bluuebunny/crossref_metadata_2025 huggingface dataset:
Model Predictive Control of Nonlinear System Based on GA‐RBP Neural Network and Improved Gradient Descent Method
Authors: Wang Youming , Qing Didi
Published: March 2021

A model predictive control (MPC) method based on recursive backpropagation (RBP) neural network and genetic algorithm (GA) is proposed for a class of nonlinear systems with time delays and uncertainties. In the offline modeling stage, a multistep‐ahead predictor with GA‐RBP neural network is designed, where GA‐BP neural network is used as a one‐step prediction model and GA is employed to train the initial weights and bias of the BP neural network. The incorporation of GA into RBP can reduce the possibility of the BP neural network falling into a local optimum instead of reaching global optimization. In the online optimizing stage, a multistep‐ahead GA‐RBP neural network predictor and an improved gradient descent method (IGDM) are proposed to efficiently solve the online optimization problem of nonlinear MPC by minimizing a modified quadratic criterion. The designed MPC strategy can avoid information loss while linearizing the controlled system and computing the Hessian matrix and its inverse matrix. Experimental results show that the proposed approach can reduce the computational burden and improve the performance of MPC (i.e., the maximum overshoots, calculation time, rise time, and RMSE tracking error value) for the solution of nonlinear controlled systems.
SSCA‐Net: Simultaneous Self‐ and Channel‐Attention Neural Network for Multiscale Structure‐Preserving Vessel Segmentation
Authors: Ni Jiajia , Wu Jianhuang , Tong Jing , Wei Mingqiang , Chen Zhengming
Published: March 2021

Vessel segmentation is a fundamental, yet not well‐solved problem in medical image analysis, due to the complicated geometrical and topological structures of human vessels. Unlike existing rule‐ and conventional learning‐based techniques, which hardly capture the location of tiny vessel structures and perceive their global spatial structures, we propose Simultaneous Self- and Channel-attention Neural Network (termed SSCA‐Net) to solve the multiscale structure-preserving vessel segmentation (MSVS) problem. SSCA‐Net differs from the conventional neural networks in modeling image global contexts, showing more power to understand the global semantic information by both self- and channel-attention (SCA) mechanism and offering high performance on segmenting vessels with multiscale structures (e.g., DSC: 96.21% and MIoU: 92.70% on the intracranial vessel dataset). Specifically, the SCA module is designed and embedded in the feature decoding stage to learn SCA features at different layers, in which the self‐attention is used to obtain the position information of the feature itself, and the channel attention is designed to guide the shallow features to obtain global feature information. To evaluate the effectiveness of our SSCA‐Net, we compare it with several state‐of‐the‐art methods on three well‐known vessel segmentation benchmark datasets. Qualitative and quantitative results demonstrate clear improvements of our method over the state‐of‐the‐art in terms of preserving vessel details and global spatial structures.
Occurrence and Antimicrobial Susceptibility Profile of Salmonella Isolates from Animal Origin Food Items in Selected Areas of Arsi Zone, Southeastern Ethiopia, 2018/19
Authors: Asfaw Geresu Minda , Assefa Wayuo Behailu , Mamo Kassa Gezahegne
Published: March 2021

The status of Salmonella and its antimicrobial susceptibility profile in animal origin food items from different catering establishments in Ethiopia is scarce. Hence, this study aimed to investigate the occurrence and antimicrobial susceptibility profile of Salmonella isolates from animal origin food items in the selected areas of Arsi Zone. One hundred ninety-two animal origin food samples were collected and processed for Salmonella isolation. Isolates were tested for their susceptibility to 13 antimicrobials using Kirby–Bauer disk diffusion assay. An overall prevalence of 9.4% (18/192) Salmonella spp. isolates were recovered from animal origin food samples collected from different catering establishments. Seven (21.9%) of “Dulet,” 4 (12.5%) of “Kitfo,” 3 (9.4%) of “Kurt,” 2 (6.3%) of raw milk, 1 (3.1%) of egg sandwich and 1 (3.1%) of cream cake samples were positive for Salmonella. Catering establishments, protective clothing, source of contamination, manner of hand washing, and money handling were among the putative risk factors that were significantly associated (

p
<
0.05

) with Salmonella spp. occurrence. Ampicillin, nitrofurans, and sulphonamide resistance were significantly associated (

p
<
0.05

) with Salmonella spp. occurrence in the selected food items. Three (16.7%), 5 (27.8%), 5 (27.8%), and 4 (22.2%) of the isolates were resistant to 3, 4, 5, and 6 antibiotics, respectively, whereas only a sole isolate was resistant to two antibiotics (viz. ampicillin and kanamycin). In conclusion, the general sanitary condition of the catering establishments, utensils used, and personnel hygienic practices were not to the recommended standards in the current study. Besides, detection of multidrug-resistant strains of Salmonella in animal origin food items from different catering establishments suggests the need for detailed epidemiological and molecular characterization of the pathogen so as to establish the sources of acquisition of resistant Salmonella strains. Hence, implementation of Salmonella prevention and control strategies from farm production to consumption of animal origin food items are crucial.
Clinical Presentation and Management Strategies in Intraorbital Foreign Bodies
Authors: Khanam Samreen , Agarwal Ayushi , Goel Ruchi , Rathie Neha , Raut Akash , Raghav Shweta , Kumar Sumit , Chhabra Mohit , Singh Sonam , Kumar Sushil
Published: March 2021

