bluuebunny/crossref_metadata_2025 huggingface dataset:
Cáncer de cervix
Authors: Amorocho Néstor H. , Arturo R. María Cecilia
Published: May 2020

1.Se presenta la incidencia total de cáncer para los años 1983-1984 en el hospital San Juan de Dios de Cali, Colombia, clasificando los casos por sexo y órganos o sistemas afectados.2.Se establece comparación con similar trabajo realizado por uno de los autores diez años atrás, 1973-1974, en el mismo centro hospitalario.3.Se encontró que el cáncer de cervix, sin considerar estadio, ocupa el segundo lugar de frecuencia en la incidencia de cáncer femenino para los años 1983 y 1984 y el primer lugar en el área genital propiamente dicha, 23.48% para los mismos años.4.Se encontró una baja franca en la incidencia de ca. de cervix I — IV frente a los hallazgos diez años atrás (1973) y en el mismo lapso, disminución significativa de ca. de cervix in situ, en favor de aumento en el diagnóstico de displasia.5.La conducta quirúrgica seguida en el hospital de San Juan de Dios de Cali, omitiendo la conización de rutina, en el manejo del ca. de cervix in situ, para confirmar el diagnóstico y llevar la paciente a cirugía, sigue siendo un buen procedimiento y sustenta la tesis planteada en 1975, puesto que el margen de error prácticamente no existe ahora.6.No se desconoce el valor de la colposcopia para hacer biopsia dirigida en casos de citología III o mayor. La falta de recurso humano y equipo en este campo no permite la secuencia lógica: citología-biopsia dirigida por colposcopia, conización, diagnóstico, tratamiento. En cambio se sigue usando el Test de Schiller con buenos resultados. Creemos que la pericia de nuestros Patólogos-Citólogos, es suficientemente confiable para decidir la conducta planteada.7.El hospital de San Juan de Dios de Cali, funciona como centro de referencia, siguiendo las normas del Servicio de Salud del Valle y la concentración de citologías vaginales grado III a V (70.16%), procedentes de Centros de Salud, demuestra un seguimiento adecuado de los casos en el programa de detección de cáncer cervical uterino.8.Los parámetros Edad-Paridad, de nuestras pacientes frente a la incidencia de neoplasia intraepitelial, ca. de cervix in situ y ca. de cervix invasor, no difieren de los encontrados por otros autores.9.La citología vaginal, más difundida ahora y una mayor concientización de las mujeres para hacer este examen periódico, es el mejor método para la detección precoz de patología cervical.
Manejo quirúrgico de las alteraciones mamarias
Authors: Del Corral Fernando , Botero T. Augusto
Published: May 2020

Se estudiaron 126 pacientes sometidas a cirugía del seno. En ellas se encontraron seis entidades diferentes teniendo algunas pacientes más de una alteración uni o bilateral; para un total de 141 casos estudiados. Las alteraciones clínicas más frecuentes encontradas sobre 106 casos fueron, la Displasia mamaria 68 casos, 64% y el fibroadenoma con 27 casos, 25.5%. Se hizo especial énfasis en el fracaso con el tratamiento médico de la displasia y en su gran tendencia a la recurrencia o perseverancia siendo necesario reintervenir quirúrgicamente 17 de 68 pacientes (25%). Se encontró Carcinoma en 3 casos (3.8%), que con diagnóstico de Displasia, fueron sometidos a biopsia. Se sometieron a procedimientos quirúrgicos de alteraciones estéticas 35 pacientes. De ellas 27 se manejaron en Prótesis, 11 casos para ptosis e hipo- mastia y 16 casos con hipomastia sola. Las complicaciones fueron mínimas si se tienen en cuenta las indicaciones y las contraindicaciones. Las más sobresalientes fueron la galactorrea post-operatoria en 6 pacientes y la fijeza o fibrosis en dos casos. Se presentaron 2 rupturas intraoperatorias de la prótesis; una por probable defecto de fabricación y otra por accidente.
МЕТОДОЛОГИЯ УПРАВЛЕНИЯ ГЕОХИМИЧЕСКИМ БАЛАНСОМ ВОДОСБОРОВ НА ТЕРРИТОРИИ ЗАПАДНОЙ СИБИРИ
Authors: Савичев Олег Геннадьевич , Гусева Наталья Владимировна
Published: May 2020

Актуальность определяется наличием нерешенных вопросов оценки состояния водных объектов, их долгосрочного прогноза, нормирования антропогенных воздействий, очистки сточных вод и рекультивации водных объектов в Западной Сибири. Цель: разработка методологии управления геохимическим балансом водных экосистем Западной Сибири в различных природных и антропогенных условиях. Методы: ландшафтно-геохимический, географо-гидрологический, статистические методы, методы математического моделирования водного стока и химического состава вод. Результаты и выводы. Предложена методология управления геохимическим балансом водосборной территории, заключающаяся в: 1) оценке состояния водных объектов, тенденций его изменения и антропогенного влияния; 2) построении комплекса математических моделей, описывающих формирование водного стока и химического состава вод; 3) разработке мероприятий, позволяющих минимизировать антропогенное влияние на водные объекты; 4) оценке эффективности водоохранных мероприятий путем сравнения результатов наблюдений и моделирования. Разработан алгоритм определения элементов геохимического баланса водосборов. Охарактеризована направленность геохимических процессов в водных объектах Западной Сибири. Сформулированы ключевые аспекты выбора методов очистки сточных вод и рекультивации нарушенных земель. Показано, что строительство очистных сооружений целесообразно, если сброс неочищенных сточных вод составляет более 5% от стока в замыкающем створе. Оптимальная структура очистки сточных вод предполагает широкое использование отстойников и сооружений биологической очистки с естественной аэрацией, которые рекомендуется совместить с естественными понижениями рельефа в долинах рек или внутри болот при условии инженерной защиты территории. Рекультивация может считаться эффективной, если разница между значениями элементов баланса до нарушения и после рекультивации не превышает 20 %.
ДЕЙСТВИЕ ГАММА-ОБЛУЧЕНИЯ НА ПАРАМЕТРЫ АКТИВНОСТИ МИКРОПОРОШКОВ АЛЮМИНИЯ
Authors: Ильин Александр Петрович , Мостовщиков Андрей Владимирович , Роот Людмила Олеговна , Змановский Сергей Владиславович , Смирнова Валентина Владимировна , Исмаилов Данияр Валерьевич , Рузиева Гузель Усеиновна
Published: May 2020

