bluuebunny/crossref_metadata_2025 huggingface dataset:
Creative Placemaking: Creating Change by Building Partnerships
Authors: Daniel Jamie Levine , Kim Mirae
Published: April 2020

Arts, artists, and creative strategies can be critical vehicles for achieving social, economic, and community goals. Creative placemaking is one type of arts-led planning that incorporates the goals of communities with stakeholder participation. Questions exist, however, around who participates in the creative placemaking process and to what end. This study explores a case where a state-sponsored workshop brought together people from diverse backgrounds to facilitate community development and engagement through creative placemaking. The study highlights how a one-shot intervention can reshape perceptions of creative placemaking that are held by planners, nonplanners, artists, and nonartists. The study shows that while pre-workshop participants focused on identifying resource-based challenges, post-workshop participants focused more on initiating collaborations and being responsive to community needs. The different attitudes before and after the state-sponsored workshop demonstrate the importance of not only building stakeholder understanding but also facilitating stakeholder engagement for successful creative placemaking.
Preliminary Analysis of COVID-19 Academic Information Patterns: A Call for Open Science in the Times of Closed Borders
Authors: Homolak Jan , Kodvanj Ivan , Virag Davor
Published: April 2020

Introduction: The Pandemic of COVID-19, an infectious disease caused by SARS-CoV-2 motivated the scientific community to work together in order to gather, organize, process and distribute data on the novel biomedical hazard. Here, we analyzed how the scientific community responded to this challenge by quantifying distribution and availability patterns of the academic information related to COVID-19. The aim of our study was to assess the quality of the information flow and scientific collaboration, two factors we believe to be critical for finding new solutions for the ongoing pandemic. Materials and Methods: The RISmed R package, and a custom Python script were used to fetch metadata on articles indexed in PubMed and published on rXiv preprint server. Scopus was manually searched and the metadata was exported in BibTex file. Publication rate and publication status, affiliation and author count per article, and submission-to-publication time were analysed in R. Biblioshiny application was used to create a world collaboration map. Results: Our preliminary data suggest that COVID-19 pandemic resulted in generation of a large amount of scientific data, and demonstrates potential problems regarding the information velocity, availability, and scientific collaboration in the early stages of the pandemic. More specifically, our results indicate precarious overload of the standard publication systems, delayed adoption of the preprint publishing, significant problems with data availability and apparent deficient collaboration. Conclusion: In conclusion, we believe the scientific community could have used the data more efficiently in order to create proper foundations for finding new solutions for the COVID-19 pandemic. Moreover, we believe we can learn from this on the go and adopt open science principles and a more mindful approach to COVID-19-related data to accelerate the discovery of more efficient solutions. We take this opportunity to invite our colleagues to contribute to this global scientific collaboration by publishing their findings with maximal transparency.
International Tourism and COVID-19: Recovery Strategies for Tourism Organisations
Authors: Strielkowski Wadim
Published: April 2020

The coronavirus pandemic will deeply affect the tourism and travel sector. It is already clear now that its economic impact would be more severe that in the case of the Severe Acute Respiratory Syndrome (SARS) in 2002-2003. Although not as deadly as SARS, coronavirus infection has a longer incubation period and leaves about 85% of the infected without any (or with just mild) symptoms which makes it more difficult to track and to contain. Moreover, it appears to be much more contagious than its predecessor. The goods news is that most people recover from the disease and develop antibodies that can protect them from getting infected again (natural vaccination). Those cured might become the key element for the post-virus recovery strategies of tourism organisations. People with the acquired immunity to the virus would be capable of travelling freely without spreading the disease. Airlines, hotels and gastronomy should aim at this group offering them discounts and special offers. However, the problem is how to effectively ensure that everyone who claims to be cured from COVID-19 is telling the truth. Health tracking bracelets, apps, and other advanced technological solutions should be put in place. Recent best practices from Hong Kong, mainland China, or India might be applied.
Systematic Cell Line-Based Identification of Drugs Modifying ACE2 Expression
Authors: Sinha Sanju , Cheng Kuoyuan , Aldape Kenneth , Schiff Eyal , Ruppin Eytan
Published: April 2020

