bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed Tomography Findings as Determinants of Local and Systemic Inflammation Biomarkers in Interstitial Lung Diseases: A Retrospective Cohort Study
Authors: Lang David , Akbari Kaveh , Horner Andreas , Hepp Magdalena , Kaiser Bernhard , Pieringer Herwig , Lamprecht Bernd
Published: August 2020

Background: Additional to high-resolution computed tomography (HRCT), peripheral blood (PBL) and broncho-alveolar lavage (BAL) could provide biomarkers to distinguish predominantly inflammatory from non-inflammatory/fibrotic interstitial lung disease (ILD) phenotypes. Methods:HRCT of 127 subsequent ILD-board patients were semi-quantitatively evaluated in a standardized way: Reticulation/honeycombing (RET), traction bronchiectasis (TBR) and emphysema (EMP) were classified as non-inflammatory/fibrotic; consolidations (CON), ground glass opacities (GGO), noduli (NDL) and mosaic attenuation (MOS) as active inflammatory findings. These HRCT findings were counted as present or absent in 6 distinct lung regions, resulting scores were graded as minimal (0-1 regions involved), medium (2-4) or extensive (5-6). Associations between routinely assessed PBL/BAL biomarkers with these radiological scores were evaluated using Spearman correlation coefficients; significance of the graded HRCT scores by applying Kruskal-Wallis tests.Results: Blood neutrophil, lymphocyte and eosinophil fraction, neutrophil-lymphocyte ratio (NLR) and BAL lymphocyte fraction consistently showed opposite correlations for inflammatory versus non-inflammatory/fibrotic HRCT finding scores. Blood lymphocyte fraction significantly differed by graded GGO (p=0.032) and CON (p=0.027) extent, eosinophil fraction by TBR (p=0.006) and NLR by CON (p=0.009). C-reactive protein was significantly related to GGO (p=0.023) and CON (p=0.004), BAL lymphocyte fraction to GGO (p=0.017). Conclusions:Blood lymphocyte and eosinophil fraction, NLR, CRP and BAL lymphocyte fraction may aid to differentiate inflammatory from non-inflammatory/fibrotic ILD patterns. Trial registration:This evaluation was based on data from the ILD registry of Kepler University Hospital Linz, as approved by the ethics committee of the federal state of Upper-Austria (EK Nr. I-26-17).
Neutrophil-lymphocyte Ratio at the Beginning of Third-line Chemotherapy Seems to be a Useful Predictor for Unresectable Colorectal Cancer
Authors: Kawahara Hidejiro , Omura Nobuo , Akiba Tadashi
Published: August 2020

Aim: This study aimed to evaluate a long-term outcome predictor after second-line chemotherapy for unresectable colorectal cancer.Methods: Between 2013 and 2018, sixteen patients (twelve males, four females) with unresectable colorectal cancer who were administered TAS-102 as third-line chemotherapy in our institution were retrospectively enrolled in this study. The mean age was 65.4 (range: 46-79) years. Patients were administered oxaliplatin with oral S-1 (tegafur, gimeracil, oteracil potassium) (SOX) as first-line chemotherapy followed by irinotecan with oral S-1 (IRIS) as second-line chemotherapy.Results: The median survival time after second-line chemotherapy was 19.2 months. Significant differences in mean age, gender, body mass index, primary site of disease, pathology of primary tumor, depth of primary tumor invasion, serum carcinoembryonic antigen (CEA) level, serum carbohydrate antigen 19-9 (CA19-9) level, and recurrence site of disease were not observed between patients with less than one year of survival versus greater than one year of survival. However, neutrophil-lymphocyte ratio (NLR) at the beginning of third-line chemotherapy was the only factor of the ten evaluated that exhibited a significant difference. Primary tumor site (p=0.015) and NLR at the beginning of third-line chemotherapy (p=0.010) were independent contributing factors to predict survival after second-line chemotherapy based on Cox proportional hazards regression.Conclusion: NLR at the beginning of third-line chemotherapy is a useful predictor for unresectable colorectal cancer after second-line chemotherapy.
SLC2A3 Promotes Macrophage Infiltration by Glycolysis Reprogramming in Gastric Cancer
Authors: Yao Xingxing , He Zhanke , Qin Caolitao , Li Guoxin , Shi Jiaolong
Published: August 2020

Background: Tumors display a high rate of glucose metabolism and the SLC2A (also known as GLUT) gene family may be central regulators of cellular glucose uptake. However, roles of SLC2A family in mechanism of metabolite communication with immunity in gastric cancer remains unknown.Methods: Bioinformatics analysis and IHC staining were used to reveal the expression of SLC2A3 in gastric cancer and the correlation with survival prognosis. Real-time PCR, western blots, OCR, ECAR, lactate production and glucose uptake assays were applied to determine the effect of SLC2A3 on glycolysis reprogramming. We then investigated the consequences of SLC2A3 upregulation or inhibition on aerobic glycolysis, also explored the underlying mechanism. Bioinformatics analysis and in vitro and in vivo research were used to reveal the role of SLC2A3 in macrophage infiltration and transition.Results: Here, we show that SLC2A3 acts as a tumor promoter and accelerates aerobic glycolysis in GC cells. Mechanistically, the SLC2A3-STAT3-SLC2A3 feedback loop could promote phosphorylation of the STAT3 signaling pathway and downstream glycolytic targeting genes. Moreover, SLC2A3 potentially contributes to M2 subtype transition of macrophage infiltration in the GC microenvironment.Conclusions: SLC2A3 could be used as a prognostic biomarker to determine prognosis and immune infiltration in GC and may provide an intervention strategy for GC therapy.
CALM1 Promotes ESCC Progression and Dampens Chemosensitivity to EGFR Inhibitor
Authors: Liu Tao , Han Xiujuan , Zheng shutao , Liu Qing , Tuerxun Aerziguli , Zhang Qiqi , Yang Lifei , Lu Xiaomei
Published: August 2020