Актуальность исследования.Один из лидеров по производству алюминиевых порошков в России ООО «СУАЛПМ» перешел от выпуска грубодисперсных порошков к производству микронных порошков, имеющих более высокую реакционную способность. Микропорошки алюминия применяются во многих отраслях промышленности:порошковой металлургии, самораспространяющемся высокотемпературном синтезе новых материалов,водородной энергетике, пиротехнике иракетных топливах. Повышение реакционной способности порошков алюминия в различных процессах приводит к понижению энергозатрат и экономии ресурсов. Цель: получение и объяснение экспериментальных данных по изменению параметров активности микропорошков алюминия после их облучения в зависимости от дозыγ-облучения. Объекты: микропорошки алюминия АСД-6, АСД-6М. Методы:дифференциальный термический анализ, рентгенофазовый анализ, методика облучения микропорошков алюминия γ-излучением, методика расчета параметров активности порошков алюминия. Результаты. Получены количественные показатели реакционной способности микропорошков алюминия АСД-6 и АСД-6М до и после облучения γ-излучением изотопа Со60 с энергией 1,17 и 1,33 МэВ, т.е. энергией существенно ниже порога фотоядерных реакций. Дозы облучения образцов порошков составляли 1, 2, 4, 8 и 10 Мрад. После γ-облучения температура начала окисления микропорошков снизилась максимально на 90 и 85 °С; максимальная скорость окисления возросла на 83 и 36 %; степень окисленности (при нагревании до 1250 °С) повысилась на 5,1 %, и минимально понизилась на 1,3 % для микропорошков АСД-6 и АСД-6М, соответственно. Удельный тепловой эффект окисления после γ-облучения всеми дозами был больше, чем для необлученных порошков.Максимальные значения удельного теплового эффекта для АСД-6на 199,5 кДж/моль, а для АСД-6М – на 134,8 кДж/моль больше тепловых эффектов, чем для необлученных порошков, что существенно превышает стандартную теплоту плавления алюминия (10,8 кДж/моль). Следовательно, такое состояние системы «алюминий – оксид алюминия» характеризуется запасенной энергией в 9 раз больше стандартной теплоты плавления алюминия, что с позиции классической термодинамики невозможно. В то же время известно, что запасание энергии в нанопорошках происходит за счет формирования двойного электрического слоя в частицах алюминия.
Psychological aspect of a Russian military servant’s linguistic persona: communicative onomastic component
Authors: Rodina Nadezhda A.
Published: May 2020

We consider the psychological characteristics of the personality of a Russian military servant in his speech activity. The purpose of the work is to conduct on the basis of practical analysis a theoretical analysis of the interaction of members of the military personnel, factors that influence the change in their personality, and also to identify the most striking psychological features of the linguistic persona of a Russian military servant. This issue is relevant at present, since the Armed Forces are of particular interest to the public, including scientific. From the point of view of psycholinguistics, the military society is less studied than in such areas as education, medicine, economics, sports, media, etc. The author of the study describes the essence of the military collective, its formation, structure, the characteristic of socio-psychological phenomena and processes taking place in this society is given. The main biological, psychological, and special changes in the personality of a person who integrates into the military personnel and continues the socialization in it, begun in another community, are listed. During the analysis of the psychological characteristics of the military servant, which are reflected in the formation of his linguistic persona, the author carried out a practical analysis of the qualities of a representative of the Armed Forces of the Russian Federation in order to identify nickname self-awareness and realize it in the nickname nomination. The research material was a survey based on an open, anonymous questionnaire of the Russian military servants. The results of theoretical and practical analysis can be used in the educational process in both civilian and military universities at seminars and special courses of psychology, psycholinguistics and speech culture.
Diáspora brasileira de ciência, tecnologia e inovação
Authors: Carneiro Ana Maria , Gimenez Ana Maria Nunes , Granja Cintia Denise , Balbachevsky Elizabeth , Consoni Flavia , Andretta Victor Fidêncio
Published: May 2020

