bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of COVID-19 on Health Services Utilization in Province-2 of Nepal: A Qualitative Study Among Community Members and Stakeholders
Authors: Singh Devendra Raj , Sunuwar Dev Ram , Shah Sunil Kumar , Karki Kshitij , Sah Lalita Kumari , Adhikari Bipin , Sah Rajeeb Kumar
Published: December 2020

Background The COVID-19 pandemic is posing unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aims to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. MethodsThe semi-structured qualitative interviews were conducted among purposively selected participants (n=41) from a mix of rural and urban settings in all districts (n =8) in Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. ResultsThe findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and, iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and fearful about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions of health services were mostly due to the closure of health services at local health facilities, limited involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from governments at all levels towards health services management during the COVID-19 pandemic. ConclusionsThis study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is essential to expand the service coverage and its quality in addition to increasing public-private sector engagement to ensure the essential health services are utilized by the population.
Human papillomavirus infection rate, distribution characteristics, and risk of age in pre- and postmenopausal women
Authors: Shen Yan , Xia Jing , Li Hui hui , Xu Yang , Xu San ping
Published: December 2020

BackgroundThe incidence rate of cervical cancer is increasing yearly. The persistent infection of high-risk Human Papillomavirus (HPV) is the main factor leading to cervical cancer. HPV infection is double peak type. This study aimed at analyzing the HPV distribution characteristics, infection rate, and risk of age in pre- and postmenopausal women. So as to provide reference for the prevention of HPV infection and cervical cancer screening strategy.MethodsA retrospective analysis of 4614 women who underwent cervical cytology, and HPV examination from January 2018 to October 2019 at the healthcare department of Wuhan Union Hospital was done. We explored the characteristics and distribution of HPV infections around the menopause, then comparing the infection rate of HPV in postmenopause and over 65 years old, in order to analyze the influence of different ages on HPV infection.ResultsGenerally, the HPV infection rate was 13.10% (539 / 4115), whereby the high-risk subtype constituted 73.84% (398 / 539) of all positive cases. On the other hand, the HPV39 infection was more common in postmenopausal women; however, there was no significant difference in the distribution of the other types in the pre- and postmenopausal women (Insert p value). The first four subtypes were 52 / 53 / 58 / 16, respectively. The infection rate of HPV in patients with lower genital tract inflammation was significantly higher, P = 0.000, 95% CI: 1.911 (1.416, 2.580) compared with those without lower genital tract inflammation. The results further showed that there was no significant difference between pre- and postmenopausal women in terms of HPV infection rate, but more susceptible to high-risk HPV infection after the age of 65 (P = 0.041). Except for 40 years old to menopause, the infection rate of high-risk HPV in this age group was different from that in postmenopause(P = 0.023,0.729(0.555,0.957)), other age groups had no significant effect on high-risk HPV infection.ConclusionsIt was concluded that whether menopause has nothing to do with HPV infection. Moreover, the infection rate of high-risk HPV increases after 65 years of age; hence the cutoff screening age should be appropriately prolonged.Trial registration: Retrospectively registered.
Spatiotemporal Modelling of COVID-19 Infection Risk in Portugal
Authors: Azevedo Leonardo , Pereira Maria João , Ribeiro Manuel , Soares Amílcar
Published: December 2020

Since its outbreak, the SARS-CoV-2 pandemic has shown complex dynamics in both time and space. These dynamics are the result of a combination of factors, including the spatial distribution of the population’s social and economic levels and its mobility patterns within a given country. After assessing the risk of infection and associated uncertainty based on infection rates by municipality, one of the most important challenges now facing health authorities concerns the ability to predict second waves and interactions with epidemics of other viruses (e.g. influenza). We propose characterizing the local spatiotemporal behaviour of risk of infection based on existing historical data, and classifying the local spatiotemporal patterns of the time series, thus allowing the management of new waves by region. We combined functional data analysis with geostatistical simulation to model the spatiotemporal evolution of infection risk by COVID-19 in mainland Portugal. The daily number of infection data by municipality reported by the Portuguese Directorate-General for Health are used to build time series of infection since the beginning of the outbreak in Portugal. We employ a dimensionality reduction of these curves using functional principal component analysis. The objective of this step is twofold: detect municipalities with a similar temporal evolution, and get a small number of coefficients to describe the temporal pattern of the series. The low-dimension coefficients are then used as experimental data to map the infection time series spatially using geostatistical simulation. With this step, we recover high-resolution maps of COVID-19 infection risk at any time step, allowing the simultaneous modelling of time and space. With the resulting spatiotemporal models, authorities can identify locations where the disease exhibits similar behaviours and, therefore, devise mitigation actions based on previous experience. Also, the models may be used for short-term forecasting as a simple data-driven proxy of full SEIR (susceptible, exposed, infectious, recovered) models.
Inclusive Planning: African Policy Inventory and South African Mobility Case Study on the Exclusion of Persons with Disabilities and Other Vulnerable Groups
Authors: Vanderschuren Marianne J.W.A. , Nnene Obiora
Published: December 2020

