bluuebunny/crossref_metadata_2025 huggingface dataset:
ACUTE STROKE IN YOUNG PATIENT: ALSO THINK ABOUT CORONAVIRUS ! (ABOUT A CASE AND A REVIEW OF THE LITERATURE)
Authors:   Department of Cardiology B., Ibn Sina Hospital Center, Mohammed V University, Rabat, Morocco., Oussou Yousra , Nadhil Zayna ,   Department of Cardiology B., Ibn Sina Hospital Center, Mohammed V University, Rabat, Morocco., Cherti Mohamed ,   Department of Cardiology B., Ibn Sina Hospital Center, Mohammed V University, Rabat, Morocco.
Published: February 2021

Certainly, the respiratory clinical smptomatology remains the most classic, however, covid 19 is recently considered to be a vasculitis affecting several organs, and which is the origin of other extra-pulmonary manifestations, in particular thromboembolic disease (both venous and arterial) which has increasingly become a dramatic complication to be feared during this pandemic, due to its negative impact on the prognosis of affected patients, increasing the need for intentive care and the death rate.The mechanism is multifactorial, associating endothelial damage, an abnormality of hemostasis, and immunothrobosis[1].We report the case of a 39-year-old female patient who had aacute ischemic stroke (AIS) by embolization of a thrombus located in the left ventricle, whose hiscovid 19 disease was subsequently diagnosed, and whose evolution was later marked by clinical worsening, so the patient was transferred to intensive care.The interest of this case report is to show the need to acquire the reflex to think about a covid 19 disease in case of AIS (especially for the young) even in the absence of other obvious respiratory signs, as well as to shed light on the mechanism and the particularity of diagnostic and therapeutic management of this kind of complications.
DOES K-DIFORMATE SUPPLEMENTATION IMPROVES GROWTH AND DIET STAIBLITY OF JUVENILE WHITE SHRIMP(LITOPENAEUS VANNAMEI)?
Authors:   Gaston Berger University, Department of Aquaculture., Amadou Ly Mouhamadou ,   National Taiwan Ocean University, Department of Aquaculture., Cheng Ann-Chung ,   Gaston Berger University, Department of Aquaculture., Cheah Wai-Leong ,   National Taiwan Ocean University, Department of Aquaculture., Tidiane Ba Cheikh ,   Cheikh Anta Diop University, Faculty of Science., Liou Chyng-Hwa ,   National Taiwan Ocean University, Department of Aquaculture.
Published: February 2021

A study was conducted to investigate the effects of potassium diformate (K-diformate) supplementation in two protein levels on growth, food conversion and survival in juvenile white shrimp, litoppenaeusvannamei.Two dietary protein levels, 41% dietary protein(CP41) and 37% dietary protein(CP37) was formulated and supplemented of graded K-diformate levels 0%, 0.1%, 0.2%, 0.4%, 0.8%, 1.4% and 2.0%.Post larvae white shrimp (Litopenaeusvannamei) of initial mean weight 0.82Â±0.08g were randomly stocked in 45 aquarium tanks with a working volume of 50 L (60Ã—40Ã—30 cm ) at a stocking density of 10 shrimps per aquarium.The result of this study did not show significant difference in percentage weight gain and survival rate among shrimps fed CP41 and CP37 with graded K-diformate supplemented diet. No K-diformate dose response was observed at the end of the study. The results of present study proof that K-diformate supplemented diet do not affect water pH and feeding diet stability in water.
THE NOISE EXPOSURE EFFECT ON WORK FATIGUE AND STRESSON WORKERS IN THE OIL AND GAS PROCESSING PLANT OF PT. X
Authors:   Lecturer in Post Graduate Program, Sahid University Jakarta, and Faculty of Economics and Business, University of Lampung, Indonesia., Abdullah Syahfirin , Purwanto Utomo Eko ,   Student Magister Program of Occupational, Health, Safety, and Environmental Post Graduate Program of Sahid University Jakarta, Indonesia., Ramli Soehatman ,   Lecturer in Post Graduate Program, Sahid Univerdity Jakarta, Indonesia, and Chairman Word Safety Organization Indonesia.
Published: February 2021

This research aims to determine noise exposure effect on work fatigue and stress on operators in the oil and gas processing plant of PT. X. The method used in this research is descriptive quantitative approach to causality research. The population in this study were all workers in the oil and gas processing plant of PT. X. From this population the sample taken is based on the number of research indicators of 40 so that the minimum number of samples is 5 times the number of indicators estimated or as much as 5 x 40 = 200. Study analysis was carried out using (SEM: Structural Equation Model) analysis with the help of the Lisrel 8.0 program. The results showed that there was an effect of noise exposure on work fatigue in workers in the oil and gas processing plant of PT. X and there is the effect of noise exposure on work stress on workers in the oil and gas processing plant of PT. X.
COMPARATIVE EVALUATION OF EFFICACY OF TOPICAL SALICYLIC ACID OINTMENT AND 5-FLUOROURACIL CREAM IN WARTS PATIENTS
Authors:   Assistant Professor, Department of dermatology, M.R.A. Medical College, Ambedkar Nagar, India., Kumar Gond Pankaj , Prakash Shivhare Dev ,   Assistant Professor, Department of dermatology, G.S.V.M. Medical College, Kanpur, India., Purwar Neetu ,   Assistant Professor, Department of pathology, G.S.V.M. Medical College, Kanpur, India., Kumar Singh Ajay ,   Associate professor, Department of biochemistry, Government Medical College, Ambedkar Nagar, India., Kumar Sharma Ashish ,   Tutor, Department of biochemistry, Government Medical College, Ambedkar Nagar, India.
Published: February 2021