O Brasil é um dos países com a maior taxa de imigrantes altamente qualificados vivendo na região da OCDE. Esta migração, mais recentemente chamada de diáspora, pode ter efeitos no desenvolvimento do país. Este trabalho foca em uma parte específica desta diáspora, os talentos na área de Ciência, Tecnologia e Inovação (CT&I) nos Estados Unidos e Reino Unido, e busca analisar seu volume, iniciativas auto-organizadas e políticas de engajamento do governo brasileiro. A utilização do termo diáspora para migração de pessoas altamente qualificadas evoluiu ao longo do tempo, indo da postura de brain drain para a percepção dos efeitos positivos da inserção dos talentos em redes de conhecimento internacionais. Os materiais utilizados foram: revisão da literatura especializada; análise de base de dados secundários (principalmente de censos demográficos); realização de entrevistas semiestruturadas com profissionais do Observatório das Migrações Internacionais e a realização de dois workshops com diasporados nos Estados Unidos e Reino Unido, junto com as Embaixadas em Washington e Londres, respectivamente. Há limitações para estimar o número de talentos da diáspora brasileira de CT&I, agravadas pela exclusão das questões sobre migração internacional do Censo 2020. As políticas mobilizadas pelo governo brasileiro são ainda embrionárias, ainda voltadas para mapeamento e engajamento genérico. As iniciativas da diáspora mapeadas possuem um grau relativo de organização, mas faltam mecanismos concretos para organizar e canalizar esse potencial da diáspora para políticas com um desenho de “alta resolução”, articulando a cooperação e o engajamento em torno de problemas nacionais específicos.
Does Treadmill Training Improve Balance Function of Healthy Untrained Young Adult Male?
Authors: Theodora Stephanie , Tinduh Damayanti , Wardhani Rr. Indrayuni Lukitra
Published: May 2020

Background: Number of falls increase among elders and young adults prior to any cause. Occult balance disorder may become one of the morbidity factors that causes fall in young adults and eventually elders. One leg stance test reflects static balance function that might show occult balance disorder in healthy population. Closed eyes crossed arms one leg stance (CECAOLS) used to eliminate balance factors such as visual and arms sways that can elevate limit of stability (LOS). Treadmill used as a dynamic balance exercise with inclination and speed level as its’ component to challenge the balance function.Aim: to compare CECAOLS value in subjects with gradual increase of speed versus inclination in moderate intensity treadmill exercise.Methods: Nineteen healthy young adults male with sedentary lifestyle aged from 26 to 37 years old were recruited. Nine people in inclination group, ten people in speed group. Treadmill exercise with moderate intensity (70% maximal heart rate), exercise duration was 30 minutes (5 minutes warming up, 20 minutes core exercise, 5 minutes cooling down), 3 times/week, for 4 weeks. Measurement of CECAOLS value were done prior to first exercise and after completion of exercise in 4th week.Results: Significant increase of CECAOLS value at right leg inclination group with p=0.038. No significant increase of CECAOLS value in speed group (p>0.05).Conclusion: Moderate intensity treadmill exercise with gradual inclination increase 30 minutes duration, 3 times/week, for 4 week was proven to increase CECAOLS value in young adult healthy untrained male.
A língua como impasse para o reconhecimento e a integração dos refugiados no Brasil
Authors: Olsen Ana Carolina Lopes , Kozicki Katya
Published: May 2020

A partir de compromissos internacionais assumidos com o Direito dos Refugiados, incorporados pela Constituição Federal de 1988 e pela Lei n. 9.474/97, o Brasil reconhece o direito ao refúgio para as vítimas de violações de direitos humanos, acolhendo em seu solo refugiados das mais diversas nacionalidades. Todavia, o processo administrativo de reconhecimento bem como a integração dos refugiados na sociedade brasileira passa por uma dificuldade crucial: a língua portuguesa. Com o objetivo de analisar as políticas públicas realizadas para solucionar esse impasse, o presente estudo, pelo método hipotético-dedutivo e através de revisão bibliográfica, incluídas pesquisas estatísticas sobre o refúgio no Brasil, concluiu que os cursos de língua portuguesa atualmente ministrados têm cumprido seu objetivo para os poucos refugiados que logram contemplar. Porém, a falta de coordenação e integração entre os programas representa um déficit que compromete a ampliação do seu alcance e mesmo a fiscalização dos resultados.
O abuso de direito no sistema jurídico nacional: origens e aplicabilidade
Authors: Remedio José Antonio , Oliveira Gustavo Henrique de
Published: May 2020

A pesquisa tem por objeto analisar o abuso de direito no sistema jurídico nacional, com ênfase à sua origem histórica, pressupostos, contornos, efeitos e aplicabilidade. Aborda a teoria do abuso de direito iniciada e desenvolvida juridicamente no século XIX na França e na Alemanha. Trata do instituto pelas óticas das teorias negativista e afirmativista, assim como pela órbita dos direitos subjetivos e objetivos. O método adotado é o hipotético-dedutivo, com base em pesquisa legal, doutrinária e jurisprudencial. Tem-se, em conclusão, que inexiste direito absoluto no sistema jurídico brasileiro, e que a vedação ao abuso de direito é uma realidade no país, inclusive em face de expressa previsão no artigo 187 do Código Civil de 2002, sendo que o exercício de ato abusivo equivale à prática de ato ilícito qualquer que seja o ramo do direito, dando ensejo à aplicação da sanção respectiva e da reparação dos danos dele decorrentes.
Rainfall uncertainty and water availability: Elements for planning water allocation to users in irrigation districts of Mexico. Study case: Irrigation District 041, Yaqui River
Authors: Sánchez Cohen Ignacio , Macías-Corral Maritza Argelia , Esquivel Arriaga Gerardo , Cerano Paredes Julián , Cabrera Carbajal Fernando , Inzunza Ibarra Marco Antonio , Díaz Padilla Gabriel , Guajardo Panes Rafael Alberto
Published: May 2020