The COVID-19 pandemic caused by SARS-COV-2 has infected over 500,000 people causing over 25,000 deaths in the last 10 weeks. A key host cellular protein required for the virus entry is angiotensin-converting enzyme 2 (ACE2). Recent studies have reported that patients with hypertension and diabetes treated with ACE inhibitors or angiotensin receptor blockers might be at a higher risk of COVID-19 infection as these drugs have been reported to increase ACE2 expression. This has raised the need to systematically investigate the effect of different drugs including antihypertensives on modulating ACE2 expression. Here, we analyzed a publicly available CMAP dataset of pre/post transcriptomic profiles for drug treatment in cell lines for over 20,000 small molecules. We show that only one subclass of antihypertensives drugs - ACE inhibitors, are significantly enriched for drugs up-regulating ACE2 expression. Studying the effects of the 672 clinically approved drugs in CMAP, we chart the drug categories that affect ACE2 expression. Specifically, we find that panobinostat (an HDAC inhibitor) confers the highest up-regulation of ACE2 expression while isotretinoin (a vitamin A derivative) is its strongest down-regulator. Our results provide initial candidates guiding further in vitro and in vivo studies aimed at assessing drug effects on ACE2 expression.
Inhibition of Viral Macrodomain of COVID-19 and Human TRPM2 by losartan
Authors: Sallari Jazzi Azhar , Mahnam Karim , Hossein Hejazi Sayed , Damavandi Mohammad Sadegh , Sadeghi Parisa , Zeinalian Mehrdad , Tabesh Faezeh , Mirbod Seyedeh Mahnaz , Khanahmad Hossein
Published: April 2020

Background: The SARS-CoV-2 virus is a new highly contagious Coronavirus with a positive-sense RNA encoding 16 non-structural proteins (nsps16, nsp15, nsp3). In this study, the coronavirus pathogenicity and the losartan functional ligand for inhibiting TRPM2 and macrodomain have been molecularly evaluated.Material and method: In this study, the structures of macrodomain binding ADP ribose in CoVs and human Transient Receptor Potential Cation Channel Subfamily M Member 2 (TRPM2) protein were downloaded from protein data bank. Then, a virtual screening was done to recognize the hit compounds from GalaXi_2019-10, KnowledgeSpace_2019-05, and REALspace_2019-12 databases. This collection, then, was imported to the ligandScout software, on the base of Adenosine Diphosphate Ribose (ADPR) pharmacophore model. Result: Among seven compounds, five compounds were finally evaluated as the structural analogs of ADPR or other nucleotides, from which one compound was a non-FDA-approved sulphonamide and was removed. The other compound, losartan, was finally selected for molecular docking and molecular dynamic simulation. According to the virtual screening and docking, losartan was candidate as an effective ligand for TRPM2 and macrodomain. Conclusion: In the current study losartan earned a proper dock score and binding affinity to create the complexes with TRPM2 and macrodomain. The inhibitory effect of losartan on PARP has been shown and it could interfere positively in several points (PARP, PARG- macrodomain and TRPM2) and decreases oxidative stress and apoptosis in COVID-19.
Modeling Popularity and Reliability of Sources in Multilingual Wikipedia
Authors: Lewoniewski Włodzimierz , Węcel Krzysztof , Abramowicz Witold
Published: April 2020

One of the most important factors impacting quality of content in Wikipedia is presence of credible sources. By following references readers can verify facts or find more details about described topic. A Wikipedia article can be edited independently in any of over 300 languages, even by anonymous users, therefore information about the same topic may be inconsistent. This also applies to use of references in different language versions of a particular article, so the same statement can have different sources. In this paper we analyzed over 40 million articles from the 55 most developed language versions of Wikipedia to extract information about nearly 200 million references and find the most popular and reliable sources. We presented 10 models for the assessment of the popularity and reliability of the sources based on analysis of meta information about the references in Wikipedia articles, page views and authors of the articles. Using DBpedia and Wikidata we automatically identified the alignment of the sources to a specific domain. Additionally, we analyzed the changes of popularity and reliability in time and identified growth leaders in each considered months. The results can be used for quality improvements of the content in different languages versions of Wikipedia.
PENGARUH PERKUATAN TIANG TERHADAP STABILITAS TIMBUNAN DIATAS TANAH LUNAK MENGGUNAKAN METODE ELEMEN HINGGA
Authors: Setiawan Bambang , Dananjaya H.I. Raden Harya , Fathurrahman Muhammad
Published: April 2020

Pile strength is widely used as a solution to the problem of road pavement on soft soil, because it can reduce vertical displacement due to the load on it and increase the safety factor value. This research analyses the vertical displacement, safety factor, effective stress and bearing capacity of the embankment on soft soil using the finite element method so the results can approach the original conditions in the field. The pile variations used are pile size variations 20x20 cm2; 25x25 cm2; and 30x30 cm2 with a square shape, variations in the distance between the piles 1,60 m; 1,80 m; 2,00 m; and 2,20 m, the depth variations 15,00 m; and 20,00 m. Loading uses truck loads based on RSNI T-14-2004 and the road classification is artery IA. The results of the analysis show that pile strength with a size 20x20 cm2, the distance between pile is 1,60 m and the depth of the piles 20 m can reduce the vertical displacement by 71,31% and increase the safety factor by 123,25%.
PERUBAHAN KUAT GESER TANAH LEMPUNG TANON PADA METODE ELEKTROOSMOSIS DENGAN VARIASI BEDA POTENSIAL
Authors: Handayani Tri Nugraheni , Surjandari Niken Silmi , Djarwanti Noegroho
Published: April 2020

