bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators to implementing measurement-based care for depression in Shanghai, China: a situational analysis
Authors: Murphy Jill K. , Michalak Erin E. , Liu Jing , Colquhoun Heather , Burton Hannah , Yang Xiaorui , Yang Tao , Wang Xing , Fei Yue , He Yanling , Wang Zuowei , Xu Yifeng , Zhang Ping , Su Yousong , Huang Jia , Huang Leping , Yang Lu , Lin Xiao , Fang Yiru , Liu Tianli , Lam Raymond W. , Chen Jun
Published: September 2021

Background

Measurement-based care (MBC) is an evidence-based practice for depression, but its use by clinicians remains low. Enhanced MBC (eMBC), which uses digital technologies, can help to facilitate the use of MBC by clinicians and patients. Understanding factors that act as barriers and drivers to the implementation of MBC and eMBC is important to support the design of implementation strategies, promoting uptake by clinicians and patients.

Objective

This situational analysis identifies barriers and facilitators to the implementation of standard and eMBC at mental health centers in Shanghai, China.

Methods

We used mixed methods to develop a comprehensive understanding of the factors influencing MBC and eMBC implementation in Shanghai. This study took place across three mental health centers in Shanghai. We used situational analysis tools to collect contextual information about the three centers, conducted surveys with n = 116 clinicians and n = 301 patients, conducted semi-structured interviews with n = 30 clinicians and six focus groups with a total of n = 19 patients. Surveys were analysed using descriptive statistics, and semi-structured interviews and focus groups were analysed using framework analysis.

Results

Several potential barriers and facilitators to MBC and eMBC implementation were identified. Infrastructure, cost, attitudes and beliefs, and perceptions about feasibility and efficacy emerged as both challenges and drivers to MBC and eMBC implementation in Shanghai.

Conclusions

The results of this study will directly inform the design of an implementation strategy for MBC and eMBC in Shanghai, that will be tested via a randomized controlled trial. This study contributes to the emerging body of literature on MBC implementation and, to the best of our knowledge, is the first such study to take place in Asia. This study identifies several factors that are relevant to the equitable delivery of MBC, recognizing the need to explicitly address equity concerns in global mental health implementation research.
Medical faculty profile is an important determinant of student profile and future practice expectations of medical students in Angola
Authors: Fronteira Inês , Freitas Helga , Guimarães Nkanga , Fresta Mário , Ferrinho Paulo
Published: September 2021

Background

Angola is among one of the most deprived countries in the world in terms of medical professionals. In the past decade, the Angolan Government has invested in the expansion of faculties of medicine in the country.  We analysed the profiles of medical students in Angola according to four clusters of medical schools: older faculty in the country, private faculties, Cuban sponsored faculties and military faculty; under the assumption that the organizational culture of the different faculties might influence the expectations and decisions towards future professional life of medical students regarding where they want to work (community versus hospital) and in which sector (exclusively public versus not exclusively public).

Methods

Observational cross-sectional study. Piloted, standardized questionnaire to final year medical students or higher year of training in the first four-month of 2014 (N = 402). Data were entered into a SPSS v.20 database and descriptive statistics computed. Statistical significance for categorical variables was tested by Pearson chi-square, Fisher exact or likelihood ratio tests as appropriate. Comparison of means was tested with Anova. Backward elimination binary logistic regression was used to test the hypothesis that type of faculty of medicine is an important determinant of future professional practice, i.e., level (hospital vs. community) or sector of practice (exclusive public sector vs. private or private and public), while controlling for confounders.

Results

After controlling for age, sex, marital status, place of birth and place of primary and secondary education, type of family and family influence, students were more likely to choose community over hospital practice and to prefer exclusive public practice if attending a Cuba supported faculty of medicine.

Conclusions

Medical education cannot be isolated from planning of the medical workforce. Some important and impactful careers choices, like choosing rural over urban practice, public over private sector practice, have deep influences in the medical professionals’ labour market. Some of these decisions are shaped even before the end of the medical training. As such, the monitoring of future professional intentions in medical schools should be done regularly to accommodate both the health system needs and the hopes and dreams of medical trainees.
What agro-input dealers know, sell and say to smallholder farmers about pesticides: a mystery shopping and KAP analysis in Uganda
Authors: Staudacher Philipp , Brugger Curdin , Winkler Mirko S. , Stamm Christian , Farnham Andrea , Mubeezi Ruth , Eggen Rik I. L. , Günther Isabel
Published: September 2021

Background

Pesticides can have negative effects on human and environmental health, especially when not handled as intended. In many countries, agro-input dealers sell pesticides to smallholder farmers and are supposed to provide recommendations on application and handling. This study investigates the role of agro-input dealers in transmitting safety information from chemical manufacturers to smallholder farmers, assesses the safety of their shops, what products they sell, and how agro-input dealers abide by laws and recommendations on best practices for preventing pesticide risk situations.

Methods

Applying a mixed-methods approach, we studied agro-input dealers in Central and Western Uganda. Structured questionnaires were applied to understand agro-input dealers’ knowledge, attitude and practices on pesticides (n = 402). Shop layout (n = 392) and sales interaction (n = 236) were assessed through observations. Actual behavior of agro-input dealers when selling pesticides was revealed through mystery shopping with local farmers buying pesticides (n = 94).