Background: Calmodulin1 (CALM1) has been identified as one of the overexpression genes in a variety of cancers and EGFR inhibitor have been widely used in clinical treatment but it is unknown whether CALM1 and epidermal growth factor receptor (EGFR) have a synergistic effect in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to explore the synergistic effects of knock-out CALM1 combined with EGFR inhibitor (Afatinib) and to elucidate the role of CALM1 in sensitizing the resistance to Afatinib in ESCC. Method: Immunohistochemistry (IHC) and qRT-PCR were used to examine the expression of CALM1 and EGFR in ESCC tissues. Kaplan–Meier survival analysis was used to analyze the clinical and prognostic significance of CALM1 and EGFR expression in ESCC. Furthermore, to evaluate the biological function of CALM1 in ESCC, the latest gene editing technique CRISPR/Cas9（Clustered regularly interspaced short palindromic repeats）was applied to knockout CALM1 in ESCC cell lines KYSE150, Eca109 and TE-1. MTT, flow cytometry, Transwell migration, scratch wound-healing and colony formation assays were performed to assay the combined effect of knock-out CALM1 and EGFR inhibitor on ESCC cell proliferation and migration.. In addition, nude mice xenograft model was used to observe the synergistic inhibition of knock-out CALM1 and Afatinib.Results: Both CALM1 and EGFR were found to be significantly over-expressed in ESCC compared with paired normal control. Over- expressed CALM1 and EGFR were significantly associated with clinical stage, T classification and poor overall prognosis, respectively. In vitro, the combined effect of knock-out of CALM1 mediated by the lentivirus and EGFR inhibitor was shown to be capable of inhibiting the proliferation, inducing cell cycle arrest at G1/S stage and increasing apoptosis of KYSE-150 and Eca109 cells; invasion and migration were also suppressed. In vivo, the results of tumor weight and total fluorescence were markedly reduced compared with the sgCtrl-infected group and sgCAML1 group.Conclusion: Our data demonstrated that knock-out of CALM1 could sensitize ESCC cells to EGFR inhibitor, and it may exert oncogenic role via promotion of EMT. Taken together, CALM1 may be a tempting target to overcome Afatinib resistance.
Full recovery from severe SARS-CoV-2 infection after requiring extracorporeal membrane oxygenation and continuous hemodiafiltration
Authors: Yoshioka Takafusa , Koganemaru Hiroshi , Murata Tomohiro , Mano Akiko , Date Kazuma , Kawata Mitsuhiro , Komatsu Kyoko , Fujimoto Hajime , Yamamoto Hiroshi , Aritaka Nanae , Sano Masahiro , Adachi Takuya , Anraku Masaki
Published: August 2020

We report two cases of severe SARS-CoV-2 infection successfully treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous hemodiafiltration (CHDF). ECMO was indicated despite immediate anti-viral and anticoagulation therapy with maximal ventilatory support. Meticulous bronchoscopic drainage was necessary during treatment by ECMO due to copious fluid secretion. Renal replacement therapy with continuous hemodiafiltration was also required for both cases due to ongoing renal dysfunction. However, both patients recovered fully without any disability or neurological sequelae. VV-ECMO is a vital tool to maintain appropriate gas exchange for severe SARS-CoV-2 infection to facilitate functional recovery. Because subsequent renal impairment is common in such severe cases, hemodiafiltration undertaken in a timely manner may be necessary. Controlling secondary bacterial infection is also key for lung recovery, as it may otherwise compromise the chance to wean patients off ECMO.
COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy.
Authors: Matteo Barabino , Gaetano Piccolo , Arianna Trizzino , Veronica Fedele , Carlo Ferrari , Vincenzo Nicastro , Andrea Pisani Ceretti , Enrico De Nicola , Maria Mariani Nicolò , Marco Giovenzana , Giovanna Scifo , Massimiliano Mazza , Ruggero Vercelli , Roberto Santambrogio , Carmelo Luigiano , Enrico Opocher
Published: August 2020

BACKGROUND.COVID-19 pandemic has impacted the Italian national health care system at many different levels, causing a complete reorganization of surgical wards. In this context, in this study we retrospectively analyzed our management strategy for patients with acute cholecystitis.METHODSWe analyzed all patients admitted to our Emergency Department for acute cholecystitis from February 27th to April 30th, 2020. We graded each case according to the 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. RESULTSThirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II and 8 grade III). According to Tokyo Guidelines 2018, patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy in 29.7%, 21.6 % and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous drainage was of 87.5%, the mean post-procedural hospitalization length was 9 days, and no related adverse event were observed.CONCLUSIONS.Bedside cholecystostomy has shown to be an effective and safe treatment, which acquired an increased relevance in the present acute phase of the pandemic. This strategy will potentially be taken into consideration in future phases, when the coexistence with the virus will require us to respond in an even more virtuous fashion.
Airway, voice and swallow outcomes following endotracheal intubation and mechanical ventilation for COVID-19 pneumonitis: preliminary results of a prospective cohort study
Authors: Miller Benjamin , Tornari Chrysostomos , Miu Kelvin , Slack Andrew , Murphy Patrick , Ahmed Imran , Burnay Victoria , Arora Asit , Simo Ricard , Karagama Yakubu
Published: August 2020