The aim of this work is to present a protocol for analyzing readily available climatic and hydrological information on watersheds, in order to achieve a rational planning of irrigation water allocation under rainfall uncertainty conditions. We present as case study the Yaqui River watershed and Irrigation District (ID) No. 041 in the state of Sonora, Mexico. The watershed is divided into three sub-watersheds that drain into three reservoirs. Our findings indicate a strong dependence of water availability on the reservoirs, conditioned by El Niño phenomenon. In addition, rainfall-runoff relationships indicate the capability to produce a runoff for each sub-watershed and the differentiated impact of El Niño. The three sub-watersheds require about the same amount of antecedent rainfall for initiating the runoff (5 mm). A standardized precipitation index (SPI) highlights the dynamics of dry and wet spells and the impact on the planted area within the irrigation district. Overall, the functional relationships between El Niño, the SPI, and the planted area in the irrigation district may serve for planning purposes under climate uncertainty scenarios.
International Undergraduate Medical Student in China and the Potentiality of Using PBL Method in the Integrated Organ/System Curriculum
Authors: Masse S.Fakhruddin , Tan Huibing
Published: May 2020

The advance of the medical field in the 21st century has influenced the development of many innovations, including in medical education. PBL (problem-based learning) is one of the pedagogical approaches that has been studying and implementing worldwide to attract medical students’ attention with their learning style and learning environment. China is the most significant “receiver” country of foreign students in Asia, and clinical medicine is one of the most chosen majors for undergraduate. In China, PBL has been implementing in some schools, but mostly with the local students and only a few implementations to the international students. International medical students in China faced a variety of challenges during their studies. In this review paper, we give the solution to adapt to the challenges by focusing on the implementation the integrated organ/system curriculum/syllabus with the PBL method to the school system with the support of the school stakeholders and students’ role.
Melatonin Promotes Seed Germination Under Salt Stress by Regulating ABA and GA3 in Cotton (Gossypium Hirsutum L.)
Authors: Chen Li , Lu Bin , Liu Liantao , Duan Wenjing , Jiang Dan , Li Jin , Zhang Ke , Sun Hongchun , Zhang Yongjiang , Li Cundong , Bai Zhiying
Published: May 2020

Background: Although previous studies have found that melatonin can promote seed germination, the phytohormone regulation mechanism by which exogenous melatonin mediates salt tolerance during cotton seed germination is still largely unknown. We investigated the effect of melatonin on the germination traits and physiological parameters of GXM9 cotton seeds (Gossypium hirsutum L.) under three salt stress treatments (CK, germination of seeds pretreated with water alone; S, germination of seeds pretreated in 150 mM NaCl under salt stress; SM, germination of seeds pretreated in 20 µM melatonin under 150 mM NaCl solution) in the laboratory.Results: We found that salt stress (150 mM) inhibited cotton seed germination and endogenous melatonin accumulation, and pretreatment with 20 µM exogenous melatonin enhanced the cotton germination rate and hypocotyl length as well as the content of endogenous melatonin during seed germination. This suggests that exogenous melatonin promotes seed germination from a morphological perspective. The contents of starch, α-amylase (EC3.3.1.1), β-galactosidase (EC3.2.1.23), abscisic acid (ABA), and gibberellin (GA) were determined simultaneously. The results showed that the α-amylase and β-galactosidase contents in the cotton seeds decreased by 56.97% and 20.18%, respectively, under salt stress compared with the control, while the starch content increased by 11.53% compared with the control at day 7. The ABA content increased by 25.18% and GA content decreased by 27.99% under salt stress compared with the control at 24 h. When exogenous melatonin was applied to the cotton seeds, the content of α-amylase and β-galactosidase increased by 121.77% and 32.76%, respectively, whereas the starch contents decreased by 13.55% compared with the S treatment at day 7. Similarly, the ABA content increased by 12.20% and the GA content increased by 4.77% at 24 h. To elucidate the molecular mechanism by which melatonin promotes seed germination under salt stress, the effects of ABA- and GA-related genes on plant hormone signal transduction were analyzed by quantitative real-time PCR and RNA sequencing. The results indicated that melatonin regulated the expression of ABA and GA genes in the plant signal transduction pathway, induced embryo root development and seed germination, and alleviated dormancy. We found that the expression of the ABA signaling gene GhABF2 was up-regulated and GhDPBF2 was down-regulated, and the expression of GA signaling genes (e.g., GhGID1C and GhGID1B) was up-regulated by melatonin.Conclusions: We discovered that melatonin enhances salt tolerance in cotton seeds by regulating ABA and GA and by mediating the expression of hormone-related genes in plant hormone signal transduction. This should help us to explore the regulatory mechanisms of cotton resistance and provide a foundation for the cultivation of new varieties.
Osteopontin/Secreted Phosphoprotein-1 Behaves as a Molecular Brake Regulating the Brain Translocator Protein-Dependent Neuroinflammatory Response to Chronic Viral Infection
Authors: Mahmud Farina J , Du Yong , Greif Elizabeth , Boucher Thomas , Dannals Robert F , Mathews William B , Pomper Martin G , Sysa-Shah Polina , Pate Kelly A Metcalf , Lyons Claire , Carlson Bess , Chacona Maria , Brown Amanda M
Published: May 2020

Background

Osteopontin (OPN) as a secreted signaling protein, is dramatically induced in response to cellular injury and neurodegeneration. Microglial inflammatory responses in the brain are tightly associated with the neuropathologic hallmarks of neurodegenerative disease, but understanding of the molecular mechanisms remains in several contexts, poorly understood.
Methods

Positron emission tomography (PET) neuroimaging using radioligands to detect increased expression of the translocator protein (TSPO) receptor in the brain, is a non-invasive tool used to track neuroinflammation in living mammals.
Results

