bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of vaginal birth after cesarean delivery in southeast China: A retrospective cohort study
Authors: Zhang Hua-Le , Zheng Liang-Hui , Cheng Li-Chun , Liu Zhao-Dong , Yu Lu , Han Qin , Miao Geng-Yun , Yan jianying
Published: May 2020

Objective

To develop and validate a nomogram to better predict the vaginal birth after cesarean (VBAC) on the premise of clinical guide application.

Methods

We retrospectively identified hospitalised pregnant women who trial of labor after cesarean (TOLAC) between October 2015 and October 2017 using data from the Fujian Provincial Maternity and Children's Hospital. The inclusion criteria were as follows: Singleton pregnant women whose gestational age was above 37 weeks and underwent a primary cesarean section. Sociodemographic data and Clinical Characteristics were extracted. The samples were randomly divided into a training set and a validation set. Least absolute shrinkage and selection operator (LASSO) regression were used to select variables and construct of VBAC success rate in training set. The validation of the nomogram was performed using the concordance index (C-index), decision curve analysis (DCA), and calibration curves in the validation set. For comparison with published VBAC prediction models, the Grobman’s model was used.

Results

Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. In multivariate logistic regression models, Maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The predictive model was constructed showed better discrimination in the validation series than Grobman’s model (c-index 0.906 VS 0.694, respectively). Decision curve analysis revealed that the new model resulted in a better clinical net benefit than the Grobman’s model.

Conclusions

The promotion of VBAC is helpful to reduce the cesarean section rate in China. On the basis of following the clinical practice guidelines, the TOLAC prediction model helps to improve the success rate of VBAC and has a potential contribution to the reduction of secondary cesarean section.
Awareness, utilization of HIV testing and counselling services and sero-status among commercial motorcyclists in Dar es Salaam, Tanzania
Authors: Challe Daniel Protasy , Chiduo Mercy Grace , Mmbando Bruno Paul , Mhina Athanas , Nkya Gineson Aleonasaa , Kilale Andrew Martin , Chille Masunga Malimi , Hayuma Paul Martine , Ishengoma Deus Simon , Kamugisha Mathias Leo
Published: May 2020

Background: In recent years, there has been an emergence of commercial motorcyclists in all parts of Tanzania known as boda-boda riders (BBRs); and these are mainly young active males. BBRs are potentially likely to share a set of high-risk behaviours for transmission of HIV. These include multiple sex partners, alcohol and drug abuse, low condom use, and limited knowledge of HIV. This study assessed the awareness, utilization of HIV testing and counselling (HTC) services and sero-status of HIV among BBRs in Dar es Salaam, Tanzania.Methods: A cross-sectional study was conducted in August 2016 in three districts (Ilala, Kinondoni and Temeke) of Dar es Salaam, Tanzania; 1) to collect quantitative data on knowledge, attitude and practise of BBRs toward HIV infections (behavioural survey); and 2) to determine HIV prevalence among BBRs through HTC (sero-survey). Data was collected electronically using android tablets through the open data kit platform hosted at the central server.Results: In the behavioural survey, 973 BBRs (aged 18 - 59 years) were interviewed; majority (77.7%) were <35 years old and 52.2% were married. Over 93% of BBRs reported that HIV is a major public health problem in Tanzania and 89.7% thought that they were at high risk of acquiring HIV. More than 95% knew that HIV mainly is transmitted through unprotected sex and it can be prevented through use of condoms. However, 99.0% of BBRs had one or more sexual partners, only 37.4% used condoms with their regular extra-marital partners. For the sero-survey, 523 (53.8%) BBRs were tested and only 13 (2.5%) were positive, with a significantly higher prevalence among those aged 35-59 years. The risk of HIV infections was significantly lower among married BBRs (OR=0.2; 95%CI: 0.1-0.9, p=0.041) and those who had regular sexual partners (OR=0.2; 95%CI: 0.1-0.9, p=0.028). However, the risk was significantly higher among BBRs who were taking alcohol (OR=4.5; 95%CI: 1.1-18.6, p=0.037).Conclusion: Despite high knowledge of HIV among BBRs, they were still at high risk of acquiring HIV due to risky behaviours such as relationships with multiple sexual partners, low use of condoms and taking alcohol.
Quantifying the effects of combination trastuzumab and radiation therapy in human epidermal growth factor receptor 2 positive breast cancer
Authors: Bloom Meghan J , Song Patrick N , Virostko John , Yankeelov Thomas E , Sorace Anna G
Published: May 2020

Background

Trastuzumab, a clinical antibody targeted to the human epidermal growth factor receptor 2 (HER2), has been shown to sensitize cells to radiation in vitro. Current studies lack longitudinal evaluation of cellular response and in vivo data is limited. The purpose of this study is to quantify the effects of combination trastuzumab and radiation therapy in vitro and in vivo over time to determine if there is a synergistic interaction.
Methods

EGFP expressing BT474, SKBR3 and MDA-MB-231 cell lines were treated with 0.1 ng/ml of trastuzumab, 5 or 10 Gy of radiation, or combination treatment, and imaged using fluorescence live cell microscopy for one week. The Bliss independence model was used to quantify the effects of combination treatment. HER2 + tumor bearing mice (female NU/J) (N = 34) were treated with saline, 10 mg/kg of trastuzumab, 5 or 10 Gy of radiation, or combination treatment. Tumor size was measured three times per week for four weeks via caliper measurements. Additional mice (N = 13) were treated with 10 mg/kg of trastuzumab, 5 Gy of radiation, or combination treatment. Tumors were harvested at one week and evaluated with immunohistochemistry for inflammation (CD45), vascularity (CD31 and α-SMA), and hypoxia (pimonidazole).
Results