Context: Warts are one of the common diseases in India. There are various modalities used for the treatment of warts. Very few studies have been done which compare the efficacy of topical salicylic acid and 5-Fluorouracil cream in warts patients. Aim: To compare the efficacy of topical salicylic acid ointment and 5% 5-fluorouracil cream in warts patients. Settings and Design: Completely randomized design. Methods and Material: Total 300 clinically diagnosed patients of warts which were divided into three groups (each contains 100 patients) depending on the treatment modalities which includes modality I treated with 16% salicylic acid, modality II treated with 5% 5-fluorouracil and modality III treated with the combination of 16% salicylic acid and 5% 5-fluorouracil. The evaluation of therapy was done by estimating the reduction in wart volume, complete regression of lesion, absence of recurrence of treated lesion after 3 months follow up. Statistical analysis used: Significant conclusion was drawn after applying the one way Anova test of significance. Results and conclusion: In Modality III, 99.95 % clearance was seen in warts volume at 12 weeks of treatment followed by Modality I (99.67% clearance in warts volume) and Modality II (99.31% clearance in warts volume) which were statistically significant at p value <0.01 level. Combination of 5-Fluorouracil and 16% salicylic acid is best for the treatment of warts with maximum recovery from warts with minimum adverse effect.
A STUDY TO ASCERTAIN THE ADVERSE EFFECTS OF MORPHINE IN CANCER PATIENTS BEING TREATED FOR SEVERE PAIN
Authors:   Professor and Head Department of Palliative Medicine SMS Medical College, Jaipur., Mathur Ashwin , Agarwal Avikesh ,   Post Graduate Student, Department of Medicine SMS Medical College, Jaipur.
Published: February 2021

Pain is a distressing symptom of cancer that affects the quality of life of patients, families, and caregivers. Moderate to severe pain is common throughout the disease trajectory of cancer, and its prevalence increases throughout the course of illness, it has been reported in 59% of patients undergoing anticancer treatment, in 64% of those with advanced/metastatic cancer, and in 33% of those having completed curative treatment. Adequate management of cancer pain is the cornerstone of symptom management for patients with cancer. [1] WHO guidelines on cancer pain continue to provide a framework approach for pharmacologic management of cancer pain management in terms of a Pain Ladder, wherein Step 1 for mild pain is prescribed NSAIDS, Step 2 for moderate pain is prescribed NSAIDS along with synthetic opioids and adjuvants and step 3 for severe pain is prescribed strong opioids like Morphine along with NSAIDS and adjuvants. Morphine being an excellent analgesic for severe pain is nowadays standard of care for terminal cancer patients with severe pain. However, its potency is a double edged sword and can give rise to side effects as well as much feared adverse effects. This study was undertaken to assess the undesirable effects on cancer patients being treated with Morphine. AIM To find the association of morphine and its adverse effects (by 4 point verbal rating scale) in cancer patient on long term morphine therapy. MATERIAL AND METHODS It is a hospital based longitudinal observational study, conducted in palliative care center, SMS hospital, Jaipur, after obtaining due approval from ethics committee and research review board of the institution. DURATION OF STUDY: One year. TOTAL PATIENTS: 30 patients evaluated one month after initiation of opioid therapy. ELIGIBILITY CRITERIA: Inclusion criteria 1. Cancer patients visiting palliative care OPD for distressing, somatic symptom like pain requiring treatment with strong opioids (step 3 WHO ladder). 2. Patients of all ages and both sexes. 3. Patients willing to give informed consent 4. Patients who understand the four point symptom rating scale. Exclusion Criteria: 1. Patients with deranged liver and kidney functions. 2. Patient with predominantly neuropathic pain. 3. Patients with altered sensorium. 4. Patient not willing to give informed consent.
Effect of Preparation Additives on the Antimicrobial Activity and Cytotoxicity of Polypyrrole
Authors: de Almeida Yslaine , Bispo Diego , Montalvão Monalisa , Mota Karina , Corrêa Cristiane , Gimenez Iara
Published: February 2021

The search for new biomaterials has increased continuously in recent years and, in this context, the application of polypyrrole (PPy) as a promising material for this function has been reported as a result of positive responses, such as bioactivity and biocompatibility. In this study, PPy was obtained through modifications/adaptations made in methodologies of previous papers, which focused mainly on conductive properties. The use of additives in the synthesis significantly improves the application in the biomedical area, which depends directly on a diversity of structural and morphological parameters. Here, physicochemical characterization was helpful to determine PPy structures and morphologies of the resulting samples. The addition of phytic acid (PA) and methyl orange (MO) directly influenced not only the particle morphology and size, but also the antibacterial activity and cytotoxicity. The results of antibacterial activity against Staphylococcus aureus and Escherichia coli as well as the negligible cytotoxicity of PPy obtained here indicate a wide applicability of the materials in wound dressing and tissue engineering.
ОПТИМИЗАЦИЯ ПРОФЕССИОНАЛЬНОГО ОБРАЗОВАНИЯ АКУШЕР-ГИНЕКОЛОГОВ
Authors: Ф.Д. Каримова , С.А. Мирходжаева
Published: February 2021

An important task of postgraduate education is to improve the efficiency of medical personnel. For its implementation, it is necessary to constantly improve the educational system and approaches to teaching.
Synthesis, Antibacterial, and Cytotoxicity Evaluation of Oleanolic Acid-4-aminoquinoline Based Hybrid Compounds
Authors: Khwaza Vuyolwethu , Oyedeji Opeoluwa O. , Aderibigbe Blessing A. , Morifi Eric , Fonkui Thierry Y. , Ndinteh Derek T. , Steenkamp Vanessa
Published: February 2021

Aim:

To prepare a class of oleanolic-based compounds.