In humanized, chronically HIV-infected mice in which OPN expression was knocked down with functional aptamers, uptake of TSPO radioligand, DPA-713 was markedly upregulated in the hippocampus, cortex, olfactory bulb, cerebellum and significantly increased in other key brain regions analyzed compared to controls. TSPO+ microglia were detected by immunolabeling of post-mortem brain tissue, thus validating the neuroimaging findings. Unexpectedly, two types of neurons also selectively stained positively for TSPO. The reactive cells were the specialized neurons of the cerebellum, Purkinje cells, and a subset of tyrosine hydroxylase positive neurons of the substantia nigra. Two-way ANOVA of immunoreactivity revealed that a well-validated marker of microglial activation in brain tissue, ionized calcium-binding adaptor molecule-1 (Iba-1) was significantly increased, in an interaction that depended on HIV replication. Interestingly, similar analyses of TSPO immunoreactivity showed a significant interaction with OPN expression.
Conclusions

Collectively, these findings using a model of chronic HIV-infection revealed for the first time two key findings: 1) two different pathways of neuroinflammation are activated, and 2) osteopontin acts as a molecular brake regulating in the brain, the inflammatory response to HIV infection.
Design and Development of a Mobile App Framework to Facilitate Breast Cancer-Preventive Behaviors (m-BCPB) in the At-Risk Women: Qualitative Study
Authors: Taymoori Parvaneh , Khazaee-Pool Maryam , Pashaei Tahereh , Ponnet Koen
Published: May 2020

Background Smartphone apps are becoming a gradually universal template for an offering of preventive behavior interventions among women who are at risk of getting breast cancer. Although, only limited methodological procedures on mixing model, document, and qualitative study for their developments are presented. Thus, this study was aimed to design and develop a model-based, document-driven, and user-centered mobile app framework to facilitate breast cancer preventive behaviors targeting at-risk women. Methods The present study explains how intervention progress may be enriched with a theoretic foundation, literature review, and qualitative research. A semi-structural individual interview and focus group dissection (FGD) were accomplished to combine the user’s participation in the development. Participants were employed using a purposing sampling method. All interviews were audio-recorded, transcribed verbatim, and coded by applying the software MAXQDA. The thematic analysis method was employed for developing themes and sub-themes. Results The ASSISTS model, self-regulation model, and the self-control model were chosen to design the app framework. Data from the literature review presented the most influential document for the designing of the programs. Nineteen women were invited to participate in a semi-structured interview and FGDs. The following five main themes revealed: content, interactive performance, template, extended action and output, and motivational nature. Mobile apps are a useful tool for learning self-care tips, suitable and healthy lifestyles, and stress management, due to their user-friendly and easy feature. The mobile app framework that developed in the present study includes culture-appropriate, user-centered, and reliable content. The mobile app design should include beautiful, visualized features, and interactive multimedia. Conclusions By applying three phases way combining a model basis, the document from the literature review, and qualitative study from the target group can be held as a pattern for the prospective app design.
How is China’s Health Development During 2012 to 2017? A Longitudinal Study Based on Comprehensive Evaluation and Linear Growth Model
Authors: Zhang Gangming , Mohammedhamid kelifa Mohammedosman , Tang Fang , Xu Jiaye , Shrestha Bhawana , Wang Peigang
Published: May 2020

Background: Since 2012, China has come into a new period of health development. This paper comprehensively described China’s health development and explored associated influencing factors during the last 6 years (2012-2017).Methods: Data for this study came from statistics yearbook and analysis unit were provincial regions. Comprehensive evaluation (principal component analysis and entropy weight method) was employed to calculate the comprehensive health index to evaluate the health. Then linear growth model was applied to explore factors that influenced the development.Results: Results showed that, since 2012, China’s health had a sustainable growth but inequities among provincial regions were still existing and becoming larger. For influencing factors, time was always a significant positive predictor ( ) and it was affected by geographical distributions ( ) and distance to Beijing ( ), which indicated that regions in central or far from Beijing had a lower growth. Among socioeconomics variables, urbanization level was the final factor ( ) that promoted China’s health development and caused development inequalities. Besides, health level was also influenced by the distance to Beijing ( ), regions near to Beijing had a higher health level.Conclusion: Time effect was the results of policy, during 2012 to 2017, China’s sustainable health development was brought by the policy effect and growth of urbanization level.Thus, it is crucial for one country to introduce suitable health policies and narrow the urban-rural gaps to improve its health. Distance to Beijing represented the potential political influence on health of one country’s capital due to the policy execution level which means that supervisions need to be strengthened for regions far from the capital. Besides, supports and supervisions also need to be enhanced in central regions. They were one of the reasons that caused development inequalities.
Serum concentration of polychlorinated biphenyls and risk of hepatocellular carcinoma: a case-control study in a highly polluted area in Italy
Authors: Donato Francesco , Moneda Marco , Portolani Nazario , Rossini Angelo , Molfino Sarah , Ministrini Silvia , Contessi Giovanni Battista , Pesenti Silvia , Palma Giuseppe De , Gaia Alice , Zanardini Elena , Sileo Claudio Vito , Magoni Michele
Published: May 2020