The authors present a retrospective, observational case study of seven patients, who presented with retained Intra-Orbital Foreign Bodies (IOrbFBs) following penetrating orbital injury at a tertiary eye hospital over a period of one year. Cases were reviewed for epidemiological features, mechanism of injury, nature of foreign body, clinical features, imaging modality, associated complications, management outcomes, and the final prognosis. The mean age of presentation was 27.43 years. Amongst the seven patients, two were children (aged <10 years). The male : female ratio was 4 : 3. Of the seven retained IOrbFBs, two were plastic, two wooden, and three metallic in nature (one gunshot injury, one ball projectile (commonly referred to as BB) injury, and one with knife). Two out of seven had no light perception at presentation. The periocular location of the foreign bodies was inferior in 4 cases and medial in 3 cases. Computed Tomography scan confirmed the diagnosis in five cases and Magnetic Resonance Imaging (MRI) was diagnostic in one. Surgical intervention was done in five cases, and two cases were managed conservatively. The authors conclude that favourable outcome can be achieved even without surgical removal in cases of inert metallic/inorganic IOrbFBs. The properties of plastic FBs can frequently render them invisible on imaging, or they may mimic chronic inflammatory conditions like tuberculosis. Long-standing wooden IOrbFBs evade identification radiologically due to prolonged hydration. The ultimate choice of intervention must be individualised, weighing the risks of retention against the risk of iatrogenic damage.
Traditional Chinese Medicine Shenmayizhi Decoction Ameliorates Memory and Cognitive Impairment Induced by Multiple Cerebral Infarctions
Authors: Sun Chengcheng , Liu Jiangang , Li Nannan , Liu Meixia , Luo Zenggang , Li Hao
Published: March 2021

This study aimed to illustrate the mechanism by which Shenmayizhi decoction (SMYZD) improves the learning memory of rats with vascular cognitive impairment (VCI). Fifty male and female Wistar rats of specific pathogen-free grade (SPF grade) were used to establish the model by the administration of a microsphere embolization. This was accomplished by injecting sterile, standardized, mass-produced microspheres of uniform particle size (100–200 µm in diameter) in a sodium alginate microsphere vascular embolic agent suspension to induce VCI. The VCI model was successfully established in 40 rats, including both male and female rats, and the rats were randomly divided into 4 groups of 10 rats each. The model group was administered an equal volume of distilled water. The donepezil group was administered 0.45 mg/kg/d donepezil, which is equivalent to the clinical dosage. The SMYZ-H group was administered 11.88 g/kg/d SMYZ, which is 4 times higher than the clinically equivalent dosage. The SMYZ-L group was administered 2.97 g/kg/d SMYZ, which is the clinically equivalent dosage. A sham-operated group was used as the control group and administered an equal volume of distilled water. The rats in the 4 groups were treated by gavage with equal volumes of liquid and the indicated concentration of drug diluted in distilled water for 8 consecutive weeks. Two months later, the Morris water maze (MWM) was used to evaluate the spatial memory of all the rats. Ultrastructural and ultrapathological changes in the capillaries of the cerebral cortex were observed by transmission electron microscopy. Furthermore, Western blot and RT-PCR analyses were used to assess the levels of platelet-derived growth factor receptor-β (PDGFR-β), neuron-glial antigen 2 (NG2), vascular endothelial growth factor A (VEGF-A), and angiopoietin 1 (Ang1) in the cerebral cortex of the rats. The results showed that SMYZD at concentrations of 11.88 g/kg/d and 2.97 g/kg/d (SMYZ-H and SMYZ-L) significantly shortened the escape latency (EL). In addition, SMYZ-H significantly prolonged the distance traveled and the time spent in the original platform quadrant by the rats with VCI. SMYZ-H significantly increased the NG2 and Ang1 protein expression levels and increased the PDGFR-β and Ang1 mRNA levels. These results demonstrated that Shenmayizhi decoction can improve the memory abilities of rats with VCI induced by multiple cerebral infarctions by preventing pericyte degeneration.
Inertial Iterative Schemes for D-Accretive Mappings in Banach Spaces and Curvature Systems
Authors: Wei Li , Yue Wenwen , Shang Yingzi , Agarwal Ravi P.
Published: March 2021

We propose and analyze a new iterative scheme with inertial items to approximate a common zero point of two countable d-accretive mappings in the framework of a real uniformly smooth and uniformly convex Banach space. We prove some strong convergence theorems by employing some new techniques compared to the previous corresponding studies. We give some numerical examples to illustrate the effectiveness of the main iterative scheme and present an example of curvature systems to emphasize the importance of the study of d-accretive mappings.
Simultaneous Determination of Eight Chemical Components in Angelicae Sinensis Radix and Its Herbal Products by QAMS
Authors: Zhang Yu , Li Qian , Feng Yanmei , Yang Lan , Wang Qi , Guo Yehong , Qiu Daiyu
Published: March 2021