Results

While 97.0% of agro-input dealers considered advising customers their responsibility, only 26.6% of mystery shoppers received any advice from agro-input dealers when buying pesticides. 53.2% of products purchased were officially recommended. Sales interactions focused mainly on product choice and price. Agro-input dealers showed limited understanding of labels and active ingredients. Moreover, 25.0% of shops were selling repackaged products, while 10.5% sold unmarked or unlabeled products. 90.1% of shops were lacking safety equipment. Pesticides of World Health Organization toxicity class I and II were sold most frequently. Awareness of health effects seemed to be high, although agro-input dealers showed incomplete hygiene practices and were lacking infrastructure. One reason for these findings might be that only 55.7% of agro-input dealers held a certificate of competency on safe handling of pesticides and even fewer (5.7%) were able to provide a government-approved up-to-date license.

Conclusion

The combination of interviews, mystery shopping and observations proved to be useful, allowing the comparison of stated and actual behavior. While agro-input dealers want to sell pesticides and provide the corresponding risk advice, their customers might receive neither the appropriate product nor sufficient advice on proper handling. In light of the expected increase in pesticide use, affordable, accessible and repeated pesticide training and shop inspections are indispensable.
The expression of miRNA-216b is negatively correlated with 18F-FDG uptake in non-small cell lung cancer
Authors: Zuo Mingfei , Yao Lan , Wen Lijuan , Shen Jianfei , Zhang Na , Bai Tian , Huang Qicheng
Published: September 2021

Background

This study aimed to investigate the correlation between miRNA-216b expression in patients with non-small cell lung cancer (NSCLC) and 18F-fluorodeoxyglucose (FDG) uptake by PET/CT and to explore the clinical application value of 18F-FDG PET/CT in miRNA-216b based on therapy for NSCLC.

Methods

Eighty patients with NSCLC and 40 healthy subjects were enrolled in our study. The SUVmax of the lesion area by PET/CT imaging was calculated. SUVmax represented the highest concentration of 18F-FDG in the lesion. The expression of miRNA-216b in the plasma and fiber bronchoscopic puncture of NSCLC patients was detected by RT qPCR. Then Pearson correlation analysis was used to analyze the correlation between miRNA-216b expression and 18F-FDG uptake in patients with different types of NSCLC.

Results

Compared with healthy subjects, SUVmax of early adenocarcinoma and advanced adenocarcinoma were increased. Compared with healthy subjects, SUVmax of early squamous and advanced squamous were increased. And the SUVmax content of advanced adenocarcinoma and squamous cell carcinoma was higher than that of early adenocarcinoma and squamous cell carcinoma. Compared with healthy subjects, the expression of miRNA-216b in the plasma of patients with early and advanced adenocarcinoma was reduced, and the expression of miRNA-216b in the plasma of patients with early and advanced squamous cell carcinoma was reduced. Compared with adjacent tissues, the expression of miRNA-216b in early adenocarcinoma tissues and advanced adenocarcinoma tissues was reduced, and the expression in early squamous cell carcinoma and advanced squamous cell carcinoma was reduced. Pearson correlation analysis showed a negative correlation between SUVmax and miRNA-216b (plasma and tissue) in patients with four types of NSCLC.

Conclusion

miRNA-216b expression was negatively correlated with 18F-FDG uptake in NSCLC. miRNA-216b could be used for the classification and staging of non-small cell lung cancer. 18F-FDG PET/CT may be used to evaluate the therapeutic response in application of miRNA-216b-based cancer treatment.
HOX cluster and their cofactors showed an altered expression pattern in eutopic and ectopic endometriosis tissues
Authors: Esfandiari Fereshteh , Chitsazian Fereshteh , Jahromi Masoumeh Golestan , Favaedi Raha , Bazrgar Masood , Aflatoonian Reza , Afsharian Parvaneh , Aflatoonian Abbas , Shahhoseini Maryam
Published: September 2021

Endometriosis is major gynecological disease that affects over 10% of women worldwide and 30%-50% of these women have pelvic pain, abnormal uterine bleeding and infertility. The cause of endometriosis is unknown and there is no definite cure mainly because of our limited knowledge about its pathophysiology at the cellular and molecular levels. Therefore, demystifying the molecular mechanisms that underlie endometriosis is essential to develop advanced therapies for this disease. In this regard, HOX genes are remarkable because of their critical role in endometrial development and receptivity during implantation, which is attributed to their ability to mediate some of the sex steroid functions during the reproductive period. Access to the expression profiles of these genes would provide the necessary information to uncover new genes for endometriosis and assist with disease diagnosis and treatment. In this study we demonstrate an altered expression pattern for the HOX clusters (A-D) and their cofactors in both eutopic and ectopic conditions compared to control tissue biopsies. Remarkably, most of the intensive changes occurred in eutopic samples from endometriosis patients compared to control tissue biopsies. Pathway analysis revealed the involvement of differentially expressed genes in cancer that correlate with an association between endometriosis and cancer. Our results suggest critical roles for the HOX cluster and their cofactors in endometriosis pathophysiology.
Chemoresistance is mediated by ovarian cancer leader cells in vitro
Authors: Karimnia Nazanin , Wilson Amy L. , Green Emma , Matthews Amelia , Jobling Thomas W. , Plebanski Magdalena , Bilandzic Maree , Stephens Andrew N.
Published: September 2021

Background

Leader cells are a subset of cancer cells that coordinate the complex cell-cell and cell-matrix interactions required for ovarian cancer migration, invasion, tumour deposition and are negatively associated with progression-free survival and response to therapy. Emerging evidence suggests leader cells may be enriched in response to chemotherapy, underlying disease recurrence following treatment.