Background:

Conventional drugs used to treat infectious diseases suffer from limitations such as drug toxicity and drug resistance. The resistance of microbes to antimicrobial agents is a significant challenge in treating microbial infections. Combining two or more drugs with different modes of action to treat microbial infections results in a delay in developing drug resistance by the microbes. However, it is challenging to select the appropriate choice of drugs for combination therapy due to the differences in stability and pharmacokinetic proﬁle of the drugs.Therefore, developing hybrid compounds using the existing drugs is a promising approach to design effective antimicrobial agents.

Objectives:

To prepare oleanolic-based hybrid compounds followed by characterization, in vitro antibacterial, and cytotoxicity evaluation.

Methods::

Oleanolic acid-4-aminoquinoline-based hybrid compounds weresynthesized via esterification and amidation. The compounds werecharacterized using FTIR, NMR, and UHPLC-HRMS. Oleanolic acid was isolated from the flower buds of Syszygium aromaticum (L.) Merr. & L.M.Perry, a specie from Kingdom Plantae, order Mytales in Myrtaceae family. Their antibacterial and cytotoxicity activity was determined against selected strains of bacteria assessed using the microdilution assay and sulforhodamine B assay against selected cancer cell lines.

Results:

The synthesized hybrid compounds exhibited antibacterial activity against the
Gram-positive bacteria Enterococcus faecalis (ATCC13047), Bacillus subtilis (ATCC19659),
Staphylococcus aureus as well as Gram-negative bacteria, Klebsiella oxytoca
(ATCC8724), Escherischia coli (ATCC25922), and Proteus vulgaris (ATCC6380)
with minimum inhibitory concentrations of 1.25 mg/mL compared to oleanolic
acid (2.5 mg/mL). Compounds 13 and 14 displayed cytotoxicity in vitro against the
cancer cell lines (MCF-7 and DU 145) compared to the oleanolic acid (IC50 ˃ 200
μM).

Conclusion:

The present study revealed that the modification of C28 of OA enhanced its biological properties.
Formulation, Characterisation and In vitro Cytotoxic Effect of Lens culinaris Medikus Seeds Extract Loaded Chitosan Microspheres
Authors: Vohra Kripi , Mehta Meenu , Garg Vandana , Dua Kamal , Dureja Harish
Published: February 2021

Objective:

The aim of present study was to formulate chitosan microspheres loaded with
ethanolic extract of Lens culinaris Medikus (L.culinaris) seeds (ME) and to explore its anticancer
potential against lung cancer (A549) cell line.

Methods:

Central composite design was applied to prepare and optimise the chitosan microspheres.
The prepared microspheres were evaluated for its physicochemical characterisation, in
vitro drug release and anti-cancer potential in vitro.

Results:

L.culinaris loaded chitosan microspheres were prepared successfully with suitable particle
size, entrapment efficiency and drug release. The developed ME were spherical shaped with the
particle size of 2.08 μm. The drug entrapment efficiency and cumulative drug release was found
1.58±0.02% and 81.95±0.35%, respectively. Differential scanning calorimetry studies revealed no
interaction between drugs and polymers used. The cytotoxic effect of the optimised formulation revealed
a significant response as compared to the ethanolic extract of L.culinaris seeds (IC50: 22.56
μg/ml vs. 63.58 μg/ml), which was comparable to that of reference drug, doxorubicin (22 μg/ml).
These observations demonstrate that the optimised microspheres are effective against lung cancer
(A549) cells.

Conclusion:

The significant cytotoxic response of the developed microspheres may be attributed
due to its low particle size, high entrapment efficiency and prolonged drug release profile.
Improvement in Cognitive Abilities, Mental and Emotional Wellbeing of Teenagers following a Meditation Retreat: An Open-Trial Pilot Study
Authors: Kanchibhotla Divya , Subramanian Saumya , Kulkarni Shashank
Published: February 2021

Background:

Today’s teenagers face several challenges that result in
poor mental health, depression and anxiety. Several studies in the past decade have
explored meditation as adjunctive therapy for mental illness however, the long-term
residual benefits of meditation have rarely been studied.

Objective:

The aim of the study was to investigate the benefits of a four day
meditation retreat on cognitive abilities, mental and emotional well-being of
teenagers.

Methods:

303 teenagers participated in this study. Cognitive abilities of the
students were measured using the Six letter cancellation test (SLCT). Mental and
emotional well-being was measured using World Health Organization Well-being
index (WHO-5) and Strength and Difficulties questionnaire (SDQ), respectively.
Data analysis was performed using paired sample t-test and repeated measure
ANOVA.

Results:

Teenagers demonstrated a 33% increase in average accuracy for SLCT
post intervention. WHO-5 mental well-being index scores also increased
significantly (p<0.001). The participants experienced a significant reduction in
emotional problems and hyperactivity as measured by SDQ. The benefits of the
retreat continued to persist, when measured after 40 days of the intervention.

