bluuebunny/crossref_metadata_2025 huggingface dataset:
Linfangiomatose disseminada: um relato de caso
Authors: Vieira Lara Andrade , Carlos Ingrid de Lima , Silva Paulo Italo Martins , Monteiro Ítalo Gustavo Lima , Capistrano Giovany Gomes , Meneses Maria Carolina Nunes Albano de , Galdino Gabriela Studart
Published: November 2022

Objetivo: relatar um caso de linfangiomatose difusa. Métodos: relatamos o caso de um paciente masculino, 27 anos, com derrames cavitários de repetição e diagnóstico de linfangiomatose disseminada sugerido por exames de imagem, com acometimento torácico, esplênico, vesical e ósseo. Submetido ao tratamento com propranolol, alendronato, talidomida e bevacizumabe. Resultados: apesar do tratamento instituído, não houve resposta clínica e radiológica satisfatória, evoluindo com coagulação intravascular disseminada (CIVD) e óbito. Conclusão: A linfangiomatose difusa é uma doença de prognóstico ruim na maioria dos casos. A CIVD no caso relatado pode estar associada a complicações da doença.
Google Docs to Manage an EFL Writing Class: How It Helps and What to Prepare
Authors: Kurniawati Atin
Published: November 2022

Google Docs has been reported by many researchers as a tool that facilitates EFL students’ performance enhancement in writing class, but the facts in using this tool from teachers’ point of view in managing a writing class still lack attention. This article aims to describe how Google Docs can assist EFL teachers in managing writing classes as well as the strategies that can be carried out to optimize the use of this tool. Using narrative inquiry, this study employed a teacher’s narratives and documentation of activities on Google Docs. Thematic coding was done to highlight meaningful experiences. It revealed that Google Docs assisted both students and teachers in terms of proofreading, giving feedback, and recording students’ activities. However, during the use of this tool, sort of challenges might hinder students’ progress, such as students’ ignorance of the helpful features and failure in complying with the instructions. Therefore, English teachers can prepare some strategies i.e. giving clear rules and instructions, having conferences and synchronous interaction more often on Google Docs, and building up students’ responsibility for the learning progress. It implies that technology itself doesn’t guarantee students’ improvement in writing, but teachers’ and students’ ability and responsibility in using the technology contribute more to the progress.
Implementasi Maqashid Syariah Indeks (Msi) Terhadap Kinerja Tenaga Kependidikan Fiai Uii
Authors: Hadidtya Sukma , Yafitz Mohammad , Nurozi Ahmad
Published: November 2022

Penelitian ini bertujuan untuk mengetahui pencapaian bentuk dari nilai-nilai maqashid syariah terhadap sistem kinerja tenaga kependidikan yang berada di Fakultas Ilmu Agama Islam Universitas Islam Indonesia. Dengan upaya menganalisis nilai-nilai maqashid syariah tersebut agar bagaimana dapat terimplementasi dalam dunia kerja, terlebih khususnya dalam lingkup tenaga kerja pendidikan di FIAI UII terhadap para mahasiswa/i, pegawai dosen dan para pegawai-pegawai lainnya. Selain itu, dalam penelitian ini juga melihat faktor pendukung dan penghambat dalam mencapai maqashid syariah.Jenis Metode yang digunakan adalah kualitatif, dengan pendekatan normatif yuridis yang menggunakan paradigma kritis berdasarkan pandangan Islam dan paradigma spiritualis. Teknik pengumpulan data dalam penelitian ini dengan menggunakan cara wawancara dan observasi. Analisis data kami lakukan dengan cara deskriptif kualitatif dan mengumpulkan Sumber data dari sumber data primer dan data sekunder.Hasil penelitian yang kerap kami lakukan, dengan munculnya istilah maqashid syariah indeks (msi) memang merupakan bagian dari suatu kajian ekonomi islam. Akan tetapi bukan berarti pembahasan hanya dalam perspektif perbankan saja, maqashid syariah indeks ini juga  dapat menjadikan acuan sebagai ikhtiar menjadi muslim yang profetik dalam menjalankan kewajiban kita dan mempunyai rasa tanggung jawab yang harus dilaksanakan. Karena dalam islam sendiri telah mengajarkan untuk bertanggung jawab atas yang dikerjakan, sebab islam adalah agama solusi yang tepat untuk memutuskan suatu perkara.
Identifikasi Demografi Dan Faktor Pemilihan Prodi Mahasiswa Angkatan 2017 Dan 2018 Di Lingkungan Fiai
Authors: Humaira Ulfa Windi , Hikmah Nailia Nurul , Fahmi Rizki Anfani
Published: November 2022