A HPLC method has been developed for simultaneously detecting chlorogenic acid, ferulic acid, senkyunolide I, senkyunolide H, coniferyl ferulate, senkyunolide A, ligustilide, and levistolide A in Angelicae Sinensis Radix through quantitative analysis of multicomponents by single-marker (QAMS) method with ferulic acid as internal standard substance. The relative analysis correction factors of each component in Angelicae Sinensis Radix have good reproducibility under different chromatography conditions. In addition, no significant difference of results was found between quantitative analysis of multicomponents by single-marker (QAMS) method and external standard method in determining content of these components of different Angelicae Sinensis Radix and its 12 kinds of preparations. As a result, the established QAMS method for Angelicae Sinensis Radix analysis with ferulic acid as internal standard substance is accurate and feasible, which could be used as an effective and economical method to control quality of Angelicae Sinensis Radix and its herbal products.
AFI‐Net: Attention‐Guided Feature Integration Network for RGBD Saliency Detection
Authors: Li Liming , Zhao Shuguang , Sun Rui , Chai Xiaodong , Zheng Shubin , Chen Xingjie , Lv Zhaomin
Published: March 2021

This article proposes an innovative RGBD saliency model, that is, attention‐guided feature integration network, which can extract and fuse features and perform saliency inference. Specifically, the model first extracts multimodal and level deep features. Then, a series of attention modules are deployed to the multilevel RGB and depth features, yielding enhanced deep features. Next, the enhanced multimodal deep features are hierarchically fused. Lastly, the RGB and depth boundary features, that is, low‐level spatial details, are added to the integrated feature to perform saliency inference. The key points of the AFI‐Net are the attention‐guided feature enhancement and the boundary‐aware saliency inference, where the attention module indicates salient objects coarsely, and the boundary information is used to equip the deep feature with more spatial details. Therefore, salient objects are well characterized, that is, well highlighted. The comprehensive experiments on five challenging public RGBD datasets clearly exhibit the superiority and effectiveness of the proposed AFI‐Net.
Identification and Validation of a Tumor Microenvironment‐Related Gene Signature for Prognostic Prediction in Advanced‐Stage Non‐Small‐Cell Lung Cancer
Authors: Zhang Xuening , Shi Xuezhong , Zhao Hao , Jia Xiaocan , Yang Yongli
Published: March 2021

The development of immunotherapy has greatly changed the advanced‐stage non‐small‐cell lung cancer (NSCLC) treatment landscape. The complexity and heterogeneity of tumor microenvironment (TME) lead to discrepant immunotherapy effects among patients at the same pathologic stages. This study is aimed at exploring potential biomarkers of immunotherapy and accurately predicting the prognosis for advanced NSCLC patients. RNA‐seq data and clinical information on stage III/IV NSCLC were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). In TCGA‐NSCLC with stage III/IV (n = 192), immune scores and stromal scores were calculated by using the ESTIMATE algorithms. Univariate, LASSO, and multivariate Cox regression analyses were performed to screen prognostic TME‐related genes (TMERGs) and constructed a gene signature risk score model. It was validated in external dataset including GSE41271 (n = 91) and GSE81089 (n = 36). Additionally, a nomogram incorporating TMERG signature risk score and clinical characteristics was established. Further, we accessed the proportion of 22 types of tumor‐infiltrating immune cells (TIIC) from the CIBERSORT website and analyzed the difference between two risk groups. OS of patients with high immune/stromal scores were higher (log‐rank P = 0.044/log‐rank P = 0.048). Multivariate Cox regression identified six prognostic TMERGs, including CD200, CHI3L2, CNTN1, CTSL, FYB1, and SLC52A1. We developed a six‐gene risk score model, which was validated as an independent prognostic factor for OS (HR: 3.32, 95% CI: 2.16‐5.09). Time‐ROC curves showed useful discrimination for TCGA‐NSCLC cohort (1‐, 2‐, and 3‐year AUCs were 0.718, 0.761, and 0.750). The predictive robustness was validated in the external dataset. The C‐index and 1‐, 2‐, and 3‐year AUCs of nomogram were the largest, which demonstrated the nomogram had the greatest predictive accuracy and effectiveness and could be used for clinical guidance. Besides, the increased infiltration of T cells regulatory (Tregs) and macrophages M2 in the high‐risk group suggested that chronic inflammation may reduce survival probability in patients with advanced NSCLC. We conducted a comprehensive analysis of the tumor microenvironment and identified the TMERG signature, which could predict prognosis accurately and provide a reference for the personalized immunotherapy for advanced NSCLC patients.
Guidance for Acupuncture Robot with Potentially Utilizing Medical Robotic Technologies
Authors: Xu Tiancheng , Xia Youbing
Published: March 2021

Acupuncture is gaining increasing attention and recognition all over the world. However, a lot of physical labor is paid by acupuncturists. It is natural to resort to a robot which can improve the accuracy as well as the efficacy of therapy. Several teams have separately developed real acupuncture robots or related technologies and even went to the stage of clinical trial and then achieved success commercially. A completed clinical practical acupuncture robot is not far from reach with the combination of existing mature medical robotic technologies. A hand-eye-brain coordination framework is proposed in this review to integrate the potential utilizing technologies including force feedback, binocular vision, and automatic prescription. We should take acupuncture prescription with artificial intelligence and future development trends into account and make a feasible choice in development of modern acupuncture.
Mercado laboral en pandemia
Authors: Tejada Mauricio
Published: March 2021