Conclusion:

A well-structured meditation retreat has significant and long-term
benefits on teenagers’ mental well-being, emotional stability and cognitive capacity.
Antecedents to Trustworthiness, Satisfaction, and Potency in ad hoc Face-to-Face and Computer-Mediated Teams
Authors: Jacques Paul H. , Garger John , Filippelli-DiManna Leslie P.
Published: February 2021

This paper tests a model that links individual perceptions of mood, trust, satisfaction, and potency in face-to-face and computer-mediated teams. Results suggest that the model is valid in both conditions but that perceptions of each construct are higher in face-to-face conditions. A direct connection exists between mood and how benevolence, integrity, and ability are perceived only in the computer-mediated condition. Implications to research include an understanding that in both computer-mediated and face-to-face teams, trust operates similarly, though perceptions are lower when communication media are leaner. When using computer-mediated communication, students might benefit from face-to-face interactions before interacting online.
Acciones para la gestión del comercio electrónico en la agencia de viajes Cubana Ecotur
Authors: Velázquez López Aliber , Martínez Carballo Massiel , Torres Hechavarría Lisandra
Published: February 2021

El sector turístico se enfrenta hoy en día al reto de adaptarse a las tendencias de un mercado altamente dinámico y cada vez más matizado por la influencia de las Tecnologías de la Información y las Comunicaciones (TICs). La Agencia de Viajes cubana Ecotur S.A, especializada en el turismo de naturaleza, se encuentra desde el año 2018 en proceso de incorporar el comercio electrónico a su gestión, pero su equipo de trabajo carece del know how para aprovecharlo al máximo. Es por ello que el presente trabajo investigativo se trazó como objetivo: proponer acciones para una gestión efectiva de esta actividad en la empresa. En el curso de la investigación se emplearon como técnicas de recogida de información la entrevista semi-estructurada, la encuesta y la observación científica. El diagnóstico de la situación del comercio electrónico en Ecotur demostró que la agencia ha alcanzado un nivel de adopción de e-transacción. Sin embargo, se detectaron deficiencias que no le permiten gestionarlo de forma óptima, siendo las más relevantes: la obsolescencia tecnológica y la falta de conocimientos con relación al mismo. Este diagnóstico y un estudio de Benchmarking realizado con las agencias de viajes Expedia, Booking.com, Greenloons, Viajes Trekking y Aventura y Viajes Tarannà, contribuyeron a formular la propuesta de acciones, dando solución a las principales insuficiencias detectadas.
Influence of Health Beliefs on Adherence to COVID-19 Preventative Practices: International, Social Media–Based Survey Study
Authors: Hsing Julianna C , Ma Jasmin , Barrero-Castillero Alejandra , Jani Shilpa G , Pulendran Uma Palam , Lin Bea-Jane , Thomas-Uribe Monika , Wang C Jason
Published: February 2021

Background

Health behavior is influenced by culture and social context. However, there are limited data evaluating the scope of these influences on COVID-19 response.

Objective

This study aimed to compare handwashing and social distancing practices in different countries and evaluate practice predictors using the health belief model (HBM).

Methods

From April 11 to May 1, 2020, we conducted an online, cross-sectional survey disseminated internationally via social media. Participants were adults aged 18 years or older from four different countries: the United States, Mexico, Hong Kong (China), and Taiwan. Primary outcomes were self-reported handwashing and social distancing practices during COVID-19. Predictors included constructs of the HBM: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Associations of these constructs with behavioral outcomes were assessed by multivariable logistic regression.

Results

We analyzed a total of 71,851 participants, with 3070 from the United States, 3946 from Mexico, 1201 from Hong Kong (China), and 63,634 from Taiwan. Of these countries, respondents from the United States adhered to the most social distancing practices (χ23=2169.7, P<.001), while respondents from Taiwan performed the most handwashing (χ23=309.8, P<.001). Multivariable logistic regression analyses indicated that self-efficacy was a positive predictor for handwashing (odds ratio [OR]United States 1.58, 95% CI 1.21-2.07; ORMexico 1.5, 95% CI 1.21-1.96; ORHong Kong 2.48, 95% CI 1.80-3.44; ORTaiwan 2.30, 95% CI 2.21-2.39) and social distancing practices (ORUnited States 1.77, 95% CI 1.24-2.49; ORMexico 1.77, 95% CI 1.40-2.25; ORHong Kong 3.25, 95% CI 2.32-4.62; ORTaiwan 2.58, 95% CI 2.47-2.68) in all countries. Handwashing was positively associated with perceived susceptibility in Mexico, Hong Kong, and Taiwan, while social distancing was positively associated with perceived severity in the United States, Mexico, and Taiwan.

Conclusions

Social media recruitment strategies can be used to reach a large audience during a pandemic. Self-efficacy was the strongest predictor for handwashing and social distancing. Policies that address relevant health beliefs can facilitate adoption of necessary actions for preventing COVID-19. Our findings may be explained by the timing of government policies, the number of cases reported in each country, individual beliefs, and cultural context.
Intentions to Seek Mental Health Services During the COVID-19 Pandemic Among Chinese Pregnant Women With Probable Depression or Anxiety: Cross-sectional, Web-Based Survey Study (Preprint)
Authors: Wang Qian , Song Bo , Di Jiangli , Yang Xue , Wu Anise , Lau Joseph , Xin Meiqi , Wang Linhong , Mo Phoenix Kit-Han
Published: February 2021

BACKGROUND

Mental health problems are prevalent among pregnant women, and it is expected that their mental health will worsen during the COVID-19 pandemic. Furthermore, the underutilization of mental health services among pregnant women has been widely documented.