Methods

CRISPR was used to insert a bicistronic T2A-GFP cassette under the native KRT14 (leader cell) promoter. 2D and 3D drug screens were completed in the presence of chemotherapies used in ovarian cancer management. Leader cell; proliferative (Ki67); and apoptotic status (Cleaved Caspase 3) were defined by live cell imaging and flow cytometry. Quantitative real-time PCR defined “stemness” profiles. Proliferation was assessed on the xCELLigence real time cell analyser. Statistical Analysis was performed using unpaired non-parametric t-tests or one-way ANOVA and Tukey’s multiple comparison post hoc.

Results

Leader cells represent a transcriptionally plastic subpopulation of ovarian cancer cells that arise independently of cell division or DNA replication, and exhibit a “stemness” profile that does not correlate with epithelial-to-mesenchymal transition. Chemotherapeutics increased apoptosis-resistant leader cells in vitro, who retained motility and expressed known chemo-resistance markers includingALDH1,TwistandCD44v6. Functional impairment of leader cells restored chemosensitivity, with leader cell-deficient lines failing to recover following chemotherapeutic intervention.

Conclusions

Our data demonstrate that ovarian cancer leader cells are resistant to a diverse array of chemotherapeutic agents, and are likely to play a critical role in the recurrence of chemo-resistant disease as drivers of poor treatment outcomes.
Effects of a Brazilian cardioprotective diet and nuts on cardiometabolic parameters after myocardial infarction: study protocol for a randomized controlled clinical trial
Authors: Marcadenti Aline , Weber Bernardete , Bersch-Ferreira Angela Cristine , Machado Rachel Helena Vieira , Torreglosa Camila Ragne , de Sousa Lara Enilda Maria , da Silva Lucas Ribeiro , Santos Renato Hideo Nakagawa , Miyada Debora Harumi Kodama , Sady Erica Regina Ribeiro , Costa Rosana Perim , Piegas Leopoldo , de Abreu-Silva Erlon Oliveira , de Quadros Alexandre Schaan , Weschenfelder Camila , dos Santos Júlia Lorenzon , Souza Gabriela Corrêa , Parahiba Suena Medeiros , Fayh Ana Paula Trussardi , Bezerra Danielle Soares , Carvalho Ana Paula Perillo Ferreira , Machado Malaine Morais Alves , Vasconcelos Sandra Mary Lima , Araújo Jéssika , de Figueiredo Neto José Albuquerque , Dias Luciana Pereira Pinto , Nagano Francisca Eugenia Zaina , de Almeida Cássia Cristina Paes , Moreira Annie Seixas Bello , Gapanowicz Débora Pinto , Purgatto Eduardo , Rogero Marcelo Macedo , Sampaio Geni Rodrigues , da Silva Torres Elizabeth Aparecida Ferraz , Duarte Graziela Biude Silva , Cavalcanti Alexandre Biasi
Published: September 2021

Background

Nut consumption has been related to improvements on cardiometabolic parameters and reduction in the severity of atherosclerosis mainly in primary cardiovascular prevention. The objective of this trial is to evaluate the effects of the Brazilian Cardioprotective Diet (DIetaCArdioprotetoraBrasileira, DICA Br) based on consumption of inexpensive locally accessible foods supplemented or not with mixed nuts on cardiometabolic features in patients with previous myocardial infarction (MI).

Methods

DICA-NUTS study is a national, multicenter, randomized 16-week follow-up clinical trial. Patients over 40 years old with diagnosis of previous MI in the last 2 to 6 months will be recruited (n = 388). A standardized questionnaire will be applied to data collection and blood samples will be obtained. Patients will be allocated in two groups: Group 1: DICA Br supplemented with 30 g/day of mixed nuts (10 g of peanuts, 10 g of cashew, 10 g of Brazil nuts); and Group 2: only DICA Br. The primary outcome will consist of LDL cholesterol means (in mg/dL) after 16 weeks of intervention. Secondary outcomes will consist of other markers of lipid profile, glycemic profile, and anthropometric data.

Discussion

It is expected that DICA Br supplemented with mixed nuts have superior beneficial effects on cardiometabolic parameters in patients after a MI, when compared to DICA Br.

Trial registration

ClinicalTrials.gov Identifier NCT03728127. First register: November 1, 2018; Last update: June 16, 2021. World Health Organization Universal Trial Number (WHO-UTN): U1111-1259-8105.
Effect of posture on pulmonary function and oxygenation after fast-tracking video-assisted thoracoscopic surgery (VATS) lobectomy: a prospective pilot study
Authors: Huang Lin , Kehlet Henrik , Petersen René Horsleben
Published: September 2021

Background

Minimally invasive surgery combined with enhanced recovery programmes has improved outcomes after lung cancer surgery and where early mobilisation may be an important factor. However, little is known about pulmonary function and oxygenation during mobilisation after video-assisted pulmonary lobectomy. The aim of this prospective pilot cohort study was to explore the effect of postural changes (from supine to sitting to standing) on pulmonary function and oxygen saturation in a well-defined enhanced recovery programmes setting after video-assisted thoracoscopic surgery lobectomy.

