Herein, we present a 68-years old man diagnosed with stage IIIA (T2N0M0G3) UPS. Next-generation sequencing (NGS) revealed a novel TMTC2-NTRK3 fusion. The NTRK3 positivity was also detected by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). He had a response to Larotrectinib. This report broadens the spectrum of NTRK fusions in UPS and highlights a new target for treatment.