Altering the order of therapies did not significantly affect BT474 cell proliferation in vitro (P > 0.05). The interaction index calculations revealed additive effects of trastuzumab and radiation treatment in all three cell lines in vitro. In vivo results revealed significant differences in tumor response between mice treated with 5 and 10 Gy single agent radiation (P < 0.001); however, no difference was seen in the combination groups when trastuzumab was added to the radiation regimen (P = 0.56), indicating a lower dose of radiation could be used without decreasing therapeutic efficacy. Histology results revealed increases in inflammation (CD45+) in mice receiving trastuzumab (P < 0.05).
Conclusions

Longitudinal evaluation of cell proliferation in vitro showed additive effects of combination therapy. In vivo results show a potential to achieve the same efficacy of treatment with reduced radiation when also administering trastuzumab. Further evaluation of tumor microenvironmental alterations during treatment could identify mechanisms of increased therapeutic efficacy in this regimen.
A Model for the Mental Health Evaluation of Skilled Workers in Technology-Based Companies
Authors: Yousefi Moein , Vanani Iman Raeesi
Published: May 2020

Human resources are considered as one of the most valuable assets of an organization. Therefore, the top priorities of organizational managers include paying attention to manpower and providing necessary facilities to bring about satisfaction with workplace and working conditions in the light of mental and physical health. Accordingly, mental health has partly been neglected by managers because it lacks concrete and tangible aspects on the contrary to other organizational dimensions such as buildings and machinery. This study was conducted to achieve the fundamental goal of identifying the aspects and characteristics affecting the mental health of employees at technology-based companies as well as the factors resulting in mental problems and disorders. It was also decided to develop a model to predict affliction or non-affliction with mental problems among employees in the long term. For this purpose, this study focused on data mining techniques in order to identify latent relationships and introduce a prediction model. Therefore, the important and major factors were identified as individual characteristics, occupational characteristics, organizational performance features, and organizational governing culture features in mental health. The analysis and evaluation of results indicated that Classification algorithms managed to predict the mental health of employees with nearly %85 of accuracy. Besides, Clustering algorithms succeeded in dividing the samples into high-risk, medium-risk, and low-risk classes. The designed models can help organizational managers identify the factors affecting the mental health of employees and predict the chances of affliction with mental health disorders to prevent destructive harm to employees and organizations.
From a PMT-based to a SiPM-based PET system: a study to define matched acquisition/reconstruction parameters and NEMA performance of the Biograph Vision 450
Authors: Carlier Thomas , Ferrer Ludovic , Conti Maurizio , Bodet-Milin Caroline , Rousseau Caroline , Bercier Yanic , Bendriem Bernard , Kraeber-Bodéré Francoise
Published: May 2020

Purpose To derive the NEMA performance (NEMA) of the recently released Biograph Vision 450 PET/CT (Vision) and to propose an approach based on noise measurement to adapt present clinical acquisition and reconstruction parameters to Vision. Methods All measurements were conducted on Vision and Biograph mCT with TrueV (mCT). A full NEMA-based performance was derived for Vision only. The adaptation of acquisition and reconstruction parameters from mCT to Vision was done using the NEMA image quality phantom. The noise level reached using mCT was set as the reference value for six different numbers of net true coincidences. The noise level computed using Vision was matched to the reference noise level (within 0.01%) using a different reconstruction set-up to determine the potential reduction of counts numbers for the same noise level. Results Vision sensitivity was 9.1 kcps/MBq for a timing resolution of 213 ps at 5.3 kBq/mL. The NEMA-based CR for the 10mm sphere was better than 75% regardless the reconstruction set-up studied. The mCT reference noise properties could be achieved using Vision with a scan time reduction (STR) of 1.34 with four iterations and a 440×440 matrix size (or STR=1.89 with a 220×220 matrix size) together with a 3D CR improvement of 53% for the 10mm sphere (24% using 220×220). Conclusion The Vision exhibited improved NEMA performances compared to mCT. Using the proposed approach, the time acquisition could be divided by almost two, while keeping the same noise properties as that of mCT with a marked improvement of contrast recovery.
miR-431-5p regulates cell proliferation and apoptosis in fibroblast-like synoviocytes in rheumatoid arthritis by targeting XIAP
Authors: Wang Yuejiao , Zhang Kailin , Yuan Xiaowei , Xu Neili , Zhao Shuai , Hou Linxin , Yang Lili , Zhang Ning
Published: May 2020