Soft clay soil located in Kalikobok village, Tanon, Sragen is one of soil type that does not qualify to build a structural building on it, because the characters of soft clay soil that has height of water content which is causing the soil carrying capacity becomes low. In other way, if the water content is low, then it will increase the carrying capacity of the soil. Dewatering process is needed, one of the examples is by electroosmosis methods. Electroosmosis is a drainage method by force that drain the water from anode to cathode so it will fix the technical properties  of soil. In this study the variables used are the length of time of the electric current and the voltage. The variation of duration is three days and five days, the variation of potential difference that used is 0 volts, 4.5 volts, 9 volts, and 12 volts. The parameters that tested as a comparison are soil shear strength of soil at each voltage and position (anode, middle, cathode). The results showed that the greater application of potential differences can increase the values of c and φ, but the value of c at the cathode position decrease due to water accumulation at the cathode.
Analysing Effect of Direction of Layups to Distortions of Laminated Carbon Fibre-Reinforced Composites
Authors: Smaradhana Dharu Feby
Published: April 2020

The distortions of the laminates (flat panels and channel sections) with different stacking sequences were investigated in this lab session. There were two methods compared, measurement of the experimental specimens and prediction using classical laminate theory. The experimental results showed that the specimens with layup (90,03) and (03,90) had the largest curvature. The spring forward/back angles of the measurement was higher than those of the prediction though the trends of the distortions of the channel and the flat specimens were almost similar. There were several factors affecting distortions such as the tool thermal expansion, chemical shrinkage, the arrangement of vacuum bag and edge effects.
Formulasi Cookies dengan Substitusi Tepung Daging Ikan Bandeng (Chanos chanos) Menggunakan Teknik Pemrograman Linier
Authors: Sari Yufia Vita , Rejeki Fungki Sri , Puspitasari Diana
Published: April 2020

Ikan bandeng merupakan salah satu bahan pangan yang hingga saat ini pemanfaatannya masih terbatas, padahal ditinjau dari nilai gizinya ikan bandeng ini tinggi akan protein dan Omega-3 dibandingkan dengan ikan-ikan yang lain. Pengolahan cookies dari ikan juga merupakan salah satu upaya penanggulangan bahan baku yang cepat mengalami pembusukan dan dapat menambah nilai guna dari bahan baku ikan, yang terlebih dahulu diolah menjadi tepung ikan. Tepung daging ikan bandeng masih belum dimanfaatkan untuk pangan, karena sampai saat ini pemanfaatannya hanya terbatas sebagai campuran tepung ikan untuk pakan ternak. Penelitian ini bertujuan untuk merumuskan model optimasi dalam membuat formulasi cookies substitusi tepung daging ikan bandeng dengan teknik pemrograman linier, untuk mengetahui kelayakan finansial produk cookies tepung daging ikan bandeng.  Dalam penelitian ini menggunakan penyelesaian Metode Simpleks. Hasil dari pemecahan model matematik, menunjukkan bahwa komposisi bahan susu bubuk penggunaannya dapat dihilangkan maupun tidak. Harga susu bubuk yang cukup mahal mengakibatkan penggunaan bahan harus dibatasi atau dihilangkan untuk meminimalkan biaya produksi cookies tepung daging ikan bandeng.
Strategy Design Method Based on Corporate Learning System
Authors: Kavaliou A. V. , Hromava A. V.
Published: April 2020

The paper proposes a method for a strategy design that corresponds to concept of dynamic capabilities. The advan-tages and disadvantages of the methods of strategy design used by various schools of strategic management are demonstrated. The authors postulate inconsistency between a new stage of scientific knowledge and the related technique of strategic analysis and strategy design methods. The purpose of the article is to develop a method for creation a strategy based on a learning system as a key element of a competitive advantage in the concept of dynamic abilities. The method compares favorably with approaches based on the analysis of the external environment, which have a methodological contradiction, since such a stra-tegy is available to all market actors, and it is easy to repeat it. Unlike the methods of the “basic” resource concept, the proposed one allows you to expand an approach to design a strategy precisely from the standpoint of strategic actions in relation to the resources, capabilities, and competencies of the company, which can be combined into clusters that provide a syner-gistic effect. The long-term horizon of the strategy invariably requires the inclusion of corporate learning system as a gene-rator  of  organizational  capabilities into the various clusters.  It has been noted  that the speed of  reaction to changes which is required in a contemporary competitive environment puts forward a corporate learning system as a key competency of a company. The method corresponding to the concept of dynamic capabilities creates the possibility of developing a strategy based on a corporate learning system and provides a dynamic sustainable competitive advantage.
Energy Saving as Key Factor for Increasing Country’s Energy Security
Authors: Korsak E. P. , Nadomin V. A.
Published: April 2020

