bluuebunny/crossref_metadata_2025 huggingface dataset:
Older persons’ thoughts about death and dying and their experiences of care in end-of-life: a qualitative study
Authors: Tjernberg Johanna , Bökberg Christina
Published: December 2020

Background: Few studies have focused on how older persons living in nursing homes perceive their last period of life. Furthermore, previous research on older persons’ perceptions of death and dying is limited. Hence, there is an urgent need to explore their experiences during their final period in life.Aim: To explore thoughts about death and dying and experiences of care in end-of-life among older persons living in nursing homes.Methods: This study employed a qualitative approach including individual interviews with 36 older persons living in Swedish nursing homes. Questions related to quality of life; physical health; thoughts about death, dying, and the future; and experiences related to the living condition and environment were asked. The interview transcripts were analysed through content analysis. The study was approved by the Regional Ethics Review Board (reference number: 2015/4).Results: The analysis resulted in the identification of three main thematic categories: The unavoidable and unknown end of life, Thoughts on control and Living your last period of life at a nursing home. The older persons did not fear death itself but had some worries about dying. Spending the last stage of life at a nursing home contributed to different thoughts and feelings among the older persons. With a few exceptions, older persons characterized life at the nursing home as boring and felt they were surrounded by people who did not belong there.Conclusions: This study indicates a need for older persons to talk about death, dying and end-life issues. Furthermore, this study highlighted that the co-residence of cognitively healthy persons and persons with dementia in the same ward adversely affected cognitively healthy persons. This situation resulted in there being not enough time to both handle the care needs of persons with dementia and have the conversations that cognitively healthy persons desired, such as conversations about thoughts about existence, that could have improved their quality of life.Trial registration: NCT02708498 Date of registration 16 February 2016.
Self-determination theory interventions versus usual care in people with diabetes: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis
Authors: Mathiesen Anne Sophie , Rothmann Mette Juel , Zoffmann Vibeke , Jakobsen Janus Christian , Gluud Christian , Lindschou Jane , Due-Christensen Mette , Rasmussen Bodil , Marqvorsen Emilie , Thomsen Thordis
Published: December 2020

BackgroundExisting self-management and behavioural interventions for diabetes vary widely in their content, and their sustained long-term effectiveness is uncertain. Autonomy supporting interventions may be a prerequisite to achieve ‘real life’ patient engagement and more long-term improvement through shared decision making and collaborative goal setting. Autonomy supportive interventions aim to promote that the person with diabetes' motivation is autonomous meaning that the person strives for goals they themselves truly believe in and value. This is the goal of self-determination theory and guided self-determination interventions. Self-determination theory has been reviewed but without assessing both benefits and harms and accounting for the risk of random errors using trial sequential analysis. The guided self-determination has not yet been systematically reviewed. The aim of this protocol is to investigate the benefits and harms of self-determination theory-based interventions versus usual care in adults with diabetes.Methods/designWe will conduct the systematic review following The Cochrane Collaboration guidelines. This protocol is reported according to the PRISMA checklist. A comprehensive search will be undertaken in the CENTRAL, MEDLINE, EMBASE, LILACS, PsycINFO, SCI-EXPANDED, CINAHL, SSCI, CPCI-S, and CPCI-SSH to identify relevant trials. We will include randomised clinical trials assessing interventions theoretically based on guided self-determination or self-determination theory provided face-to-face or digitally by any health care professional in any setting. The primary outcomes will be quality of life, mortality, and serious adverse events. The secondary will be diabetes distress, depressive symptoms, and adverse events not considered serious. Exploratory outcome will be glycated haemoglobin and motivation. Outcomes will be assessed at the end of the intervention and at maximum follow-up. The analyses will be performed using Stata version 16 and Trial Sequential Analysis. Two authors will independently screen, extract data from, and perform risk of bias assessment of included studies using the Cochrane risk of bias tool. Certainty of the evidence will be assessed by GRADE.DiscussionSelf-determination theory interventions aim to promote a more autonomous patient engagement and are commonly used. It is therefore needed to evaluate the benefit and harms according to existing trials. Systematic review registration The protocol has been registered in PROSPERO ID nr. CRD42020181144 on the 5th July 2020.
Temperament and character of patients with alcohol toxicity during COVID -19 pandemic
Authors: Estedlal AliReza , Mani Arash , Vardanjani Hossein Molavi , Kamali Mahsa , Zarei Leila , Heydari Seyed Taghi , Lankarani Kamran B
Published: December 2020