Background: Polychlorinated biphenyls (PCBs) are human carcinogens, based on sufficient evidence for melanoma and limited evidence for non-Hodgkin lymphoma and breast cancer. Few data are available for liver cancer, although PCBs cause it in rats and determined liver damage in poisoned people. We investigated the association between PCB serum levels and hepatocellular carcinoma (HCC) with a case-control study in a PCB-polluted area in North Italy.Methods: We enrolled prospectively 102 HCC incident cases and 102 age- and gender-matched hospital controls. Serum concentrations of 33 PCB congeners were determined by a gas chromatograph coupled to mass spectrometry.Results: Of the 102 HCC cases, 62 who had lost < 3 kg of body weight in past 3 years were included in the analysis (67.7% males, mean age 68 years). 69% of them (8% of controls) had one or more risk factors for HCC: past alcohol intake ≥60 g/day and/or HBV or HCV infection. The odds ratio (OR) for HCC for 3rd compared to 1st tertile of PCB distribution was 1.76 (95% confidence interval 0.62-5.03) for total PCB, adjusting for socio-demographic variables and risk factors for HCC by logistic regression. No differences were found restricting the analysis to HCC cases and controls with or without the main risk factors for HCC. For most PCB congeners, ORs > 1.5 or 2 were found, although the 95% CIs included the null value for almost all of them. Conclusions: This preliminary study suggests that PCBs might play a role in HCC development.Electronic word count for abstract: 252 words.
Cluster analysis of resistance combinations in Escherichia coli from different human and animal populations in Germany 2014-2017
Authors: Suwono Beneditta , Eckmanns Tim , Kaspar Heike , Merle Roswitha , Zacher Benedikt , Kollas Chris , Weiser Armin A. , Noll Ines , Feig Marcel , Tenhagen Bernd-Alois
Published: May 2020

Background

Recent findings on Antibiotic Resistance (AR) have brought renewed attention to the comparison of data on AR from human and animal sectors. This is however, a major challenge since the data is not harmonized. This study performs a comparative analysis of phenotypical AR data from different routine surveillance and monitoring systems in Germany. Escherichia coli data were used as a model to describe the similarities based on the resistance patterns in human and different animal populations in Germany. Method: Data on E. coli isolates were collected from 2014 to 2017 from human clinical isolates, non-clinical isolates from food-producing animals and food, and clinical isolates from food-producing and companion animals from national routine surveillance and monitoring for AR in Germany. Four antibiotics - ampicillin, cefotaxime, ciprofloxacin and gentamicin - were chosen for the analysis. Resistant isolates were defined according to EUCAST clinical breakpoints for humans. Based on the 16 possible resistance combinations to these four antibiotics, cluster analysis was performed using hierarchical clustering with Euclidian and average distance. All analyses were performed with the software “R”.
Result

Data of 333,496 E. coli isolates were included in this study. Forty-one different human and animal populations were included in the cluster analysis. Three main clusters were detected. Within these three clusters, all human populations (intensive care unit (ICU), general ward and outpatient care) showed similar relative frequencies of the resistance combinations and clustered together. They demonstrated similarities with clinical isolates from different animal populations and most isolates from pigs from both non-clinical and clinical isolates. Isolates from healthy poultry demonstrated similarities in relative frequencies of resistance combinations and clustered together. However, they clustered separately from the human isolates. All isolates from different animal populations with low relative frequencies of resistance combinations clustered together and likewise separately from the human populations.
Conclusion

Cluster analysis facilitated the comparison of phenotypical AR data across human and animal sectors. It indicated linkage among human isolates and with isolates from various animal populations based on the resistance combinations in E. coli. Further analyses based on these findings might promote a better one-health approach for AR in Germany.
Differences in clinical features of HIV/HCV co-infected individuals compared with HCV mono-infected individuals in Southern Thailand
Authors: Pongmanee Werapon , Chamroonkul Naichaya , Piratvisuth Teerha
Published: May 2020

Objectives

HIV/HCV co-infection is associated with more aggressive liver than HCV mono-infection. However, there are limited data in Thailand. This study was done to compare demographic data, basic laboratory results and hepatic fibrosis between HIV/HCV co-infected patients and HCV mono-infected patients in a major tertiary care center in Southern Thailand.

Methods

This was a cross-sectional single center 2-year retrospective study of HCV-treatment-naïve HIV/HCV co-infected patients and HCV mono-infected patients in Songklanagarind Hospital in Southern Thailand. The records of demographic data, basic laboratory results and hepatic fibrosis information were noted from all eligible patients.

Results

Data from 151 treatment-naïve HCV infected patients during the years 2018-2019 were collected. 51(34%) patients had HIV/HCV co-infections. Genotype 3a was predominant in HCV mono-infected patients(51%), while genotype 1a was predominant in HIV/HCV co-infected patients(35%). The median BMI in HCV mono-infected patients was higher than in HIV-HCV co-infected patients(23.1, IQR 20.3-24.8 vs 20.7, IQR 18.9-22.1, p<0.001). In multivariate analysis, HIV/HCV co-infected patients had higher alcohol consumption(AOR 24.9, p< 0.001), higher rates of unsafe sex(AOR 18.6, p=0.004) and MSM (AOR 8.48, p=0.006), and higher percents of genotype 1a(AOR 8.48, p=0.006) and HCV-RNA(AOR 2.3, p=0.035), while HIV/HCV co-infected individuals were less likely to be married (AOR 0.02, p<0.001), had higher median BMI(AOR 0.82, p=0.02), a higher rate of hepatic steatosis as assessed by controlled attenuation parameter (CAP)(AOR 0.98, p=0.02) and hepatic fibrosis as assessed by FibroScan 502(AOR 0.91, p<0.001) than HCV mono-infected patients. In HIV/HCV co-infected individuals, hepatic fibrosis as evaluated by liver stiffness measurement was not correlated with level of CD4 in our study.