Power engineering is one of the main types of economic activity of the Republic of Belarus. The priority deve-lopment of the country’s energy sector is determined by its key role in ensuring the efficient functioning of the national economy,  stable  operation  of  the  social infrastructure, and observance of  social  norms  and  standards  for  the  population. and importance of energy resources for the development of the economy and society as a whole can hardly be overestimated because of their active influence on the intensity of production and consumption processes. Currently, the main sources of energy are oil, natural gas, coal, oil shale and nuclear energy. Economy of the Republic is very dependent on energy imports. This is a serious test for the country under conditions of constant rise in hydrocarbon prices. Belarus imports more than 90 % of oil, 100 % of natural gas and 25 % of liquefied gas and 100 % of the whole consumed coal. The energy intensity of domestic enterprise products is significantly higher than in industrialized countries. Therefore, improvement of energy efficiency is fundamental for our country. In this regard, a real economic sector depends on the stable operation of energy enterprises, timely modernization of equipment, rational use of fuel and energy resources and effective implementation of energy conservation measures. Most of the energy sector problems can be solved by improving the energy security indicators of the Republic, namely, as a result of the introduction of a range of energy-saving measures, use of secondary energy resources and development of renewable energy sources.
Specific Features of Modern Innovative Environment in the Republic of Belarus
Authors: Bliznyuck O. S.
Published: April 2020

The paper is devoted to study of the modern innovative environment in the Republic of Belarus, its most important characteristics, problem areas. A conceptual apparatus has been given in the paper that determines an innovative environment, institutional conditions that contribute to its formation, priorities for development of research activities have been given and specified in the paper with due account of the requirements for modernization of the economy. The paper presents a definition of the innovation system which is given by distinguished western scientists and researchers who have been seriously engaged in its study. The aim of the research is qualitative, quantitative analysis of the innovation environment of the Republic of Belarus and also a comparative  analysis of  the innovation  environment of  the  Republic of  Belarus, its main  components  (legal, financial support, institutional specific features of function- ning) against the background of Russia and Kazakhstan. The paper contains SWOT-analysis which is used  to find possible directions of  innovative development of  the economy of the Republic  of  Belarus  on the basis of the existing national economic system and taking into account the peculiarities of the national mentality. Attention has been attracted to the fact that such factor of innovative development as “innovative behavior of employees” which is one of the key factors of competitive advantage in the world's leading companies is very important for evaluation and analysis of the innovation environment. The paper presents  an own model of the national innovation  system which consists of three subsystems: human capital, technological infrastructure and innovation support subsystem. Process of creating innovative products  has been shown in the paper and these products make it possible to understand interrelation of  the innovative ideas market  and the market of innovative product. It is proposed to use a categorical apparatus of legal acts of the Republic of Belarus to describe and characterize the markets of innovative ideas and innovative products. The analysis has been performed while using legislative acts, resolutions of the Government of the Republic of Belarus, analytical articles, conference materials, electronic resources, official statistics of the National Statistical Committee of the Republic of Belarus.
Joint Optimization of Well Locations, Types, Drilling Order, and Controls Given a Set of Potential Drilling Paths
Authors: Lu Ranran , Reynolds A. C.
Published: April 2020

Much work has been performed on the optimal well placement/control problem, including some investigations on optimizing well types (injector or producer) and/or drilling order. However, to the best of our knowledge, there are only a handful of papers dealing with the following problem that is sometimes given to reservoir-engineering groups: given a potential set of reasonable drilling paths and a drilling budget that is sufficient to drill only a few wells, find the optimal well paths, determine whether a well should be an injector or a producer, and determine the drilling order that maximizes the net present value (NPV) of production over the life of the reservoir.

In this work, the optimal choices of drilling paths, types, and drilling order are found using the genetic algorithm (GA) with mixed encodings. A binary encoding for the optimization variables pertaining to well-location indices and well types is proposed to effectively handle a large amount of categorical variables, while the drilling sequence is parameterized with ordinal numbers. These two sets of variables are optimized both simultaneously and sequentially. Finally, control optimization using a stochastic simplex approximate gradient (StoSAG) is performed to further improve the NPV of life-cycle production.

The proposed workflow is tested on two examples: a 3D channelized reservoir where the potential well paths are either vertical or horizontal, and the Brugge model where only vertical wells are drilled. Both numerical examples indicate that GA combined with StoSAG is a viable solution to the problem considered.
Prognostic value of TP53 concurrent mutations for EGFR- TKIs and ALK-TKIs based targeted therapy in advanced non-small cell lung cancer: a meta-analysis
Authors: Qin Kang , Hou Helei , Liang Yu , Zhang Xiaochun
Published: April 2020