Penelitian ini merupakan penelitian terhadap identitas demografi dan faktor pemilihan program studi di Fakultas Ilmu Agam Islam Universitas Islam Indonesia bagi mahasiswa angkatan 2017 dan 2018. Sekitar 610 dari 990 mahasiswa telah mengisi kuisioner ini. Hasil dari penelitian ini faktor dalam pemilihan program studi tidak hanya temuat dalam faktor internal dan eksternal. Melainkan dari demografi mahasiswa dimana faktor letak geografis juga berpengaruh. Data ini menunjukkan ada kesamaan dalam asal mahsiswa, sekolah dan letak FIAI. Data ini menghasilkan bahwa ada suatu emosi terkait lingkungan dalam pemilihan. Selain itu dalam faktor pemilihan program studi dibagi menjadi 4 yaitu alasan pemilihan lanjut kuliah, Fakultas, dan program studi. Faktor lanjut kuliah didominasi dengan dorongan orang tua. Pemilihan fakultas rata-rata karena sesuai dengan minat. Sedangkan pemilihan prodi karena akreditas. Serta pendukung lain seperti waktu memilih yang kebanyakan setelah pengumuman PTN dan sumber informasi dari keluarga dan website.
Status Keberlanjutan Pengelolaan Das Mandar Di Sulawesi Barat, Indonesia
Authors:   Program Studi Kehutanan, Fakultas Pertanian dan Kehutanan, Universitas Sulawesi Barat, Jl. Prof. Baharuddin Lopa, Talumung, Majene, 91214, Indonesia, Ritabulan Ritabulan , Rosmaeni Rosmaeni ,   Program Studi Kehutanan, Fakultas Pertanian dan Kehutanan, Universitas Sulawesi Barat, Jl. Prof. Baharuddin Lopa, Talumung, Majene, 91214, Indonesia, Alim Nurmaranti ,   Program Studi Agroekoteknologi, Fakultas Pertanian dan Kehutanan, Universitas Sulawesi Barat, Jl. Prof. Baharuddin Lopa, Talumung, Majene, 91214, Indonesia
Published: November 2022

Mandar River is an important cultural entity for the Mandar community in West Sulawesi, in fact, faces threats such as floods and landslides. To support the government's efforts in achieving the Sustainable Development Goals  (SDGs), the management of Mandar Watershed needs to integrate the ecological, economic, social, institutional, and technological dimensions. This study aims to: (1) measure the status of the sustainability of the Mandar Watershed; and (2) identify the factors that influence the sustainability of the Mandar watershed management. This  research used the method of observation, interviews, documentation study, and literature review. Data analysis used a descriptive analysis approach and Multidimensional Scaling (MDS) analysis with analysis tools suc as rapfish  /  rapDASMandar.  The  results  showed  that  the  sustainability  status  of  watershed management in the ecological dimension was quite sustainable; on the social and institutional dimensions, it is categorized as less sustainable; and in the economic and technological dimensions, the upstream and middle Mandar sub-watersheds are categorized  as less sustainable. The multidimensional sustainability status of Mandar watershed management is categorized as less sustainable. There are 13 factors that need attention to improve the sustainability status of Mandar watershed  management, especially in the technological, institutional, and social dimensions.
Kebijakan Perlindungan Ekosistem Gambut Di Indonesia: Pengendalian Kebakaran Hutan Dan Lahan Pasca 2015
Authors:   Fakultas Ilmu Administrasi, Universitas Lancang Kuning, Jl. Yos Sudarso No.KM. 8, Umban Sari, Kec. Rumbai, Kota Pekanbaru, Riau 28266, Indonesia, Z,                                                       Z Afni , DH Triono ,   Fakultas Ilmu Budaya, Universitas Lancang Kuning, Jl. Yos Sudarso No.KM. 8, Umban Sari, Kec. Rumbai, Kota Pekanbaru, Riau 28266, Indonesia, Amelia Vita ,   Fakultas Ilmu Budaya, Universitas Lancang Kuning,  Jl. Yos Sudarso No.KM. 8, Umban Sari, Kec. Rumbai, Kota Pekanbaru, Riau 28266, Indonesia
Published: November 2022

The peat protection policy has been in place for more than two decades, but fires are still recurring in peatlands.  This  study  examines  the  peat  ecosystem  protection  policy  in  Indonesia,  before  and  after  2015.  The  qualitative  research method relies on historical policy data and empirical data. The results show that before 2015 the use of peat was oriented towards economic growth, and after 2015 the policy orientation was towards sustainable use of peat. There has been a shift in the working paradigm of forest and land fire control from extinguishing to prevention. In addition to corrective policy measures, corrective actions have also taken place to protect peat ecosystems in the  field (corrective action).
The Relationship between Ambient Fine Particulate Matter (PM2.5) Pollution and Depression: An Analysis of Data from 185 Countries
Authors: Rajkumar Ravi Philip
Published: November 2022

Several studies have identified a relationship between air pollution and depression, particularly in relation to fine particulate matter (PM2.5) exposure. However, the strength of this association appears to be moderated by variables such as age, gender, genetic vulnerability, physical activity and climatic conditions, and has not been assessed at a cross-national level to date. The current study examines the association between the prevalence of depression in each country, based on the most recent Global Burden of Disease Study data, and the average national level of PM2.5 based on the World Health Organization’s database. The observed associations were adjusted for age, gender, level of physical activity, income, education, population density, climate, and type of depression. It was observed that there was a modest but significant positive correlation between PM2.5 level and the prevalence of depression even after adjusting for the above confounders. This association was more marked above a certain threshold and applied chiefly to major depressive episodes. These findings are of significant public health importance in terms of preventive strategies aimed at reducing the population-level burden of depression.
Assessment of Nutritional Status and Risk of Malnutrition Using Adapted Standard Tools in Patients with Mental Illness and in Need of Intensive Psychiatric Treatment
Authors: Risch Ladina , Hotzy Florian , Vetter Stefan , Hiller Sascha , Wallimann Kathrin , Seifritz Erich , Mötteli Sonja
Published: November 2022