BackgroundAlmost half of the African population is under the age of 18 years, while females make up just over half of the overall population. Estimates of the number of persons living with disabilities, on the African continent, range between 60-300 million individuals. Children, the elderly, females and people with disabilities all require amendments to traditional transport planning.MethodThis paper investigates the availability of transport policies and guidelines in 29 different African countries, focussing on the inclusion of persons with disabilities, women and children. A desktop study was conducted, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines and appropriate implementation leads to a lack of accessibility, opportunities and social isolation. ResultsThe data analysed revealed that Ghana and Kenya, have the most inclusive policy and legislative framework, while Tanzania has the most inclusive transport related framework. The private sector, NGOs, and NPOs are most active in the inclusion of people living with disabilities in Ghana, Ethiopia, Uganda, Tanzania and South Africa.In South Africa (STATSSA, 2013), over 2.2 million people (4.5% of the population) did not travel at all in the seven days before the interview, as their disability or age prohibits them to do so, or due to a lack of appropriate services. When comparing the trip rates per week, people with disabilities travel significantly less than their abled counterparts, between 65.8% and 27.2% less.ConclusionsThe study concludes that people with disability live less integrated, more isolated lives, due to the lack of accommodating infrastructure and services, in addition to the lack of binding policies, legislation, standards and guidelines. The results underpin the need for Disability Inclusive Planning in the African context and provides recommendations that mitigate the isolation challenges faced by people with disabilities.
Niche conservatism drives the elevational diversity gradient in major groups of free-living soil unicellular eukaryotes
Authors: Fernández Leonardo D. , Seppey Christophe V. W. , Singer David , Fournier Bertrand , Tatti Dylan , Mitchell Edward A. D. , Lara Enrique
Published: December 2020

Ancestral adaptations to warm and humid climates drive the biogeographical and macroecological patterns of numerous multicellular organisms. Recent evidence suggests that this niche conservatism may also be shaping broad-scale diversity patterns of soil unicellular organisms, although empirical evidence is limited to Acidobacteria and testate amoebae. Herein, we tested the predictions of this hypothesis for five major soil protist groups (Bacillariophyta, Cercomonadida, Ciliophora, Euglyphida and Kinetoplastida), separately, as well as combined, along an elevational gradient in Switzerland. We found support for the predictions of this hypothesis in all protist groups, including decreasing diversity and increasing geographical ranges towards high and cold elevations (Rapoport effect); correlations between diversity and temperature (species-energy effect); and communities phylogenetically structured by competition (phylogenetic overdispersion) at warm-humid sites and habitat filtering (phylogenetic clustering) at cold-humid sites. Mid-domain null models confirmed that these findings were not the result of stochastic processes. Our results therefore suggest that soil protists exhibit evolutionary constraints to warm and humid climates, probably linked to an ancestral adaptation to (sub)tropical-like environments, which limits their survival in exceedingly cold sites. This niche conservatism possibly drives their biogeographical and macroecological patterns both at the local (e.g., temperature, humidity gradients along elevation gradients) and more global (e.g., latitudinal gradients) spatial scales.
The Association Between Alcohol Consumption and Dysmenorrhea in University Students in North China 
Authors: Yang Zhuo , Guo Jia , Sun Ming-li , He Qin-cheng , Ma Ya-Nan
Published: December 2020

Background: Dysmenorrhea is a condition frequently affecting menstruating women worldwide. Unfortunately, only a few studies have estimated the relationship between alcohol consumption and dysmenorrhea among women. In particular, there are fewer studies to explore the association between alcohol consumption, dysmenorrhea, and age at menarche. Objective: This study aimed to evaluate whether and to what extent alcohol consumption is related to dysmenorrhea and age at menarche. Methods: This was a cross-sectional, observational study conducted among college students. A total of 3,837 participants (age ≥18 years) volunteered to participate in the study and completed the questionnaire. Moreover, 145 were excluded from the study owing to exclusion criteria. We divided female college students into two groups stratified by age at menarche (AAM) 13 years. Logistic regression models were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of alcohol consumption with dysmenorrhea, adjusting for confounding factors. Results: A total of 3692 female college students completed the survey, including 409 (11.08%) who reported alcohol use. We found that alcohol consumption was not related to dysmenorrhea. However, stratified by age at menarche, we found that a positive association between alcohol consumption and dysmenorrhea among participants with AAM ≥13 years (OR,1.41; 95% CI, 1.06, 1.88). Compared with participants who reported no alcohol consumption, participants who reported consuming alcohol at least once a month (OR,1.29; 95% CI, 0.94, 1.78) and alcohol consumption at least once a week (OR,1.92; 95% CI, 1.07, 3.45) were more likely to have dysmenorrhea adjusting for other confounding factors. Conclusion: Our findings showed overall no association of alcohol consumption with dysmenorrhea but a statistically significant positive association for those whose AAM was >13 years.
Cutaneous Anthrax Outbreak Associated with Handling Dead Animals, Rhino Camp Sub-county: Arua District, Uganda, January-May 2018
Authors: Ntono Vivian , Eurien Daniel , Bulage Lilian , Kadobera Daniel , Harris Julie , Ario Alex Riolexus
Published: December 2020