Conclusions

HIV/HCV co-infected individuals were associated with genotype 1a, unsafe sex, single status and low BMI, while HCV mono-infected individuals were associated with high CAP and high hepatic fibrosis. Large-scale cohort studies are needed to confirm these results, especially hepatic fibrosis in this era of high-fat food consumption.
Cost-effectiveness analysis of initial nonoperative management versus emergency laparoscopic appendectomy for acute complicated appendicitis in Japan
Authors: Sugiura Kiyoaki , Suzuki Keiichi , Umeyama Tomoshige , Omagari Kenshi , Hashimoto Takeo , Tamura Akihiko
Published: May 2020

Background: Although evidence regarding the safety and efficacy of nonoperative management is growing, the best treatment strategy for acute complicated appendicitis remains controversial. In this study, we performed a cost-effectiveness analysis of operative management with emergency laparoscopic appendectomy (ELA) alone as the first-line therapy in complicated appendicitis patients in a municipal hospital in Japan.Methods: We constructed a Markov model to compare treatment strategies for complicated appendicitis with emergency laparoscopic appendectomy in otherwise-healthy adults. Health outcomes were measured in quality-adjusted life years (QALYs) gained, and cost-effectiveness was evaluated using an incremental cost effectiveness ratio (ICER). Model variables were abstracted from a literature review, and from data from the hospital records of Tochigi Medical Center. Uncertainty surrounding model parameters was assessed via one-way- and probabilistic-sensitivity analyses. Threshold analysis was performed using the willingness-to-pay threshold set at the World Health Organization's criterion of ¥12 million.Results: Operative management cost ¥677,570 per patient. Nonoperative management without interval laparoscopic appendectomy (ILA) cost ¥109,257 more than operative management and produced only 0.005 more QALYs. Nonoperative management without ILA cost ¥26,049 more than operative management, and also yielded only 0.005 additional QALYs. The ICER for both nonoperative managements were > ¥12 million/QALY in the probabilistic sensitivity analysis.Conclusions : Nonoperative management with ILA and Nonoperative management without ILA were not cost-effective strategies compared with operative management to treat complicated appendicitis. Operative management remains the standard of care, but nonoperative management deserves serious consideration as a treatment option in complicated appendicitis.
COVID-19: Repeated video-watching vs. combined video-watching and live demonstration as training to health care providers for donning and doffing personal protective equipment
Authors: Li Yongxing , Wang Yong , Li Yuhui , Zhong Ming , Liu Huihui , Wu Caineng , Gao Xiaoqiu , Xia Zhengyuan , Ma Wuhua
Published: May 2020

Background

During the COVID-19 pandemic, not only was there a lack of personal protective equipment (PPE) for health care workers but a dearth in training in respect of its donning and doffing. This study compared two training methods for donning and doffing PPE in order to teach health care workers how to do so more effectively and quickly.
Method

A total of 48 health care workers were recruited and randomly divided into two groups. Group A watched a 10-minute demonstration (demo) video repeated four times, while Group B watched the same demo video twice followed by a 10-minute live demo twice. The learning time of both groups was the same, and an examination was performed immediately after the completion of training. The examination scores of Group A and Group B were recorded according to the checklist (Appendix 1). The time taken for the participants to don and doff PPE, their satisfaction with the training, and the confidence to don and doff PPE were analyzed.
Results

The average score of Group B was better than that of Group A, with a mean (SD) of 94.92 (1.72) vs. 86.63 (6.34), respectively (P < 0.001). The average time spent by Group B to do the examination was shorter than that of Group A, with a mean (SD) of 17.67 (1.01) vs. 21.75 (1.82), respectively (P < 0.001). The satisfaction and confidence of Group B were higher than those of group A (P < 0.001).
Conclusions

Compared with repeated video-watching learning, the video-watching plus a live demonstration teaching method is more suitable for health care workers to learn how to put on and remove personal protective equipment.
Association between echinococcosis-specific health literacy and behavioral intention to prevent echinococcosis among herdsmen on the Tibet Plateau in China
Authors: Zhao Jie , Dawa Yangzong , Deji Cuo , Deng Bentai , Leng Bao , Li Zengyue , Chen Wanli , Wang Jiangya , Zhang Yuxin , Ake Zhong , Wang Jiwei , Shi Lizheng
Published: May 2020

Background

Echinococcosis is considered a neglected zoonotic disease. It has been an major worldwide health problem primarily affecting pastoral and poor rural communities with weak infrastructures, limited economic resources and poor sanitation. In general, the population in these poor areas has a low level of health literacy. This study aims to examine the association between echinococcosis-specific health literacy(ES-HL) and behavioral intention to prevent echinococcosis(BIPE) among herdsmen on the Tibet Plateauin in China.
Methods

A cross-sectional study of 401 Tibetan herdsmen was conducted in Gande country of Qinghai Province, China. Participants were recruited from August to September 2018 and from February to March 2019. A self-developed questionnaire was used to measure demographic information, ES-HL and BIPE. Hierarchical regression analysis was done to identify the factors associated with BIPE.
Results

In the hierarchical regression analysis, we entered age, sex, education level, marital state and family monthly income per capita into model 1 which explained a significant amount of variance in BIPE (Adjusted R2 change = 0.029, P = 0.006), and sex(β= -0.125, P = 0.013) and family monthly income per capita(β= -0.133, P = 0.009) were found to be associated with BIPE. Then three factors of ES-HL was added to Model 1 to create Model 2. In Model 2, the two factors of ES-HL, perceived echinococcosis information support (β = 0.229, P < 0.001) and echinococcosis-specific self-management ability (β = 0.252, P < 0.001), were significantly associated with BIPE, while the information acquisition and evaluation ability factor (β = 0.093, P = 0.089) was not found to be associated with BIPE. The model improved significantly when ES-HL was included (Model 2) explaining 25.8% of variance of BIPE(Adjust R2 change = 0.229, P < 0.001)
Conclusions