Introduction: The coronavirus pandemic has resulted in unprecedented rates of patients requiring intubation and ventilation over a short period of time. The authors present 3-month data on airway, voice and swallow outcomes for this cohort to better understand the impact of COVID-19 critical illness on laryngotracheal morbidity. Methods: An observational cohort study was performed on all patients discharged following critical illness at our tertiary institution over a 2-month period (1st March 2020 - 30th April 2020). Patients were stratified on the basis of primary diagnosis: COVID-19 pneumonitis, Non-COVID-19 respiratory failure and non-respiratory. Our primary outcome measure was reported airway, voice, and swallow dysfunction during inpatient admission and on 6-12 week Critical Illness Recovery Clinic follow up. Endoscopic findings of patients referred onward to our Multidisciplinary Laryngology-Speech Therapy Clinic were recorded.Results: 141 patients were included in our study. During inpatient admission there were no statistically significant differences in reported rates of airway, voice, or swallow dysfunction. In Critical Illness Recovery Clinic, there were markedly higher rates of reported airway, voice and swallow dysfunction in the COVID-19 pneumonitis cohort, although these rates only reached statistical significance in respect to airway outcomes (airway p=0.038, voice p=0.064, swallow p=0.240). 100% of patients reviewed to date in the Laryngology-Speech Therapy Clinic following COVID-19 critical illness had clinically significant laryngeal pathology.Conclusion: Our data highlights an impending surge in COVID-19 related laryngotracheal morbidity. Robust, prospective screening and clear referral pathways for all patients following COVID-19 critical illness are essential to identifying and managing this cohort.
Transcriptional Expression of Minichromosome Maintenance 10 as an Independent Negative Predictor of Survival in Hepatocellular Carcinoma
Authors: Chen Yiru , Li Yi-Ting , Chen Xi-Jie , Chen Yan-Ling , Zhu Sen-Lin
Published: August 2020

Background: The minichromosome maintenance protein 10 (MCM10) is a replication licensing factor that initiates eukaryotic genome replication by interacting with CDC45-MCM2-7 complex, thereby mediating cellular proliferation. Recent studies have found that MCM10 is involved in tumorigenesis and cancer development. However, research on the role of MCM10 in hepatocellular carcinoma (HCC) is scarce.Methods: In this study, the transcriptional expression, prognostic efficacy and function of MCM10 in HCC were explored through the public dadabases and bioinformatic tools, including ONCOMINE, Kaplan-Meier plotter, cBioPortal, TIMER and GEPIA. Statistical significance was inferred at a P-value < 0.05.Results: It was found that MCM10 expression was commonly overexpressed in cancer specimens compared to match normal tissues. Up-regulation of MCM10 gene in HCC had a close relationship with patients’ survival time. A higher level of MCM10 expression was correlated with shorter overall survival (OS) and progression-free survival (PFS) in HCC patients, especially at early stages (grade 2 or stage 1+2). MCM10 was also demonstrated to be an independent negative predictor of OS and disease-free survival (DFS) in patients with HCC by multivariate Cox regression. Additionally, according to the levels of marker genes for different immune cells in HCC, MCM10 expression was markedly positively correlated with the numbers of tumor-infiltrating B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils and dendritic cells, indicating its potential immunogenic role in HCC. Conclusions: MCM10 could be exploited as a potential independent prognostic indicator as well as therapeutic target for HCC patients.
Ocular Syphilis With Optic Disc Neovascularization Treated With Bevacizumab Evaluated by OCT Angiography and Electroretinography
Authors: Miura Gen , Baba Takayuki , Takeishi Marie , Tatsumi Tomoaki , Yokouchi Hirotaka , Yamamoto Shuichi
Published: August 2020

We present our findings in an atypical case of ocular syphilis with optic disc neovascularization that was treated with intravitreal bevacizumab and followed by multimodal imaging and electroretinography. A 29-year-old man presented with a chief complaint of night blindness of one-year duration. Our initial examination showed that an optic disc neovascularization was present, and the optical coherence tomographic (OCT) images showed a reduction in the length of the ellipsoid zone of both eyes. Fluorescein angiography showed leakage from the optic disc neovascular tissue, and the presence of nonperfused areas in the peripheral retina. Blood test was strongly positive for syphilis. He was administered oral amoxicillin and prednisolone. He was also treated with an intravitreal injection of bevacizumab which led to a rapid suppression of the neovascularization. However, panretinal photocoagulation had to be performed because OCT angiography and fluorescein angiography detected residual neovascularization. Although these treatments suppressed the activity of the ocular syphilis, electrophysiological improvements were not seen even one year after the initial treatment. OCT angiography and electroretinogram are useful techniques for monitoring the effectiveness of the treatments.
Association Between Serum Uric Acid and Triglycerides in Chinese Children and Adolescents With Short Stature
Authors: Chu Yuntian , Zhao Qianqian , Zhang Mei , Ban Bo , Tao Hongbing
Published: August 2020