Background The prognostic significance of TP53 concurrent mutations in patients with epidermal growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)- mutated advanced non–small-cell lung cancer (NSCLC) who received EGFR-tyrosine kinase inhibitors (TKIs) or ALK-TKIs based targeted therapy remains controversial. Therefore, the present meta-analysis was performed to investigate the association between TP53 concurrent mutations and prognosis of patients with advanced NSCLC undergoing EGFR-TKIs or ALK-TKIs treatments. Methods Eligible studies were identified by searching the online databases PubMed, Embase, Medline, The Cochrane library and Web of Science. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to clarify the correlation between TP53 mutation status and prognosis of patients. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results In total, 15 studies with 1342 patients were included for final analysis. Overall, concurrent TP53 mutation was associated with unfavorable progression-free survival (PFS) (HR=1.88, 95%CI: 1.59-2.23, p<0.001, I2=0.0%, P=0.792) and overall survival (OS) (HR=1.92, 95%CI: 1.55-2.38, p<0.001, I2=0.0%, P=0.515). Subgroup analysis based on type of targeted therapy (EGFR-TKIs or ALK-TKIs, pathological type of cancer (adenocarcinoma only or all NSCLC subtypes) and line of treatment (first-line only or all lines) all showed that TP53 mutations was associated with shorter survivals of patients with EGFR-TKIs or ALK-TKIs treatments. Particularly, in patients with first-line EGFR-TKIs treatment, significantly poorer prognosis was observed in patients with TP53 concurrent mutations (pooled HR for PFS: 1.69, 95% CI 1.25-2.27, P<0.001, I2=0.0%, P=0.473; pooled HR for OS: 1.94, 95% CI 1.36-2.76, P<0.001, I2=0.0%, P=0.484). Begg’s funnel plots and Egger’s tests indicated no significant publication bias in this study. Conclusions This meta-analysis indicated that concurrent TP53 mutations was a negative prognostic factor and associated with poorer outcomes of patients with EGFR-TKIs or ALK-TKIs treatments in advanced NSCLC. In addition, our study provided evidence that TP53 mutations might be involved in primary resistance to EGFR-TKIs treatments in patients with sensitive EGFR mutations in advanced NSCLC.
Institutional Delivery Service Utilization and Associated Factors in Ethiopia: A Systematic Review and Meta Analysis
Authors: Nigusie Adane , Azale Telake , Yitayal Mezgebu
Published: April 2020

Background: Different primary studies in Ethiopia showed the weight of institutional delivery service utilization and the factors associated with it. However, variation among those studies was seen. This study was aimed to estimate the pooled national prevalence and associated factors of Institutional delivery service utilization in Ethiopia.Methods: PubMed, Cochrane library, Web of Science, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of associated factors.Result: A total of twenty four studies were included in this review. The pooled prevalence of Institutional delivery service utilization was 31% (95% CI: 0.30, 0.31; I2 = 0.00%). Attitude towards institutional delivery of 3 studies(AOR=2.83; 95% CI 1.35,5.92 ), maternal age at first pregnancy of 4 studies((AOR= 3.59; 95% CI 2.27,5.69 )), residence setting of 7 studies (AOR= 3.84; 95% CI 1.31, 11.25), educational status of 5 studies(AOR=2.91;95% 1.88,4.52), availability of information source of 6 studies(AOR= 1.80;95% CI 1.16,2.78), ANC follow-up of 13 studies((AOR= 2.57 95% CI 1.46,4.54 )), frequency of ANC follow up of 4 studies(AOR= 4.04;95% CI 1.21,13.46), knowledge of institutional delivery & danger signs during pregnancy of 11 studies((AOR=3.04;95% CI 1.76 ,5.24 )) and place of birth the most recent birth of 4 studies(AOR=8.44;95% CI 5.75,12.39) were identified factors of institutional delivery service utilization.Conclusions: The findings of this review found several modifiable factors such as empowering women through education, promoting antenatal care to prevent home delivery, increasing awareness of women through mass media and making services more accessible would likely to increase utilization of institutional delivery.
Access to health care for people with disabilities in rural Malawi: what are the barriers?
Authors: Harrison Josephine , Thomson Rachael , Banda Hastings T. , Mbera Grace B. , Gregorius Stefanie , Stenberg Berthe , Marshall Tim
Published: April 2020

Background

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored.

Methods

Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Short Set (WGSS) questions, were recruited. The WGSS questions concern a person’s ability in core functional domains (including seeing, hearing and moving), and a score of 3 indicates ‘a lot of difficulty’ whilst 4 means ‘cannot do at all’. People with cognitive impairments were not included in this study. All who were selected for the study participated in an individual in-depth interview and full recordings of these were then transcribed and translated.

Results

Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Attitudinal factors were explored and, whilst unfavourable health seeking behaviour was found to act as an access barrier for some participants, community and health care workers’ attitudes towards disability were not reported to influence health care accessibility in this study.

Conclusions

This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.