Background: On the 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. About 9 persons fell ill after reported contact with livestock that died suddenly. We investigated to determine the scope, mode of transmission and exposures associated with identified anthrax, to guide control and prevention measures.Methods: We defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December, 2017 to 31 May, 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test.Results: We identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (AR: 12/10,000). Mean age of case-persons was 33years (SD: 22).The epidemic curve shows that the outbreak lasted for 5 months, from January 2018-May 2018, peaking in February.Skinning(RR=2.7, 95%CI=1.1-6.7), dissecting (RR=3.0, 95%CI=1.2-7.6), and carrying the dead animals (RR=2.7, 95%CI=1.1-6.7) were associated with increased risk of illness, as were carrying dissected parts of the animal (RR=2.9, 95%CI 1.3-6.5) and preparing and cooking the meat (RR=2.3, 95%CI 2.7-8.1). We found evidence of animal remains on pastureland.Conclusion: Multiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.
LncRNA TSIX acts as a ceRNA of miR-342-3p to Promote the Progression of Nasopharyngeal Carcinoma by Regulating AGR2
Authors: Chen Shupeng , Zhang Qiongxia , Li Zhenyu , Qin Xintian , Wang Zhe , Liu Huimin , Mo Kailan , Wu Shaoyun , Li Yaoying , Wang Dan , Shi Zhi , He Xingxiang
Published: December 2020

Background: LncRNA TSIX has been observed to be abnormally expressed in many human cancers. However, its roles in nasopharyngeal carcinoma (NPC) remains unclear, and this study aims to explore the functions of TSIX in NPC.Methods: The expression of TSIX and miR-342-3p in NPC tissues and corresponding cell lines was detected by qRT-PCR. Bioinformatics analysis and luciferase activity assay and RIP assay were applied to determine the interaction between TSIX, miR-342-3p, and AGR2. The roles of TSIX, miR-342-3p and AGR2 in the proliferation, apoptosis, migration and invasion of NPC cells were explored both in vitro and in vivo. In addition, the rescue experiments were used to confirm the functions of TSIX, miR-342-3p, and AGR2 in NPC progression.Results: Our study firstly found that TSIX was significantly upregulated in NPC tissues and corresponding cell lines. Moreover, upregulation of TSIX obviously exacerbated the NPC progression including the proliferation, apoptosis, migration and invasion, while downregulation of TSIX efficiently attenuated the development of NPC. Further, our results demonstrated that TSIX could increase the expression of AGR2, which was directly targeted by miR-342-3p, and then lead to the facilitated development of NPC cells.Conclusion: In summary, our study revealed that lncRNA TSIX promoted the progression of NPC through targeting miR-342-3p/AGR2 axis, suggested that it might be a potential therapeutic target for NPC.
La cuestión del ser en la actualidad: un análisis desde la teoría crítica
Authors: Fernández Jaimes Carol
Published: December 2020

El concepto ser se encuentra en las primeras preguntas formuladas por los pensadores griegos. Explícitamente, se hallan interrogantes como ¿qué es el ser?, ¿quién es el ser?, ¿cuál es el sentido del ser?, ¿cuál es la cosa que propiamente es? En un intento por responder a estos cuestionamientos, se abrieron dos tradiciones filosóficas: por el lado de Parménides, una que apostaba por la permanencia del ser; y por el lado de Heráclito, una que comprendía el ser en un constante advenimiento. De igual manera, se han generado discusiones en las cuales se comprende el ser o bien como esencia o bien como existencia. Sin embargo, en estas posturas así como en posteriores discusiones, se lee una comprensión del ser que centra la discusión en el ser mismo, apartado de un análisis articulado con la historia y lo social. Es así como desde la teoría crítica y en discusión con el psicoanálisis, se encontrará una posibilidad de comprender el ser en articulación con la historia, lo social y la subjetividad, de manera tal que se reavivan por un lado, las discusiones en torno a este problema filosófico por excelencia, por el otro, indagar por la esencia de lo humano en un momento histórico atravesado por una política neoliberal y una economía consumista en la que resultan obliterados tanto el sujeto como el ser. Se encuentra, finalmente, que en dimensiones propiamente humanas como el trabajo y el lenguaje, es posible trazar un camino que permita comprender el ser en relación con la subjetividad y las dinámicas propias de la época actual.
Formación para el análisis, el pensamiento crítico y la solución de problemas en las universidades regionales
Authors: García-Duque Carlos Emilio
Published: December 2020

Pese a que en los documentos oficiales de casi todas las instituciones universitarias colombianas se declara un firme compromiso con la formación para el análisis, el pensamiento crítico y la capacidad de resolución de problemas de los estudiantes (a lo cual denominaremos el compromiso esencial de laeducación superior), en este artículo defiendo la tesis de que en las universidades regionales pocas veces se logra materializar dicho planteamiento. También ofrezco un análisis del compromiso esencialy de las razones que impiden su completa realización y hago algunas recomendaciones que contribuirían a su obtención.
Diseño de Objeto de Aprendizaje basado en una WebQuest para la programación de áreas que definen el espacio arquitectónico
Authors: Molina Zambrano Mayre , Ruiz Morales Yovanni Alexander
Published: December 2020