El 2020, con la pandemia del COVID-19 desatada en el país y las medidas de confinamiento implementadas para contenerla, configuró un contexto muy complejo para la economía en general, y para el mercado laboral en particular. En efecto, la producción de la economía promedió una tasa de crecimiento en doce meses de -6% en 2020, siendo el periodo entre abril y agosto el más complejos al mostrar caídas superiores del 10%. Continuar leyendo...
Cochlear Implantation and Other Treatments in Single-Sided Deafness and Asymmetric Hearing Loss: Results of a National Multicenter Study Including a Randomized Controlled Trial
Authors: Marx Mathieu , Mosnier Isabelle , Venail Frederic , Mondain Michel , Uziel Alain , Bakhos David , Lescanne Emmanuel , N’Guyen Yann , Bernardeschi Daniele , Sterkers Olivier , Deguine Olivier , Lepage Benoît , Godey Benoit , Schmerber Sébastien , Bonne Nicolas-Xavier , Vincent Christophe , Fraysse Bernard
Published: March 2021

Introduction: Cochlear implantation is a recent approach proposed to treat single-sided deafness (SSD) and asymmetric hearing loss (AHL). Several cohort studies showed its effectiveness on tinnitus and variable results on binaural hearing. The main objective of this study is to assess the outcomes of cochlear implantation and other treatment options in SSD/AHL on quality of life. Methods: This prospective multicenter study was conducted in 7 tertiary university hospitals and included an observational cohort study of SSD/AHL adult patients treated using contralateral routing of the signal (CROS) hearing aids or bone-anchored hearing systems (BAHSs) or who declined all treatments, and a randomized controlled trial in subjects treated by cochlear implantation, after failure of CROS and BAHS trials. In total, 155 subjects with SSD or AHL, with or without associated tinnitus, were enrolled. After 2 consecutive trials with CROS hearing aids and BAHSs on headband, all subjects chose any of the 4 treatment options (abstention, CROS, BAHS, or cochlear implant [CI]). The subjects who opted for a CI were randomized between 2 arms (CI vs. initial observation). Six months after the treatment choice, quality of life was assessed using both generic (EuroQoL-5D, EQ-5D) and auditory-specific quality-of-life indices (Nijmegen Cochlear implant Questionnaire [NCIQ] and Visual Analogue Scale [VAS] for tinnitus severity). Performances for speech-in-noise recognition and localization were measured as secondary outcomes. Results: CROS was chosen by 75 subjects, while 51 opted for cochlear implantation, 18 for BAHSs, and 11 for abstention. Six months after treatment, both EQ-5D VAS and auditory-specific quality-of-life indices were significantly better in the “CI” arm versus “observation” arm. The mean effect of the CI was particularly significant in subjects with associated severe tinnitus (mean improvement of 20.7 points ± 19.7 on EQ-5D VAS, 20.4 ± 12.4 on NCIQ, and 51.4 ± 35.4 on tinnitus). No significant effect of the CI was found on binaural hearing results. Before/after comparisons showed that the CROS and BAHS also improved significantly NCIQ scores (for CROS: +7.7, 95% confidence interval [95% CI] = [4.5; 10.8]; for the BAHS: +14.3, 95% CI = [7.9; 20.7]). Conclusion: Cochlear implantation leads to significant improvements in quality of life in SSD and AHL patients, particularly in subjects with associated severe tinnitus, who are thereby the best candidates to an extension of CI indications.
A 3′ Untranslated Region Polymorphism of CTNNB1 (Rs2953) Alters MiR-3161 Binding and Affects the Risk of Ischemic Stroke and Coronary Artery Disease in Chinese Han Population
Authors: Zhao Xin-Yi , Hu Shu-Yan , Yang Jia-Lei , Chen Xing-Mei , Huang Xian-Li , Tang Lue-Jun , Gu Lian , Su Li
Published: March 2021

Background: CTNNB1 is reported to be related to the pathological process of ischemic stroke (IS) and coronary artery disease (CAD). Polymorphism located in the 3′ untranslated region (3′UTR) of a gene might affect gene expression by modifying binding sites for microRNAs (miRNAs). This study aimed to analyze the association between polymorphism rs2953, which locates in the 3′UTR of CTNNB1, and the risk of IS and CAD. Methods: The CTNNB1 messenger RNA (mRNA) expression level in peripheral venous blood was measured. In total, 533 patients with IS, 500 patients with CAD, and 531 healthy individuals were genotyped by Sequenom Mass­Array technology. The binding of miR-3161 to CTNNB1 was determined by dual-luciferase reporter assay. Results: The CTNNB1 mRNA expression level for the IS group was significantly lower than that for the control group. Rs2953 was significantly associated with both IS risk and CAD risk. Significant association was also found between polymorphism rs2953 and many conventional factors, such as serum lipid level, blood coagulation markers, blood glucose level, and homocysteine level in patients. Rs2953 T allele introduced a binding site to miRNA-3161 and thus decreased luciferase activity. Conclusion: Polymorphism rs2953 is associated with the risk of both IS and CAD. Moreover, polymorphism rs2953 (T) introduces a binding site to miRNA-3161 and thus decreases luciferase activity in cell lines.
Cardiovascular and Bleeding Outcomes with Anticoagulants across Kidney Disease Stages: Analysis of a National US Cohort
Authors: Sy John , Hsiung Jiu-Ting , Edgett Drake , Kalantar-Zadeh Kamyar , Streja Elani , Lau Wei Ling
Published: March 2021