Methods

A total of 24 patients were evaluated daily for postoperative pain score, pulmonary function (forced expiratory volume 1 s) and oxygen saturation in supine, sitting and standing position from 6 h after surgery to 6 h after chest drain removal.

Results

Mobilisation from supine to standing position showed a significant 7.9% increase (p = 0.04) in forced expiratory volume in 1 s percentage and oxygen saturation about 1.8% (p< 0.001) without increasing pain (p = 0.809).

Conclusions

Early mobilisation should be encouraged to enhance recovery after video-assisted thoracoscopic surgery lobectomy by increasing lung function and oxygen delivery.

Trial registration

• Name of the registry: clinicaltrials.gov

• Trial registration number: NCT04508270

• Date of registration: August 11, 2020
Influence of osmolality on gastrointestinal fluid volume and drug absorption: potential impact on oral salt supplementation
Authors: Takemura Miyuki , Tanaka Yuki , Inoue Katsuhisa , Tamai Ikumi , Shirasaka Yoshiyuki
Published: September 2021

Background

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is the most frequent cause of hyponatremia in patients with cerebrovascular disease, and is often treated with oral salt tablets. However, we have shown that osmolality-dependent variations in gastrointestinal (GI) fluid volume can alter the concentration of a poorly permeable drug in the GI tract, potentially affecting its absorption. Here, we examined the effect of ingestion of hyperosmotic solution (10% NaCl) on drug concentration and absorption in the GI tract.

Methods

The effects of osmolality on luminal fluid volume and drug absorption in rat intestine (jejunum, ileum and colon) were examined by means of an in situ closed loop method using fluorescein isothiocyanate-dextran 4000 (FD-4) and atenolol. In vivo absorption in rats was determined by measuring the plasma concentration after oral administration of the test compounds dissolved in purified water or hyperosmotic solution (10% NaCl).

Results

Administration of hyperosmotic solution directly into the GI tract significantly increased the GI fluid volume, owing to secretion of water into the lumen. After administration in hyperosmotic solution, the luminal concentration of non-permeable FD-4 was significantly lower than the initial dosing concentration, whereas after administration in purified water, the luminal concentration exceeded the initial concentration. The fraction absorbed of atenolol was markedly lower after administration in hyperosmotic solution than after administration in purified water. An in vivo pharmacokinetic study in rats was consistent with these findings.

Conclusions

Administration of hyperosmotic NaCl solution increased GI fluid volume and reduced the plasma level of orally administered atenolol. This may imply that oral salt tablets used to treat hyponatremia in SIADH patients could decrease the intestinal absorption of concomitantly administered drugs, resulting in lower plasma exposure.
Reviews
Authors: Avakian Bob , Sayers Colin M.
Published: September 2021

Blizzards and Broken Grousers: A Year of Antarctic Glaciology, by Les R. Denham, ISBN 978-1-560-80377-5, 2020, SEG, 348 p. Geologic Fracture Mechanics, by Richard A. Schultz, ISBN 978-1-107-18999-7, 2019, Cambridge University Press, 608 p.
Predictive Modeling for Adverse Events and Risk Stratification Programs for People Receiving Cancer Treatment
Authors: Osterman Chelsea K. , Sanoff Hanna K. , Wood William A. , Fasold Megan , Lafata Jennifer Elston
Published: September 2021

Emergency department visits and hospitalizations are common among people receiving cancer treatment, accounting for a large proportion of spending in oncology care and negatively affecting quality of life. As oncology care shifts toward value- and quality-based payment models, there is a need to develop interventions that can prevent these costly and low-value events among people receiving cancer treatment. Risk stratification programs have the potential to address this need and optimally would consist of three components: (1) a risk stratification algorithm that accurately identifies patients with modifiable risk(s), (2) intervention(s) that successfully reduce this risk, and (3) the ability to implement the risk algorithm and intervention(s) in an adaptable and sustainable way. Predictive modeling is a common method of risk stratification, and although a number of predictive models have been developed for use in oncology care, they have rarely been tested alongside corresponding interventions or developed with implementation in clinical practice as an explicit consideration. In this article, we review the available published predictive models for treatment-related toxicity or acute care events among people receiving cancer treatment and highlight challenges faced when attempting to use these models in practice. To move the field of risk-stratified oncology care forward, we argue that it is critical to evaluate predictive models alongside targeted interventions that address modifiable risks and to demonstrate that these two key components can be implemented within clinical practice to avoid unplanned acute care events among people receiving cancer treatment.
Long-Term Report of a Comprehensive Molecular and Genomic Analysis in NRG Oncology/RTOG 0424: A Phase II Study of Radiation and Temozolomide in High-Risk Grade II Glioma
Authors: Fleming Jessica L. , Pugh Stephanie L. , Fisher Barbara J. , Lesser Glenn J. , Macdonald David R. , Bell Erica H. , McElroy Joseph P. , Becker Aline P. , Timmers Cynthia D. , Aldape Kenneth D. , Rogers C. Leland , Doyle Thomas J. , Werner-Wasik Maria , Bahary Jean-Paul , Yu Hsiang-Hsuan Michael , D'Souza David P. , Laack Nadia N. , Sneed Penny K. , Kwok Young , Won Minhee , Mehta Minesh P. , Chakravarti Arnab
Published: September 2021

PURPOSE

This study sought to determine the prognostic significance of the WHO-defined glioma molecular subgroups along with additional alterations, including MGMT promoter methylation and mutations in ATRX, CIC, FUBP1, TERT, and TP53, in NRG/RTOG 0424 using long-term follow-up data.