People with severe mental illness (SMI) are often in poor physical health, resulting in higher mortality and reduced life expectancy compared to the general population. Although eating habits are one of the main predictors of physical health, few studies assess the nutritional status and eating behaviour of people with SMI. The aim of this study was to examine the nutritional status and risk of malnutrition in people with SMI and in need of intensive psychiatric treatment. The cross-sectional study included 65 inpatients and 67 outpatients with psychotic or depressive disorders from the Psychiatric Hospital of the University of Zurich. Patients’ assessments at admission included anthropometric measurements, such as weight and height, and interview data including severity of symptoms and functioning (SCL-K-9, PHQ-D, CGI, m-GAF), personal and medical data, nutrition risk screening tools (adapted NRS, MNA-SF) and laboratory values. The results showed that 32% of the inpatients (body mass index [BMI] = 25.3) and 34% of the outpatients (BMI = 27.9) were at risk of malnutrition, which was associated with higher levels of psychiatric symptoms and lower levels of functioning. These results indicate that a substantial proportion of psychiatric patients seem to be at risk of malnutrition, despite most being overweight, and hence they might benefit from nutritional support during their psychiatric treatment. Moreover, nutritional risk screening tools specifically developed for the mental healthcare setting are needed.
Hourly Water Level Forecasting in an Hydroelectric Basin Using Spatial Interpolation and Artificial Intelligence
Authors: Tucci Mauro
Published: November 2022

In this work a new hydroelectric basin modelling approach is described and applied to the Pontecosi basin, Italy. Several types of data sources were used to learn the model: a number of weather stations, satellite observations, Reanalysis dataset and basin data. With the goal of predicting the water level of the basin, the model was composed by three cascade modules. Firstly, different spatial interpolation methods, such as Kriging, Radial Basis Function and Natural Neighbours, were compared and applied to interpolate the weather stations data nearby the basin area to infer the main environmental variables (air temperature, air humidity, precipitation and wind speed) in the basin area. Then, using these variables as inputs, a neural network was trained to predict the mean soil moisture concentration over the area, also to improve the low availability due to satellite orbits. Finally, a non-linear auto regressive exogenous input (NARX) model was trained to simulate the basin level with different prediction horizons, using the data from the previous modules and past basin data (water level, discharge flow rate, turbine flow rate). Accurate predictions of the basin water level were achieved within 1 to 6 hours ahead, with mean absolute errors (MAE) between 2cm and 10cm respectively.
Velocity of Light through a Moving Medium Applied to the Fizeau Experiment
Authors: Filipescu Filip Dambi
Published: November 2022

Light travels in a moving medium through densities that differ from the density of that medium at rest. This study derives a formula for light velocity through a moving medium for any direction of light propagation in that medium that, applied to the Fizeau experiment, gives a fringe shift of 0.23541. The Fresnel drag coefficient applied to the Fizeau experiment offers a fringe shift of 0.20466. The mean of the fringe shift observations in the Fizeau experiment of 0.23016 confirms both expectations.
Which Mode Will Be Effective in a Massive Evacuation?
Authors: Lee Jun , Kim Jae Hun ,   The Korea Transport Institute 370 Sicheong-daero, Sejong 30147, Korea,   Hanyang University, Gyeonggi-do, Korea
Published: November 2022

The earthquake which struck Eastern Japan in 2011 caused many casualties. The ratio of the mode of evacuation in areas damaged by the earthquake varied depending on geographical conditions, but cars were the primary mode in many areas. Although the Japanese government has provided guidelines to assist evacuation during a natural disaster, the disaster in 2011 demonstrated that the behavior of refugees did not adhere to these guidelines. This study analyzes refugees’ behavior during evacuations using a dataset gathered through surveys of refugees in 2011. By analyzing their evacuation speed and distance based on their geographical conditions, the necessary distance and available distance for their evacuation are calculated in this study, following which an optimized distance for evacuation is derived. Analyzing various modes of evacuation, such as walking, bicycling, and car travel, this study identifies thresholds for an efficient mode of evacuation based on evacuation distance. In conclusion, this study finds that a walking-based evacuation plan is necessary in most areas, whereas vehicles are required in areas where it is impossible to evacuate by walking.
Development of augmented reality integrated physics e-worksheet to improve students' problem-solving skills
Authors: Suryanto Rosalita Anggi , Dewi Poppy Sari , Rosana Dadan
Published: November 2022

The STEM approach through the augmented reality usage can provide visualization to students in online learning. The purposes of this research are to develop Physics E-Worksheet based on STEM using augmented reality system, and to improve the problem-solving skills of high school students on Momentum and Impulse material. The type of research used is research and development (R&D) with a 4D model (define, design, develop and disseminate). This study involved 24 students as a field trial class and 31 students in class X as a field operational class. The results of this study are: This Physics AR E-Worksheet is valid and reliable for use in the physics learning process for Momentum and Impulse material based on the results of validation analysis using an average value of a scale of four with a score of 3.73 in very good criteria. The results of the Paired T-Test analysis showed the value of Sig. 0.00, so that there is an effect of using AR Physics E-Worksheet on improving problem-solving skills of high school students. The score of Normalized Gain obtained 0.77 in high category improvement. The results showed that the AR Physics E-Worksheet was effective in improving problem solving skills so that it could be used as a learning medium for the Momentum and Impulse topic by class X science students.
Numerical analysis of dike effects on the Mississippi River using a two-dimensional Adaptive Hydraulics model (AdH)
Authors: McKnight C. , May David , Jones Keaton
Published: November 2022