Background: Elevated triglyceride (TG) levels are a biomarker of CVD risk. The relationship between serum uric acid (SUA) and TG in adults and obese children is well established. However, studies on children with short stature with SUA and TG are limited. Aim: The aim of this study was to examine the relationship between SUA and TG in Chinese children and adolescents with short stature.Methods: This study is a cross-sectional analysis of a cohort study. A total of 1095 children and adolescents with short stature (720 males and 375 females) were included. The related clinical characteristics, including body mass index (BMI), serum uric acid (SUA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), were determined.Results: The univariate analysis results showed a significant positive association between SUA and TG (P < 0.001). Furthermore, a smooth curve fitting after adjusting for potential confounders was performed, and a nonlinear relationship between SUA and TG was observed. A multivariate piecewise linear regression model revealed a significant positive association between SUA and TG when the SUA level was greater than 7 mg/dL (β 0.13, 95% CI 0.05, 0.22; P = 0.002). However, we did not observe a significant relationship between SUA and TG when the SUA level was lower than 7 mg/dL (β 0.01, 95% CI -0.01, 0.04; P=0.799).Conclusion: This study described a nonlinear relationship between UA and TG in children and adolescents with short stature. When SUA rises to a certain level, there is a strong positive association between UA and TG. This finding suggests that elevated UA levels may be another risk indicator of cardiovascular disease in children and adolescents with short stature.
Overcoming the Impact of COVID-19 Using Integrated Project Delivery Model
Authors: G Ramya
Published: August 2020

Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. Analysing various project management activities and their synergy between each other have studied. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the Royal Institute of British Architects (RIBA ) plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track, discussed in the research
Improvement of bacterial blight resistance of the popular variety, Nellore Mahsuri, NLR34449 through marker-assisted breeding
Authors: D Aleena , V Padma , G Rekha , T Dilip , E Punniakotti , MBVN Kousik , B Laxmi prasanna , RK Swapnil , Sinha Pragya , G Harika , RR Kale , MA Das , SK Hajira , M Anila , K Pranathi , shaik Mastanbee , GS Laha , MS Prasad , SM Balachandran , LV Subbarao , D Ratna Babu , M Lal Ahamed , JV Ramana , A Vijaya Gopal , Sundaram Raman
Published: August 2020

To combat the dreaded diseases in rice like bacterial blight and blast, host plant resistance has been advocated as a sustainable method. Through the present study, we have successfully incorporated three major bacterial blight (BB) resistance genes viz., Xa21, xa13 and xa5 into NLR3449, a high yielding, blast resistant, fine-grain type popular rice variety through marker-assisted backcross breeding. Foreground selection was carried out using PCR based, gene-specific markers viz., pTA248 (Xa21), xa13prom (xa13) and xa5FM (xa5) at each generation of backcrossing, while 127 polymorphic SSR markers spanning on 12 chromosomes were used for background selection and backcrossing was limited to two rounds. At BC2F1 generation, a single plant (NLR-87-10) with 89.9% recovery and possessing all the three bacterial blight resistance genes was forwarded to BC2F2 generation. A solitary BC2F2 plant viz., NLR-87-10-106 possessing all the three resistance genes and > 90% genome recovery was identified and advanced through selfing till BC2F4 generation by adopting pedigree method. Three best lines at BC2F4 lines, possessing high level of resistance against bacterial blight and blast and equivalent or superior to NLR 34449 in terms of yield, grain quality and agro-morphological traits have been identified and advanced for multi-location trials.
Intra-mammary Lymph Nodes, an Overlooked Prognostic Tool?
Authors: Hashem Tarek , Moez Ahmed Abdel , Rozeka Ahmed , Azeem Hazem Abdel
Published: August 2020

BackgroundDue to the high variability of incidence and prevalence of intra-mammary lymph nodes(IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer, might aid in proper therapeutic decision making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013-2019. Radiological, pathological and surgical data were studied.ResultsIntra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phylloides tumors and two cases had duct carcinoma in situ. All ten cases were excluded. The remaining 90 cases had all invasive breast cancer and were divided into two groups. One group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumour size (4.7 cm) , larger mean size of the IMLN (1.4 cm), higher incidence of lymphovascular invasion( 65.9%) and a higher rate of extracapsular extension in axillary lymph nodes (57.4%). All these criteria were statistically significant. In addition the pathological N stage was significantly higher in the malignant IMLNs group.ConclusionIntra-mammary lymph nodes are frequently overlooked by clinicians. More effort should be done to detect them during preoperative imaging, and during pathological processing of specimens. A suspicious IMLN should be biopsied by FNAC . Malignant IMLN are associated with advanced pathological features and should be removed during surgery.
Temporal Physical Activity Patterns are Associated with Obesity in U.S. Adults
Authors: Aqeel Marah , Guo Jiaqi , Lin Luotao , Gelfand Saul , Delp Edward , Bhadra Anindya , Richards Elizabeth A. , Hennessy Erin , Eicher-Miller Heather A.
Published: August 2020