METHODS

Mutations were determined using an Ion Torrent sequencing panel. 1p/19q co-deletion and MGMT promoter methylation were determined by Affymetrix OncoScan and Illumina 450K arrays. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and tested using the log-rank test. Hazard ratios were calculated using the Cox proportional hazard model. Multivariable analyses (MVAs) included patient pretreatment characteristics.

RESULTS

We obtained complete molecular data to categorize 80/129 eligible patients within the WHO subgroups. Of these, 26 (32.5%) were IDHmutant/co-deleted, 28 (35%) were IDHmutant/non-co-deleted, and 26 (32.5%) were IDHwild-type. Upon single-marker MVA, both IDHmutant subgroups were associated with significantly better OS and PFS ( P values < .001), compared with the IDHwild-type subgroup. MGMT promoter methylation was obtained on 76 patients, where 58 (76%) were methylated and 18 (24%) were unmethylated. Single-marker MVAs demonstrated that MGMT promoter methylation was statistically significant for OS ( P value < .001) and PFS ( P value = .003). In a multimarker MVA, one WHO subgroup comparison ( IDHmutant/co-deleted v IDHwild-type) was significant for OS ( P value = .045), whereas MGMT methylation did not retain significance.

CONCLUSION

This study reports the long-term prognostic effect of the WHO molecular subgroups, MGMT promoter methylation, and other mutations in NRG/RTOG 0424. These results demonstrate that the WHO molecular classification and MGMT both serve as strong prognostic indicators, but that MGMT does not appear to add statistically significant prognostic value to the WHO subgrouping, above and beyond IDH and 1p/19q status.
Rate of Gestational Weight Gain and Glucose-Insulin Metabolism Among Hispanic Pregnant Women With Overweight and Obesity
Authors: Lindsay Karen L , Gyllenhammer Lauren E , Entringer Sonja , Wadhwa Pathik D
Published: September 2021

Context

Hispanic women are at elevated risk of gestational glucose intolerance and postpartum type 2 diabetes compared with non-Hispanic White women. Identification of potentially modifiable factors contributing to this trajectory of beta-cell dysfunction is warranted.

Objective

We aimed to determine the association between rate of gestational weight gain (rGWG) and glucose-insulin metabolism in Hispanic pregnant women with overweight and obesity.

Methods

This cross-sectional, observational study, conducted from 2018-2020 at the clinical research center at University of California, Irvine, included 33 nondiabetic Hispanic pregnant women at 28 to 30 weeks’ gestation with pre-pregnancy body mass index (BMI) 25.0 to 34.9 kg/m2. Participants consumed a standardized liquid mixed meal after an overnight fast. Serial blood samples were collected at fasting and up to 2 hours postprandial. The glucose and insulin area under the curve (AUC), insulin sensitivity index (ISI) and insulin secretion sensitivity index (ISSI)-2 were computed.

Results

Average rGWG (0.36 ± 0.22 kg/week) was classified as excessive in 60% of women. While rGWG was not associated with the glucose or insulin AUC or ISI, it accounted for 13.4% of the variance in ISSI-2 after controlling for covariates (maternal age, parity, and pre-pregnancy BMI); for each 1 unit increase in rGWG, ISSI-2 decreased 2.1 units (P = 0.015).

Conclusion

Even in the absence of gestational diabetes, rGWG was inversely associated with beta-cell function in a high-risk population of Hispanic pregnant women with overweight and obesity. Beta-cell decline is an established risk factor for transition to type 2 diabetes, and these cross-sectional findings highlight rGWG as a potentially modifiable contributor to this process.
Approach to Neurologic Infections
Authors: Berkowitz Aaron L.
Published: September 2021

PURPOSE OF REVIEW

This article provides an overview of the clinical approach to the diagnosis of neurologic infections, focusing on the symptoms, signs, imaging features, and laboratory findings of the major categories of neuroinfectious diseases.

RECENT FINDINGS

The increased use of immunosuppressive and immunomodulatory therapy to treat autoimmune diseases has led to an increase in opportunistic neurologic infections. The description of numerous causes of autoimmune antibody–mediated encephalitis over the past decade has expanded the differential diagnosis of encephalitis beyond infection. The emergence of metagenomic next-generation sequencing has led to diagnoses of rare or unexpected causes of neurologic infections and has the potential to enhance diagnostic precision in neuroinfectious diseases.

Infections of the nervous system can affect any level of the neuraxis and present over any time course. Neurologic infections may present atypically with respect to clinical, radiologic, and CSF analysis features in immunocompromised patients or older adults. A thorough evaluation including systemic features, past medical history, travel, exposures, detailed examination, neuroimaging, and CSF analysis is often necessary to make a definitive diagnosis. It is important to be aware of the test characteristics and limitations of microbiological tests on CSF for neurologic infections to avoid being misled by false positives or false negatives.
Neurologic Complications of Lyme Disease
Authors: Roos Karen L.
Published: September 2021

PURPOSE OF REVIEW

This article reviews the symptomatology, diagnosis, and treatment of neuroborreliosis.

RECENT FINDINGS

The most recent guidelines for the diagnosis and treatment of Lyme disease were published in 2020 by the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology.