BackgroundmiR-431-5p is dysregulated in various cancers and plays an important function in the development of cancer. However, its role in fibroblast-like synoviocytes (FLSs) in patients with rheumatoid arthritis (RA) remains to be understood.MethodsQuantitative real-time polymerase chain reaction was used to detect the relative expression of miR-431-5p in synovial tissues and FLSs. Cell proliferation assays helped examine RA FLS proliferation. Flow cytometry was performed to determine apoptosis and cell cycle progression in RA FLSs. We used dual-luciferase assays to determine the correlation between miR-431-5p and its putative target, X-linked inhibitor of apoptosis (XIAP). Quantitative real-time PCR and western blotting were used to measure XIAP levels in synovial tissues and transfected RA FLSs.ResultsmiR-431-5p was downregulated in synovial tissues and FLSs of patients with RA. Upregulation of miR-431-5p prohibited cell proliferation and the G0/G1-to-S phase transition, but promoted apoptosis in RA FLSs; while miR-431-5p inhibition showed the opposite results. miR-431-5p directly targeted XIAP in RA FLSs, and reversely correlated with XIAP levels in synovial tissues. Notably, XIAP silencing partially restored the effects of miR-431-5p inhibition in RA FLSs.ConclusionmiR-431-5p regulates cell proliferation, apoptosis，and cell cycle of RA FLSs by targeting XIAP, suggesting its potential in the treatment of RA.
HLA-B*35 as a new marker for susceptibility to Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) in patients with Human T-cell Lymphotropic Virus type 1 (HTLV-1) in Argentina
Authors: Benencio Paula , Gonzalez Sindy A. Fraile , Ducasa Nicolás , Page Kimberly , Berini Carolina A. , Biglione Mirna M.
Published: May 2020

Background
Human T lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV associated myelopathy/ Tropical Spastic Paraparesis (HAM/TSP) and Adult T cell leukemia/lymphoma (ATLL), in around 2–5% of the infected individuals. Host genetic background might play a role in disease progression. Several previous studies across many countries report HLA haplotype to be one such factor. Here, we sequenced HLA-A, -B and -C of 73 individuals by Sequence-Based Typing (SBT), and compared the frequency of different alleles among ATLL patients, HAM/TSP patients, asymptomatic carriers and non-infected individuals in Argentina.
Results
The frequency of HLA-A, -B and -C alleles largely matched that of the general population in Argentina. We identified HLA-A*02 and HLA-B*35 as associated to protection from ATLL (p = 0.042) and susceptibility to HAM/TSP (p = 0.006), respectively. We also found a strong correlation between high proviral load (PVL) and disease (p = 0.0177), but were unable to identify any particular allele associated with high or low PVL.
Conclusions
Our results match several previous reports that link HLA-A*02 and protection from disease. However, this is the first study associating HLA-B*35 to susceptibility to disease in HTLV-1, an allele that has been largely associated to different severity factors related to other viral infections, such as Human Immunodeficiency Virus (HIV-1) and Hepatitis B Virus (HBV).
Genetic Diversity and Complexity of Plasmodium Falciparum Infections in the Microenvironment Among Siblings of the Same Household in North-central Nigeria
Authors: Oyedeji Segun Isaac , Bassi Peter Usman , Oyedeji Samuel Adeola , Ojurongbe Olusola , Awobode Henrietta Oluwatoyin
Published: May 2020

Background: Plasmodium falciparum parasites are known to exhibit extensive genetic diversity in areas of high transmission intensity and infected individuals in such communities often harbour several complex mixture of parasite clones with different genetic characteristics. However, in the microenvironment, the extent of genetic diversity of the P. falciparum parasites remain largely unknown. In this study therefore, we investigated the complexity of P. falciparum infections in households, among symptomatic siblings living under the same roof in North-central Nigeria.Methods: Children were enrolled into the study if they were at least two from a household and presented with symptoms of uncomplicated malaria. Clinical malaria was confirmed by light microscopy of Giemsa stained thick and thin blood films. Genomic DNA was isolated from blood spots on filter paper. Molecular characterization of P. falciparum isolates was done by allele-specific nested PCR of the highly polymorphic merozoite surface protein-2 (MSP-2) gene.Results: 93 children from 43 households were enrolled into this study. A total of 26 different MSP-2 alleles were identified from 215 fragments (range: 180-480bp). Majority of the isolates [65.6% (n=61)] were polyclonal infections consisting of 2-6 clones and were significantly more common with the FC27 allelic family (p = 0.036). The multiplicity of infection (MOI) per household ranged from 1.0 to 4.5 while the overall MOI in the study population was 2.31. The pattern of distribution of MSP-2 allele types among the households fell into two categories: households where both MSP-2 allele types (FC27 and 3D7) were present; and households where only one MSP-2 allele type (FC27 or 3D7) was present. Majority of the households [88.4% (n=38)], had both MSP-2 allele types but they were disproportionately distributed among the children while in a few households [11.6% (n=5)], all the children were infected with only one type of MSP-2 allele.Conclusion: Our findings showed that P. falciparum isolates exhibit remarkable degree of genetic diversity in the microenvironment and are composed mainly of multiclonal infections, which is an indication of a high ongoing parasite transmission. This suggests that the microenvironment is an important area of focus for malaria control interventions and for evaluating intervention programmes.
Family planning practices of women working in the Cambodian garment industry: a qualitative study
Authors: Masuda Chisato , Oreglia Elisa , Sokhey Ly , McLaren Megan , Free Caroline , Tijamo Camille , Amra Ou , Velthoven Michelle van , Williamson Amy , Smith Chris
Published: May 2020

Background Women working in Cambodian garment factories have unmet needs for contraception and safe abortion services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results We interviewed 16 women and 13 providers between August and November 2018. Most women were married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to side effects and misconceptions related to with modern contraception. Fear of infertility was particularly reported among young women without children.Conclusion This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work needs to address this gap by developing appropriate and effective interventions and informative tools for women in the Cambodian garment industry.
A technique for the extraction of the Proximal Femoral Nail Anti-rotation (PFNA) after unlocking failure
Authors: Cao Mingde , Yang Zhong-Meng , Lu Hua-Ding
Published: May 2020