El artículo desarrolla un Objeto de Aprendizaje (OA) para un entorno virtual de enseñanza del proceso proyectual. Se diseñó un OA según el perfil de los estudiantes: estilos de aprendizaje, competencias proyectuales y destrezas digitales, además se valoró la calidad del OA. El estudio fue de carácter cuantitativo y diseño no experimental, se emplearon 2 muestras: 10 estudiantes de arquitectura y 4 expertos en diseño instruccional, proyectos arquitectónicos, tecnología educativa y evaluación. El desarrollo del OA se basó en el modelo PRADDIE (2003), Dorrego (1994) y la WebQuest. En conclusión, el perfil de los estudiantes se caracterizó por estilos de aprendizaje visual (100%) activo (80%), secuencial (80%) y sensitivo (30%). El 86% no tiene conocimiento práctico de los métodos para formulación, investigación, procesamiento y síntesis del proceso de diseño. El 97,37% gestiona búsqueda de información online y el 96,67% tiene habilidad de comunicarse por medios electrónicos. El OA diseñado satisfactoriamente reunió calidad de la metodología didáctica, general y técnica
Design of binary weighted DAC for asynchronous ADC with improved slew rate and with calibrated size of capacitors
Authors: Ling Qianhua , Ikbal Mohammad Asif
Published: December 2020

This work proposed a binary-weighted Digital-to-Analog Converter (DAC), which is designed to be used in Asynchronous successive approximation register (SAR) based Analog-to-digital converters (ADCs) specifically and in other relevant operations .The design has yielded an improved slew rate, and it is less prone to noise as the size of capacitors is taken in accordance with KT/C noise calculation. For achieving all mentioned goals, and to restrict the size of DAC, within suitable dimensions charge scaling DACs are used. One more advantage of this design is its accuracy, further it does not require op-Amps for its operation. Results of statistical simulation and mathematical consideration are published which depicts the supremacy of the design. A high-resolution DAC designed for this specific purpose has to have special consideration for the effect of local mismatch, parasitic and matching of the capacitors, for that, the common-centroid approach has been followed. This design has displayed a high resolution with small unit capacitances and that too without expensive factory calibration.
Impact of Metaheuristic Techniques in Pandemic of COVID-19
Authors: Kumar Vijay , Singh Dilbag , Kaur Manjit
Published: December 2020

:

The early detection and diagnosis of novel coronavirus disease 2019 (COVID-19) are required
to cure the disease. Metaheuristic techniques can be used to develop an automated tool for
detecting the symptoms of an infected person and provide appropriate precautionary measures. The
metaheuristic-based software can be designed to analyze the radiographic patterns of infected individuals
and determine the severity of COVID-19 infection. The genome structure of coronavirus
can be easily understood through metaheuristic techniques. Based on the genome structure, an effective
drug combination can be explored by using metaheuristics for the treatment of COVID-19.
Effect of Casein Tablet Made from Goat Milk Yogurt on Liver Histopathological Profile, Dioxin Residue, and Malondialdehyde level in Broiler Exposed to 2,3,7,8-Tetrachlorodibenzo-P-Dioxin
Authors: Aeni Nur , Srihardyastutie Arie , Mahdi Chanif
Published: December 2020

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a toxic compound of organic pollutants that is very persistent in the environment. This compound can accumulate in the body through contaminated food and can cause various adverse effects on human health. The purpose of this study was to observe the effect of casein tablets made from goat milk yogurt on Liver histopathological profile, residual TCDD and malondialdehyde (MDA) levels in broiler chicken exposed to 50 ng/mL TCDD. A total of 18 male broiler chickens aged 3 weeks were used in this study and were divided into 3 experimental groups based on a completely randomized design (CRD): 1 (negative control group), 2 (positive control group), 3 (therapeutic group) which were administered by 750 mg of casein from goat milk yogurt for 21 days. TCDD residue and MDA levels in the liver were measured using a UV-Vis spectrophotometer and thiobarbituric acid reactive substances test, respectively. The liver histopathological profile was observed using hematoxylin-eosin staining. The results showed that the administration of casein tablets decreased the level of TCDD residue and MDA by 5.75% and 43.74%, respectively. Moreover, the liver histopathological profile of the therapeutic group was better than that of the positive control group. It is suggested that casein tablet made from goat milk yogurt possesses anti-dioxin and antioxidant capacities.
Natural Disaster Preparedness Planning: Synchronizing Artificial Intelligence with a New Set of Leadership Skills for Generating an Inclusive Strategy in a Remote Workplace
Authors: Morrison James L.
Published: December 2020

An increasing number of major hurricanes, flooding, and wildfires has introduced an unusual amount of uncertainty and thus changes in our daily lives. However, one positive outcome is that they have also resulted in new opportunities to re-examine past approaches for planning to survive a natural disaster. A critical behavior practiced by inclusive leaders is to seek new ideas and perspectives from co-workers who have different values, expectations, and goals. Being receptive to different views enables organizational leaders to challenge the way they personally perceive how future practices and policies can be designed when planning to survive a natural disaster. However, particularly in the private sector, one sobering account has been the social cost of not convening face-to-face in our daily working environments whereby a free exchange of ideas is less likely to occur. This purpose of this theoretical paper is to propose a new skill set for those leaders working with remote co-workers when designing a plan for natural disaster preparedness for their organizations.
Лучшие инновационные продукты выставки "VacuumTechExpo 2020"
Authors: Нестеров С.Б.
Published: December 2020