Background: While direct oral anticoagulants (DOACs) are considered safe among patients without chronic kidney disease (CKD), the evidence is conflicting as to whether they are also safe in the CKD and end-stage kidney disease (ESKD) population. In this observational cohort study, we examined whether DOACs are a safe alternative to warfarin across CKD stages for a variety of anticoagulation indications. Methods: Individuals on DOACs or warfarin were identified from OptumLabs® Data Warehouse (OLDW), a longitudinal dataset with de-identified administrative claims, from 2010 to 2017. Cox models with sensitivity analyses were used to assess the risk of cardiovascular disease and bleeding outcomes stratified by CKD stage. Results: Among 351,407 patients on anticoagulation, 45% were on DOACs. CKD stages 3–5 and ESKD patients comprised approximately 12% of the cohort. The most common indications for anticoagulation were atrial fibrillation (AF, 44%) and venous thromboembolism (VTE, 23%). DOACs were associated with a 22% decrease in the risk of cardiovascular outcomes (HR 0.78, 95% CI: 0.77–0.80, p < 0.001) and a 10% decrease in the risk of bleeding outcomes (HR 0.90, 95% CI: 0.88–0.92, p < 0.001) compared to warfarin after adjustment. On stratified analyses, DOACs maintained a superior safety profile across CKD stages. Patients with AF on DOACs had a consistently lower risk of cardiovascular and bleeding events than warfarin-treated patients, while among other indications (VTE, peripheral vascular disease, and arterial embolism), the risk of cardiovascular and bleeding events was the same among DOAC and warfarin users. Conclusion: DOACs may be a safer alternative to warfarin even among CKD and ESKD patients.
Distinct Solute Removal Patterns by Similar Surface High-Flux Membranes in Haemodiafiltration: The Adsorption Point of View
Authors: Gomez Miquel , Bañon-Maneus Elisenda , Arias-Guillén Marta , Fontseré Néstor , Broseta José Jesús , Ojeda Raquel , Maduell Francisco
Published: March 2021

Introduction: Haemodialysis (HD) allow depuration of uraemic toxins by diffusion, convection, and adsorption. Online haemodiafiltration (HDF) treatments add high convection to enhance removal. There are no prior studies on the relationship between convection and adsorption in HD membranes. The possible benefits conferred by intrinsic adsorption on protein-bound uraemic toxins (PBUTs) removal are unknown. Methods: Twenty-two patients underwent their second 3-days per week HD sessions with randomly selected haemodialysers (polysulfone, polymethylmethacrylate, cellulose triacetate, and polyamide copolymer) in high-flux HD and HDF. Blood samples were taken at the beginning and at the end of the treatment to assess the reduction ratio (RR) in a wide range of molecular weight uraemic toxins. A mid-range removal score (GRS) was also calculated. An elution protocol was implemented to quantify the amount of adsorbed mass (Mads) for each molecule in every dialyser. Results: All synthetic membranes achieved higher RR for all toxins when used in HDF, specially the polysulfone haemodialyser, resulting in a GRS = 0.66 ± 0.06 (p < 0.001 vs. cellulose triacetate and polyamide membranes). Adsorption was slightly enhanced by convection for all membranes. The polymethylmethacrylate membrane showed expected substantial adsorption of β2-microglobulin (MadsHDF = 3.5 ± 2.1 mg vs. MadsHD = 2.1 ± 0.9 mg, p = 0.511), whereas total protein adsorption was pronounced in the cellulose triacetate membrane (MadsHDF = 427.2 ± 207.9 mg vs. MadsHD = 274.7 ± 138.3 mg, p = 0.586) without enhanced PBUT removal. Discussion/Conclusion: Convection improves removal and slightly increases adsorption. Adsorbed proteins do not lead to enhanced PBUTs depuration and limit membrane efficiency due to fouling. Selection of the correct membrane for convective therapies is mandatory to optimize removal efficiency.
Bacterial Contamination during Continuous Administration of Liquid Enteral Nutrition Formula in a Sterile Sealed Bag: A Prospective Interventional Study
Authors: Hatakeyama Junji , Aso Shotaro
Published: March 2021

Introduction: In nutrition therapy for critically ill patients, it is recommended that enteral nutrition (EN) formula be changed every 8 h to avoid bacterial contamination. However, it remains unknown whether long-term administration of EN formula from a sterile sealed bag without changing the formula can cause bacterial contamination. This study investigates the association between bacterial contamination and administration of liquid EN formula from a sterile sealed bag without changing the formula for 24 h. Methods: This single-center, prospective, interventional study included patients aged ≥20 years who were admitted to an intensive care unit and received 24-h continuous liquid EN formula from a sterile sealed bag. A 3-mL sample of the formula was collected from each bag every 4 h for bacterial culture. The primary outcome was the detection of bacterial colonies. Results: A total of 630 specimens from 30 patients were cultured. No bacterial colonies were detected. Conclusion: There was no association between bacterial contamination and continuous administration of liquid EN formula from a sterile sealed bag for 24 h. Therefore, this study recommends continuous administration of EN from a sterile sealed bag for 24 h without changing the EN formula under those limited conditions.
Effects of Rearing on the Behaviour of Zoo-Housed Chimpanzees (Pan troglodytes)
Authors: Spiezio Caterina , Vaglio Stefano , Vandelle Camille , Sandri Camillo , Regaiolli Barbara
Published: March 2021