The most common neurologic complications of Lyme disease are cranial neuritis (most often a unilateral or bilateral facial nerve palsy), meningitis, and radiculoneuritis/mononeuropathy multiplex. Testing for Lyme disease begins with an enzyme-linked immunosorbent assay (ELISA). If the ELISA is positive or borderline, Western blots should be performed for both IgM and IgG antibodies. As a general rule, in infectious diseases, an IgM antibody response is followed by an IgG antibody response. A central nervous system infection has either a CSF pleocytosis or pathogen-specific intrathecal antibody production. Lyme meningitis, cranial neuropathy, radiculoneuropathy, or other peripheral nervous system manifestations are treated with oral doxycycline or IV ceftriaxone, cefotaxime, or penicillin G. No additional antibiotic therapy is indicated for patients with posttreatment Lyme disease syndrome or patients with concern for chronic Lyme disease with no evidence of previous or current Lyme infection.
Meningitis
Authors: Aksamit Allen J. , Berkowitz Aaron L.
Published: September 2021

PURPOSE OF REVIEW

This article reviews the diagnosis and treatment of infectious meningitis, including updates on newer molecular diagnostic techniques for microbiological diagnosis.

RECENT FINDINGS

New polymerase chain reaction (PCR)-based molecular diagnostic techniques have improved the timeliness of microbiological diagnosis in meningitis, but clinicians must be aware of the limitations of such tests. Next-generation sequencing can now be applied to CSF, allowing for diagnosis of infections not identifiable by conventional means.

Infectious meningitis can be caused by a broad range of organisms. The clinician must be aware of the test characteristics of new molecular techniques for microbiological diagnosis as well as traditional techniques to tailor antimicrobial therapy appropriately in patients with meningitis.
Effective Dose of Prophylactic Oxytocin Infusion During Cesarean Delivery in 90% Population of Nonlaboring Patients With Preeclampsia Receiving Magnesium Sulfate Therapy and Normotensives: An Up-Down Sequential Allocation Dose-Response Study
Authors: Tyagi Asha , Mohan Aparna , Singh Yuvraj , Luthra Ankit , Garg Devansh , Malhotra Rajeev Kumar
Published: September 2021

BACKGROUND:

Oxytocin administration during cesarean delivery is the first-line therapy for the prevention of uterine atony. Patients with preeclampsia may receive magnesium sulfate, a drug with known tocolytic effects, for seizure prophylaxis. However, no study has evaluated the minimum effective dose of oxytocin during cesarean delivery in women with preeclampsia.

METHODS:

This study compared the effective dose in 90% population (ED90) of oxytocin infusion for achieving satisfactory uterine tone during cesarean delivery in nonlaboring patients with preeclampsia who were receiving magnesium sulfate treatment with a control group of normotensives who were not receiving magnesium sulfate. This prospective dual-arm dose-finding study was based on a 9:1 biased sequential allocation design. Oxytocin infusion was initiated at 13 IU/h, on clamping of the umbilical cord, in the first patient of each group. Uterine tone was graded as satisfactory or unsatisfactory by the obstetrician at 4 minutes after initiation of oxytocin infusion. The dose of oxytocin infusion for subsequent patients was decided according to the response exhibited by the previous patient in the group; it was increased by 2 IU/h after unsatisfactory response or decreased by 2 IU/h or maintained at the same level after satisfactory response, in a ratio of 1:9. Oxytocin-associated side effects were also evaluated. Dose-response data for the groups were evaluated using a log-logistic function and ED90 estimates were derived from fitted equations using the delta method.

RESULTS:

The ED90 of oxytocin was significantly greater for the preeclampsia group (n = 27) than for the normotensive group (n = 40) (24.9 IU/h [95% confidence interval {CI}, 22.4–27.5] and 13.9 IU/h [95% CI, 12.4–15.5], respectively); the difference in dose requirement was 10.9 IU/h (95% CI, 7.9–14.0; P < .001). The number of patients with oxytocin-related hypotension, defined as a decrease in systolic blood pressure >20% from baseline or to <90 mm Hg, was significantly greater in the preeclampsia group (92.6% vs 62.5%; P = .030), while other side effects such as ST-T depression, nausea/vomiting, headache, and flushing, were not significantly different. There was no significant difference in the need for additional uterotonic or uterine massage, estimated blood loss, and need for re-exploration for uncontrolled bleeding.

CONCLUSIONS:

Patients with preeclampsia receiving preoperative magnesium therapy need a greater intraoperative dose of oxytocin to achieve satisfactory contraction of the uterus after fetal delivery, as compared to normotensives.
Singlewomen and Illicit Pregnancy in Late Medieval France
Authors: McDougall Sara
Published: September 2021

This article examines the consequences of extramarital pregnancy for women in late medieval France. Pregnancy outside marriage is typically thought of as a disaster for women and children alike and for their families. However, careful analysis of records of royal pardon, other legal and prescriptive sources, and a wide range of other materials all suggests otherwise. The article demonstrates that, at least for some single mothers in late medieval France, illicit pregnancy did not necessarily mean disaster at all. Pregnant women could help themselves, and were helped by others. All this has important implications for our understanding of the regulation of sexuality and reproduction in late medieval France, and of the role of mercy in medieval justice.