Key words

Health care access, barriers, disability, impairment, Malawi, rural, in-depth interviews
Changes in health inequalities for patients with diabetes among middle-aged and elderly in China from 2011 to 2015
Authors: Cao Guizhen , Cui Zhizhen , Ma Qinghua , Wang Congju , Xu Yong , Sun Hongpeng , Ma Yana
Published: April 2020

Objective: The purpose of this paper is to measure income-related health inequality among middle-aged and elderly patients with diabetes in China from 2011 to 2015 and to investigate factors that might be related to this inequality. Methods: The data for this study were obtained from the China Health and Retirement Longitudinal Study that was carried out in 2011, 2013 and 2015. In total, 48519 Chinese middle-aged and elderly patients were included (15457 in 2011, 16576 in 2013 and 16486 in 2015 ). A principal component analysis was performed to measure asset-based economic status. The concentration index was used to measure income-related inequality in patients with diabetes. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in patients with diabetes. Results: The prevalence of self-reported diabetes among middle-aged and elderly Chinese adults was 5.61%, 7.49% and 8.99% in 2011, 2013 and 2015, respectively. The concentration indices and 95% confidence intervals for diabetes were 0.1359 (0.0525-0.0597), 0.1207 (0.0709-0.0789), 0.1021 (0.0855-0.0942) in 2011, 2013, and 2015, respectively , which are indicative of inequality that favors the rich. The decomposition of the concentration index showed that urban location (39.38%), BMI (31.16%), education level (7.28%), and region (6.09%) had positive contributions to the measured inequality in diabetes in China in 2015. Age (-29.93%) had a negative contribution to inequality. Conclusions: The findings confirm a health inequality in diabetes that favor the rich. Furthermore, the inequality declined from 2011 to 2015. We suggest that policy and intervention strategies should be developed to alleviate this health inequality, such as establishing an integrated urban-rural medical insurance scheme.
First description of antimicrobial resistance in carbapenem-susceptible Klebsiella pneumoniae after imipenem treatment, driven by outer membrane remodeling
Authors: Tian Xuebin , Wang Qiongdan , New Laura Perlaza-Jiménez , Zheng Xiangkuo , Zhao Yajie , New Vijay Dhanasekaran , Fang Renchi , Li Jiahui , Wang Chong , Liu Haiyang , New Trevor Lithgow , Cao Jianming , Zhou Tieli
Published: April 2020

Background:The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a looming threat to human health. Although there are numerous studies regarding porin alteration in association with the production of ESBLs and/or AmpC β-lactamase, a systematic study on the treatment-emergence of porins alteration in antibiotic resistance does not yet exist. The aim of this study was to investigate the underlying mechanism and evolution of resistance of K. pneumoniae during carbapenem treatment.
Results:Here, we report three strains (FK-2624, FK-2723 and FK-2820) isolated from one patient before and after imipenem treatment during hospitalization. Antibiotic susceptibility testing indicated that that the first isolate, FK-2624, was susceptible to almost all tested antimicrobials, being resistant only to fosfomycin. The subsequent isolates FK-2723 and FK-2820 were multidrug resistant (MDR). After imipenem therapy, FK-2820 had evolved to be carbapenem-resistant. PCR and Genome Sequencing analysis indicated that oqxA, and fosA5, were identified in all three strains. In addition, FK-2624 also harbored bla SHV-187 and blaTEM-116. The blaSHV-187 and blaTEM-116 genes were not detected in FK-2723 and FK-2820. blaDHA-1, qnrB4, aac (6’)-IIc, and blaSHV-12, EreA2, CatA2, SulI, and tetD , were identified in both FK-2723 and FK-2820. Moreover, the genes bla DHA -1, qnrB4, aac(6’)-IIc were co-harbored on a plasmid. Of the virulence factors found in this study, ybtA, ICEKp6, mrkD, entB, iroN, rmpA2-6, wzi16 and capsular serotype K57 were found in the three isolates. The results of pairwise comparisons, multi-locus sequencing typing (MLST) and pulsed-field gel electrophoresis (PFGE) revealed high homology among the isolates. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) results showed that isolate FK-2820 lacked OmpK36, with genome sequence data validating that there was a premature stop codon in the ompK36 gene and real-time RT-PCR suggesting high turnover of the ompK36 non-sense transcript in FK-2820, with the steady-state mRNA level 0.007 relative to the initial isolate.
Conclusion:This study in China highlight that the alteration of outer membrane porins due to the 14-day use of imipenem play a potential role in leading to clinical presentation of carbapenem-resistance. This is the first description of increased resistance developing from a carbapenem-susceptible K. pneumoniae with imipenem treatment driven by outer membrane remodeling.
Why is tobacco control progress in Indonesia stalled? - A qualitative analysis of interviews with tobacco control experts
Authors: Astuti Putu Ayu Swandewi , Assunta Mary , Freeman Becky
Published: April 2020