Early-life experiences may considerably affect the behavioural patterns of adult primates. Particularly, atypical rearing practices might lead to abnormal behaviours and social-sexual deficiencies in captive, adult non-human primates. We conducted behavioural observations of mother-reared (n = 5) and hand-reared (n = 6) adult chimpanzees in a social group at Parco Natura Viva, Italy. We used continuous focal animal sampling to collect behavioural data focusing on individual and social behaviours. We found that all study subjects performed individual and social species-specific behaviours. However, mother-reared chimpanzees performed locomotion and affiliative behaviours significantly more than hand-reared subjects. In addition to these species-typical behaviours, hand-reared chimpanzees showed significantly more abnormal behaviours than mother-reared subjects. Therefore, these findings suggest that hand-rearing could have wide-reaching effects on the behavioural repertoire in adult zoo-housed chimpanzees. Hence, even if sometimes human intervention in rearing may be necessary to ensure the survival of captive infant chimpanzees, our results suggest that zoo-housed chimpanzees might benefit from minimised human-animal interactions and exposure to conspecifics throughout their development. These suggestions should be implemented in regular husbandry practices.
Brain Atrophy Subtypes and the ATN Classification Scheme in Alzheimer’s Disease
Authors: Cedres Nira , Ekman Urban , Poulakis Konstantinos , Shams Sara , Cavallin Lena , Muehlboeck Sebastian , Granberg Tobias , Wahlund Lars-Olof , Ferreira Daniel , Westman Eric ,   Alzheimer’s Disease Neuroimaging Initiative
Published: March 2021

Introduction: We investigated the association between atrophy subtypes of Alzheimer’s disease (AD), the ATN classification scheme, and key demographic and clinical factors in 2 cohorts with different source characteristics (a highly selective research-oriented cohort, the Alzheimer’s Disease Neuroimaging Initiative [ADNI]; and a naturalistic heterogeneous clinically oriented cohort, Karolinska Imaging Dementia Study [KIDS]). Methods: A total of 382 AD patients were included. Factorial analysis of mixed data was used to investigate associations between AD subtypes based on brain atrophy patterns, ATN profiles based on cerebrospinal fluid biomarkers, and age, sex, Mini Mental State Examination (MMSE), cerebrovascular disease (burden of white matter signal abnormalities, WMSAs), and APOE genotype. Results: Older patients with high WMSA burden, belonging to the typical AD subtype and showing A+T+N+ or A+T+N− profiles clustered together and were mainly from ADNI. Younger patients with low WMSA burden, limbic-predominant or minimal atrophy AD subtypes, and A+T−N− or A+T−N+ profiles clustered together and were mainly from KIDS. APOE ε4 carriers more frequently showed the A+T−N− and A+T+N− profiles. Conclusions: Our findings align with the recent framework for biological subtypes of AD: the combination of risk factors, protective factors, and brain pathologies determines belonging of AD patients to distinct subtypes.
Assessment of precautionary measures against COVID-19 in Indonesian workplaces
Authors: Pratama Muhammad Ricky , Supriyadi Agung , Sari Nurhalina
Published: March 2021

As the coronavirus disease 19 (COVID-19) pandemic spread across Indonesia, the precautionary measures have been taken by nearly all stakeholders, including industries and employers. The purpose of this study is to assess the measures took against COVID-19 pandemic in the workplaces across the country. This research involved participants from 103 different companies using a questionnaire adapted from Better Work Indonesia (BWI), occupational safety and health association (OSHA) and centers for disease control and prevention (CDC) COVID-19 guidelines. The data analysis conducted with descriptive statistics that resulted with the following key findings. Indonesian companies have taken precautionary measures against COVID-19 at their workplace. Most aspects of COVID-19 preventive measures: policy and procedure, operational aspect, health and safety, and external activities have been observed by the vast majority of the subjects. This study found that among 30 COVID-19 programs, the emergency exercise at work was the only one that had not been conducted by more than half of respondents. As the number of active cases still growing at the time this study conducted, all precautionary measures against COVID-19 shall be carried out with consistency by the company management).
Relationship of knowledge and attitude with food handling practices: A systematic review
Authors: Ernawati Kholis , Nadhifah Qatrunnada , Muslikha Anis , Hidayat Muhammad , Soesilo Tri Edhi Budhi , Jannah Fathul , Widianti Dini , Yusnita Yusnita
Published: March 2021

Foodborne disease is still a public health problem in several countries. Food handler's knowledge, attitude, and practice (KAP) are factors that are risk factors for foodborne disease incidence. The research objective was to assess the level of knowledge, attitudes, and behavior of food handlers in maintaining food hygiene using a systematic review approach. The research method used is the preferred reporting items for systematic review and meta-analyses (PRISMA) protocol approach. The article search process was accessed on PLOS ONE, Pro-Quest, and Google Scholar. A descriptive analysis was carried out on each research variable. The results obtained eight papers (100% sociodemography, 100% knowledge, 62.5% attitude, and 87.5% behavior). The mean of significant articles on sociodemographic variables was 18.5%, experience 59.38%, attitudes 13.33%, and 23.81%. There are 37.5% of the articles showed significant relationship between knowledge and attitude with food handling practice.
Risk factors associated with the development of dental caries in Bulgarian children
Authors: Damyanova Dobrinka Mitkova , Velikova Valentina
Published: March 2021