OBJECTIVE

We aimed to identify factors that are associated with pregnant women’s intentions to seek mental health services. We specifically assessed pregnant women who were at risk of mental health problems in mainland China.

METHODS

A web-based survey was conducted from February to March, 2020 among 19,515 pregnant women who were recruited from maternal health care centers across various regions of China. A subsample of 6248 pregnant women with probable depression (ie, those with a score of ≥10 on the 9-item Patient Health Questionnaire) or anxiety (ie, those with a score of ≥5 on the 7-item General Anxiety Disorder Scale) was included in our analysis.

RESULTS

More than half (3292/6248, 52.7%) of the participants reported that they did not need mental health services. Furthermore, 28.3% (1770/6248) of participants felt that they needed mental health services, but had no intentions of seeking help, and only 19% (1186/6248) felt that they needed mental health services and had intentions of seek help. The results from our multivariate logistic regression analysis showed that age, education level, and gestational age were factors of not seeking help. However, COVID-19–related lockdowns in participants’ cities of residence, social support during the COVID-19 pandemic, and trust in health care providers were protective factors of participants’ intentions to seek help from mental health services.

CONCLUSIONS

Interventions that promote seeking help for mental health problems among pregnant women should also promote social support from health care providers and trust between pregnant women and their care providers.
Defining the Scope of Digital Public Health and Its Implications for Policy, Practice, and Research: Protocol for a Scoping Review (Preprint)
Authors: Iyamu Ihoghosa , Gómez-Ramírez Oralia , Xu Alice X T , Chang Hsiu-Ju , Haag Devon , Watt Sarah , Gilbert Mark
Published: February 2021

BACKGROUND

There has been rapid development and application of digital technologies in public health domains, which are considered to have the potential to transform public health. However, this growing interest in digital technologies in public health has not been accompanied by a clarity of scope to guide policy, practice, and research in this rapidly emergent field.

OBJECTIVE

This scoping review seeks to determine the scope of digital health as described by public health researchers and practitioners and to consolidate a conceptual framework of digital public health.

METHODS

The review follows Arksey and O’Malley’s framework for conducting scoping reviews with improvements as suggested by Levac et al. The search strategy will be applied to Embase, Medline, and Google Scholar. A grey literature search will be conducted on intergovernmental agency websites and country-specific websites. Titles and abstracts will be reviewed by independent reviewers, while full-text reviews will be conducted by 2 reviewers to determine eligibility based on prespecified inclusion and exclusion criteria. The data will be coded in an iterative approach using the best-fit framework analysis methodology.

RESULTS

This research project received funding from the British Columbia Centre for Disease Control Foundation for Population and Public Health on January 1, 2020. The initial search was conducted on June 1, 2020 and returned 6953 articles in total. After deduplication, 4523 abstracts were reviewed, and 227 articles have been included in the review. Ethical approval is not required for this review as it uses publicly available data.

CONCLUSIONS

We anticipate that the findings of the scoping review will contribute relevant evidence to health policy makers and public health practitioners involved in planning, funding, and delivering health services that leverage digital technologies. Results of the review will be strategically disseminated through publications in scientific journals, conferences, and engagement with relevant stakeholders.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/27686
A Web-Based, Population-Based Cirrhosis Identification and Management System for Improving Cirrhosis Care: Qualitative Formative Evaluation (Preprint)
Authors: Javier Sarah J , Wu Justina , Smith Donna L , Kanwal Fasiha , Martin Lindsey A , Clark Jack , Midboe Amanda M
Published: February 2021

BACKGROUND

Cirrhosis, or scarring of the liver, is a debilitating condition that affects millions of US adults. Early identification, linkage to care, and retention of care are critical for preventing severe complications and death from cirrhosis.

OBJECTIVE

The purpose of this study is to conduct a preimplementation formative evaluation to identify factors that could impact implementation of the Population-Based Cirrhosis Identification and Management System (P-CIMS) in clinics serving patients with cirrhosis. P-CIMS is a web-based informatics tool designed to facilitate patient outreach and cirrhosis care management.

METHODS

Semistructured interviews were conducted between January and May 2016 with frontline providers in liver disease and primary care clinics at 3 Veterans Health Administration medical centers. A total of 10 providers were interviewed, including 8 physicians and midlevel providers from liver-related specialty clinics and 2 primary care providers who managed patients with cirrhosis. The Consolidated Framework for Implementation Research guided the development of the interview guides. Inductive consensus coding and content analysis were used to analyze transcribed interviews and abstracted coded passages, elucidated themes, and insights.

RESULTS

The following themes and subthemes emerged from the analyses: outer setting: needs and resources for patients with cirrhosis; inner setting: readiness for implementation (subthemes: lack of resources, lack of leadership support), and implementation climate (subtheme: competing priorities); characteristics of individuals: role within clinic; knowledge and beliefs about P-CIMS (subtheme: perceived and realized benefits; useful features; suggestions for improvement); and perceptions of current practices in managing cirrhosis cases (subthemes: preimplementation process for identifying and linking patients to cirrhosis care; structural and social barriers to follow-up). Overall, P-CIMS was viewed as a powerful tool for improving linkage and retention, but its integration in the clinical workflow required leadership support, time, and staffing. Providers also cited the need for more intuitive interface elements to enhance usability.

CONCLUSIONS

P-CIMS shows promise as a powerful tool for identifying, linking, and retaining care in patients living with cirrhosis. The current evaluation identified several improvements and advantages of P-CIMS over current care processes and provides lessons for others implementing similar population-based identification and management tools in populations with chronic disease.