This report describes the hydraulic effects of dikes on water surface elevation (WSE) and velocities in the Mississippi River near Vicksburg, MS, from Interstate 20 to Highway 80 using a previously calibrated 2D Adaptive Hydraulics numerical model. Dike heights and their associated hydraulic roughness values were varied to quantify the overall effects of adjustments to dike fields. Steady flows characterized as low, medium, and high conditions were simulated. The WSE and velocity difference plots were generated to illustrate the hydraulic effects on the river under all scenarios discussed above. Overall, the dike adjustments had negligible impacts on WSEs and showed minimal effects on velocities on a system-wide scale.
Automation of gridded HEC-HMS model development using Python : initial condition testing and calibration applications
Authors: Matus Sean , Gambill Daniel
Published: November 2022

The US Army Corps of Engineers’s (USACE) Hydrologic Engineering Center-Hydrologic Modeling System (HEC-HMS) rainfall-runoff model is widely used within the research community to develop both event-based and continuous rainfall-runoff models. The soil moisture accounting (SMA) algorithm is commonly used for long-term simulations. Depending on the final model setup, 12 to 18 parameters are needed to characterize the modeled watershed’s canopy, surface, soil, and routing processes, all of which are potential calibration parameters. HEC-HMS includes optimization tools to facilitate model calibration, but only initial conditions (ICs) can be calibrated when using the gridded SMA algorithm. Calibrating a continuous SMA HEC-HMS model is an iterative process that can require hundreds of simulations, a time intensive process requiring automation. HEC-HMS is written in Java and is predominantly run through a graphical user interface (GUI). As such, conducting a long-term gridded SMA calibration is infeasible using the GUI. USACE Construction Engineering Research Laboratory (CERL) has written a workflow that utilizes the existing Jython application programming interface (API) to batch run HEC-HMS simulations with Python. The workflow allows for gridded SMA HEC-HMS model sensitivity and calibration analyses to be conducted in a timely manner.
Clasificación de la canal del cuy en recría mediante indicadores biométricos en una granja comercial
Authors:   , Mosto Travezan Gianfranco
Published: November 2022

La falta de información sobre los índices biométricos y la alta variabilidad en los pesos de las carcasas comerciales en la carcasa de cuy, nos plantea un problema a resolver con el presente estudio. El objetivo de esta investigación fue asociar las medidas biométricas con el peso de la carcasa del cuy, para establecer una clasificación a partir de la asociación de la variabilidad del peso de la canal mediante indicadores anatómicos. Así mismo, se evaluó el efecto del sexo, edad al beneficio (8,10,12 y más de 12 semanas), tamaño de camada y peso vivo antes del beneficio sobre el peso de 129 canales comerciales de cuy, como variables explicativas. Se utilizó el proceso estadístico “Stepwise regression” para evaluar la asociación de las medidas biométricas que explican mejor el peso de carcasa ajustado. En esta se indicó que el valor significante de la circunferencia de nalga (LN) (p˂.0001), el peso vivo antes del beneficio (wvi) (p˂.0001) y peso al destete (wdest) (p=0.0434) tienen un mayor efecto en la variabilidad del peso de la carcasa del cuy (wcar). En conclusión, la longitud de la circunferencia de nalga fue el indicador biométrico más importante que explica las variaciones del peso de la canal.
Why Ethiopian Meat is Considered Dark Cutting and Unsuitable for the Export Market: Lessons Learnt from the Livestock Chain
Authors: Muleta Birmaduma Gadisa , Dida Mulisa Faji , Kiani Ali , Mapiye Cletos , Bruce Heather , Ponnampalam Eric
Published: November 2022

Dark-cutting (DC), also known as dark, firm, and dry (DFD) meat is one of the major challenges confronting the Ethiopian meat industry. A large percentage of carcasses from Ethiopia animals (cattle and shoats) are rejected in domestic and international markets due to DC. The current review highlights the factors that predispose animals to DC in Ethiopia. Overall, DC in Ethiopia is caused by a combination of on-farm and off-farm factors. The major on-farm factors include disease, animal nutrition, production system, age at slaughter, sex, breed, genetics, and management. Off-farm activities include stress experienced during transport, in lairage, or at slaughter such as unusual noise, mixing with unfamiliar animals, overcrowding, beating, vibration, restraint, deprivation of feed and water, adverse weather conditions, fighting in lairage, and stunning. However, DC meat is a dynamic condition that can be handled by humane animal handling and management, appropriate training of abattoir staff and tradesmen, creating awareness for all stakeholders and appropriate transport and slaughter regulations.
Discovering the rheology of Antarctic Ice Shelves via physics-informed deep learning
Authors: Wang Yongji , Lai Ching-Yao , Cowen-Breen Charlie
Published: November 2022

Ice shelves are floating extensions of grounded ice and play a crucial role in slowing ice discharge into the ocean. Ice flows in response to stresses according to the flow law, which is essential for predicting the mass loss of ice sheet. Laboratory experiments have shown that polycrystalline ice obeys Glen’s flow law, a power-law relation between the stress and strain rate that has been applied to ice-sheet models for decades. However, it remains unclear how processes at ice-shelf scales impact the flow law, i.e. rheology, of glacial ice. Here, we reveal the rheology of glacial ice in Antarctic Ice Shelves leveraging the availability of remote-sensing data and physics-informed deep learning. We find that the rheology of ice shelves differs substantially between the compression and extension zones. In the compression zone near the grounding line the rheology of ice closely obeys power laws with exponents in the range 1 < n < 3, consistent with prior laboratory experiments. In the extension zone, which comprises most of the total ice-shelf area, the rheology deviates from laboratory findings and does not follow a clear trend. Our result highlights a need to examine the impact of ice-shelf scale processes on glacial rheology.
Preimplantation genetic testing for aneuploidy helps to achieve a live birth with fewer transfer cycles for the blastocyst FET patients with unexplained recurrent implantation failure
Authors: Wang Sidong , Liu Luochuan , Ma Minyue , Wang Hui , Han Yibing , Guo Xinmeng , Yeung William S B , Cheng Yanfei , Zhang Huiting , Dong Fengming , Zhang Bolun , Tian Ye , Song Jiangnan , Peng Hongmei , Yao Yuanqing
Published: November 2022