Cet article examine les conséquences des grossesses illicites pour les mères célibataires dans le Nord de la France à la fin du Moyen Age. La grossesse hors mariage est traditionnellement considérée comme une catastrophe pour les mères et les enfants, ainsi que pour leurs familles. Une analyse des documents relatifs à la grâce royale, d'autres sources juridiques et normatives et d'un large éventail d'autres documents suggère tout le contraire. L'article montre que, du moins pour certaines mères célibataires de la France médiévale tardive, une grossesse illicite ne signifie pas nécessairement une catastrophe. Les mères pouvaient s'aider elles-mêmes et étaient aidées par d'autres. Cette conclusion a des implications importantes pour la réglementation de la sexualité et de la reproduction, et pour le rôle de la miséricorde dans la justice médiévale.
Study on the Gel Cleaning System for Removal of Poly (vinyl acetate) Fixative
of the Mural Paintings of the Payathonzu Temple in Bagan, Myanmar (I)
- Focusing on Properties and Removability of Gel Cleaners -
Authors: Yu Yeong Gyeong , Han Gyu-Seong , Lee Hwa Soo , Han Kyeong Soon
Published: September 2021

In the past, PVAc [poly(vinyl acetate)] was used as a fixative for the conservation of the murals in the murals of the Payathonzu temple located in Bagan, Myanmar. In this study, attention was paid to gel cleaning as a method for stably removing such PVAc fixatives. Based on the recent research trend related to the cleaning of murals in Bagan ruins, 3 types of gelling agents (Nevek®, Laponite®RD, Carbopol®980) and 2 types of organic solvents (Acetone, Dimethyl carbonate) were selected. Six types of gel cleaners were prepared by mixing gelling agents and organic solvents, and the properties and fixative removability of these cleaners were compared. As a result of confirming the properties of the prepared gel cleaners, the pH of the cleaners was all in the weak acidic to weakly alkaline range, which was a stable condition for mural application. Also, there was no difference in the viscosity of the cleaners depending on the type of solvent, but there was a difference depending on the type of gelling agent used. Regarding the weight loss ratio of PVAc, which is an indicator of removability, the exposure conditions of the gel cleaners, the boiling point of the solvent used, and the viscosity of the gelling agent acted as factors affecting. As a result of comparing the removability of gel cleaners, it was confirmed that the solvent’s fixative solubility, the volatility of the solvent itself, and the solvent release control properties of the gelling agent had a great effect on the removability of the gel cleaners. In Part 2, the stability and the running applicability of the gel cleaners will be investigated by making mockup samples reflecting the properties of the materials and techniques used to produce the mural paintings in the Payathonzu Temple.
ПРОБЛЕМЫ КАДРОВОГО ПЛАНИРОВАНИЯ В РОССИЙСКИХ КОМПАНИЯХ И ИНСТРУМЕНТЫ ИХ УСТРАНЕНИЯ
Authors: Demidova Elena V.
Published: September 2021

Автор статьи исходит из того, что кадровое планирование играет решающую роль в реализации стратегии кадровой политики предприятия, способствует ее воплощению через соответствующие мероприятия. Комплектование современными кадрами всех подразделений предприятия невозможно без четкого планирования персонала, которое согласуется с производственными, финансовыми планами, планами научно-исследовательских работ и другими планами предприятия.
В силу того, что система планирования на предприятии включает в себя системную работу по разработке планов - стратегического плана, долговременного плана, текущих и оперативных планов, то особое внимание следует уделить стратегическому плану, который являясь основополагающим, определяет главные цели предприятия на 10-15 лет вперед, нацелен на долговременное решение вопросов стратегии предприятия. В отличие от него, текущее планирование увязывает все направления деятельности предприятия и работу функциональных служб предприятия, в том числе и службу управления персоналом, однако не является определяющим в перспективном развитии бизнеса.
Практические работники отмечают, что тенденцией развития бизнеса последнего времени стало признание и понимание факта взаимосвязи эффективности кадрового планирования с эффективностью самой организации, в отличие от устаревших взглядов об исключительно закрытии кадровой потребности данной функцией [16, с. 11].
Актуальность и новизна работы определяется тем, что формирование и совершенствование эффективной системы кадрового планирования как предпосылки поступательного развития предприятия выступает базой для определения дальнейших путей изучения данного института на современном этапе, с экстраполяцией результатов на будущее время. Предложенные рекомендации по развитию кадрового планирования на основе передовых международных кадровых технологий позволят преодолеть недостатки существующих моделей их функционирования.
Цель – разработка рекомендаций по решению наиболее распространенных вопросов совершенствования кадрового планирования на предприятии с учетом последних тенденций HR-технологий.
Метод или методология проведения работы: в статье использовались общенаучные методы, а также метод экспертных оценок, метод скорректированной экстраполяции планирования персонала.
Результаты: получена модель развития инструментов кадрового планирования с привязкой к стратегии развития предприятия.
Область применения результатов: полученные результаты возможно применять на производственных предприятиях и организациях.
Ceramic supplier selection using analytical hierarchy process method
Authors: Rahmiati Filda , Syafei H.M Yani , Purwanto Purwanto , Andianto Jonathan
Published: September 2021