Background: Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse.Methods: This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results: Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43±10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12±14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). According to temperament and character index, mean scores of novelty seeking, harm avoidant, and self-transcendence were higher in the alcohol toxicity group than normal population (P<0.01). Mean scores of reward dependent, cooperativeness, and self-directedness were higher in normal population than the alcohol toxicity group (P<0.001). The mean score of persistence was not significantly different between methanol intoxicated and normal population groups (P=0.718). Conclusion: Alcohol intoxicated patients had higher scores of novelty-seeking and self-transcendence and lower scores of reward-dependency scores, cooperativeness and self-directedness. These scores are associated with higher likelihood of personality disorders.
Simulation-Based Curriculum Development: Lessons Learnt in Global Health Education
Authors: Sawaya Rasha , Mrad Sandra , Rajha Eva , Saleh Rana , Rice Julie
Published: December 2020

Abstract:
Background: Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center.
Methods : A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation.
Results : 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-hour sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-minute sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-hour slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities.
Conclusion : Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.
The effect of cognitive dysfunction on mid- and long-term mortality after vascular surgery
Authors: Szabo Andras , Toth Krisztina , Nagy Adam , Domokos Dominika , Czobor Nikoletta , Eke Csaba , Sandor Agnes , Merkely Bela , Susánszky Éva , Gal Janos , Szekely Andrea
Published: December 2020

Background: In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery.Methods: In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses.Results: The patients’ mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4% and 47.6% in the control and cognitive impairment groups, respectively (p=0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p=0.004).Conclusion: Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery.
Effect of oxaliplatin plus 5-fluorouracil or capecitabine on circulating and imaging biomarkers in patients with metastatic colorectal cancer: a prospective biomarker study
Authors: Mahmood Reem , Shaw Danielle , Descamps Tine , Zhou Cong , Morgan Robert D. , Mullamitha Saifee , Saunders Mark , Mescallado Nerissa , Backen Alison , Morris Karen , Little Ross A. , Cheung Susan , Watson Yvonne , O’Connor James P. B. , Jackson Alan , Parker Geoff J. M. , Dive Caroline , Jayson Gordon C.
Published: December 2020

Background: Patients with metastatic colorectal cancer are treated with cytotoxic chemotherapy supplemented by molecularly targeted therapies. There is a critical need to define biomarkers that can optimise the use of these therapies to maximise efficacy and avoid unnecessary toxicity. However, it is important to first define the changes in potential biomarkers following cytotoxic chemotherapy alone. This study reports the impact of standard cytotoxic chemotherapy across a range of circulating and imaging biomarkers.Methods: A single-centre, prospective, biomarker-driven study. Eligible patients included those diagnosed with colorectal cancer with liver metastases that were planned to receive first line oxaliplatin plus 5-fluorouracil or capecitabine. Patients underwent paired blood sampling and magnetic resonance imaging (MRI), and biomarkers were associated with progression-free survival (PFS) and overall survival (OS).Results: 20 patients were recruited to the study. Data showed that chemotherapy significantly reduced the number of circulating tumour cells as well as the circulating concentrations of Ang1, Ang2, VEGF-A, VEGF-C and VEGF-D from pre-treatment to cycle 2 day 2. The changes in circulating concentrations were not associated with PFS or OS. On average, the MRI perfusion/permeability parameter, Ktrans, increased in response to cytotoxic chemotherapy from pre-treatment to cycle 2 day 2 and this increase was associated with worse OS (HR 1.099, 95%CI 1.01-1.20, p=0.025).Conclusions: In patients diagnosed with colorectal cancer with liver metastases, treatment with standard chemotherapy changes cell- and protein-based biomarkers, although these changes are not associated with survival outcomes. In contrast, the imaging biomarker, Ktrans, offers promise to direct molecularly targeted therapies such as anti-angiogenic agents.
A promising prognostic risk model for advanced renal cell carcinoma (RCC) with immune-related genes
Authors: Cao Peng , Zhang Jian-Dong , Sun Ze-Jia , Zheng Xiang , Yu Bao-Zhong , Cao Hao-Yuan , Zhang Fei-Long , Gao Zi-Hao , Wang Wei
Published: December 2020