Background: Few attempts have been made to incorporate multiple aspects of physical activity (PA), including timing and volume, to classify patterns that link to health. Temporal PA patterns integrating time and activity counts were created to determine their association with health. Methods: PA accelerometry data obtained from the cross-sectional National Health and Nutrition Examination Survey 2003-2006 was used to pattern PA counts and time of activity from 1,999 non-pregnant adults with one random valid weekday of activity. Constrained dynamic time warping with Sakoe-Chiba band and kernel k-means clustering grouped participants to 4 clusters representing temporal PA patterns. Multivariate regression models controlling for potential confounders and adjusting for multiple comparisons (p<0.05/6) determined associations between clusters and health status indicators and conditions obesity, type 2 diabetes, and metabolic syndrome. Results: Participants in Cluster 2, represented by a temporal PA pattern with activity counts reaching >1.2e5 counts/ h (cph) and tapering off through the day, had lower mean body mass index (BMI) (p<0.001), waist circumference (WC) (p<0.01), and 65% lower odds of obesity relative to normal weight status compared with participants in Cluster 1 with the lowest PA counts reaching 4.8e4 cph from 6:00 to 23:00 (OR: 0.3; 95% CI: 0.2, 0.8). Cluster 3, characterized by a temporal PA pattern with activity counts reaching 9.6e4-1.2e5 cph between 16:00 to 21:00, was associated with lower mean BMI (p<0.001) and WC (p<0.01), and 60% lower odds of obesity relative to normal weight status compared to Cluster 1 (OR: 0.4; 95% CI: 0.2, 0.8). Cluster 4 characterized by activity counts reaching 9.6e4 cph between 8:00 to 11:00 was associated with lower BMI and WC compared to Cluster 1 (both p<0.05). Conclusions: U.S. adults with temporal PA patterns of higher activity counts ranging between 9.6e4->1.2e5 cph performed early (8:00 to 11:00), late (16:00 to 21:00), or throughout the day had significantly lower mean BMI and WC compared with adults with a temporal PA pattern of the lowest PA counts reaching 4.8e4 cph from 6:00 to 23:00. Temporal PA patterns created by integrating time with PA counts throughout a day meaningfully link to health status.
El derecho de los pacientes: fundamentos teóricos y comparados
Authors: Momblac Liuver Camilo
Published: August 2020

En la actualidad es notaria la existencia de un cambio profundo en la relación médico-paciente. Se ha evolucionado hacia modelos reconocedores de sus derechos con especial consagración del respeto a su autonomía. En este artículo se presenta una sistematización en el orden teórico, exegético y comparado de los elementos conformadores de los derechos del paciente. Como resultado se revela la tendencia en el desarrollo a su protección jurídica con un mayor nivel de precisión en disposiciones infraconstitucionales.
Investidores-anjo e capital de risco:
Authors: Mendonça Pabrício Braz , Costa Filho Francisco Carlos Da , Carlos Filho Francisco De Assis , Ferreira Max André De Araújo
Published: August 2020

Este trabalho teve o objetivo de analisar a percepção de acadêmicos e empreendedores da cidade de Boa Vista, sobre a importância do capital de Risco, na modalidade do Investimento-Anjo, para o desenvolvimento da economia local. Essa pesquisa é classificada como qualitativa.Foi realizado estudo de caso. O meio de coleta dos dados foi realizado através de entrevistas semi-estruturadas. A Amostra foi composta por 6 representantes da academia e empreendedores. Como principais resultados pode-se inferir que parte da amostra crê que a figura do Investidor-Anjo pode ajudar a modificar a realidade local; que o termo Investimento-Anjo ainda é pouco conhecido pelos empreendedores locais, mas que existem iniciativas em curso; que a concorrência será a grande indutora do desenvolvimento da economia local nos próximos anos. Diante desse contexto, o financiamento de empresas nascentes via Capital de Risco, por meio do Investimento-Anjo, torna-se vital para a criação de uma atmosfera propícia ao desenvolvimento de negócios inovadores e sustentáveis na capital de Roraima. Como limitação os resultados oriundos de trabalhos que utilizam a técnica de estudo de caso não podem ser generalizados.
Importância da Gestão Orçamentária e de Custos como Suporte à Tomada de Decisões em Micro e Pequenas Empresas
Authors: Bergamim Graciele , Engelage Emanuele , Dutra Marcelo Haendchen
Published: August 2020

Este estudo objetiva demonstrar a importância e fomentar a utilização da gestão orçamentária e de custos em Micro e Pequenas Empresas (MPEs), ao evidenciar sua aplicabilidade e suporte à tomada de decisão em um restaurante situado no estado de Santa Catarina, Brasil. A coleta de dados ocorre entre os meses de agosto de 2017 a fevereiro de 2018. Realizam-se entrevistas e acompanhamentos dos procedimentos junto ao sócio proprietário, funcionários e membros próximos da cadeia. Também se analisam relatórios e documentos e apuram-se dados pertinentes ao mercado de atuação. Elaboram-se os orçamentos operacionais da empresa (venda, matéria-prima, mão de obra, custos indiretos e custos com venda, distribuição e administração) de maio a dezembro de 2018. As informações orçamentárias são validadas pelo gestor e analisa-se sua percepção quanto à relevância do instrumento. Segundo o gestor as informações orçamentárias proporcionaram reflexão e conhecimento e o fizeram ponderar sobre a importância do planejamento e controle, incorrendo, inclusive, em mudança de algumas práticas. Isso porque, por mais que os resultados financeiros apurados sejam satisfatórios, o detalhamento das informações demonstrou que há possibilidades para maximizá-los. Portanto, esta ferramenta cumpre seu papel como instrumento gerencial a MPEs, ao proporcionar maior compreensão da situação atual, projetar cenários futuros e indicar pontos a serem aperfeiçoados. Apesar de reconhecer suas vantagens informacionais, o gestor apontou algumas dificuldades quanto à utilização dos orçamentos e alega que sua implantação deve ser um processo gradual.
A participação das microempresas e empresas de pequeno porte nas contratações públicas do Governo Federal
Authors: França Carlos Alberto de , Moutinho Junior Fernando Augusto
Published: August 2020