ES-HL is an important predictor of whether individuals take preventive actions against echinococcosis. ES-HL promotion action project should be developed aiming at different target population to enhance some of the specific abilities needed to prevent echinococcosis.
Emergence of a Mortality Disparity in Denmark, 1968-2017
Authors: Holmager Therese Lucia Friis , Thygesen Lars , Buur Lene Tønder , Lynge Elsebeth
Published: May 2020

The authors have removed this preprint from Research Square.
Multivariate Multiscale Entropy: An Approach to Estimating Vigilance of Driver
Authors: Ahammed Kawser , Ahmed Mosabber Uddin
Published: May 2020

This research has been done using recently introduced multivariate multiscale entropy method with a view to
estimating vigilance of drivers during driving in simulated environment. In this driving simulation experiment,
twenty one subjects including twelve men and nine women were participated. Multivariate multiscale entropy
(MMSE) has been applied to this multimodal Seed dataset for estimating vigilance from electroencephalogram
(EEG) and electrooculogram (EOG) signals in order to build a vigilance detection system. The experimental
MMSE analysis curves show statistically signi cant di erences (p < 0.01) in terms of complexity among brain
EEG signals, forehead EEG signals and EOG signals. Moreover, the di erence in the multivariate sample
entropy across all scales in awake (1.0828 0.4664), tired (0.7841 0.3183) and drowsy (0.2938 0.1664)
states are statistically signi cant (p <0.01). Also, the support vector machine (SVM), a machine learning
technique, has discriminated the cognitive states (awake, tired and drowsy) with the promising classi cation
accuracy of 76.2%. As a result, the MMSE analysis of cognitive states can be implemented practically for
vigilance detection by building a programmable vigilance detection system .
Urban Malaria Prevalence and Its Associated Risk Factors: The Case of Batu Town, East Shoa, Oromia Regional State, Ethiopia
Authors: Hassen Jifar , Dinka Hunduma
Published: May 2020

Background- Malaria is one of the leading causes of morbidity and mortality particularly in sub-Saharan Africa including Ethiopia. Approximately, 68% of its population is at a risk of malaria infection and nearly three-fourth of the Ethiopia landmass is considered as malarious. Most of the malaria related researches are being conducted in the rural areas; however, urban malaria should be also targeted without which malaria elimination is impossible. Therefore, the aim of this study was to assess the prevalence of malaria and its associated risk factors in Batu town, Oromia Regional state, Ethiopia.Methods – Finger pricked blood samples were collected from 356 febrile individuals visiting health facilities in Batu town from April to July, 2018 supplemented with questionnaire survey to assess socio-demographic and risk factors associated with malaria infection.Results – In the current study an overall prevalence of 17.13% (61/356) malaria infection was observed of which 50.8% (31/61) were positive for P. vivax, 45.95% (28/61) were positive for P. falciparum and 3.3% (2/61) were mixed infections of P. falciparum and P. vivax. Males (32 (9%)) were more infected with malaria than females (29 (8.2%)). Sex had no statistical significance association with malaria (χ2 = 2.026, P = 0.155). Logistic regression analysis revealed that individuals who possessed ITN (OR = 0.38, 95% CI (0.194, 0.743) and P = 0.005) and whose houses were sprayed with insecticides (OR = 0.18, 95% CI (0.097, 0.34) and P <0.001) were found less likely to get malaria infection. Individuals living closer to stagnant water had more chance of malaria infection than those who were found at a distant from stagnant water (OR = 0.34, 95% CI (0.19, 0.59) and P<0.001).Conclusion- The current study revealed that malaria is still public health problem in Batu town, which might indicate the same in other urban areas of the country. Therefore, in order to get the national picture about the prevalence of urban malaria and its associated risk factors, we recommend large scale investigation of the situation.
The importance of COVID-19 testing to assess socioeconomic fatality drivers and true case fatality rate. Facing the pandemic or walking in the dark?
Authors: Ibarra-Armenta Cristina Isabel , Alarcon-Osuna Moises Alejandro
Published: May 2020

Up to date, European and other developed countries became the centre of the pandemic. While the COVID-19 spread to developing countries and less developed regions, seems to be still very low. The Case Fatality Rate (CFR) differs a lot among countries, genetics, health systems, population characteristics as well as public health and social measures (lockdown measures) are believed to be the determinants of such diversity. Through an Ordinal Probit, Cross Section and Panel data models for 71 countries, it is shown that the nations applying more tests per million inhabitants are also those reporting more cases and deaths, yet greater testing helped to reduce CFR; while, health infrastructure and population health indicators could not be confirmed as drivers for CFR. The Stringency Index showed a negative correlation with the number of deaths. Our main finding is that, the pandemic concentration on developed nations is highly related with their ability and resources for tracking the pandemic. Three additional conclusions are drawn: first, the true CFR and its drivers at national levels cannot be estimated without increasing the number of tests per million inhabitants; second, there is an under-identification of cases and/or deaths and the countries applying more tests, are most clearly identifying the reality of the pandemic, while countries with less cases, are actually still walking in the dark; third lockdown measures have been effective at reducing the number of deaths.