Introduction Proximal Femoral Nail Anti-rotation (PFNA) is a routine method to deal with intertrochanteric fractures in the elder population. It is extremely difficult to remove PFNA in some cases as a result of stripping of blade heads. In this Technical Note, we report a simple technique using commonly available instrument that can be used to remove stripped even broken anti-rotation blade where regular methods have failed. Methods The subject underwent a PFNA removal surgery fifteen months after the previous fixation. We encountered difficulties using regular instrument to remove the anti-rotation blade. A 5mm tungsten carbide bur was used to drill a single cortical hole at the end of the blade. Then double-strand steel wire was threaded through the hole and the distal part was shaped into a circle which could tie to the extraction screw. Slide Hammer was applied to gently knocked out the blade along the anatomical direction of the femoral neck. Results The technique helped us successfully remove the dispatched anti-rotation blade and provided the patient with a satisfactory result. Conclusion The use of a tungsten reamer and steel wire loop to remove the proximal femoral anti-rotation blade may provide a simple and cost-effective method of dealing with extraction failure.
Cardiac evaluation in adults with dengue virus infection by serial echocardiography
Authors: Mansanguan Chayasin , Hanboonkunupakarn Borimas , Muangnoicharoen Sant , Huntrap Arun , Poolcharoen Akkapon , Mansanguan Suyanee , Piyaphanee Watcharapong , phumratanaprapin Weerapong
Published: May 2020

Background
Dengue virus infection (DVI) is a major health problem in many parts of the world. Its manifestations range from asymptomatic infections to severe disease. Although cardiac involvement has been reported in DVI, its incidence has not yet been well established.
Methods
From July 2016 to January 2018, patients hospitalized at the Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, with dengue virus infection confirmed by positive NS1 or positive dengue immunoglobulin M findings, participated in the study. We characterized the incidence and change in cardiac function by serial echocardiography and levels of troponin-T and creatinine kinase-myocardial band (CK-MB) on the day of admission, the day of defervescence, the first day of hypotension (if any), and at 2-week follow-up.
Results
Of the 81 patients evaluated, 6 (7.41%) exhibited elevated biomarker levels. There was no difference in clinical presentation amongst dengue fever, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) except the amount of bleeding. Cardiac involvement was found in 22% of patients: 3 (3.70%) had left ventricular systolic dysfunction, 3 (3.70%) had transient diastolic dysfunction, 6 (7.41%) had increased levels of at least one cardiac biomarker (troponin-T or CK-MB), and 6 (7.41%) had small pericardial effusion. Myocarditis was suspected in only two patient (with DHF); thus, myocarditis was uncommon in patients with dengue virus infection. Three patients developed DSS during admission and transfer to the intensive care unit.
Conclusion
Cardiac involvement in adults with dengue infection was found in 22.22% of cases, ranging from elevated cardiac biomarker, transient left ventricular systolic and diastolic dysfunction and pericardial effusion. We found that DHF was the significant risk factor for cardiac involvement (p < 0.001). Abnormalities in cardiac function had resolved spontaneously by the day of follow-up without specific treatment.
Evaluation of 68Ga-PSMA PET/CT Images Acquired with a Reduced Scan Time Duration in Prostate Cancer Patients using the Digital Biograph Vision
Authors: Weber Manuel , Hofferber Regina , Herrmann Ken , Fendler Wolfgang Peter , Conti Maurizio , Wetter Axel , Kersting David , Rischpler Christoph , Jentzen Walter , Costa Pedro Fragoso
Published: May 2020

Aim
68Ga-PSMA PET/CT allows for a superior detection of prostate cancer (PC) tissue, especially in context of a low tumor burden. Digital PET/CT bears the potential of reducing scan time duration / administered tracer activity due to, for instance, its higher sensitivity and improved time coincidence resolution. It might thereby expand 68Ga-PSMA PET/CT that is currently limited by 68Ge/68Ga-generator yield. Our aim was to clinically evaluate the influence of a reduced scan time duration in combination with different image reconstruction algorithms on the diagnostic performance.
Methods
Twenty PC patients (11 for biochemical recurrence, 5 for initial staging, 4 for metastatic disease) sequentially underwent 68Ga-PSMA PET/CT on a digital Siemens Biograph Vision. PET data were collected in continuous-bed-motion mode with a scan time duration of approximately 17 min (reference acquisition protocol) and 5 min (reduced acquisition protocol). 4 iterative reconstruction algorithms were applied using a time-of-flight (TOF) approach alone or combined with point-spread-function (PSF) correction, each with 2 or 4 iterations. To evaluate the diagnostic performance, the following metrics were chosen: (a) per-region detectability, (b) the tumor maximum and peak standardized uptake values (SUVmax and SUVpeak) and (c) image noise using the liver’s activity distribution.
Results
Overall, 98% of regions (91% of affected regions) were correctly classified in the reduced acquisition protocol independent of the image reconstruction algorithm. Two nodal lesions (each ≤ 4 mm) were not identified (leading to downstaging in 1/20 cases). Mean absolute percentage deviation of SUVmax (SUVpeak) was approximately 9% (6%) for each reconstruction algorithm. The mean image noise increased from 13–21% (4 iterations) and from 10–15% (2 iterations) for PSF + TOF and TOF images.
Conclusions
High agreement at 3.5-fold reduction of scan time in terms of per-region detection (98% of regions) and image quantification (mean deviation ≤ 10%) was demonstrated; however, small lesions can be missed in about 10% of patients leading to downstaging (T1N0M0 instead of T1N1M0) in 5% of patients. Our results suggest that a reduction of scan time duration or administered 68Ga-PSMA activities can be considered in metastatic patients, where missing small lesions would not impact patient management.
Field evaluation of four commercial light traps, trap placement, and effect of carbon dioxide on phlebotomine sand fly collection in Thailand
Authors: Somwang Puckavadee , Khositharattanakool Pathamet , Pathawong Nattaphol , Pongsiri Arissara , Davidson Silas A. , Ponlawat Alongkot
Published: May 2020