CLINICALTRIAL
Application of an Anomaly Detection Model to Screen for Ocular Diseases Using Color Retinal Fundus Images: Design and Evaluation Study (Preprint)
Authors: Han Yong , Li Weiming , Liu Mengmeng , Wu Zhiyuan , Zhang Feng , Liu Xiangtong , Tao Lixin , Li Xia , Guo Xiuhua
Published: February 2021

BACKGROUND

The supervised deep learning approach provides state-of-the-art performance in a variety of fundus image classification tasks, but it is not applicable for screening tasks with numerous or unknown disease types. The unsupervised anomaly detection (AD) approach, which needs only normal samples to develop a model, may be a workable and cost-saving method of screening for ocular diseases.

OBJECTIVE

This study aimed to develop and evaluate an AD model for detecting ocular diseases on the basis of color fundus images.

METHODS

A generative adversarial network–based AD method for detecting possible ocular diseases was developed and evaluated using 90,499 retinal fundus images derived from 4 large-scale real-world data sets. Four other independent external test sets were used for external testing and further analysis of the model’s performance in detecting 6 common ocular diseases (diabetic retinopathy [DR], glaucoma, cataract, age-related macular degeneration, hypertensive retinopathy [HR], and myopia), DR of different severity levels, and 36 categories of abnormal fundus images. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity of the model’s performance were calculated and presented.

RESULTS

Our model achieved an AUC of 0.896 with 82.69% sensitivity and 82.63% specificity in detecting abnormal fundus images in the internal test set, and it achieved an AUC of 0.900 with 83.25% sensitivity and 85.19% specificity in 1 external proprietary data set. In the detection of 6 common ocular diseases, the AUCs for DR, glaucoma, cataract, AMD, HR, and myopia were 0.891, 0.916, 0.912, 0.867, 0.895, and 0.961, respectively. Moreover, the AD model had an AUC of 0.868 for detecting any DR, 0.908 for detecting referable DR, and 0.926 for detecting vision-threatening DR.

CONCLUSIONS

The AD approach achieved high sensitivity and specificity in detecting ocular diseases on the basis of fundus images, which implies that this model might be an efficient and economical tool for optimizing current clinical pathways for ophthalmologists. Future studies are required to evaluate the practical applicability of the AD approach in ocular disease screening.
Masificación universitaria y población estudiantil. El estudiantado de la UBA en dos décadas de democracia (1983-2004)
Authors: Cristal Yann
Published: February 2021

En el presente artículo se analizan las características sociodemográficas del estudiantado de la Universidad de Buenos Aires (UBA), Argentina y sus transformaciones en las primeras dos décadas de la actual democracia en Argentina, momento en que dicha institución triplicó su matrícula y se convirtió en una de las dos universidades con más alumnos de América Latina. A partir del análisis de censos universitarios y otros documentos, el texto se pregunta hasta qué punto la masificación universitaria supuso un proceso de democratización del acceso a la educación superior y cómo fue mutando la población estudiantil de la UBA en el periodo, caracterizada por una profunda heterogeneidad.
Neonatal alloimmune thrombocytopenia and neutropenia associated with maternal human leucocyte antigen antibodies and drug-induced hemolytic anemia
Authors: Sun Mengya , Liu Yan , Qin Miao , Li Ting , Jiang Hong
Published: February 2021

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is commonly
associated with antibodies against platelet antigens, and alloimmune
neonatal neutropenia (ANN) is frequently caused by anti-neutrophil
antibodies. Human leukocyte antigen (HLA) antibodies are rarely reported
to result in FNAIT or ANN, let alone the combination of FNAIT and ANN.
We report here a very unusual case of a first twin pregnancy produced in
vitro by donated oocytes where the mother developed markedly elevated
HLA antibodies in the absence of anti-platelet or anti-neutrophil
antibodies that provoked severe thrombocytopenia and neutropenia in one
of the twins. In addition, drug-induced hemolytic anemia (DIHA) that
required red blood cell transfusion was detected in this twin. We
hypothesize that the complete HLA-incompatible twin pregnancy due to
oocyte donation might have contributed to the severity of the clinical
manifestations.
"Social Distancing"? Eine leibphänomenologische Studie über Nähe und Distanz in Ausnahmesituationen
Authors: Schellhammer Barbara
Published: February 2021

Gerade in Ausnahmesituationen rücken Menschen zusammen – eigentlich. Das ist in Zeiten des Coronavirus anders, denn hier gilt das Gebot des „Social Distancing“. Ich möchte die Ambivalenz, die nicht nur in dieser paradoxen Wortkombination zum Ausdruck kommt, sondern auch in der Erfahrung von vielen Menschen, mit Hilfe eines leibphänomenologischen Zugangs näher beleuchten. Dabei untersuche ich, wie sich das spannungsreiche Verhältnis von Nähe und Distanz in Zeiten der Corona-Pandemie in Alltagssituationen sowie in Bildungskontexten zeigt. Darüber hinaus gehe ich der Frage nach, was die Erfahrung des „Social Distancing“ für die Philosophie – nicht nur in Ausnahmesituationen – bedeuten kann, und plädiere dafür, sie als eine Übungsmöglichkeit des Philosophierens zwischen Nähe und Distanz, Körper und Geist, Eigenem und Fremdem sowie Natur und Kultur zu sehen, um auf diese Weise problematischen Extremen auf beiden Seiten zu entgehen.
Einleitung: Ethik der Integrität
Authors: Knauß Stefan
Published: February 2021