Background Indonesia shoulders a significant tobacco burden, with almost two million cases of tobacco-related illnesses and more than two hundred thousand tobacco-related deaths annually. Indonesian tobacco control is progressing but lags behind other countries. Our study evaluates factors that contribute to the slow progress of tobacco policy change in Indonesia from the perspective of tobacco control experts (TCEs). Method We conducted qualitative interviews with four international and ten national TCEs, who have been active in tobacco control for at least 5 years. Our interview guideline included questions on the current tobacco control situation in Indonesia and explored reasons why tobacco control is progressing so slowly. The interviews were conducted either in English or Bahasa Indonesia, recorded and then transcribed verbatim. We conducted a thematic analysis based on five core causal factors for policy adoption: institutions, networks, socio-economic factors, agendas and ideas. Results The multistage delay of tobacco policy adoption is principally due to political structures and policy hierarchy, complex bureaucracy, unclear roles and responsibilities, and a high degree of corruption. The low bargaining position and lack of respect for the Ministry of Health also contributes. There are contrasting frames of tobacco as a strategic economic asset and tobacco control as a sovereignty threat. There is an imbalance of power and influence between well entrenched and resourced tobacco industry networks compared to relatively young and less established tobacco control networks. The policy agenda is likely influenced by the privileged position of tobacco in Indonesia as a socially acceptable product with high consumption. There are constraints on transferring ideas and evidence to successful policy adoption. Conclusion Tobacco companies have substantially influenced both policy decisions and public perceptions, signifying a power imbalance within the government system and broader networks. Acceding to and enforcing the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) would enable the Indonesian government to shift the power imbalance towards public health stakeholders. Tobacco control advocates must enhance their network cohesion and embrace other community groups to improve engagement and communication with policymakers.
Earthquake Preparedness of Households and Its Predictors Based on Health Belief Model
Authors: Rostami-Moez Masoumeh , Rabiee-Yeganeh Mohammad , Shokouhi Mohammadreza , Dosti-Irani Amin , Rezapur-Shahkolai Forouzan
Published: April 2020

Background : Earthquakes are one of the most destructive natural disasters in which many people are injured, disabled, or died. Although Iran has only one percent of the world's population, its earthquake-related deaths are six percent. Therefore, this study aimed to determine the level of earthquake preparedness of households and its predictors using the Health Belief Model (HBM) . Methods : This observational descriptive and analytical study was conducted on 933 households in Hamadan province, located in the west of Iran, in 2019. Multistage random cluster sampling was used for selecting the participants. The inclusion criteria were being at least 18 years old and being able to answer the questions. A questionnaire was used for data collection including earthquake preparedness, awareness of earthquake response, predictors of earthquake preparedness based on the HBM, and demographic information. Analysis of variance, independent t-test, and a linear regression model was used . Results : The mean age of participants was approximately 38.29 ±12.80 years. Furthermore, 60.83% of the participants did not complete a post-secondary education. The earthquake preparedness was low (approximately 30%) among households. There was a significant relationship between earthquake preparedness and gender, homeownership, marriage status, and previous earthquake experience (P <0.001). Regarding the HBM constructs, perceived benefits, cues to action, and self-efficacy were significant predictors of earthquake preparedness (P <0.01). conclusions: Earthquake preparedness was insufficient. Besides, perceived benefits, cues to action, and self-efficacy were predictors of earthquake preparedness. It is suggested that health providers take into account these predictors for designing future interventions. Keywords : Crises, Hazards, Health promotion, Health education, Natural disasters, Safety
Hypoxic hepatocellular carcinoma cells acquire arsenic trioxide resistance through upregulating HIF-1α expression
Authors: Chen Yaoting , Li Huiqing , Chen Dong , Jiang Xiongying , Wang Weidong , Li Dan , Shan Hong
Published: April 2020

Background : Although arsenic trioxide (ATO) is used in the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials, it is not satisfactory in terms of improving HCC patients’ overall survival. Intratumoral hypoxia and overexpression of hypoxia-inducible-1α (HIF-1α) may result in ATO-resistance and tumor progression. We investigated the mechanisms involving HIF-1α expression and acquired ATO chemoresistance in HCC cells and mice. Methods: The therapeutic effects of ATO in normoxic and hypoxic HCC cells were assessed using cell viability and apoptosis assays in vitro and a xenograft model in vivo . mRNA and protein expression of HIF-1α, P-glycoprotein, and VEGF were measured by qRT-PCR and western blotting. HIF-1α inhibition was performed to investigate the mechanism of ATO-resistance. VEGF secretion was tested using ELISA and tube-formation assays. Results : Compared to normoxic cells, hypoxic HCC cells were more resistant to ATO, with higher IC 50 values and less apoptosis, and upregulated HIF-1α protein expression, accompanied with the enhancement of P-glycoprotein and VEGF synthesis after ATO treatment. VEGF secretion was elevated in the supernatant of ATO-treated HCC cells, and this change can potentiate angiogenesis in vitro . HIF-1α inhibition attenuated ATO-resistance and angiogenesis, and promoted the anticancer effects of ATO both in vitro and in vivo by downregulating therapy-induced P-glycoprotein and VEGF overexpression. Conclusions : Hypoxic HCC cells acquire ATO resistance by upregulating HIF-1α levels; thus, combining ATO with a HIF-1α-targeting agent may lead to enhanced antitumor effects in HCC.
Drug resistance occurred in a newly characterized preclinical model of lung cancer brain metastasis.
Authors: Shah Neal , Liu Zhongwei , Tallman Rachel M. , Mohammad Afroz , Sprowls Samuel A , Saralkar Pushkar A. , Vickers Schuyler D. , Pinti Mark V. , Gao Weimin , Lockman Paul R
Published: April 2020

Background
Cancer metastasis and drug resistance have traditionally been studied separately, though these two lethal pathological phenomena almost always occur concurrently. Brain metastasis occurs in a large proportion of lung cancer patients (~30%). Once diagnosed, patients have a poor prognosis surviving typically less than 1 year due to lack of treatment efficacy.