Background
Several light trap devices have been invented and developed to assess the abundance of sand flies. Traps available in the market have different designs and attractant combinations to catch sand fly vectors. We evaluated the efficacy of four commercial light traps and determined the effect of trap placement and carbon dioxide (CO2) on sand fly collection in northern Thailand.
Methods
Trap evaluations were conducted at two natural caves located in Chiang Rai province, Thailand. In the first part of the study, the efficacies of four trap types including the Centers for Disease Control miniature light trap (CDC LT), Encephalitis Vector Survey trap (EVS), CDC Updraft Blacklight trap (CDC UB), and Laika trap (LK) were evaluated and compared using a Latin square experimental design. The second half of the study evaluated the influence of trap placement and CO2 on sand fly collection. Additionally, CDC LT were placed inside, outside, and at the entrance of caves to compare the number of sand flies collected.
Results
For the trap efficacy experiment, a total of 11,876 phlebotomine sand flies were collected over 32 trap-nights. Results demonstrated that CDC LT, CDC UB, and LK collected significantly more sand flies than EVS (P > 0.05). However, there were no significant differences between the numbers of sand flies collected by CDC LT, CDC UB, and LK. A total of 6,698 sand flies were collected from the trap placement and CO2 experiment over 72 trap-nights. Results showed that CO2 did not influence the numbers of sand flies captured (P < 0.05), whereas trap placement at the entrance of the caves resulted in collection of significantly more sand flies than traps placed inside and outside of the caves.
Conclusion
We found the CDC LT, CDC UB, and LK without CO2 captured the greatest amount of sand flies. This was particularly observed when traps were placed at the entrance of a cave, perhaps because of the greater passage of stimuli caused by wind flow at the entrance of the cave. The light traps in this study can be used effectively to collect sand fly vectors in northern Thailand.
Model for Utilizing Distance Learning post COVID-19 using (PACT)™ A Cross Sectional Qualitative Study
Authors: Ahmed Samar A , Hegazy Nagwa Nashat , Malak Hany W. Abdel , Kayser Cliff W. , Elrafie Noha M , Hassanien Mohammed , Al-Hayani Abdulmonem A , Saadany Sherif A El , AI-Youbi Abdulrahman O , Shehata Mohamed Hany Kamel
Published: May 2020

Background COVID -19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to make sure that the content delivered is satisfactory for student progression.Methods This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 32-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and actions to maintain upsides and avoid downsides of each method.Results Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. Participants agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal chances to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL is much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks. Action steps were determined to ensure best experience in either method.Conclusion In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.
The roles of E2Fs in gastric cancer: the transcription factors E2F1/2/3/4/5 as potential therapeutic targets and E2F6/7/8 as new prognostic biomarkers in gastric cancer
Authors: Li Hui , Zhao Shufen , Shen Liwei , Wang Peige , Liu Shihai , Ma Yingji , Liang Zhiwei , Wang Gongjun , Lv Jing , Qiu Wensheng
Published: May 2020

Background E2F is a family of transcription factor proteins with multiple functions; E2F proteins are involved in cell cycle regulation, cell differentiation, the DNA damage response and cell death. Studies have shown that E2Fs have prognostic significance in many cancers, but the expression patterns and prognostic values of E2Fs in gastric cancer have not been systematically elucidated. Methods In this study, we used the ONCOMINE database and UALCAN online analysis website to compare the transcriptional levels and expression of eight E2F family members between gastric cancer and normal samples. UALCAN was also used to analyze the relationship between the expression of 8 E2F members and clinicopathological parameters. The prognostic value of the E2Fs were determined by Kaplan-Meier Plotter. A protein-protein interaction (PPI) network was constructed using the STRING database. The functions and pathways of E2F family and its neighboring 50 frequently changed genes were analyzed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) software. Finally, quantitative PCR was used to verify the expression of E2Fs in gastric cancer cells. Results The expression patterns of 8 E2F members were significantly related to the clinical cancer stage and tumor grade of gastric cancer patients. High mRNA expression of E2F1/2/3/4/5 was a prognostic factor for poor OS in gastric cancer patients, while high expression of E2F6/7/8 was associated with better OS. In addition, a high mutation rate (46%) for E2Fs was observed in patients with gastric cancer. The expression levels of E2F1/2/3/5/8 in AGS and HGC27 cell lines were higher than those in normal cells, while E2F7 showed the opposite trend. Conclusions In summary, these results indicate that E2F1/2/3/4/5 can be used as potential therapeutic targets in gastric cancer, and E2F6/7/8 can be used as new prognostic markers to improve the survival rate and prognostic accuracy in gastric cancer.
Urban and Peri-urban Milk Market Channel Choice Using Multivariate Probit Approach: Evidence from Arsi Highland of Ethiopia
Authors: Zeleke Bedilu Demissie , Assegidaw Endashaw Terefe , . Abiot Deddefo
Published: May 2020