Представлено краткое описание лучших инновационных продуктов выставки вакуумного и криогенного оборудования "ВакуумТехЭкспо 2020".
Исследование спектров поглощения фторуглеродных покрытий, полученных при помощи НЧ-плазмотрона атмосферного давления
Authors: Шведов А.В. , Елинсон В.М. , Кузькин В.И. , Мурныкина В.В.
Published: December 2020

В работе представлены результаты исследования спектров поглощения фторуглеродных покрытий, полученных при помощи низкочастотного плазмотрона низкотемпературной плазмы атмосферного давления. Рассмотрены амплитуды пиков поглощения и установлен химический состав покрытий. Определена ширина запрещенной зоны по методу Тауца.
O papel da antepraia na resposta costeira durante a elevação do nível do mar na Barreira Regressiva de Torres a Imbé, RS
Authors: GERMANI Yana Friedrich , De FIGUEIREDO Salette Amaral , CALLIARI Lauro Júlio , VIANNA Humberto Dias
Published: December 2020

A zona costeira é um sistema muito dinâmico, o qual busca atingir um estado de equilíbrio dinâmico. Nos últimos 5,5 ka, o nível médio do mar (NMM) apresentou comportamento praticamente estável, porém, devido às mudanças climáticas está em elevação. Objetivando analisar a influência das variações na morfologia do substrato entre setores costeiros adjacentes (Torres-Capão-Imbé), na resposta à elevação do NMM em médio e longo prazo, foram projetadas linhas de costa futuras para estes cenários. Além da morfologia, investigou-se a existência de diferenças significativas nessas projeções em função das variações na batimetria da antepraia e do balanço sedimentar. Para isso, foi utilizado o modelo RanSTM (Random Shoreface Translation Model). Os três setores apresentaram taxas de recuo (transgressão) da linha de costa diferenciadas, influenciadas, primeiramente, pelas variações batimétricas, seguidas do balanço sedimentar. A influência da topografia no recuo foi irrelevante. O setor “Capão”, com maior declividade na antepraia, apresentou menores valores de recuo, enquanto o setor “Imbé”, com menor declividade na antepraia, apresentou maiores valores de recuo. Ainda, ao padronizar-se o comprimento do perfil no setor “Imbé”, obteve-se cerca de 30% de diminuição nos valores de recuo da linha de costa. Os resultados obtidos demonstram a forte influência das variações na morfologia do perfil batimétrico em situação de elevação do NMM, as quais podem ter implicações relevantes no manejo e adaptação locais de regiões costeiras em condição de mudanças climáticas.
Efficacy and safety of phytoestrogens in the treatment of postmenopausal depressive disorders: a systematic review and meta-analysis
Authors: Jieyun Li , LI Huijuan , Peijing Yan , Guo Liping , Li Jingwen , Han Jiani , Qiu Jie , Yang Kehu
Published: December 2020

Background：Depression is one of the most common and specific symptoms
among postmenopausal women, leading to significant personal, family, and
economic burdens. Some studies have shown that phytoestrogens can help
relieve symptoms of depression. Objectives: This systematic review and
meta-analysis aims to assess the efficacy and safety of phytoestrogens
in treating depression among postmenopausal women. Methods: A
comprehensive search for relevant studies published until November 25,
2020, was conducted in PubMed, the Cochrane Library, Chinese Biomedical
Literature Database, Web of Science, and EMBASE. Statistical analyses
were performed with Stata12.0, Comprehensive Meta-Analysis 3.0, and
Review Manager 5.4. Results: 2,183 studies were identified and 10
studies were included, involving 1,248 participants. The quality of the
four studies was assessed as high risk, six studies were assessed as
unclear. The analyses conducted according random effects model indicated
a positive effect on depressive symptoms for postmenopausal women
compared to the placebo (SMD=-0.45; 95% [CI]= -0.60 to -0.29;
Q=40.42, df=18, P=0.002; I2=55.5%). The high dose phytoestrogens
(dose>100mg/day) have better effectiveness (SMD =-0.48;
95%[CI]= -0.76 to -0.20; I2=52.8%, P<0.05) than low dose
(25mg/day≤dose≤100mg/day) (SMD=-0.45; 95%[CI]=-0.68 to-0.23;
I2=66.7%; P>0.05) and ultralow dose (00.05). Isoflavones
had better effectiveness (SMD=-0.52; 95% [CI]= -0.75 to 0.30;
I2=65.8%, P<0.05) than lignans of phytoestrogens (SMD= -0.23;
95% [CI]= -0.05 to 0.01; I2=0%, P>0.05). The
effectiveness varies in regions. The adverse reactions frequently
reported were gastrointestinal symptoms and cold or upper respiratory
tract infection. Conclusions: Phytoestrogen can relieve depression
symptoms among postmenopausal women. High-dose isoflavones is the most
effective. Although mild adverse reactions have been reported,
phytoestrogen could be considered as a complementary treatment for
postmenopausal depression.
Cardiometabolic Profile of Women with Uterine Leiomyoma: A Cross-Sectional Study
Authors: AlAshqar Abdelrahman , Ouweini Hala El , Gornet Megan , Yenokyan Gayane , Borahay Mostafa
Published: December 2020