Background Renal cell carcinoma (RCC) is a common tumor of the urinary system. Nowadays, immunotherapy is a hot topic in treatment of solid tumors, especially those with pre-activated immune state. Methods In this study, we have downloaded genomic and clinical data of RCC samples from TCGA database. Four immune-related genetic signatures were used to predict the prognosis of RCC by Cox regression analysis. We have established a prognostic risk model. The model consists of the genes most related to prognosis from the four genes signatures and aims at prognosis of the RCC samples via Kaplan-Meier survival analysis. Independent data from the ICGC database were used to test the predictive stability of the model. Furthermore, we have performed landscape analysis to assess the presence of mutations in the genes of interest in the RCC samples from the TCGA. Finally, we have explored the correlation between the selected genes and the level of tumor immune infiltration via TIMER platform. Results We have used four genetic signatures to construct prognostic risk models and found that each of the models divide the RCC samples into high- and low-risk groups, each of the groups correlating with significantly different prognosis, especially in the advanced RCC cases. A comprehensive prognostic risk model was constructed with eight candidate genes from four signatures (HLA-B, HLA-A, HLA-DRA, IDO1, TAGAP, CIITA, PRF1 and CD8B) dividing the advanced RCC samples from the TCGA database into high-risk and low-risk groups with a significant difference in the overall survival. The stability of the model was verified by independent data from the ICGC database. The samples from different subgroups. Landscape analysis showed that the mutation ratios in some genes were different between two risk groups. Besides, the expression levels of the selected genes were interrelated with the infiltration degree of the immune cells in the advanced RCC. ConclusionsEight immune-related genes were screened in our study to construct a promising prognostic risk model with a great predictive value for the prognosis of advanced RCC. The selected genes were associated with infiltrating immune cells in tumors which presents a chance for personalized treatment for advanced RCC.
The draft genome of the specialist flea beetle Altica viridicyanea (Coleoptera: Chrysomelidae)
Authors: Xue Huai-Jun , Niu Yi-Wei , Segraves Kari A. , Nie Rui-E , Hao Ya-Jing , Zhang Li-Li , Cheng Xin-Chao , Zhang Xue-Wen , Li Wen-Zhu , Chen Run-Sheng , Yang Xing-Ke
Published: December 2020

Background: Altica (Coleoptera: Chrysomelidae) is a highly diverse and taxonomically challenging flea beetle genus that has been used to address questions related to host plant specialization, reproductive isolation, and ecological speciation. To further evolutionary studies in this interesting group, here we present a draft genome of a representative specialist, Altica viridicyanea, the first Alticinae genome and the fifth chrysomelid genome reported thus far. Results: The genome is 864.8 Mb and consists of 4,490 scaffolds with a N50 size of 557 kb, which covered 98.6% complete and 0.4% partial insect Benchmarking Universal Single-Copy Orthologs. Repetitive sequences accounted for 62.9% of the assembly, and a total of 17,730 protein-coding gene models and 2,462 non-coding RNA models were predicted. To provide insight into host plant specialization of this monophagous species, we examined the key gene families involved in chemosensation, detoxification of plant secondary chemistry, and plant cell wall-degradation. Conclusions: The genome assembled in this work provides an important resource for further studies on host plant adaptation and functionally affiliated genes. Moreover, this work also opens the way for comparative genomics studies among closely related Altica species, which may provide insight into the molecular evolutionary processes that occur during ecological speciation.
A multilevel study of patient-centered care perceptions in mental health teams
Authors: Durand Francois , Fleury Marie-Josée
Published: December 2020

Background: The successful combination of interprofessional collaboration in multidisciplinary teams with patient-centered care is necessary when it comes to delivering complex mental health services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines correlates of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration and informational role self-efficacy in multidisciplinary mental health teams.Method: A cross-sectional multilevel survey design was used, based on self-administered bilingual validated questionnaires. Participants (N=314) were mental health professionals and managers working in public primary care or specialized mental health services, in inpatient or outpatient settings. Results: This study showed that belief in interprofessional collaboration’s relationship with patient-centered perceptions is increased in teams with high collaboration. Collaboration is also found as a mediator, representing a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: Our results were in line with recent studies on team processes establishing that collaboration is a key component in multilevel examinations of predictors of patient-centered care. In terms of practice, our study showed that multidisciplinary teams should know that working hard on collaboration is an answer to the complexity of patient-centered care. Collaboration is related to the teams’ ability to respond to its challenges. It is also related to individuals’ beliefs central to the delivery of interprofessional care.
Application of Random Forest and Data Integration Identifies Three Dysregulated Genes and Enrichment of Central Carbon Metabolism Pathway in Oral Cancer
Authors: Mukhopadhyay Srija , Ghosh Sahana , Das Debodipta , Arun P , Roy Bidyut , Biswas Nidhan K , Maitra Arindam , Majumder Partha
Published: December 2020