The purpose of this study was to examine the risk factors associated with the development of dental caries in children in Bulgaria. The research has been carried out at the Faculty of Dental Medicine, in the period 2015-2016, with the permission of the University Scientific Research Committee and informed consent signed by each parent. The subject of observation was parents of children from Varna region in Bulgaria. The results were statistically processed with SPSS v.20.0, using variation and comparison (chi-square) analyzes. For significance level we assume p<0.05. The volume of observation encompasses 100 persons. Units of observation are patients aged three to six years with the need for prevention and treatment of dental caries of the primary dentition. The registration was done in a specially developed questionnaire, including 22 questions, each with the possibility of more than one answer. In processing the obtained data, Student's criterion was used to compare the mean values of two independent samples. In a comparative analysis of the results, we found that 71.01% of children aged three to six years visit a dentist, and patients use fluoride only in the form of toothpaste containing fluoride. When studying the knowledge and behavior of parents in the direction of risk factors for the development of dental caries and oral prophylaxis, need for a new approach of pediatric dentists has been found, focused on programming preventive and non-invasive treatment of children according to their individual needs.
Ability of chitosan membrane from blood clam (Anadara granosa) shells to removal iron level (Fe) in water
Authors: Sari Nur Rafiqa Puspita , Eri Iva Rustanti , Nurmayanti Demes , Kriswandana Ferry , Narwati Narwati
Published: March 2021

Clam shells are a food solid waste that increases and accumulates every day, causing environmental pollution. Clam shells (Anadora granosa) contain chitin. Chitin can be processed into chitosan, which effective in absorbing heavy metals. To increase absorption, chitosan modified into a membrane. The purpose of this study was to analyze the membrane's ability of chitosan waste from blood clam shells to reduce levels of iron in water. The design of this study was pure experimentation. The object of research used was iron-containing artificial water made from iron salt powder at a dose of 4.50 mg/L. Variations of Chitosan concentration to the membranes manufacture were 1%, 2%, 3%. Analysis of the data used was One Way Anova Test. Chitosan characterization analysis using XR Diffraction showed that chitosan was isolated from shells at peak angles at 17.99o and 34.04o. The highest percentage of iron reduction was given by membranes with a chitosan concentration of 3%, which have decreased of 94%. The results showed that the membrane of blood shells chitosan can reduce iron levels in water and can be an alternative material in the utilization of clamshell waste. The membrane can be applied in simple water treatment filtration systems in the community.
A spatiotemporal analysis of dengue hemorrhagic fever in Banyumas, Indonesia
Authors: Rejeki Dwi Sarwani Sri , Nurhayati Nunung , Aji Budi
Published: March 2021

Dengue hemorrhagic fever (DHF) is a public health problem in the world and also in Indonesia. One of the districts in Central Java that is still having problems with this disease is Banyumas, Indonesia. The incidence rate (IR) data in 2018 was 2.75 per 100,000 populations and the case fatality rate (CFR) was 3.64%. Spatiotemporal analysis was used to determine local variation, geographic determination of risk zones, and measurement of disease control interventions. Therefore, this study aimed to determine the distribution and grouping of dengue cases based on the spatiotemporal analysis. The design was observational with a cross-sectional spatial analysis. This study was conducted in Banyumas, Indonesia with the analysis unit for dengue fever patients in 2018 using as many as 57 cases. Furthermore, the data analysis used includes overlay, buffering, and clustering with SaTScan and ArcGis software. The results showed that there was a clustering of dengue cases in Banyumas, with one primary and three secondary clusters detected. The primary cluster occurred in March-April 2018, involving four sub-districts in urban areas. It was then concluded that the significantly identified clusters indicate a transmission of dengue fever in the Banyumas area with a radius of three kilometers.
Relative share, frequency and correlation of restorations in both dental dentitions in childhood
Authors: Damyanova Dobrinka Mitkova , Andreeva-Borisova Radosveta
Published: March 2021

This research aimed to analyze of the relative share, frequency and correlation of restorations in both dental dentitions in childhood. The decayed, missing, and filled permanent teeth (DMFT) index is one of the most commonly used indices in epidemiologic surveys of dental caries. It quantifies dental health status based on the number of carious, missing and filled teeth. A total of 602 schoolchildren in Varna, aged 3-18 years were selected for this study. The children have a determined high caries risk DMFT index >1. The patients are divided into 16 groups according to age limit. The research takes place in the Faculty of Dental Medicine, Medical University of Varna, in the time period 2016-2018. This study is retrospective, based on medical data of the participants. Pearson's correlation and simple linear regression were used to estimate the correlation between restorations, DMF (T+t) and age. The average value of determining the level of caries of the examined groups of children is DMF (T+t) =5.46±3.95 (range 0-20). With the correlation analysis we proved a direct dependence of the ratio. The number of preventive fillings with photopolymers and composites increased with increasing age of the studied children (r=0.725; p<0.001). Their high distribution among the studied patients was established by determining the average frequency of carious lesions. The correlation analysis determined that with increasing age of the patients the number and frequency of composite restorations and sealants in the control groups increased.
Knowledge, attitudes, and practices of Indonesian residents regarding COVID-19: A national cross-sectional survey
Authors: Yodang Yodang , Kiik Stefanus Mendes , Fauji Achmad , Hamka Hamka , Pratiwi Rizky Meuthia , Nuridah Nuridah , Yusuf Rahmad , Fitrina Yossi
Published: March 2021