This article aims at analyzing the factors that affect urban and peri-urban dairy farmers’ milk market channel choice in the Arsi Highland of Ethiopia. The reason for focusing on milk is because the product is a key dairy product that contributes to dairy households' economic development, employment creation, and a pathway out of poverty. Four milk marketing channels were thoroughly investigated: a) cooperative channel, b) cafeteria/restaurant channel, c) consumer channel, and d) assembler/trader channel. Primary data collected from 259 dairy farmers through a field survey were used to analyze the simultaneous selection of multiple milk marketing channels. A multivariate probit approach was used and showed that market distance, milk production, artificial insemination (AI), market satisfaction, contractual agreement, quality management, cooperative membership, average milk price, number of the dairy cow, and quantity of milk sold affected farmers milk marketing channel choice. The outcome suggests that policies aimed at strengthening the use of well-organized milk cooperative to access appropriate technology; enhancing milk quality management to ensure milk safety along the milk channel; introducing milk quality incentives; promoting vertical coordination through strengthening the existing informal contractual agreement; establishing advanced milk payment system and improving the volume of milk production could enhance the distribution channel of the study area milk marketing particularly, and developing nation generally.
COVID-19 Associated Coagulopathy In The Setting of Underlying Malignancy
Authors: Lim Su Lin , Chan Kok Hoe , Guron Gunwant , Shaaban Hamid S
Published: May 2020

Coronavirus Disease 2019 (COVID-19) associated coagulopathy is growingly recognized as the predictor for morbidity and mortality in COVID-19 patients. Deep vein thrombosis (DVT) and pulmonary embolism (PE) have been increasingly observed in COVID-19 patients. Nonetheless, there are no consensus guidelines on the use of therapeutic coagulation in this group of patients. We herein presenting a unique case of a COVID-19 patient with metastatic ovarian cancer who presented with DVT/PE despite being on therapeutic anticoagulation, highlighting the unpredictability of COVID-19 associated coagulopathy. This is to raise the awareness that thrombophilic state in metastatic malignancies is potentially augmented by COVID-19. We also discussed the complexity of making anticoagulation treatment decision in COVID-19 patients in the absence of evidence-based guidelines.
Study of Radiation Damage with the Radiation Workers by Low Dose Irradiation
Authors: Liu Gang , Li Ye
Published: May 2020

Objective To explore the sensitivity index of radiation injury of radiation workers was analyzed and investigate whether the body changes and radiation doses of workers exposed to low-dose radiation have a dose-effect relationship. Methods The occupational health monitoring data of radiology staff were analyzed by retrospectively. Results Individual dose monitoring data, interventional radiology workers had the highest average cumulative annual dose, 0.86mSv. Lens opacity has a high detection rate, Compared with the control group, the lymphocyte count was increased. Annual cumulative dose reached 2.04 mSv, and single cycle average dose reached 1.62 mSv, dicentric chromosome was detected. Conclusions Radiation workers have certain radiation damage, and the focus is on those engaged in interventional radiology. The chromosome aberration rate was highest in people with more than 20 years of working life. Annual cumulative dose reached 2.04 mSv, and single cycle average dose reached 1.62 mSv, dicentric chromosome was detected, it suggests that the chromosome aberration analysis is an important index in occupational health monitoring of radiological workers.
A BUROCRACIA NOS CONTRATOS DE AVERBAÇÃO DE TECNOLOGIA NO BRASIL
Authors: Ralile de Figueiredo Magalhães Gabriel , Sichel Ricardo Luiz
Published: May 2020

O presente artigo aborda uma análise sobre a exigência legal de averbação de contrato de transferência de tecnologia e franquia junto ao Instituto Nacional da Propriedade Industrial (INPI). O trabalho observa questões relativas à insegurança jurídica, o excesso de burocracia gerado, a relação da questão com o Sistema Brasileiro de Defesa Econômica e a inexistência dessa realidade em outras sistemáticas jurídicas de países de maior relevo internacional. Por fim, tais procedimentos burocráticos passam a ser objeto de crítica sob o olhar da adoção de medidas compatíveis com o grau de abertura econômica do Brasil, entendendo com isso que dita exigência legal contribui para o chamado “Custo Brasil”.
YAŞLILARIN “GÖÇ” VE “YERİNDE YAŞLANMA” BAĞLAMINDA KENTSEL DÖNÜŞÜM İLE İLGİLİ DEĞERLENDİRMELERİ
Authors: ÖZMETE Emine , DİNÇ Bahadır
Published: May 2020