Methods
Human metastatic lung cancer cells (PC-9-Br) were injected into the left cardiac ventricle of female athymic nude mice. Brain lesions were allowed to grow for 21 days, animals were then randomized into treatment groups and treated until presentation of neurological symptoms or when moribund. Prior to tissue collection mice were injected with Oregon Green and 14C-Aminoisobutyric acid followed by an indocyanine green vascular washout. Tracer accumulation was determined by quantitative fluorescent microscopy and quantitative autoradiography. Survival was tracked and tumor burden was monitored via bioluminescent imaging. Extent of mutation differences and acquired resistance was measured in-vitro through half-maximal inhibitory assays and qRT-PCR analysis.

Results
A PC-9 brain seeking line (PC-9-Br) was established. Mice inoculated with PC-9-Br resulted in a significantly decreased survival time compared with mice inoculated with parental PC-9. Non-targeted chemotherapy with cisplatin and etoposide (51.5 days) significantly prolonged survival of PC-9-Br brain metastases in mice compared to vehicle control (42 days) or cisplatin and pemetrexed (45 days). Further in-vivo imaging showed greater tumor vasculature in mice treated with cisplatin and etoposide compared to non-tumor regions, which was not observed in mice treated with vehicle or cisplatin and pemetrexed. More importantly, PC-9-Br showed significant resistance to gefitinib by in-vitro MTT assays (IC50>2.5 µM at 48hrs and 0.1 µM at 72hrs) compared with parental PC-9 (IC50: 0.75 µM at 48hrs and 0.027 µM at 72hrs). Further studies on the molecular mechanisms of gefitinib resistance revealed that EGFR and phospho-EGFR were significantly decreased in PC-9-Br compared with PC-9. Expression of E-cadherin and vimentin did not show EMT in PC-9-Br compared with parental PC-9, and PC-9-Br had neither T790 mutation nor amplifications of MET and HER2 compared with parental PC-9.

Conclusion
Our study demonstrated that brain metastases of lung cancer cells may independently prompt drug resistance without drug treatment.
Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania
Authors: Finda Marceline Francis , Christofides Nicola , Lezaun Javier , Tarimo Brian , Chaki Prosper , Kelly Ann H. , Kapologwe Ntuli , Kazyoba Paul , Emidi Basiliana , Okumu Fredros O.
Published: April 2020

Background

Malaria control in Tanzania currently relies primarily on long-lasting insecticidal nets and indoor residual spraying, alongside effective case management and behaviour change communication. This study explored opinions of key stakeholders on the national progress towards malaria elimination, the potential of currently available vector control interventions in helping achieve elimination by 2030, and the need for alternative interventions that could be used to supplement malaria elimination efforts in Tanzania.

Methods

In this exploratory qualitative study, focus group discussions were held with policy-makers, regulators, research scientists and community members. Malaria control interventions discussed were: a) improved housing, b) larval source management, c) mass drug administration (MDA) with ivermectin to reduce vector densities, d) release of modified mosquitoes, including genetically modified or irradiated mosquitoes, e) targeted spraying of mosquito swarms, and f) spatial repellents.

Results

Larval source management and spatial repellents were widely supported across all stakeholder groups, while insecticide-spraying of mosquito swarms was the least preferred. Support for MDA with ivermectin was high among policy makers, regulators and research scientists, but encountered opposition among community members, who instead expressed strong support for programmes to improve housing for poor people in high transmission areas. Policy makers, however, challenged the idea of government-supported housing improvement due to its perceived high costs. Techniques of mosquito modification, specifically those involving gene drives, were viewed positively by community members, policy makers and regulators, but encountered a high degree of scepticism among scientists. Overall, policy-makers, regulators and community members trusted scientists to provide appropriate advice for decision-making.

Conclusion

Stakeholder opinions regarding alternative malaria interventions were divergent except for larval source management and spatial repellents, for which there was universal support. MDA with ivermectin, housing improvement and modified mosquitoes were also widely supported, though each faced concerns from at least one stakeholder group. While policy-makers, regulators and community members all noted their reliance on scientists to make informed decisions, their reasoning on the benefits and disadvantages of specific interventions included factors beyond technical efficiency. This study suggests the need to encourage and strengthen dialogue between research scientists, policy makers, regulators and communities regarding new interventions.