Background: Studies of epigenomic alterations associated with diseases primarily focus on methylation profiles of promoter regions of genes, but not of other genomic regions. In our past work (Das et al. 2019) on patients suffering from gingivo-buccal oral cancer – the most prevalent form of cancer among males in India – we have also focused on promoter methylation changes and resultant impact on transcription profiles. Here, we have investigated alterations in non-promoter (gene-body) methylation profiles and have carried out an integrative analysis of gene-body methylation and transcriptomic data of oral cancer patients. Methods: Tumor and adjacent normal tissue samples were collected from 40 patients. Data on methylation in the non-promoter (gene-body) regions of genes and transcriptome profiles were generated and analyzed. Because of high dimensionality and highly correlated nature of these data, we have used Random Forest (RF) and other data-analytical methods.Results: Integrative analysis of non-promoter methylation and transcriptome data revealed significant methylation-driven alterations in some genes that also significantly impact on their transcription levels. These changes result in enrichment of the Central Carbon Metabolism (CCM) pathway, primarily by dysregulation (overexpression) of (a) NTRK3, which plays a dual role as an oncogene and a tumor suppressor; (b) SLC7A5 (LAT1) which is a transporter dedicated to essential amino acids, and is overexpressed in cancer cells to meet the increased demand for nutrients that include glucose and essential amino acids; and, (c) EGFR which has been earlier implicated in progression, recurrence, and stemness of oral cancer, but we provide evidence of epigenetic impact on overexpression of this gene for the first time.Conclusions: In rapidly dividing cancer cells, metabolic reprogramming from normal cells takes place to enable enhanced proliferation. Here, we have identified that among oral cancer patients, genes in the CCM pathway – that plays a fundamental role in metabolic reprogramming – are significantly dysregulated because of perturbation of methylation in non-promoter regions of the genome. This result compliments our previous result that perturbation of promoter methylation results in significant changes in key genes that regulate the feedback process of DNA methylation for the maintenance of normal cell division.
The cost analysis of breast cancer: A comparison between private and public hospitals 
Authors: Afkar Abolhasan , Jalilian Habib , Pourreza Abolghasem , Mir Habibeh , Sigaroudi Abdolhosein Emami , Heydari Somayeh
Published: December 2020

Backgrounds Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results The estimated total mean (SD) direct cost of patients who referred to the private hospital and the public hospital was $10050 (19480) and $3960 (6780), respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870 (%15 of total costs) and $22350 (%85 of total costs), respectively. These differences were statistically significant (P<0.05). Conclusion Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.
Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study
Authors: Imaoka Shinsuke , Sato Koji , Furukawa Masahide , Okita Minoru , Higashi Toshio
Published: December 2020

Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: In diabetes patients with minor amputations, requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and off-loading walking are necessary to reduce the risk of reamputation. Patients with these risk factors should be encouraged to participate in physical therapy.
Development of a prognostic signature for esophageal cancer based on nine immune related genes
Authors: Zhang zhi , chen cheng , fang ying , Li sheng , Wang xiaohua , Sun lei , Zhou guoren , ye jinjun
Published: December 2020

Background: Function of the immune system is correlated with the prognosis of the tumor. The effect of immune microenvironment on esophageal cancer (EC) development has not been fully investigated. Methods: This study aimed to explore a prognostic model based on immune-related genes (IRGs) for EC. We obtained the RNA-seq dataset and clinical information of EC from the Cancer Genome Atlas (TCGA). Results: We identified 247 upregulated IRGs and 56 downregulated IRGs. Pathway analysis revealed that the most differentially expressed IRGs were enriched in Cytokine-cytokine receptor interaction. We further screened 13 survival-related IRGs and constructed regulatory networks involving related transcription factors (TFs). Finally, a prognostic model was constructed with 9 IRGs (HSPA6, S100A12, CACYBP, NOS2, DKK1, OSM ,STC2 ,NGPTL3 and NR2F2) by multivariate Cox regression analysis. The patients were classified into two subgroups with different outcomes. When adjusted with clinical factors, this model was verified as an independent predictor, which performed accurately in prognostic prediction. Next, M0 and M2 macrophages and activated mast cells were significantly enriched in high-risk group, while CD8 T cells and regulatory T cells (Tregs) were significantly enriched in low-risk group. Conclusions: Prognosis related IRGs were identified and a prognostic signature for esophageal cancer based on nine IRGs was developed.
Health education services utilization and its determinants among migrants: a cross-sectional study in urban-rural fringe areas of Beijing, China
Authors: Shao Shuang , Zhang Huirong , Chen Xiaolei , Xu Xiaojingyuan , Zhao Yali , Wang Meirong , Du Juan
Published: December 2020