Bu çalışma, yaşlı bireylerin göç ve yerinde yaşlanma bağlamında kentsel dönüşüme ilişkin görüşlerini ortaya koymak amacıyla yapılmıştır. Sanayileşme hareketi ile birlikte artan istihdamın ortaya çıkardığı konut ihtiyacının karşılanamaması kentlere göç eden bireylerin gecekondu tipi meskenler inşa etmelerine neden olmuştur. Son yıllarda artan kentsel dönüşüm uygulamaları, gecekondu bölgelerinde yaşayan bireyleri, özellikle de incinebilir bir grup olarak yaşlı bireyleri sosyal, psikolojik ve ekonomik anlamda etkilemeye başlamıştır. Bu çalışmada, önceki yıllarda yoğun sanayi faaliyetlerinin yapıldığı ve günümüzde büyük bir gecekondu nüfusunun yaşadığı İstanbul ilinin Beykoz ilçesinde bulunan Paşabahçe mahallesindeki yaşlı bireylerin kentsel dönüşüm sürecinden nasıl etkilendiklerinin belirlenmesi ve bu konudaki değerlendirmelerinin ortaya konulması amacıyla yürütülmüştür. Bu çalışmada nitel araştırma yöntemi kullanılmıştır. Yarı yapılandırılmış olarak oluşturulan soru formu Paşabahçe mahallesinde yaşayan 30 yaşlı bireye derinlemesine görüşme yöntemi ile uygulanmış ve veriler elde edilmiştir. Araştırma sonuçlarına göre; yaşlı bireyler çoğu akrabalarından oluşan komşularıyla birlikte, komşuluk ilişkilerinin ve mahalle kültürünün sağlamış olduğu güvenli çevre içinde yaşamak istediklerini ifade etmişlerdir. Yaşlı bireylerin tamamına yakını bahçesi olan bir evde yaşadıklarını ve bahçenin kendileri için vazgeçilmez olduğunu belirterek apartmanda yaşamak istemediklerini açıklamışlardır. Yaşlı bireylerin her ne kadar altyapı, şehir hizmetleri ve planlı bir çevre olmasa da yaşadıkları yeri sevdikleri ve kentsel dönüşüm ile yaşam alanlarının değiştirilmesini istemedikleri belirlenmiştir.
COVID-19 Pandemi Döneminde Tele-tıp Uygulamaları
Authors: ÇAPACI Merve , ÖZKAYA Serdar
Published: May 2020

Bilişim teknolojileri ve sistemlerinin ivmelenerek geliştiği çağda, tele-tıp uygulamalarının sağlık hizmetlerinin sunumundaki yeri önem kazanmaktadır. Yeni koronavirüs hastalığı sürecinde uygulanan sosyal izolasyon nedeniyle etkileşimin kısıtlanması, tele-tıbbın kullanım alanlarının çoğalmasını gündeme getirmiştir. Ülkemizde de e-sağlık uygulamalarıyla canlı doktor görüşmelerine rağbet artmaktadır, fakat tele-tıp yolu ile sunulabilecek sağlık hizmetlerinin işleyişine ilişkin bir düzenleme bulunmamaktadır. Bu nedenle, hekimlerin yükümlülüklerine, hastalara sunulan sağlık hizmetinin sınırlılığına, hangi durumlarda nasıl kullanılabileceğine, aydınlatılmış onamın gerekliliğine, ücretlendirme ve sigorta ödemelerinin nasıl yapılacağına ilişkin birçok sorun tartışmaya açılmıştır. Bu yazıda, pandemi sürecinde kullanımı artan tele-tıp uygulamaları, bu uygulamaların sağlık hizmetindeki dönüştürücü etkisi ve ortaya çıkarabileceği sorunlar irdelenmektedir.
Cumhuriyet’in Kuruluş Dönemi Türk Oyun Yazarlığında Etik – İdeolojik İdealizasyon
Authors: Alpan Ezgi Deniz
Published: May 2020

Türk tiyatrosunun geleneksel (metinsiz) tiyatrodan Batılı (metinli) tiyatroya geçişi süreci, kendiliğinden değil, resmi ideoloji eliyle gerçekleştirilmiştir. Batılı tiyatronun ideal, gerçek tiyatro olduğu düşüncesi saray ve çevresi, devlet görevlileri, Türk elçileri ve yabancı elçilikler, aydınlar ve basın tarafından yayılmış, benimsenmesi sağlanmaya çalışılmıştır. Yani çıkış noktasında Batılı anlamdaki Türk tiyatrosu, öğretici ve ideoloji taşıyıcı bir aygıt olarak kullanılmak istenmiştir. Bu makalenin amacı da söz konusu dönemde tiyatro metinlerinin idealleştirme işlevini araştırmaktır. Çalışmada kullanılan yöntem, nitel araştırma yöntemidir. Bu yöntemden, oyun metinlerinin analizinde faydalanılmıştır. Dolayısıyla cevap aranacak sorular konunun niçin seçildiği, oyun kahramanının yargılarının ve eylemlerinin nasıl oluştuğu, çevresinden ne şekilde etkilendiği ile aynı tartışmaları açmayı hedefleyen oyun metinleri arasındaki benzerlikler ve farklılıklardır. Bunun için 1923 – 1946 yılları arasına değinen kuramsal çalışmalarla birlikte, söz konusu dönemde yazılan tiyatro oyunları değerlendirilmiştir. Oyunların dramatik yapılarında tema, çatışma, kişileştirme, mesaj gibi unsurlar bakımından önemli benzerlikler saptanmıştır. Bu benzerliğin nedeni söz konusu dönemde tiyatronun devlet tarafından teşvik edilmesi ve denetlenmesi olarak okunmalıdır. Böylece Türk oyun yazarlığı tarihinin dayandığı temel, çeşitlikten çok tektiplik, bireysel olandan çok toplumsal olan, estetikten çok işevsel ve var olandan çok idealize edilendir. Dönemde Cumhuriyet’i idealleştirmek için Osmanlı’ya ait değerlerin olumsuzlanması, salt Batı’ya öykünmeyip milli değerlere sahip çıkılması gereklilikleri vurgulanırken; ideal kadın ve erkek de buna göre kurgulanmıştır. Böylece ideal kadının özellikleri milli değeri olan Anadolu kültürüne sahip çıkan, ülkesi ve ailesi için her şeyi feda etmeye hazır olan kadın; ideal erkeğin özellikleri ise vatanına bağlı, dinç, çalışkan, cesur olarak tanımlanmıştır. Bu dönem yazarlar için de yeni bir dönemdir; yazdıkları dramatik metinler yeni bir türdür. Bu nedenle onların da Milli Mücadele, Cumhuriyet, Batılı değerler, milli değerler kavramları arasında sıkışıp kalmalarına şaşırmamak gerekir. Diğer yandan dönemde bu konular haricinde kalem oynatan yazarlar dışlanmıştır. Yazarlar için kaçınılmaz olarak statüko önyargısı oluşmuştur. Bugünden bakınca Türk tiyatrosunda hala kuruluş yılları ile hesaplaşma yapılamadığı, buradaki hikayelerin tükenmediği söylenmelidir.
Recent Advances in the Synthesis of Pyrroles
Authors: Iqbal Sarosh , Rasheed Hina , Awan Rabiya Javed , Awan Ramsha Javed , Mukhtar Asma , Moloney Mark G.
Published: May 2020