Objetivo deste artigo é analisar a participação das microempresas e empresas de pequeno porte nas contratações públicas do Governo Federal, com base nos dados do Painel de Compras, uma nova ferramenta lançada em 2015, voltada para remodelar a atuação do Sistema de Serviços Gerais (SISG) do governo federal. Os resultados indicam que as contratações públicas do governo federal movimentaram mais R$ 258 bilhões de reais entre 2012 e 2016 com 50,85% de participação das ME/EPP e desse percentual 22,72% das compras foram homologadas para ME/EPP, sendo que, a partir de 2014 esse percentual de compras homologadas para ME/EPP diminui significativamente para 13,31 % em 2016. A principal conclusão deste trabalho é a necessidade de atualizações e/ou alterações nas normas e legislações como a Lei Complementar n° 123/2006, Lei Complementar n° 147/2014, Lei nº 8.666/93 e Decreto nº 8.538/2015 para aumentar e melhorar a participação de microempresas e empresas de pequeno porte nas compras do Governo Federal e consequentemente nos Estados, Distrito Federal e Municípios.
Medição de desempenho:
Authors: Silva Rafael Henrique , Silva Elias Araújo , Galdamez Edwin Cardoza
Published: August 2020

A presente pesquisa tem por objetivo identificar o nível de aderência ao framework de medidas de desempenho utilizadas pelas aceleradoras do estado do Paraná para acompanhar o desenvolvimento das startups. Possui como objeto de estudo as aceleradoras do estado do Paraná, tendo como população estimada 09 empresas. A coleta de dados foi realizada por meio de questionários semiestruturados. Utilizou-se de estatística descritiva para realizar a análise dos dados. Os resultados apontaram uma baixa aderência ao framework entre as aceleradoras paranaenses, tanto para medidas financeiras quanto para não financeiras.  Contudo, verificou-se que alguns indicadores financeiros e não financeiros possuem um nível satisfatório de aderência, concluindo-se então que as aceleradoras paranaenses se utilizam de medidas de desempenho no processo de aceleração. Verificou-se também que as aceleradoras em sua grande maioria prezam por utilizar medidas de desempenho específicas em cada etapa do ciclo de vida das startups e de acordo com cada modelo de negócio, conforme sugere a literatura.
Evaluating Population Density as a Parameter for Optimizing COVID-19 Testing: Statistical Analysis (Preprint)
Authors: Budhwani Karim I , Budhwani Henna , Podbielski Ben
Published: August 2020

BACKGROUND

SARS-CoV-2 transmission risk generally increases with the proximity of those shedding the virus to those susceptible to infection. Thus, this risk is a function of both the number of people and the area they occupy. However, the latter continues to evade the COVID-19 testing policy.

OBJECTIVE

The aim of this study is to analyze per capita COVID-19 testing data reported for Alabama to evaluate whether testing realignment along population density, rather than density agnostic per capita, would be more effective.

METHODS

Descriptive statistical analyses were performed for population, density, COVID-19 tests administered, and positive cases for all 67 Alabama counties.

RESULTS

Tests reported per capita appeared to suggest widespread statewide testing. However, there was little correlation (r=0.28, P=.02) between tests per capita and the number of cases. In terms of population density, new cases were higher in areas with a higher population density, despite relatively lower test rates as a function of density.

CONCLUSIONS

Increased testing in areas with lower population density has the potential to induce a false sense of security even as cases continue to rise sharply overall.
Challenges of implementing the health system transformation plan in the health sector (Preprint)
Authors: Azizzadeh Fariba , Koohi Asghar
Published: August 2020

BACKGROUND

Today, health is one of the top priorities in people's lives. In today's world, health perspectives are broader.

OBJECTIVE

Therefore, this study was conducted to identify the challenges of implementing the transformation of the health system in the health sector of Gotvand city in Iran.

METHODS

This qualitative study was conducted by an in-depth and semi-structured interview method. Participants, including 11 experts in the Health Transformation Project, were targeted. The Grounded Theory method (Foundation Data Theory) was used for analysis.

RESULTS

According to the identified categories and components, managerial challenges are: appointment without criteria, lack of meritocracy, instability of management, incompatibility of responsibilities, and authority of managers has been identified. Challenges have also been identified in human resource management, such as inefficient human resource management, employee frustration (hopelessness), and difficult job placement conditions. In the political sphere, factors such as the instability of domestic and foreign policy were also identified. In the financial field, the Health Transformation Plan faced the challenges of financial resource instability and lack of sustainable financing.