Objective: To determine the association of cardiometabolic comorbidities
and use of cardiometabolic medications with diagnosis of uterine
leiomyoma (UL). Design: Cross-sectional study. Setting: The John Hopkins
Health System. Population or sample: Women 18 years or older who had at
least one visit or hospital encounter and one blood pressure
measurement. Methods: Aggregate-level data from January 1, 2013 to
January 1, 2020 were collected using SlicerDicer feature of Epic
electronic medical record system. Participants were assigned as cases or
controls according to UL status. The individual prevalence of each
pre-specified cardiometabolic comorbidity and relevant prescription
medications was obtained. Main Outcome Measures: We used prevalence odds
ratios to assess the association of cardiometabolic comorbidities and
use of medications with UL. Results: The study included 27,703 women
with UL. Women with UL were more likely to be obese (2.56; 95%CI,
2.49-2.63), have metabolic syndrome (1.82; 95%CI, 1.51-2.19), essential
hypertension (1.45; 95%CI, 1.42-1.49), diabetes mellitus (1.29; 95%CI,
1.24-1.33) and hyperlipidemia (1.23; 95%CI, 1.19-1.26). These
associations were stronger among younger women and persisted after
excluding those who had a hysterectomy. Notably, statins were the only
medications associated with a lower UL risk (0.81; 95%CI, 0.79-0.84).
Conclusions: UL is associated with an unfavorable cardiometabolic
profile in women. If found to be more definitively correlated,
prevention and early management of cardiometabolic risk factors may
decrease the incidence of UL, and screening women UL for cardiometabolic
comorbidities may aid in cardiovascular disease prevention. Funding: NIH
grant [1R01HD094380-01] to Mostafa A. Borahay. Keywords:
Cardiometabolic comorbidity; Statins; Uterine Fibroids
Accuracy of antepartum ultrasound in evaluating placental pathology using superb microvascular imaging: main research article
Authors: Furuya Natsumi , HASEGAWA JUNICHI , Doi Masatomo , Koike Junki , Suzuki Nao
Published: December 2020

Objectives: To clarify whether microvascular ultrasound Doppler (SMI:
superb microvascular imaging) can detect antenatal histological findings
in pathologic placentas. Methods: In this prospective diagnostic
observational study (STROBE), pregnant women who were admitted to our
perinatal center for perinatal management were enrolled. Ultrasound
examinations to identify placental pathologies using SMI were performed
before delivery. After delivery, the placental tissue was clipped for
microscopic examination, as the location of the placenta obtained
ultrasound findings. The accuracy of antenatal ultrasound detection of
placental pathologies was compared between women who were admitted due
to fetal growth restriction (FGR), pre-eclampsia, and other indications.
Results: The highest accuracy was observed with placental infarction in
FGR (positive predictive value [PPV], 100%; sensitivity, 89%; area
under the curve [AUC], 0.945), whereas PPV, sensitivity, and AUC in
cases of preeclampsia were relatively low (AUC 0.540). Additionally,
PPV, sensitivity, and AUC for avascular villi were 100%, 57%, and
0.785 in cases with FGR, 67%, 67%, and 0.780 in cases with
preeclampsia, and 80%, 80%, and 0.920, respectively. The diagnostic
accuracies predictive of congestion of stem villi and chorangiosis were
insufficient (AUC<0.700). Conclusions: SMI can accurately
detect placental pathologic findings, such as placental infarction and
avascular villi. This modality may improve the perinatal management in
cases of placental abnormalities.
Targeting the autonomic nervous system during AF ablation: should we fight or take flight?
Authors: Aksu Tolga , Gupta Dhiraj
Published: December 2020

Demonstration that the myocardial sleeves of the pulmonary veins (PVs)
are the main triggering and maintaining foci for paroxysmal atrial
fibrillation (AF) have stimulated studies investigating
electrophysiological properties of PVs and the adjacent left atrial (LA)
myocardium. It has been shown that PV myocytes have a shorter action
potential duration and are more prone to effects of local autonomic
nerve stimulation in terms of shortening of action potential duration,
early after depolarization formation and triggered firing compared to
left atrial myocytes (1). The intrinsic cardiac autonomic nervous system
(ICANS) forms clusters of neurons called ganglionic plexi (GPs), and
studies using histologic examination of heart sections have shown that
these GPs are localized preferentially at certain epicardial sites
adjacent to the left and right atria (2). The precise role of ICANS in
AF continues to be an area of intense research (3), and matters are not
helped by the uncertainty regarding the best way to identify and target
ICANS peri-procedurally. As there can be significant variability of GP
sites in individual patients, endocardial high-frequency stimulation
(HFS) has been used to aid their localization in the electrophysiology
laboratory (4).
A Review of the Strategy for the Northeast Asia Power System Interconnection
Authors: Ogino Kaoru
Published: December 2020