This study tried to implement the Analytical Hierarchy Process (AHP) and the weights of the criteria and sub-criteria to find the best supplier. According to QCDFR (quality, cost, delivery, flexibility, and responsiveness). This study took place in one of the biggest tile producers, ranks fifth in the world and the first in Indonesia. However, the company currently only uses quality, cost, and delivery methods to choose the best supplier of raw material, namely feldspar. This research tries to use the systematic method to find the best supplier based on the importance of the criteria. The method used the quantitative approach to enumerate the data to analyze the information.  The company analyzed six suppliers. The primary tool used in this research is a Super Decision Software version 3.2 to create and manage the AHP model, enter the judgments, get results, and perform sensitivity analysis on the results. The result found that Semarang is the best supplier. The company will choose Semarang to become the company's business partner compared to the other suppliers because Semarang has met the criteria that the company prioritizes the most. By having the best supplier selection, the company can provide the right material consistency and suitable material suitability.
Prevalence and Determining Factors of Stunting among School-Aged Children in a Rural Nigerian Community: A Cross-Sectional Study
Authors: Okafor Adaobi Mary-Ann , Ikwumere Chinaza Mary , Egumgbe Uchechukwu Dominica , Eze Chidimma Bibian , Obitulata Chiamaka Glory
Published: September 2021

Stunting, an indicator of chronic childhood under-nutrition, is a challenging community health issue among rural Nigerian school children. This study assessed the prevalence and determining factors of stunting among school-aged children (SAC) in a rural Nigerian community. Three hundred and eighty SAC from government primary schools in Achi, Oji-River Local Government Area, Enugu state were selected for the study using multistage sampling technique. Structured and validated questionnaire, anthropometric measurements and biochemical assessments of serum zinc, presence of malaria and intestinal parasites were used for data collection.Stunting, underweight, thinness and overweight prevalence were 21.1%, 17.0%, 16.6% and 10.0%, respectively. Zinc deficiency, malaria and intestinal parasitemia existed in 12.5%, 27.5% and 35.0%, respectively. SAC who were males, 6-8 years, of the third birth order, underweight, overweight, zinc deficient and had intestinal parasitemia had higher odds of being stunted. Having secondary education, farming as an occupation and low monthly income among the mothers; nuclear family system and household size of ≥ 9 were other determinants of stunting observed in the study. These findings suggest the need for targeted intervention against the major determinants of stunting in the area.
Oral Administration of Lactobacillus casei and Bifidobacterium bifidum Improves Glucagon like Peptide-1(GLP-1) and Glucose-Dependent Insulinotropic Polypeptide (GIP) Level in Streptozotocin Induced Diabetic Rats
Authors: Srivastava Sumiran , Singh Prof. Rambir
Published: September 2021

The gut microbiome plays significant role in the function and integrity of the gastrointestinal tract. They also maintain immune homeostasis and host energy metabolism. The metabolic products of these intestinal microbes can alter carbohydrate metabolism, nutrient absorption and reduce appetite to promote healthy lifestyle. Intestinal disbiosis observed in metabolic disorders like obesity and diabetes. Restoration of dysbiosed gut microbiome through oral administration of probiotics that may have profound health effect in diabetes. In case of diabetes, reports postulated impaired level of incretin, therefore we explored the effect of oral administration of probiotic bacteria Lactobacillus casei NCDC 017 (LC017) and Bifidobacterium bifidum NCDC 231 (BB231) alone and in combination on secretion of incretin hormones such as glucagon like peptide-1 and glucose dependent insulinotropic polypeptide. Thirty six male Wistar rats were randomly divided into six groups and diabetes was induced by single dose of streptozotocin (50 mg/kg body weight) in experimental rats intraperitonially except a group of healthy rats. The diabetic rats were daily administered orally with single dose (~107cfu/ml) of LC017 and BB231 alone and in combination for 28 days. Also, one group of diabetic rats was treated with an anti-diabetic drug, acarbose (10mg/kg body weight) and used a standard control. The change in body weight, sucrose tolerance test, GLP-1, GIP level in serum and GLP-1 level in different part of intestine were observed. The results have shown reduction in body weight in diabetic rats as compared to non-diabetic rats but improved after treatment of probiotic bacteria. Administration of LC017 and BB231 significantly improved GLP-1 and GIP level which were initially impaired in diabetic rats and their combination significantly decreased glucose level in sucrose tolerance test. This study indicated that LC017 and BB231 have significant hypoglycaemic potential in diabetic rats by increasing GLP-1 and GIP level. These findings offered a base for the use of LC017 and BB231 for improvement and treatment of diabetes.
Quality Improvement of Cakes with Buckwheat Flour, and its Comparison with Local Branded Cakes
Authors: Farzana Tasnim , Fatema Jannatun , Hossain Fahiza Bisrat , Afrin Sadia , Rahman Shaikh Shahinur
Published: September 2021

Buckwheat is one of the potential food ingredients for the functional food industry. A growing trend for consumer demand highlights the need for the development of composite flour-based bakery products like cookies and cakes. The aim of this study was to analysis the nutrient composition, and microbiological safety examination of buckwheat fortified cakes (BFC), as well as comparative evaluation with locally available branded cakes (LBC). BFC was prepared with the incorporation of 10, 20, 30, and 40% buckwheat flour in wheat flour to measure the quality and acceptability of cakes. As the concentration of buckwheat flour was increased up to 30%, BFC got the best quality, and high sensorial acceptability score evaluated by skilled panelists. BFC had the highest protein, fat, fiber, and micronutrients than all other LBC. No significant (P<0.05) changes were found in sensory tests of the tested cakes. On the basis of microbiological point of view, BFC was found acceptable up to 09 days. Therefore, cake prepared with the incorporation of 30% buckwheat in wheat flour is nutritionally more acceptable than other cakes available in Bangladesh.