CONCLUSIONS

According to interviews and responses received, the most important factor from the respondents' point of view was the instability of domestic and foreign policies as the main focus of political challenges.
Measuring the level of knowledge and awareness about COVID-19 among the community of a college in Dubai: A comparative observational study between participants of health sciences and non-health sciences backgrounds. (Preprint)
Authors: Alhajri Lamia , Mohamed Heba
Published: August 2020

BACKGROUND

COVID-19 which has resulted worldwide pandemic, prompted various healthcare organisations to take meticulous measures to stop or slow down the spread of it. These measures will require a behavioural change, hence the Health Belief Model was used According to the model, knowledge and awareness is needed to establish an assessment of threat and consequently decide whether or a not a behaviour will be changed. However, since the outbreak is a viral infection, it is expected that people with health backgrounds would have more knowledge and awareness about COVID-19.

OBJECTIVE

This study aims to compare the level of knowledge and awareness of health sciences to non-health sciences faculty, staff and students at a Females College in Dubai towards COVID-19. This assessment will help to anticipate the risk assessment of individuals, and consequently compliance to regulations.

METHODS

A cross-sectional observational descriptive study was conducted using a self-administered online questionnaire to test the hypothesis. Participants were recruited via emails and/ or during their virtual lectures. Results were then analyzed using Chi-square or Fisher Exact test for categorical data to compare the differences in proportion.

RESULTS

Knowledge and awareness of participants regarding contagiousness, transmission, incubation period, recovery and mortality rate, susceptibility of elderlies and stay home policy was generally high irrespective of their background (p=n.s.). The high knowledge could be attributed to the rapid dissemination of information through social media. Yet, health sciences participants were significantly more knowledgeable regarding certain preventive measures (washing hands, wearing masks, social distancing), the causative pathogen and that it can be transmitted through animals (P<0.05). Hence, as per the model, it is expected that participants with higher knowledge are expected to perceive threat differently, and consequently decide to change the behavior.

CONCLUSIONS

Overall, there was a high level of knowledge and awareness amongst participants irrespective of their background. Yet, there were some areas where the knowledge of health sciences group was higher than the non-health sciences group. Assessing knowledge and awareness was important to ensure that people understand and consequently change their behaviour to mitigating the spread of COVID-19.

CLINICALTRIAL

Not applicable
Obesity in children: criteria for predicting the development of hypertension
Authors: Sorokman T.V. , Popeliuk N.O.
Published: August 2020

Background. Obesity in childhood causes a wide range of serious complications and increased risk of diabetes, hypertension, cardiovascular and other diseases. Formation of various types of hypertension in adolescents with overweight and obesity is cha­racterized by imbalance in the production of biologically active substances. Materials and methods. One hundred and sixty people were examined: with overweight (n = 35), obesity (abdominal (n = 35), uniform (n = 35)), and 55 healthy people. Blood lipids (total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol), endothelin-1, β2-micro­globulin were studied, as well as 6-hydroxymelatonin sulfate in the urine. Results. A significant increase in the average daily va­lues of systolic, diastolic, mean hemodynamic and pulse blood pressure was established. Obese children had a tendency to react excessively in the form of an increase in the daily rate of systolic blood pressure elevations. In 57.1 % of patients with obesity, pathological abnormalities of the blood lipids were found: levels of total cholesterol, LDL cholesterol, triglycerides were higher, and HDL cholesterol was lower in both groups of patients. A significant increase in the content of endothelin-1 and β2-microglobulin in the blood plasma of obese children and a tendency towards an increase in children with overweight, disturbances of the circadian rhythm of 6-hydroxymelatonin sulfate secretion were revealed. Conclusions. Metabolic risk factors for the development of hypertension have been identified in children with obesity and overweight: dyslipidemia (hypertriglyceridemia, increased LDL cholesterol, reduced HDL cholesterol), increased β2-microglobulin and endothelin-1 levels, and an imbalance of melatonin secretion. Patients with these adverse factors should be closely monitored by a physician. A special attention should be paid to children with overweight as potential candidates for the development of obesity and its complications, including arterial hypertension.
The role of ghrelin and serotonin in the control of eating behavior in patients with obesity and diabetes mellitus type 2
Authors: Urbanovych A.M. , Laniush F.V.
Published: August 2020

In recent years, the incidence of obesity and type 2 diabetes mellitus (DM) has been increasing steadily; therefore, the search for hormonal and metabolic substances the correction of which can normalize human eating behavior is required. The main system for controlling hunger and appetite — the melanocortin pathway — is located in the hypothalamus. Activation of this signa­ling system by melanocortins leads to appetite decrease and causes a feeling of satiety. Neuropeptide Y and agouti-related protein act antagonistically and enhance hunger. There are different types of eating disorders, such as binge eating and night ­eating syndrome, which are most common among obese patients and those with type 2 DM. They are characterized by excessive intake of food and, consequently, complication of the course of underlying disease due to its negative impact on carbohydrate and lipid metabolism. There are various hormonal and metabolic substances that are responsible for suppressing and stimulating the center of hunger in the hypothalamus. This article examines the effect of ghrelin and serotonin on the mechanism of eating habits formation and the control of eating behavior in patients with obesity and type 2 DM. This article highlights the role of ghrelin and serotonin in eating behavior. Ghrelin is an orexigenic hormone and is capable of activating the center of hunger. The concentration of this hormone in patients with obesity and/or type 2 DM is reduced compared to healthy individuals that indicates the adaptation of the body to positive energy balance and excess calorie intake by humans. In turn, serotonin, whose receptors are also present in the hypothalamus, upon bin­ding to 5-HT2C receptor causes inhibition of neuropeptide Y secretion that leads to feeling of satiety and normalization of appetite and weight, thus exhibiting anorexigenic properties. Lorcaserin is currently the only serotonin receptor agonist approved by the Food and Drug Administration for the treatment of obesity. That is why studies of hormonal and metabolic substances that are involved in the signaling pathways of the hypothalamus hunger center will help find effective ways to treat obesity and type 2 DM.
COVID-19 и сахарный диабет: менеджмент пациентов во время пандемии
Authors: Pashkovska N.V. , Pankiv V.I. , Pashkovska O.V.
Published: August 2020