This paper examines, summarizes, and updates the study of a strategy for the Northeast Asia Power System Interconnection conducted by the Asian Development Bank. It presents independent reviews and assessments by various stakeholders from Japan, Mongolia, the People’s Republic of China, the Republic of Korea, and the Russian Federation together with additional analysis by experts from the private and public sectors, academe, and international research and development institutions. It also calls for further discussions, studies, and activities in the development of the vast renewable energy potential of Mongolia’s South Gobi. Specific integrated investment project approaches for solar and wind power development and two cross-border transmission links in the region are proposed.
Psychological symptoms of COVID-19 epidemic: A systematic review of current evidence
Authors: Seyed Alinaghi , Karimi Amirali , Shobeiri Parnian , Nowroozi Ali , Mehraeen Esmaeil , Afsahi Amir , Barzegary Alireza
Published: December 2020

Since the outbreak of COVID?19, several published reports of increased psychological problems turned the attention towards this field and ignited controversies surrounding it. Our aim was to address the issues in this area of interest to provide information for a more robust approach. We carried out a systematic search in PubMed, Embase, Scopus, UpToDate, Science direct, and Web of Science databases. We included English-written original papers, abstracts, reports, and letters to the editor published from December 2019 to April 2020. After evaluating the title and abstract to select the most relevant papers based on inclusion and exclusion criteria, articles underwent quality assessment. The full text of selected articles was then thoroughly read to extract the essential findings. The current review of the literature showed that psychological symptoms might happen among most people, including medical staff, and patients during the COVID?19 epidemic. We identified 24 potential psychological symptoms of the SARS-CoV?2 public health emergency. Reviewing extracted studies revealed that there was a risk of occurrence of psychological symptoms among the general population during the COVID?19 outbreak. However, firstline medical staffs who provide healthcare services to patients with COVID?19 were more susceptible to these symptoms. The systematic review highlights that anxiety, depression, stress, and sleep disturbance symptoms were the most frequent psychological symptoms of the COVID?19 pandemic situation. It is recommended that future studies evaluate practical interventions to reduce psychological symptoms, especially in health care workers during the COVID?19 epidemic.
HbA1c Change and Diabetic Retinopathy During GLP-1 Receptor Agonist Cardiovascular Outcome Trials: A Meta-analysis and Meta-regression
Authors: Bethel M. Angelyn , Diaz Rafael , Castellana Noelia , Bhattacharya Indranil , Gerstein Hertzel C. , Lakshmanan Mark C.
Published: December 2020

Background: Long-term glycemic control reduces
retinopathy risk, but transient worsening can occur with glucose control
intensification. GLP-1 receptor agonists (RA) lower glucose, but long-term
impact on retinopathy is unknown. GLP-1RA cardiovascular outcome trials (CVOTs)
provide long-term follow-up, allowing examination of retinopathy outcomes.

Purpose:
To
examine the associations between retinopathy, HbA1c, systolic blood pressure
(SBP) and weight in GLP-1RA CVOTs.

Data
Sources: Systematic
review identified 6 placebo-controlled GLP-1RA CVOTs reporting prespecified
retinopathy outcomes.

Study
Selection: Published
trial reports were used as primary data sources.

Data
Extraction: HbA1c,
SBP, and weight data throughout follow-up by treatment group were extracted.

Data
Synthesis: Random
effects model meta-analysis showed no association between GLP-1RA treatment and
retinopathy (odds ratio [OR] 1.10; 95% CI 0.93, 1.30), with high heterogeneity
between studies (I2=52.2%; Q-statistic p=0.063). Univariate meta-regression
showed an association between retinopathy and average HbA1c reduction during
the overall follow-up (slope=0.77, p=0.007), but no relationship for SBP or
weight. Sensitivity analyses for HbA1c showed a relationship at 3 months
(p=0.006) and 1 year (p=0.002). A 0.1% (1.09 mmol/mol) increase in HbA1c
reduction was associated with 6%, 14%, or 8% increased ln (OR) for retinopathy
at the 3-month, 1-year, and overall follow-up, respectively.

Limitations:
CVOTs
were not powered to assess retinopathy outcomes and differed in
retinopathy-related criteria and methodology. The median follow-up of 3.4 years
is short compared to the onset of retinopathy.

Conclusions:
HbA1c
reduction was significantly associated with increased retinopathy risk in
meta-regression for GLP-1RA CVOTs. The magnitude of HbA1c reduction was
correlated with retinopathy risk in people with diabetes and additional
cardiovascular risk factors, but the long-term impact of improved glycemic
control on retinopathy is unmeasured in these studies. Retinopathy status
should be assessed when intensifying glucose-lowering therapy.
Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening
Authors: Lomonaco Romina , Leiva Eddison Godinez , Bril Fernando , Shrestha Sulav , Mansour Lydia , Budd Jeff , Romero Jessica Portillo , Schmidt Siegfried , Chang Ku-Lang , Samraj George , Malaty John , Huber Katherine , Bedossa Pierre , Kalavalapalli Srilaxmi , Marte Jonathan , Barb Diana , Poulton Danielle , Fanous Nada , Cusi Kenneth
Published: December 2020

Objective: Assess the prevalence of NAFLD and of
liver fibrosis associated with nonalcoholic steatohepatitis (NASH) in
unselected patients with T2DM.