Background: Domestic migration poses a challenge for China as migrants have little access to preventive healthcare services and are vulnerable to certain risks and diseases. This research sought to unveil and explore the determinant factors associated with health education utilization as a key aspect in basic public health services for migrants in Beijing, China.Methods: A sample of 863 inter-provincial migrants, 18 years old and above, was selected by three-stage stratified cluster sampling method in urban-rural fringe areas of Beijing during 2016 to 2017. Face-to-face structured interviews were conducted in the questionnaire survey. The effects of the explanatory variables on health education utilization from predisposing, enabling, health behaviors and need variables were used to demonstrate by Anderson health service utilization model. Results: The study revealed that 61.6% migrants desired to receive health education, while only 53.8% of them received in the past year. There were differences in the utilization and needs of health education among the migrants in different ages and genders. Many migrants desired to gain access to various types of health education information from the internet. Chi-square independence test lists such major determinant factors in migrants whole health education as age, "Hukou" registration system, marital status, education level, long-term residence plan in Beijing, one or more children in Beijing, employment status, housing source, average daily working time, exercises, health knowledge, smoking, self-rated health. The binary logistic regression indicates that the migrants with younger age, high education level, one or more children in Beijing, exercises and good self-rated health were more likely to receive whole health education. The results also show that average daily working time of enabling variables and exercise of health behavior variables were the strong and consistent determinants of three types of health education utilization, including communicable, non-communicable and occupational diseases.Conclusion: Gaps exist between the needs and utilization in health education and more attention should be given to the migrants with heavy workload and low education level. Feasible policies and measures, such as multiple health information channels, should be vigorously implemented to ensure equitable and easy access to health education for migrants.
Dys-regulation of lnc-SNHG1 and miR-216b-5p correlate with chemo-resistance and indicate poor prognosis of serous epithelial ovarian cancer
Authors: Pei Mei Li , Zhao Zong Xia , Shuang Ting
Published: December 2020

Aim: This study aimed to explore whether the dysregulation of lnc-small nucleolar RNA host gene 1 (SNHG1) and miR-216b-5p correlated with chemoresistance and indicated poor prognosis of serous epithelial ovarian cancer (EOC). Methods and Results: The expression of lnc-SNHG1 was upregulated, while miR-216b-5p showed low expression in patients with chemoresistant EOC compared with patients with chemosensitive EOC. The multivariate Cox regression analysis showed that the expression of miR-216b-5p and FIGO stage were independent prognostic factors for the overall survival (OS) of patients with serous EOC. Kaplan–Meier curves revealed a significant association of the increased expression level of lnc-SNHG1 with shorter OS and disease-free survival (DFS). Patients with a low expression level of miR-216b-5p also had shorter OS and DFS. The biological functions were tested using CCK-8 assay, colony formation assay, wound healing assay, and cell apoptosis. The knockdown of SNHG1 and the overexpression of miR-216b-5p stimulated paclitaxel sensitivity in A2780/Taxol cells through inhibiting cell growth and migration and promoting apoptosis. The inhibition of miR-216b-5p could rescue the effect of lnc-SNHG1 inhibition on the sensitivity of A2780/Taxol cells to paclitaxel. Luciferase reporter assay, RNA Binding Protein Immunoprecipitation Assay (RIP), and quantitative reverse transcription–polymerase chain reaction (qRT-PCR) indicated that lnc-SNHG1 acted as a sponge of miR-216b-5p in A2780/Taxol cells.Conclusions: This study showed that the overexpression of lnc-SNHG1 and decreased expression level of miR-216b-5p correlated with the chemoresistance of patients with serous EOC and indicated shorter OS and DFS. Lnc-SNHG1 functioned as a ceRNA with miR-216b-5p, which was critical in modulating the paclitaxel sensitivity of ovarian cancer cells.
Root causes of elective surgical case cancellation in Ethiopia: a systematic review and meta-analysis
Authors: Yohanes Yeneabat Birhanu , Sinshaw Aklilu Endalamaw , Ayisa Aynalem Adu
Published: December 2020