Coronavirus disease (COVID-19) infection has been a major public health-related issue worldwide, including Indonesia. The COVID-19 cases still escalating until this study finished in June 2020 due to the disease positively spreading from person to person. To reduce the spreading of the disease, investigating Indonesian’s knowledge, attitudes, and practice on COVID prevention and mitigation during the outbreak period was crucial. A survey cross-sectional was conducted and using social networking apps to recruit participants. All Indonesian residents who have 18 years old and over and living in Indonesia during the COVID-19 outbreak were voluntarily invited to participate in this study. There are 3464 participants involved in this study. The mean age was 27.63 years, and mostly were women, domicile in Java, held bachelor degrees, students, Muslims, and single/never married. The lowest mean practices score was found among residents who live in Maluku, Papua, and Papua Barat, senior high qualification, unemployed, indigenous religions, and single/never married. The majority of Indonesian residents have good knowledge, positive attitudes, and good practice to promote COVID-19 prevention and mitigation to reduce the pandemic spreading within the country. However, there is a lack of knowledge, attitudes, and practice among a particular group of participants.
Socio-demography, nutritional status and physical activity among elderly in Samarahan division, Sarawak, Malaysia
Authors: Bin Saad Mohd Fakhree , Lian Cheah Whye , Hazmi Helmy
Published: March 2021

The physical activity among elderly has been associated with reduction of risk from all-cause mortality and improve physical, mental, and social well-being. The objectives were to determine the physical activity status among elderly in Samarahan Division, Sarawak and its association with socio- demographic characteristics and nutritional status. A cross-sectional study was carried out on 199 elderly, aged between 60 to 90 years, from rural area in Samarahan Division (Asajaya and Simunjan district), Malaysia. Socio-demographic characteristic was taken via questionnaire, nutritional status and body composition of the elderly was measured using anthropometric measurement, and physical activity using pedometer. Data were analyzed using IBM SPSS version 26. The proportion of physically active among elderly was 12.6% and mean daily steps are 3946 steps (SD=1669 steps). Multiple linear regressions revealed that age, body mass index (BMI), and sex were significant associated with physical activity. Lack of physical activity among elderly remain a problem. Understanding these predictors related to physical activity is important for designing intervention program.
Healthy family index assessment through community-based health information system approach
Authors: Kurniawan Rico , Baharuddin Nur Ryza Jazid , Yuliyanti Sayekti , Nuridzin Dion Zein , Kartinah Neng Tine
Published: March 2021

The healthy Indonesia program with a family approach (PIS-PK) has not been implemented optimally. There are several obstacles and challenges in this program’s implementation, e.g., human resources. A community-based health information system (CBHIS) is a strategic approach to obtain data and information at the population level by directly involving cadres and the community. A project with the CBHIS approach was implemented in Kasemen Village, Serang, Banten Province, Indonesia to support the PIS-PK program. The study aimed to determine the population’s health status according to the healthy family index through the CBHIS approach. The data of healthy family indicators in the village were collected by cadres using a mHealth application. Overall, 1316 households consisting of 5312 residents were registered. The analysis results of the healthy family index showed that most families in the Kasemen subdistrict were pre-healthy (64.2%), almost one third were unhealthy (27.8%) and only a small proportion were healthy (8%). Assessing the healthy family index through the CBHIS approach can support decision-making at the community level, thereby determining the magnitude of family health problems and providing appropriate interventions to improve community health status. Well-trained cadres equipped with better electronic data collection tools may be an alternative to community-based data collection.
Optimal Threshold of Left Ventricular Ejection Fraction for Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta‐Analysis
Authors: Perry Andrew S. , Li Song
Published: March 2021

Background

The optimal threshold of left ventricular ejection fraction (LVEF) that should prompt aortic valve replacement (AVR) in asymptomatic patients with high‐gradient severe aortic stenosis (AS) is controversial. The aim of this study was to assess the relationship between LVEF and mortality benefit in comparing early AVR versus watchful waiting in asymptomatic patients with severe AS.

Methods and Results

MEDLINE, Embase, Web of Science, and Google Scholar were searched for observational studies and randomized controlled trials on adults with asymptomatic severe AS. Severe AS was defined by a peak aortic velocity ≥4 m/s and/or mean aortic valve gradient ≥40 mm Hg and/or calculated aortic valve area <1.0 cm
2
or an indexed valve area <0.6 cm
2
. Studies comparing AVR with conservative management were included and meta‐analysis on all‐cause mortality was performed. Ten eligible studies were identified with a total of 3332 patients. In 5 observational studies comparing early AVR versus watchful waiting, our meta‐analysis showed early AVR was associated with lower mortality with a hazard ratio (HR) of 0.41 (CI, 0.23–0.71;
P
<0.01). In 4 observational studies comparing AVR versus no AVR, our meta‐analysis showed AVR was associated with lower mortality with a HR of 0.31 (CI, 0.17–0.58;
P
<0.001). In a meta‐regression analysis pooling all 10 studies, there was no statistically significant correlation between study mean LVEF and the size of mortality benefit of AVR (
P
=0.83).

Conclusions

Among asymptomatic patients with high‐gradient severe AS, AVR was associated with a mortality benefit across the spectrum of LVEF. Our study calls into question the need of an LVEF threshold for recommending AVR in this patient population.
Animism, Aristotelianism, and the Legacy of William Gilbert’sDe Magnete
Authors: Kochan Jeff
Published: March 2021

William Gilbert’s 1600 book, De magnete, greatly influenced early modern natural philosophy. The book describes an impressive array of physical experiments, but it also advances a metaphysical view at odds with the soon to emerge mechanical philosophy. That view was animism. I distinguish two kinds of animism – Aristotelian and Platonic – and argue that Gilbert was an Aristotelian animist. Taking Robert Boyle as an example, I then show that early modern arguments against animism were often effective only against Platonic animism. In fact, unacknowledged traces of Aristotelian animism can be found in Boyle’s mechanical account of nature. This was Gilbert’s legacy.