Purpose: This retrospective cohort study aimed to investigate the value of preimplantation genetic testing for aneuploidy (PGT-A) as a screening test for patients suffered from unexplained recurrent implantation failure (RIF).
Methods: After screening patients in one reproductive medicine center, twenty-nine, eighty-seven and thirty-eight women (<40-year-old) who had suffered unexplained RIF with PGT-A, or RIF without PGT-A, or no RIF with PGT-A were included. The clinical pregnancy rate and live birth rate per transfer, the conservative and optimal cumulative clinical pregnancy rates (CCPR) and live birth rates (CLBR) after three blastocyst FETs were analyzed.
Results: The live birth rate per transfer was significantly higher in the RIF+PGT-A group than that in the RIF+NO PGT-A group (47.4% vs 31.6%) after adjusting the confounder (the maternal age). After 3 cycles of FET, RIF+PGT-A group had a significantly higher conservative cumulative live birth rate (CLBR) compared to the RIF+PGT-A group (69.0% vs 42.5%, odds ratio [OR] 3.777, p=0.005), but had similar CLBR compared to the NO RIF+PGT-A group (69.0% vs 81.6%). The optimal CLBR in the RIF+PGT-A patients was similar to those in the other 2 groups. The miscarriage rate per clinical pregnancy was not different between the RIF+PGT-A and RIF+NO PGT-A, RIF+PGT-A and NO RIF+PGT-A groups.
Conclusion: Although PGT-A could land on the non-beneficial side after three blastocyst FETs, it did be superior in reducing the number of transfer cycles required to achieve a similar live birth rate. Further studies to identify the RIF patients who would benefit most from PGT-A are necessary.
How to reach agreement: the impact of different analytical approaches to Delphi process results in core outcomes set development
Authors: Webbe James , Allin Benjamin , Knight Marian , Modi Neena , Gale Chris
Published: November 2022

Background: Core outcomes sets are increasingly used to define research outcomes that are most important for a condition. Different consensus methods are used in the development of core outcomes sets; the most common is the Delphi process. Delphi methodology is increasingly standardised for core outcomes set development, but uncertainties remain. We aimed to empirically test how the use of different summary statistics and consensus criteria impact Delphi process results.
Methods: Results from two unrelated child health Delphi processes were analysed. Outcomes were ranked by mean, median, or rate of exceedance, and then pairwise comparisons were undertaken to analyse whether the rankings were similar. The correlation coefficient for each comparison was calculated, and Bland-Altman plots produced. Youden’s index was used to assess how well the outcomes ranked highest by each summary statistic matched the final core outcomes sets.
Consensus criteria identified in a review of published Delphi processes were applied to the results of the two child-health Delphi processes. The size of the consensus sets produced by different criteria was compared, and Youden’s index was used to assess how well the outcomes that met different criteria matched the final core outcomes sets.
Results: Pairwise comparisons of different summary statistics produced similar correlation coefficients. Bland-Altman plots showed that comparisons involving ranked medians had wider variation in the ranking. No difference in Youden’s index for the summary statistics was found.
Different consensus criteria produced widely different sets of consensus outcomes (Range: 5-44 included outcomes). They also showed differing abilities to identify core outcomes (Youden’s index Range: 0.32-0.92). The choice of consensus criteria had a large impact on Delphi results.
Discussion: The use of different summary statistics is unlikely to affect how outcomes are ranked during a Delphi process: mean, median and rates of exceedance produce similar results. Different consensus criteria have a large impact on resultant consensus outcomes and potentially on subsequent core outcomes sets: our results confirm the importance of adhering to pre-specified consensus criteria.
Factors affecting the level of medication adherence to anti-diabetic treatment: A multi-center cross-sectional study in Eastern Bhutan
Authors: Wangchuk Tashi , Norbu Phuntsho
Published: November 2022

Purpose: Diabetes Mellitus (DM) has affected millions of people worldwide. Medication adherence to long-term treatment of DM is a health major concern. Globally, the level of adherence to anti-diabetic treatment is low. Its risk factors have been extensively discussed elsewhere, however, in Bhutan, there is an insufficient scientific record on the level of anti-diabetic adherence. This study aimed to find the level of medication adherence to anti-diabetic treatment and identify its risk factors.
Methods: A multicenter cross-sectional observational study was conducted at six eastern district hospitals from June 2019 to February 2020. Participants of the research were from the daily cohort of patients visiting diabetic clinics.
Results: Out of 390 research subjects analyzed in this study, the overall level of adherence was an intermediate level with a mean Morisky score of 6.06 (95% CI 5.91-6.22). Of the total, 57.7% of participants had either a high or an intermediate level of adherence. For risk factors, the presence of adverse drug reactions and the type of drug regimen (polypharmacy or monotherapy) had a statistically significant (p<0.05) association with the mean Morisky scores.
Conclusions: The eastern region of Bhutan stood at an intermediate level of medication adherence to anti-diabetic treatment. The presence of adverse drug reactions and the type of drug regimen affected the level of adherence however, further studies are needed to draw a definitive conclusion.
Recent advances in the delivery and applications of nonviral CRISPR/Cas9 gene editing
Authors: Sinclair Frazer , Begum Anjuman Ara , Dai Charles Chuankai , Toth Istvan , Moyle Peter Michael
Published: November 2022

The CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 genome editing system has been a major technological breakthrough that has brought revolutionary changes to genome editing for therapeutic and diagnostic purposes and precision medicine. With the advent of the CRISPR/Cas9 system, one of the critical limiting factors has been the safe and efficient delivery of this system to cells/tissues of interest. Several approaches have been investigated to find delivery systems that can attain tissue-targeted delivery, lowering the chances of off-target [PM2] editing. While viral vectors have shown promise for in vitro, in vivo and ex vivo delivery of CRISPR/Cas9; further clinical applications have been restricted due to shortcomings including: limited packaging capacity, difficulties with large-scale production, immunogenicity and insertional mutagenesis. Rapid progress in nonviral delivery vectors, including the use of lipid, polymer, peptide and inorganic nanoparticle-based delivery systems, has established nonviral delivery approaches as a viable alternative to viral vectors. This review will introduce the molecular mechanisms of the CRISPR/Cas9 gene editing system, current strategies for delivering CRISPR/Cas9-based tools, an overview of strategies for overcoming off-target genome editing, and approaches for improving sequence targeting, genome targeting and tissue targeting. We will also highlight current developments and recent clinical trials for the delivery of CRISPR/Cas9. Finally, future directions for overcoming the limitations and adaptation of this technology for clinical trials will be discussed.
Impact of non-muscle cutting periumbilical transverse incision on the risk of incisional hernia as compared to midline incision during laparoscopic colon cancer surgery: A study protocol for a multi-centre randomised controlled trial
Authors: Park Soo Yeun , Kim Changhyun , Ha Gi Won , Lee Soo Young , Son Gyung Mo
Published: November 2022

Background

Minimally invasive surgery has become popular as a surgical approach for colorectal cancer, contributing to fewer complications related to abdominal incision and perioperative complications. However, the incidence of incisional hernias in laparoscopic surgery has been reported to be similar to that in open surgery. We developed a new method, non-muscle cutting periumbilical transverse incision, for small incision in laparoscopic colon cancer surgery. This study aims to evaluate the effectiveness of non-muscle cutting transverse incision in reducing the risk of incisional hernia in comparison with midline incision.

Methods/analysis

This multi-centre, open-label, parallel, superiority, randomised trial will compare the effectiveness of non-muscle cutting periumbilical transverse incision with that of midline incision on the incidence of incisional hernia in patients undergoing laparoscopic colon cancer surgery. Altogether, 174 patients will be allocated in a 1:1 ratio either the midline incision or non-muscle cutting periumbilical transverse incision group, after stratifying by the location of the tumour (right-sided/left-sided). The primary outcome of this study is the incidence of incisional hernia (both symptomatic and radiologic hernias) at 12 months after surgery. The secondary outcomes include operative outcomes, 30-day postoperative complications, pathological results, and patient-reported outcomes (Short-Form-12 Health Survey Questionnaire and Body Image Questionnaire). Both primary (intention-to-treat) and secondary analyses (as-treat principles) will be performed for all outcomes. Statistical significance is set at a p value < 0.05 (two-sided testing).

Discussion

This trial may provide evidence on the non-muscle cutting transverse incision will reduce the incidence of incisional hernia, as compared to midline incision.

Trial registration number

KCT0006082, registered on April 12, 2021
Time-dependent estimation of origin-destination matrices using partial path data and link counts
Authors: Vahidi Milad , Shafahi Yousef
Published: November 2022

The precise estimation of time-varying demand matrices using traffic data is an essential step for planning, scheduling, and evaluating advanced traffic management systems (ATMS). This paper presents an innovative method (based on the least squares approach) to deal with the inherent complexities in estimating the dynamic characteristics of changing demand flow over time and considering congestion conditions. The time-dependent Origin-Destination (OD) demand matrices of the network are estimated by exploitation of the received partial paths data from an automated vehicle identification (AVI) system, and vehicle counts data from loop detectors on a subset of the links. A traffic assignment approach based on partial paths is embedded into the measurement equations of the least squares model. For all time intervals, the relation between the variable aspects of congestion (the temporal and spatial distribution of the OD traffic flows) is established by their variance-covariance matrices. The LSQR algorithm, an iterative algorithm that is logically equivalent to the conjugate gradient method, is employed for solving the proposed least squares problem. Numerical examples performed on three different approaches (only link counts data, only partial path flows data, and both of them) show that using the variance-covariance matrices is more precise for estimating time-dependent OD matrices. The Sioux Falls network is presented to examine the solution algorithm’s effectiveness and the model’s main ideas. This paper reports the features of the discussed model based on synthetic data as proof of concept that using partial path flows significantly improves the results for solving time-dependent OD matrices estimation problems.
Migration-agglomeration-lockup of metal particles in zeolite for ultra-stable propane dehydrogenation catalysts
Authors: Zhu Haibo , Xu Zhikang , Gao Mingbin , Yue Yuanyuan , Bai Zhengshuai , Yuan Pei , Ye Mao , Fornasiero Paolo , BASSET JEAN , Bao Xiaojun
Published: November 2022