Das vorliegende Themenheft „Ethik der Integrität“ (Herausgeber: Stefan Knauß, Universität Erfurt) der Zeitschrift für Praktische Philosophie (ZfPP) vereint Beiträge aus der Rechts-, Moral- und Umweltphilosophie, die sich mit den deskriptiven und normativen Möglichkeiten und Grenzen von „Integrität“ beschäftigen. Die Untersuchung von Integrität nimmt dabei die Anwendung des Konzepts auf menschliche Personen und nichtmenschliche Naturwesen wie Tiere, Pflanzen und Ökosysteme in den Blick. Integrität impliziert im weitesten Sinne die Annahme, Wesen könnten und sollten als „ganze“ betrachtet, auch gegen innere und äußere Widerstände in der Lage sein, gemäß ihrer eigenen „Zwecke“ zu verfahren. Zwar taucht integritas bereits bei Cicero in De officiis und bei Thomas v. Aquin in Summa theologiae vereinzelt auf, doch nimmt die Begriffsverwendung vor allem in der zweiten Hälfte des 20. Jahrhunderts zu. Es scheint offenkundig ein Bedürfnis danach zu bestehen, z.T. recht unterschiedliche Phänomene als „Ganzheiten“ zu beschreiben und deren „Intaktheit“ positiv zu bewerten. Personen sollten hiernach in elementaren, ihre Identität dennoch im umfassenden Sinne betreffenden Aspekten in „Übereinstimmung“ mit sich selbst leben können. Die Integrität der Natur wird in wichtigen klimapolitischen Verträgen wie dem Abkommen von Paris (2015) sowie bei der Kodifizierung der Rechte der Natur z. B. in der Verfassung von Ecuador (2008) als Wert normativ vorausgesetzt. Das naturwissenschaftliche Paradigma des Anthropozäns verwendet ebenfalls eine umfassende Perspektive auf Mensch und Natur, die auch als Plädoyer für die Schutzwürdigkeit der Erde als „ganzer“ ausgedeutet wird. Noch wissen wir nicht, ob dem Konzept der Integrität im 21. Jahrhundert eine ähnliche „Karriere“ bevorsteht, wie sie der Begriff der Würde im 20. Jahrhundert erlebt hat. Dieses Heft ist ein Versuch, die verschiedenen Verwendungskontexte zu überblicken und einige stichprobenartig zu überprüfen.
Morphometric analysis of the human endoneurial extracellular matrix components during aging
Authors: Kundalic Braca , Ugrenovic Sladjana , Jovanovic Ivan , Petrovic Vladimir , Petrovic Aleksandar , Stojanovic Vesna , Antovic Aleksandra , Kundalic Jasen , Graovac Ivana
Published: February 2021

The aim of this study was to analyze the expression of extracellular matrix (ECM) proteins in human endoneurium during aging. We harvested 15 cadaveric sural nerves, distributed in 3 age groups (I: 25-44, II: 45-64, III: 65-86 years old). Histological sections were stained immunohistochemically for the presence of collagen type I, type IV and laminin, and the ImageJ processing program was used in morphometrical analysis to determine the percentages of these endoneurial proteins. In two younger groups, the endoneurial matrix of the sural nerve was composed from about equal proportions of these proteins, which may be considered a favorable microenvironment for the regeneration of nerve fibers. Linear regression analysis showed a significant increase in endoneurial collagen type IV with age, while collagen type I and laminin significantly decreased during the aging process. In cases older than 65 years, remodeling of the endoneurial matrix was observed to be significantly higher for the presence of collagen type IV, and lower for the expression of collagen type I and laminin. This age-related imbalance of ECM proteins could represent a disadvantageous microenvironment for nerve fiber regeneration in older adults. Our findings contribute to the development of therapeutic approaches for peripheral nerve regeneration.
Maxillary arch development with Invisalign system:
Authors: Lione Roberta , Paoloni Valeria , Bartolommei Lorenzo , Gazzani Francesca , Meuli Simonetta , Pavoni Chiara , Cozza Paola
Published: February 2021

Objectives

To evaluate tooth movements during maxillary arch expansion with clear aligner treatment.

Materials and Methods

The study group included 28 subjects (16 females, 12 males, mean age 31.9 ± 5.4 years) collected prospectively from January 2018 to May 2019. Inclusion criteria were European ancestry, posterior transverse discrepancy of 3–6 mm, permanent dentition stage, presence of second permanent molars, mild or moderate crowding, and good compliance with aligners. Treatment protocol included nonextraction strategies, application of Invisalign clear aligner system, and no auxiliaries other than Invisalign attachments. Linear and angular measurements were performed before treatment (T1), at the end of treatment (T2), and on final virtual models (T2 ClinCheck). A paired t-test was used to compare T2-T1 and T2-T2 ClinCheck changes. The level of significance was set at 5%.

Results

Statistically significant differences were found for all measurements, except for ones at the upper second molars. The greatest increase in maxillary width was detected at the upper first and second premolars: +3.5 mm for the first premolar and +3.8 mm for the second premolar at T2. Comparison of T2-T1 angular outcomes showed statistically significant changes in the inclinations of all teeth except for the second permanent molars. T2-T2 ClinCheck showed significant differences for both linear and angular measurements for maxillary canines, resulting in poor predictability.