Background: Cancellation of elective surgical operation recognized as a major cause of emotional trauma to patients as well as their families. In Ethiopia, prevalence and root causes for elective surgical case cancellation varies from time to time in different settings. This systematic review and meta-analysis aimed to find the pooled prevalence and root causes for elective surgical case cancellation in Ethiopia.Methods: The databases for the search were Web of Science, PubMed, and Google Scholar. The last literature search was performed on February 8, 2020. To assess publication bias Egger's regression analysis was applied. The pooled estimation was estimated using random-effects model meta-analysis. Subgroup analysis was also done based on the root causes of surgical case cancellation. Results: This meta-analysis included a total of 5 studies with 5591 study participants. The pooled prevalence of elective surgical case cancellation was 21.41% (95% CI: 12.75 to 30.06%).Administration-related reason (34.50%) was the most common identified root cause, followed by surgeon (25.29%), medical (13.90%), and patient-related reasons (13.34%).Conclusion: The prevalence of elective surgical case cancellation was considerable. The most common root cause for elective surgical case cancellation was administration-related reasons, followed by the surgeon, medical and patient-related reasons. The causes for the surgical cancellations are potentially preventable. Thus, efforts should be made to prevent unnecessary cancellations through careful planning.
Successful live birth in a Chinese woman with P450 oxidoreductase deficiency through frozen-thawed embryo transfer: a case report with review of the literature
Authors: Pan Ping , Zheng Lingyan , Chen Xiaoli , Huang Jia , Yang Dongzi , Li Yu
Published: December 2020

Background: Congenital adrenal hyperplasia (CAH) caused by P450 oxidoreductase deficiency (PORD) in 46,XX patients is characterized by genital ambiguity, primary amenorrhea, absent or incomplete sexual maturation, infertility, skeletal malformations and so on. But few pregnancies have been reported from these female patients with PORD. Case Description: A 29-year-old Chinese woman with PORD due to the compound heterozygous mutation (c.1370G>A/c.1196_1204del) in the P450 oxidoreductase(POR) gene had suffered from primary amenorrhea and infertility. She had one cancelled cycle of ovulation induction due to low serum estradiol(E2), high progesterone(P) levels and thin endometrium，then in vitro fertilization (IVF) was recommended. At the first IVF cycle, 4 oocytes were retrieved and 4 viable embryos were cryopreserved due to thin endometrium associated with low E2 and prematurely elevated P after ovarian stimulation, even though oral dexamethasone were used to control adrenal P overproduction at the same time. When basal P fell to <1.5ng/ml, artificial endometrial preparation and frozen embryo transfer were performed, resulting in a twin pregnancy. She delivered a healthy boy and a healthy girl by caesarean section at 37 weeks and 2 days of gestation. Conclusions: We report the pregnancy achieved in a CAH woman caused by a compound heterozygous POR mutation, with primary amenorrhea and disorders of steroidogenesis. It seemed that disorders of steroidogenesis caused by PORD didn’t impair the developmental potential of oocytes. IVF and frozen embryo transfer after adequate hormonal control and endometrial preparation should be an effective infertility treatment for PORD women.
Relativity and View Effects
Authors: Fischli Bernard
Published: December 2020

Relativity has been based on the implicit assumption that electromagnetism would exclusively describe interactions. Relativistic view effects are included as well, and they act with no force and no energy exchanges. The Ehrenfest paradox is solved. View effects specific to each point of view are the solution. The calculation of the deflection of light by the sun explains in detail why the deflection angle must be almost double the value obtained with Newton’s laws. The compatibility of General Relativity with the new interpretation is discussed. View effects cannot impact total energy. An object has no speed limit due to relativity but can be limited due to other causes. Inertial behavior is examined. Inertial masses are redundant, but this does not introduce gravitation to General Relativity.
Determining the Rating of Ukrainian Banks on the Risk of Legalization of Illegally Obtained Income
Authors: Lyeonov Serhii V. , Kuzmenko Olha V. , Mynenko Serhii V. , Kwilinski Aleksy S. , Lyulyov Oleksii V.
Published: December 2020