Propane dehydrogenation (PDH) over Pt catalyst operated in a moving-bed mode is becoming the dominant process for the on-purpose production of propylene worldwide1-3. Sintering and coking deactivations of Pt catalysts, which greatly decrease the durability and efficiency of this scarce and costly noble metal, are the most challenging issues for the sustainable development of the PDH process4. Even after over half a century of efforts, the development of long-term durable Pt catalysts that are feasible for more economic and efficient fixed-bed operation remains as a formidable task5-10. Herein we report a strategy to modulate the migration-agglomeration-lockup of Pt particles in zeolite silicalite-1 (S-1) for synthesizing highly sintering- and coking-resistant (Pt-Sn2)2@S-1 PDH catalysts. It is found that the migration of Pt-Sn2 clusters in S-1 crystals during the PDH reaction leads to a competition between intra-crystalline agglomeration and external-surface agglomeration of Pt-Sn2 clusters. We show that, when the b-axis length of S-1 crystals is longer than 2 μm, the intra-crystalline agglomeration becomes dominant over the external-surface agglomeration, resulting in the formation of ultra-stable (Pt-Sn2)2@S-1 in which the (Pt-Sn2)2 dimers are securely locked in the channels of S-1 crystals. The long-term durability (4500 hours or about 6 months on stream without perceptible deactivation tendency) of (Pt-Sn2)2@S-1 is at least three orders of magnitude higher than that of the best catalyst reported, which is expected to bring about a breakthrough in revolutionizing the moving-bed operation of the current PDH process to fixed-bed operation. We anticipate that modulating metal migration-agglomeration-lockup within zeolite can act as a general strategy for the synthesis of durable noble metal catalysts, which is beneficial to greatly maximizing the service lifetime of noble metals in industry application11-15.
Synergetic-PI controller based on genetic algorithm for DPC-PWM strategy of a multi-rotor wind power system
Authors: Benbouhenni Habib , Gasmi Hamza , Colak Ilhami , Bizon Nicu , Thounthong Phatiphat
Published: November 2022

This work designs a powerful new nonlinear method using synergetic control (SC), proportional-integral (PI) controller, and genetic algorithm (GA) for multi-rotor wind energy (MRWE) conversion systems, whereby an asynchronous generator is used to achieve optimal energy extraction. The direct power control (DPC) is used based on the proposed synergetic-PI-GA (SPI-GA) method to control the generator in a MRWE system, where this new nonlinear technique is used to achieve stable control characteristic under random changes in wind speed and to provide great robustness against modeling uncertainties. Moreover, the pulse width modulation (PWM) technique is used to control the generator inverter due to its simplicity and ease of implementation. In this proposed DPC-SPI-GA method, we need to measure current and voltage to estimate the active power and the reactive power. Also, inner loops are not used in this proposed DPC-SPI-GA method as is the case in the field-oriented control (FOC) method, where the proposed system in this work is characterized by an integrated structure. Three different tests are proposed to study and verify the behavior of the designed DPC-SPI-GA strategy compared to the DPC technique.
Feasibility of oral doxycycline as first-line therapy for conjunctival mucosa-associated lymphoid tissue lymphoma
Authors: Choi Se Hyun , Yang Min Kyu , Kim Tae Min , Choi Hyuk Jin
Published: November 2022

Objectives: To investigate the long-term outcomes of oral doxycycline as first-line treatment in patients with conjunctival extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) MALT lymphoma.
Methods: In this case series, the medical records of 67 patients with conjunctival MALT lymphoma who received doxycycline as their primary treatment and were followed up for at least 5 years were retrospectively reviewed. Progression-free survival (PFS) was analyzed at 3, 5, and 10 years after the initial doxycycline treatment. A Cox proportional hazards model was used to assess the independent risk factors for progression.
Results: After the initial treatment, 25 patients(37.3%) achieved complete response, 8 patients(11.9%) achieved partial response, 30 patients(44.8%) showed stable disease, and 4 patients(6.0%) showed disease progression. The median PFS in all patients was 168 months, and the 3-, 5- and 10-year PFS rates for all patients were 70%, 65%, and 62%, respectively. No further progression was observed 6 years after the initial doxycycline treatment. Older age and TNM stage T1c were significant risk factors for the time to progression in the multivariate Cox regression analysis (p<0.05). Additional doxycycline (> 2 cycles) showed no benefit. There were no serious adverse events associated with doxycycline therapy, and most patients were successfully salvaged by the current best treatment modalities.
Conclusion: In this case series, oral doxycycline treatment showed acceptable long-term PFS with minimal complications. Especially in patients with stage T1a or T1b conjunctival MALT lymphoma, first-line doxycycline treatment could be considered under close monitoring for at least 6 years.
Optimal therapy for concomitant EGFR and TP53 mutated non-small cell lung cancer: A real- world study
Authors: Sun Haiyan , Ren Peng , Chen Yongzi , Lan Lan , Yan Zhuchen , Yang Yinli , Wang Bin , Wang Cong , Li Yanwei , Li Ling , Zhang Yu , Li Yanyang , Wang Zuolin , Pan Zhanyu , Jiang Zhansheng
Published: November 2022