Research Design and
Methods: 561 patients with T2DM (age: 60±11;
BMI: 33.4±6.2 kg/m2; HbA1c: 7.5±1.8%) attending primary care
or endocrinology outpatient clinics and unaware of having NAFLD. At the visit, volunteers were invited to be
screened by elastography for steatosis and fibrosis by CAP (≥274 dB/m) and LSM (≥7.0 kPa), respectively. Secondary causes of liver disease were ruled
out. Diagnostic panels for prediction of advanced fibrosis, such as APRI and
FIB-4, were also measured. A liver
biopsy was performed if results were suggestive of fibrosis.

Results: The prevalence of steatosis was 70% and of fibrosis 21% (LSM≥7.0 kPa). Moderate fibrosis (F2: LSM≥8.2 kPa) was
present in 6% and severe fibrosis or cirrhosis (F3-4: LSM≥9.7 kPa) in 9%,
similar to that estimated by FIB-4 and APRI panels. Non-invasive testing was
consistent with liver biopsy results. Elevated
AST or ALT ≥40 U/L were present in a minority of patients with steatosis (8%
and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This
suggests that AST/ALT alone are insufficient as initial screening. However,
performance may be enhanced by imaging (e.g., transient elastography) and
plasma diagnostic panels (e.g., FIB-4, APRI).

Conclusions: Moderate-to-advanced fibrosis (F≥2), an established risk
factor for cirrhosis and overall mortality, affects at least one-out-of-six (15%)
patients with T2DM. These results support the ADA guidelines to screen for clinically
significant fibrosis in patients with T2DM with steatosis or elevated ALT.
Exercise During the First Trimester of Pregnancy and the Risks of Abnormal Screening and Gestational Diabetes Mellitus
Authors: Ehrlich Samantha F. , Ferrara Assiamira , Hedderson Monique M. , Feng Juanran , Neugebauer Romain
Published: December 2020

Objective: To estimate the
effects of exercise during the first trimester on the risks of abnormal
screening and gestational diabetes mellitus (GDM).

Research Design and
Methods: Data
come from PETALS, a prospectively followed pregnancy cohort (n= 2,246, 79% minorities) receiving care at Kaiser Permanente
Northern California. A Pregnancy Physical Activity Questionnaire was used to
assess exercise. Glucose testing results for screening and diagnostic tests were
obtained from electronic health records. Inverse probability of treatment
weighting and Targeted Maximum Likelihood with data-adaptive estimation
(machine learning) of propensity scores and outcome regressions were used to
obtain causal risk differences adjusted for potential confounders, including
prepregnancy BMI, exercise before pregnancy, and gestational weight gain.
Exercise was dichotomized at: 1) the cohort’s 75th percentile for
moderate to vigorous intensity exercise (≥ 13.2 MET hours per week, approximately
≥ 264 minutes per week of moderate exercise), 2) current recommendations (≥ 7.5 MET hours
per week, or ≥ 150 minutes per week of moderate exercise), and 3) any
vigorous exercise.

Results: Overall,
24.3% and 6.5% had abnormal screening and GDM, respectively. Exercise meeting
or exceeding the 75th percentile decreased the risks of abnormal
screening and GDM, by 4.8 (95% CI 1.1, 8.5) and 2.1 (0.2, 4.1) fewer cases per
100, respectively, in adjusted analyses.

Conclusions: Exercise
reduces the risks of abnormal screening and GDM but the amount needed to
achieve these risk reductions is likely higher than current recommendations.
Future interventions may consider promoting ≥ 38 minutes per day of moderate
intensity exercise to prevent GDM.
Educational Challenges of Roma Minorities: The Case of the Republic of North Macedonia
Authors: Rizova Elena , Bekar Mira , Velkovski Zoran ,   Faculty of Philology, Ss.Cyril and Methodius University - Skopje, Republic of North Macedonia,   Faculty of Philosophy, Ss.Cyril and Methodius University - Skopje, Republic of North Macedonia
Published: December 2020

Linguistic diversity comes in various forms. The most common ways of developing knowledge of more than one language according to some authors are either by learning a second language through participation in some form of bilingual education or being raised in a bilingual environment, such as school or a bilingual family. The phenomenon of development of literacy competencies of minority groups, specifically, the context of Roma people, in the Republic of North Macedonia, whose mother tongue is not even considered a standard language is the main research purpose of this paper. Research conducted in comparative studies on integrated education shows that in the elementary schools with high numbers of Roma students actions are rarely taken to enhance the integration of these minority students, because of 1) the lack of iconography, which is important for the ethnic identity of this minority and 2) low competence level of parents and teachers who are not adequately trained to work with students coming from different linguistic backgrounds or social backgrounds that are characterized by low literacy levels and low learning competences. Participants in this study were from several primary schools in North Macedonia and the responses were categorized according to the major themes that occurred. The findings show how women are excluded from obtaining better education and that multilingual children from deprived economic settings with poorly educated parents struggle and are seriously challenged to obtain proper literacy and education in elementary schools. The study reveals important details about the educational legislation, treatment of Roma people by local and international organizations and provides suggestions for improvement of the current status of the Roma population.