The article examines a scientific and methodological approach to the rating of banks on the risk of money laundering. A sample of 18 indicators of 65 Ukrainian banks in 2019 was selected. The relative indicators that characterize the risk of using the bank's operations to legalize illegal income are considered. Logically, the indicators are divided into three parts. The first group of indicators characterizes the quantity and quality of the bank's compliance with the current legislation of Ukraine in the field of financial monitoring. The second group of indicators reflects the size of cash turnover in the bank, which is a characteristic of the bank's participation as a conversion center. The third group of indicators characterizes the bank's involvement in international income laundering cycles, considering transactions in countries - offshore zones and dubious transactions without explicit confirmation by a foreign trade contract. The study of input data on multicollinearity was carried out, based on which 5 indicators that are collinear with others were excluded. Normalization of the input data set based on nonlinear normalization is carried out. The weights of each indicator are calculated based on the principal component’s method. The optimal number of factors was determined based on the percentage of the variance explained by each factor and the graph of the scree plot. Minkowski metric was used to construct the integral index. Based on the integrated indicator, the rating of banks on the risk of money laundering was formed. The verbal-numerical Harrington scale provided a qualitative characterization of the risk of using bank operations to legalize illicit income. MS Office Excel software and Correlations of the statistical package STATISTICA 10 were used for calculations.

Keywords: Anti-money laundering, the rating of banks, on the risk of legalization, integral indicator, Minkowski metric.
Desafios para o concreto sustentável
Authors: Silva Danillo de Almeida e , Melo Carlos Eduardo Luna de
Published: December 2020

O presente artigo busca referenciar a problemática do uso do agregado reciclado para concreto e os mecanismos relacionados à sua produção e qualidade, fatores que são preponderantes no desempenho do concreto reciclado. Os critérios elaborados para esse estudo têm como base os fatores que influenciam nas propriedades físicas, mecânicas e ambientais do agregado reciclado, tais como conscientização da mão de obra, processo de coleta, processo de beneficiamento e produção do concreto reciclado. O uso dos resíduos de construção e demolição como agregado para produção de concretos reciclados, blocos estruturais, blocos de vedação e outros componentes construtivos são uma realidade promissora, e estão sendo difundidos e implementados em vários países com potenciais ganhos ambientais. Bons estudos estão sendo realizados em vários países sobre o uso do agregado reciclado para concretos sustentáveis. Os mecanismos para mitigar a problemática do uso deste material tão abundante tem difundindo cada vez mais o potencial deste material sustentável. A pesquisa teve como alvo periódicos de pesquisas realizadas no Brasil e no exterior, normas brasileiras e portarias que normatizam o uso do resíduo de construção e demolição como agregado para concreto e materiais construtivos, tendo como enfoque a produção com sustentabilidade. O processo de beneficiamento do resíduo de construção e demolição tem forte influência nas propriedades mecânicas dos agregados, tais como granulometria, forma, textura e densidade, e podem ser controladas melhorando o desempenho do concreto reciclado e potencializando o seu ganho ambiental.
Viabilidade do aproveitamento domiciliar de águas pluviais em municípios de regimes pluviométricos distintos
Authors: Rodrigues Lívia Veloso , Leite Marcella Piceli , Thebaldi Michael Silveira , Rodrigues Karina Vilela , Franco Camila Silva , Assemany Paula Peixoto
Published: December 2020

Objetivou-se com este estudo analisar a viabilidade técnica e econômica de reservatórios de aproveitamento de água de chuva, dimensionados para três municípios com climas distintos do Estado de Minas Gerais, sendo eles Lavras, Montes Claros e Uberlândia. Para análise da viabilidade técnica, foram usados os métodos de dimensionamento de reservatório apresentados pela NBR 15527: Rippl, Simulação, Azevedo Netto, Alemão, Inglês e Australiano. Para tal, foram utilizadas as séries históricas pluviométricas de cada município para o período de 01/01/1988 a 31/12/2018. A área de captação adotada foi de 100 m², e foram consideradas demandas de água potável de 100, 150 e 300 L per capita, em residências ocupadas por três habitantes, sendo o percentual de substituição de água potável por pluvial equivalente a 30%. Para análise da viabilidade econômica, foram utilizadas as metodologias do Payback Descontado e Índice de Lucratividade. Estas foram embasadas nos valores das tarifas praticadas pelas companhias de abastecimento de água e nos custos de aquisição dos reservatórios dimensionados. Os resultados obtidos mostraram que os reservatórios dimensionados por meio do Método da Simulação apresentaram maiores viabilidades técnica em relação aos demais. Com este, a simulação do comportamento dos reservatórios em todos os meses do ano se mostrou eficaz inclusive nos meses de pouca chuva. Ademais, o tempo necessário para retorno do investimento realizado esteve dentro do horizonte de 30 anos adotado, variando de 4,31 a 25,98 anos. O investimento também foi considerado vantajoso quando analisados os Índices de Lucratividade, os quais foram todos superiores a um, com valores oscilando de 1,16 a 15,79. Lavras, segunda cidade com maior valor de precipitação média anual dentre as avaliadas, foi a mais viável economicamente para implantação de reservatórios, destacando a tarifa de água e esgoto como um fator de grande relevância na análise.
FOLLOW-UP OF PATIENTS AND PROGNOSTIC IMPACT OF TUMOUR MARKER CA 15-3 ON PATIENTS OF BREAST CANCER: A RETROSPECTIVE COHORT STUDY
Authors:   Associate Professor, Department of Lab Medicine, Delhi State Cancer Institute, Dilshad Garden, New Delhi, India., Vinocha Anjali
Published: December 2020