Коронавирусная болезнь 2019 (COVID-19) — потенциально тяжелая острая респираторная инфекция, вы­званная коронавирусом-2 (SARS-CoV-2), с выраженным острым респираторным синдромом. Люди с сахарным диабетом (СД) имеют повышенный риск возникновения серьезных расстройств на фоне COVID-19. В статье сообщается, что СД и неконтролируемая гликемия являются важными предикторами тяжести и смерти среди пациентов, инфицированных различными вирусами, включая пандемический грипп A (H1N1) в 2009 году, SARS-CoV и MERS-CoV. В условиях продолжающейся пандемии SARS-CoV-2 в некоторых исследованиях не выявлено четкой связи между СД и тяжестью заболевания. Однако анализ данных из Китая и Италии показал, что пациенты пожилого возраста с хроническими заболеваниями, включая СД, имеют больший риск тяжелой COVID-19 и смертности. Среди случаев смертности от COVID-19 в Ухане (Китай) основными сопутствующими заболеваниями были СД (42,3 %), артериальная гипертензия (53,8 %), заболевания сердца в анамнезе (19,2 %) и церебральные расстройства (15,4 %). Также смертность существенно возрастает (на 6 %) при наличии СД (7,3 %) и других сопутствующих заболеваний, таких как сердечно-сосудистые (10,5 %), хронические заболевания органов дыхания, артериальная гипертензия и рак. По данным исследований, распространенность СД у людей, зараженных вирусом, примерно такая же, как и в общей популяции, даже несколько ниже. Согласно результатам метаанализа 12 исследований, которые описывают данные 2108 китайских пациентов с COVID-19, распространенность СД составила 10,3 %, что было аналогично распространенности 10,9 % в 2013 году. Пациентам с СД рекомендуется придерживаться общих советов по уменьшению риска заражения, а также специфических для лиц с СД. Все современные рекомендации медицинских организаций и научных сообществ подчеркивают важность надлежащего контроля гликемии во время пандемии COVID-19, так как это может помочь уменьшить риск заражения и тяжесть болезни.
Уровень эндотелина-1 в крови больных сахарным диабетом в зависимости от характеристик заболевания
Authors: Sokolova L.K. , Belchina Yu.B. , Pushkarev V.V. , Cherviakova S.A. , Vatseba T.S. , Kovzun O.I. , Pushkarev V.M. , Tronko M.D.
Published: August 2020

Актуальность. Эндотелин (ЭТ-1) является одним из наиболее значимых регуляторов функционального состояния эндотелия сосудов. Это самый мощный вазоконстриктор и маркер эндотелиальной дисфункции. Эндотелий играет важную роль в регуляции тонуса сосудов. ЭТ-1 оказывает как воспалительное, так и пролиферативное действие и приводит к патогенным процессам в сердечно-сосудистой системе. При диабете повышенные концентрации глюкозы и гликированного гемоглобина (HbA1c) влияют на образование ЭT-1. Целью работы было изучение содержания ЭТ-1 в крови больных сахарным диабетом с различными показателями индекса массы тела (ИМТ), длительности заболевания и уровня HbA1c. Материалы и методы. Концентрация ЭТ-1 оценивалась методом ИФА у 103 человек: 17 здоровых добровольцев и 86 пациентов с сахарным диабетом. Для определения ЭT-1 использовали набор Еndotelin (1-21) EIA kit (1-21) («Biomedica»). Гликированный гемоглобин определяли с использованием набора one HbA1c FS — DiaSys Diagnostic Systems. Результаты. Средний уровень эндотелина в крови больных сахарным диабетом составил 0,536 ± 0,047 фмоль/мл (контроль — 0,118 ± 0,017 фмоль/мл). У всех пациентов с сахарным диабетом уровень ЭT-1 в крови был выше, чем в контрольной группе, и увеличивался пропорционально показателю HbA1c. С увеличением продолжительности сахарного диабета концентрация ЭT-1 возрастает, достигая самых высоких значений при длительности заболевания более 11 лет. Уровень ЭT-1 у пациентов с ожирением (> 30 кг/м2) значительно выше, чем у пациентов с ИМТ менее 25 кг/м2 и в диапазоне 25–30 кг/м2. Выводы. Экспрессия и секреция ЭТ-1 у пациентов с диабетом повышаются с увеличением продолжительности заболевания, ИМТ и содержания HbA1c. Сердечно-сосудистая патология является основным осложнением у пациентов с сахарным диабетом 2-го типа. Эндотелиальная дисфункция относится к ранним признакам диабетического сосудистого поражения. Изменение баланса ЭТ-1 эндотелия является ключевым событием при инициации атеросклероза из-за активации адгезии лейкоцитов, связанной с наличием сосудистого воспаления.