Pyrroles are the most prevalent heterocyclic compounds, which are present as the basic cores in
many natural products, such as vitamin B12, bile pigments like bilirubin and biliverdin, the porphyrins of
heme, chlorophyll, chlorins, bacteriochlorins, and porphyrinogens. The biological activities of compounds
having pyrrole analogs include antimicrobial (antibacterial, antifungal), anti-cancer (anti-cytotoxic, antimitotic),
anti-tumor, anti-hyperlipidemic, anti-depressant, anti-inflammatory, antihyperglycemic, antiproliferative,
anti-HIV and anti-viral activities. Accordingly, significant attention has been paid to develop competent
methods for the synthesis of pyrroles with improved yields in short times. This review gives an overview of
different methods for the synthesis of pyrrole using easily available precursors using the following routes.

Synthesis of monosubstituted pyrrole using 2,5-dimethoxyfuran

Synthesis of pyrrole using dialkylacetylene dicarboxylate

Synthesis of pyrroles using β-ketoester

Synthesis of pyrrole using 1,2-dicarbonyl compounds

Synthesis of pyrroles using 1,3-dicarbonyl compounds

Synthesis of pyrroles using 1,3-dicarbonyl, amine, nitro and aldehyde group

Synthesis of pyrroles using 1,4-dicarbonyl compound and amines

Synthesis of pyrrole using enones

Synthesis of pyrroles using moieties having acetylene group
Dissemination of Plasmid-Mediated Aminoglycoside-Modifying Enzymes Among MDR Acinetobacter baumannii Isolates from a Tertiary Care Egyptian Hospital
Authors: Tawfick Mahmoud M. , Rady Hamada F. , El-Borhamy Mervat I. , Maraqa Anwar D.
Published: May 2020

Background:

Acinetobacter baumannii is one of the most challenging multidrug-resistant (MDR) nosocomial pathogens worldwide. Aminoglycosides are used for the treatment of A. baumannii infections, however, resistance to aminoglycosides is currently emerging, limiting therapeutic choices.

Objective:

In this study, the prevalence of aminoglycoside resistance and plasmid-mediated mechanisms of aminoglycoside resistance were investigated in A. baumannii clinical isolates collected from ICU patients at a tertiary care hospital in Egypt.

Methods:

The automated Vitek 2 system was used to identify A. baumannii species and determination of the antimicrobial susceptibility pattern. The identification of A. baumannii was confirmed by the detection of the blaOXA-51-like gene intrinsic to this species. Minimum Inhibitory Concentration (MIC) of gentamicin was determined using E-test following the CLSI breakpoints. Isolates were screened for the prevalence and diversity of the plasmid-carried aminoglycoside-modifying enzymes encoding genes aacC1, aadA1, aadB and aphA6. For genetic diversity analysis, the ERIC-PCR method was performed.

Results:

All A. baumannii isolates were MDR with high resistance rates to tested antimicrobials. The resistance rate to gentamicin was 92.9% with elevated MICs (≥ 32 μg/mL). The gentamicin-resistant isolates harboured one or more of the studied genes with the prevalence of aphA6 (81%). ERIC-based genotyping revealed that there was no evidence of A. baumannii clonal dissemination among isolates.

Conclusion:

The study concluded that MDR A. baumannii isolates were highly resistant to gentamicin. The plasmid-carried aminoglycoside-modifying enzymes encoding genes were disseminated among isolates with the AphA6 gene, which was the most prevalent one. The acquisition of more than one aminoglycoside resistance gene was associated with an elevated MIC of gentamicin. Thus, regular surveillance studies of the emerging resistance to antimicrobials and strict measures to control the dissemination of resistance determinants genes are warranted.