Introduction:Breast cancer is the most common cancer in women, with 5- and 10-year relative survival rates are 91% and 84%, respectively for women with invasive breast cancer. This study aimed to detect the role of serum breast cancer marker CA 15-3 for early detection of metastasis, relapse or recurrence for management of breast cancer patients. Methods: It was a retrospective cohort study with a total of 132 breast cancer patients from the year 2010 to march 2020 were taken and followed up. For these patients demographic, biochemical parameters, radiological and clico-pathological data were collected and analysed. Result: The mean age at the time of presentation and mean duration of follow-up was 47 years and 31 months respectively. There was elevation in the serum level of CA 15-3 at the time of diagnosis of metastasis, recurrence or residual disease in 41 patients. This shows that sensitivity of elevated CA 15-3 (> 30 IU/ml) level in Ca Breast patients was 84%, 75 % and 75 % with respect to metastasis, recurrence and relapse. Log Rank test Chi- square value was 7.39 which was statistically significant (p=0.007). Cox proportional hazard model was created for effect of age at presentation, CA 15-3 at the time of diagnosis and MRM on distant metastasis and was statistically significant (p=0.037). Conclusion: We recommend that for the management of breast cancer patients, Cancer antigen (CA 15-3) levels can be used as prognostic marker for early diagnosis of metastasis, recurrence or relapse.
Vallás és wellness
Authors: Szántó Ákos , Juhász Annamária
Published: December 2020

E tanulmány célja annak bemutatása, hogy a wellness és a vallás, vagy talán helyesebben a vallásgyakorlás, a hitélet milyen remekül megférnek egymás mellet, sőt milyen jól kiegészíthetnék egymást. Sőt, egy kölcsönösen előnyös, egymást kölcsönösen erősítő együttműködés mindkét fél ügyfélkörét (vendégek és hívők) szélesíthet, és elégedettségüket növelhet. A wellness- és a vallási szakirodalom is ráadásul szinte ugyanazokat a tényezőket tartja alapvetőnek a jóllét eléréséhez. A wellness dimenzióinál megtalálhatók ugyanazok az elemek, melyeket a szakrális szakirodalom a lelki jóllét elemeiként megjelöl. Ily módon a szakirodalom mindkét szakterület esetében egybecseng. Ez alátámasztja az általam is alapvetően fontosnak tartott lelki jóllét jelentőségét a kiegyensúlyozott élet(vitel) szempontjából. A fent említett kooperáció egy plusz elem lehet a wellness-szolgáltatók kínálatában, melyre a marketing mixükben is támaszkodhatnak. A marketing kommunikációjukat pedig akár alapozhatják erre. Az egyházak esetében pedig egy olyan eszköz lehet ez az együttműködés, mellyel jelentős mértékben tudják növelni ismertségüket, elfogadottságukat és a hívők körét.
Main tools of integrated marketing communications of banks
Authors: Demko Mariana , Zintso Yuliya
Published: December 2020

The question of the essence of the main tools of integrated marketing communications in the activity of banks of Ukraine is investigated. Their introduction in the management of Ukrainian banks is becoming relevant nowadays. Influence of such factors as intensification of competition; penetration of foreign banks into the Ukrainian market; expansion of the scope of banks’ activities determine the search for effective tools of integrated marketing communications. The purpose of the study is to substantiate and systematize theoretical and methodological approaches to the application of the main tools of integrated marketing communications of banks. The object of research is main tools of integrated marketing communications in the activities of banks. The theoretical basis of the study is the theories and marketing concepts of scientists. The results of the study allowed to determine the essence of such concepts as «marketing tools», «tools», «tools of marketing communications». The main tools of integrated marketing communications of banks as the most effective tools in modern market conditions are highlighted. Their use plays an important role in forming a positive image of the bank. Features of application of the main tools of integrated marketing communications for promotion of banking products and provision of banking services are considered.