Conclusions

Maxillary arch development revealed a progressive reduction of the expansion rate and buccal tipping in the anterior, lateral, and posterior regions, with the greatest net increase at the first and second premolars. Clinical attention should be paid to maxillary canine movements, and overcorrection should be planned for them during dentoalveolar expansion.
Efficacy and Safety of Imeglimin Monotherapy Versus Placebo in Japanese Patients With Type 2 Diabetes (TIMES 1): A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group, Multicenter Phase 3 Trial
Authors: DUBOURG Julie , FOUQUERAY Pascale , THANG Carole , GROUIN Jean-Marie , UEKI Kohjiro
Published: February 2021

Objective. The aim of this study was to investigate the efficacy and safety of
imeglimin, the first in a new class of oral antidiabetic agent, in Japanese
patients with type 2 diabetes.

Research Design and Methods. This was a double-blind, randomized,
parallel-group, placebo-controlled phase 3 trial in 30 sites in Japan. Eligible
participants were individuals aged 20 years or older with type 2 diabetes
treated with diet and exercise stable for at least 12 weeks prior to screening
and an HbA1c of 7.0%-10.0% (53-86mmol/mol). Patients were randomly assigned
(1:1) to either oral imeglimin (1000 mg BID), or matched placebo for 24 weeks.
Investigators, participants and the sponsor of the study remained blinded
throughout the trial. The primary endpoint was the change in mean HbA1c from
baseline to week 24, and the key secondary endpoints were the percentage of
responders (according to two definitions) at week 24.

Results. Between 26th December 2017 and 1st February 2019, we
randomly assigned 106 patients to imeglimin 1000 mg BID and 107 patients to
placebo. Compared with placebo, adjusted mean difference in change from
baseline HbA1c at week 24 was -0.87% (95% CI -1.04 to -0.69 / -9.5mmol/mol
(95%CI -11.4 to -7.5) (p<0.0001). Forty-seven (44.3%) patients reported at
least one adverse event in the imeglimin group versus 48 (44.9%) in the placebo
group.

Conclusions. Imeglimin significantly improved HbA1c in Japanese patients with type 2
diabetes compared with placebo, and showed a similar safety profile to placebo,
representing a potential new treatment option for this population.
Features of design and quality control of wooden structures, taking into account the strength class of wood
Authors:   Emperor Alexander I St. Petersburg State Transport University, Petrova T. M. , Belentsov Yu. A. ,   Emperor Alexander I St. Petersburg State Transport University, Leykin A. P. ,   Emperor Alexander I St. Petersburg State Transport University, Tihonov Yu. M. ,   Saint Petersburg State University of Architecture and Civil Engineering
Published: February 2021

The transition to strength classes in the design of wooden structures allows correctly assessing the level of reliability of the designed constructions. The article presents a comparison analysis of the safety factor values in the Russian regulative standards and those previously in force and assesses their impact on the reliability level. The influence of the transition to probabilistic normalization of the strength properties of elements and structures made of wood in general using strength classes is substantiated. The development of the approach will significantly improve the reliability and safety of wooden structures, especially large-span structures and multi-storey buildings.
Methodology and algorithms for buildinga telematic automated vehicle movement control system
Authors:   General of the Army A. V. Khrulev Military Logistics Academy, Morozov E. V.
Published: February 2021

The article proposes promising trends of research in the field of building automated systems for controlling the movement of transport vehicles (TS) in order to ensure a continuous monitoring and operational control. A method for substantiating technical requirements and assessing the characteristics of measuring instruments for automated control of vehicle movement, an algorithm for determining the optimal values of characteristics of measuring tools and an algorithm for choosing the optimal version of telematic automatic control devices (TASK) for vehicle movement have been developed. The concept of a telematic automated control system for controlling the movement of vehicles (TASU CD TS) is formulated. The presented results make it possible to build the TASU CD of the vehicle based on the optimal choice of TASK movement and the assessment of the effectiveness of their application. Creation of a local telematic automated control system for controlling the movement of the vehicle will effectively manage traffic flows through the implementation of continuous control and monitoring of the vehicle along the entire route of movement, and operational coordination of the interactions of all road users, special services and departments.
Methodological approachesto the management of territorial development of the city in the conditions of digitalization
Authors:   State Research and Design Center of Saint Petersburg Master Plan, Ershova S. A. , Orlovskaya T. N. ,   Saint Petersburg State University of Architecture and Civil Engineering
Published: February 2021

The digital transformation of the city development management, the development of information base for the implementation of plans and programs on improvement of the urban environment quality is an urgent task. The article considers methodological approaches to the formation of a methodological basis for digital transformation of the city territorial development management system. The authors have carried out an analysis of scientific works in the field of the city management digitalization and legislative acts concerning the procedure for monitoring of the City Master Plan implementation. Based on the results of the research, the principles and objectives of monitoring are indicated, and an algorithm for the formation of the system of monitoring indicators is proposed aimed at assessing the efficiency of the City Master Plan implementation.
Building structures in the monuments of wooden architecture (on the example of the wooden tower in the village of Astashovo)
Authors:   Saint Petersburg State University of Architecture and Civil Engineering, Mironova S. I. , Mitrakova A. V. ,   Saint Petersburg State University of Architecture and Civil Engineering
Published: February 2021

The article analyzes the restoration work carried out at the wooden tower originally designed by the Russian architect Ivan Pavlovich Ropet in the village of Astashovo, Russia. The features of load-bearing structures have been studied, which allowed ensuring a high degree of the object preservation. Construction approaches which made it possible to reassemble the structure have been revealed. Some carpentry techniques that have not yet been observed in other monuments of wooden architecture have been discovered.