Background
Concomitant TP53 mutation results in poor prognosis in patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) treated with tyrosine kinase inhibitors (TKIs) and may preferentially benefit from a combination regimen. The present study aims to compare the benefits of EGFR-TKIs and its combination with antiangiogenic drugs or chemotherapy in patients with NSCLC harboring EGFR and TP53 co-mutation in a real-life setting.
Methods
This retrospective analysis included 124 patients with advanced NSCLC having concomitant EGFR and TP53 mutations, who underwent next-generation sequencing prior to treatment. Patients were classified into the EGFR-TKI group and combination therapy group. The primary endpoint of this study was progression-free survival (PFS). Kaplan–Meier (KM) curves were plotted to analyze PFS, and log-rank test was used to compare differences between groups. Univariate cox regression analysis was performed on the risk factors associated with survival.
Results
The combination group included 72 patients who received the regimen of EGFR-TKIs combined with antiangiogenic drugs or chemotherapy, while the EGFR-TKI monotherapy group included 52 patients treated with TKI only. The median PFS was significantly longer in the combination group than in the EGFR-TKI group (18.0 months; 95% confidence interval [CI]: 12.1–23.9 vs. 7.0 months; 95% CI: 6.1–7.9; p < 0.001) with greater PFS benefit in TP53 exon 4 or 7 mutations subgroup. Subgroup analysis showed a similar trend. The median duration of response was significantly longer in the combination group than in the EGFR-TKI group. Patients with 19 deletions or L858R mutations both achieved a significant PFS benefit with combination therapy versus EGFR-TKI alone.
Conclusions
Combination therapy had a higher efficacy than EGFR-TKI alone for patients with NSCLC having concomitant EGFR and TP53 mutations. Future clinical trials are needed to determine the role of combination therapy for this patient population.
Research Capacity, Motivators and Barriers to Conducting Research Among Healthcare Providers in Tanzania’s Public Health System: A Mixed Methods Study
Authors: Kengia James Tumaini , Kalolo Albino , Barash David , Chwa Cindy , Hayirli Tuna Cem , Kapologwe Ntuli A. , Kinyaga Ally , Meara John G. , Staffa Steven J. , Zanial Noor , Alidina Shehnaz
Published: November 2022

Background: Building and strengthening health research capacity in low- and middle-income countries is essential to achieving universal access to safe, high-quality healthcare. It can enable healthcare workers to conduct locally relevant research and apply findings to strengthen their health delivery systems. However, lack of funding, experience, know-how, and weak research infrastructures hinders their ability. Understanding research capacity, engagement, and contextual factors that either promote or obstruct research efforts by healthcare workers can inform national strategies aimed at building research capacity.
Methods: We used a convergent mixed-methods study design to understand research capacity and engagement of healthcare workers in Tanzania’s public health system, including the barriers, motivators, and facilitators to conducting research. Our sample included 462 randomly selected healthcare workers from 45 facilities. We conducted surveys and interviews to capture data in five categories: 1) research capacity; 2) research engagement; 3) barriers, motivators, and facilitators; 4) interest in conducting research; and 5) institutional research capacity. We assessed quantitative and qualitative data using frequency and thematic analysis respectively; we merged the data to identify recurring and unifying concepts.
Results: Respondents reported low experience and confidence in quantitative (34% and 28.7% respectively) and qualitative research methods (34.5% and 19.6% respectively). Less than half (44%) of healthcare workers engaged in research. Engagement in research was positively associated with: working at a District Hospital or above (p=0.006), having a university degree or more (p=0.007), and previous research experience (p=0.001); it was negatively associated with female sex (p=0.033). Barriers to conducting research included lack of research funding, time, skills, opportunities to practice, and research infrastructure. Motivators and facilitators included a desire to address health problems, professional development, and local and international collaborations. Almost all healthcare workers (92%) indicated interest in building their research capacity.
Conclusion: Individual and institutional research capacity and engagement among healthcare workers in Tanzania is low, despite high interest for capacity building. We propose a four-fold pathway for building research capacity in Tanzania through 1) high-quality research training and mentorship; 2) strengthening research infrastructure, funding, and coordination; 3) implementing policies and strategies that stimulate research engagement; and 4) strengthening local and international collaborations.
Corticosteroid in anti-inflammatory treatment of pediatric acute myocarditis: a systematic review and meta-analysis
Authors: Yao Qi , Zhan Shanshan
Published: November 2022

Background. To evaluate the efficacy of corticosteroids in anti-inflammatory treatment of pediatric acute myocarditis.
Methods. We searched PubMed, Embase and Cochrane library and included studies before October 2022 for clinical trials, observational studies and retrospective studies which reported on children with acute myocarditis treated with corticosteroid anti-inflammatory therapy. The quality of the clinical trials was assessed by Jadad score as an exclusion criterion.
Results. This systematic review included 6 studies involving 604 pediatric patients with acute myocarditis. Corticosteroid therapy was not associated with reduced risk of mortality due to acute myocarditis (P = 0.53; RR = 0.87; 95% CI = 0.58 to 1.33) compared to anti-failure treatment. There was a significant improvement in pediatric patients’ left ventricular function measured by left ventricular ejection fraction in the group on corticosteroid anti-inflammatory treatment (P = 0.0009; MD = 11.93%; 95% CI = 4.87% to 18.99%). No conclusion can be drawn due to the high heterogeneity in meta-analyses of risk of getting to a clinical endpoint (death or heart transplantation) and changes in left ventricular end-diastolic diameter (LVEDD).
Conclusions. Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis patients showed no significant improvement in reducing the risk of mortality, but showed significant improvement in LVEF.