bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of COVID-19 pandemic on rheumatology practice and rheumatologists: a cross-sectional multinational study
Authors: Ziade Nelly , Hmamouchi Ihsane , Kibbi Lina el , Abdulateef Nizar , Halabi Hussein , Abutiban Fatemah , Hamdi Wafa , Rakawi Manal el , Eissa Mervat , Masri Basel 
Published: July 2020

Abstract
ObjectiveTo evaluate the impact of the COVID-19 pandemic on rheumatology practice and on the rheumatologists themselves, and to develop suggestions to improve the practice.MethodsA cross-sectional web survey was designed by members of the Arab League of Associations for Rheumatology (ArLAR), validated by its scientific committee and disseminated through e-mail and social media. It included close-ended questions about the impact of the pandemic on the activities (in percentage, where 100% corresponds to complete suspension), and open-ended questions about unmet needs. Univariate and multivariable logistic regression analyses were used to evaluate the predictors of impact. Suggestions were developed to improve practice.ResultsA total of 858 rheumatologists were included in the analysis (27.3% of registered), 37% were 35-44 years-old, 60% were females and 48% worked in the private sector. The impact of COVID-19 was a decrease of 69% in hospitalizations, 65% in outpatient clinic, 56% in infusion centers and 43% in income. It was associated with the region (highest in the Gulf), the use of telemedicine, the impact on income and the practice sector (lowest in private). Telemedicine was mostly based on traditional telephone contacts and e-mails and reimbursed in 12%. Fifteen rheumatologists (1.8%) were infected and 156 cases of COVID-19 among patients were reported, of whom 22% died. The top-cited unmet needs were: access to drugs and a telemedicine platform.Conclusion The negative COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice.
The prognostic role of plasma fibrinogen in adult secondary hemophagocytic lymphohistiocytosis
Authors: Yin Guangli , Man Changfeng , Liao Shengen , Qiu Hon'gxia 
Published: July 2020

Abstract
Background: Coagulation abnormality is common in hemophagocytic lymphohistiocytosis (HLH), but the more frequently reported anomaly is an isolated decrease in fibrinogen (FIB). Nonetheless, the prognostic value of FIB in adult secondary HLH (sHLH) remains uncertain. Methods: Circulating plasma levels of FIB were measured at diagnosis in 293 cases of adult sHLH. We categorized FIB levels into tertiles. Multivariable Cox proportional hazards models were conducted to evaluate the relationship between FIB and mortality. Restricted cubic spline models and two-piecewise Cox proportional hazards models were used to address the nonlinear association between FIB and mortality.Results: During a median follow-up of 52 (interquartile ranges, 18-221) days, 208 deaths occurred, with 137 deaths in MHLH and 71 deaths in non-MHLH. After multivariable adjustment, compared to the highest tertile of FIB, the hazard ratios (HRs) with 95% confidence intervals (CIs) of mortality for tertile 2 and tertile 1 were 0.88 (0.61-1.26) and 1.51 (1.05-2.18), respectively. The restricted cubic spline curve displayed a nonlinear and inverse relationship between FIB and mortality. Furthermore, threshold effect analysis demonstrated that the inflection point for the curve was at a FIB level of 1.76 g/L. The HRs (95% CIs) for mortality were 2.47 (1.52-4.04) and 0.83 (0.64 -1.09) on the left and right side of the inflection point, respectively. Conclusions: These results suggest that plasma fibrinogen is nonlinearly and inversely associated with the risk of mortality in adult secondary hemophagocytic lymphohistiocytosis.
Fall Inducing Movable Platform (FIMP) for Overground Trips and Slips
Authors: Er Jie Kai , Donnelly Cyril John William , Wee Seng Kwee , Ang Wei Tech 
Published: July 2020

Abstract
Background: The study of falls and fall prevention/intervention devices requires the recording of true falls incidence. However, true falls are rare, random, and difficult to collect in real world settings. A system capable of producing falls in an ecologically valid manner will be very helpful in collecting the data necessary to advance our understanding of the neuro and musculoskeletal mechanisms underpinning real-world falls events. Methods: A fall inducing movable platform (FIMP) was designed to arrest or accelerate a subject's ankle to induce a trip or slip. The ankle was arrested posteriorly with an electromagnetic brake and accelerated anteriorly with a motor. A power spring was connected in series between the ankle and the brake/motor to allow freedom of movement (system transparency) when a fall is not being induced. A gait phase detection algorithm was also created to enable precise activation of the fall inducing mechanisms. Statistical Parametric Mapping (SPM1D) and one-way repeated measure ANOVA were used to evaluate the ability of the FIMP to induce a trip or slip. Results: During FIMP induced trips, the brake activates at the terminal-swing or mid-swing gait phase to induce the lowering or skipping strategies, respectively. For the lowering strategy, the characteristic leg lowering and subsequent contralateral leg swing was seen in all subjects. Likewise, for the skipping strategy, all subjects skipped forward on the perturbed leg. Slip was induced by FIMP by using a motor to impart unwanted forward acceleration to the ankle with the help of friction-reducing ground sliding sheets. Joint stiffening was observed during the slips, and subjects universally adopted the surfing strategy after the initial slip. Conclusion: The results indicate that FIMP can induce ecologically valid falls under controlled laboratory conditions. The use of SPM1D in conjunction with FIMP allows for the time varying statistical quantification of trip and slip reactive kinematics events. With future research, fall recovery anomalies in subjects can now also be systematically evaluated through the assessment of other neuromuscular variables such as joint forces, muscle activation and muscle forces.
Correlation of P53 and Bcl-2 With the Presence of Hpv-16 in Sudanese Female Patients Diagnosed With Cervical Pre-cancerous and Squamous Cell Carcinoma of The Cervix.
Authors: Ali Eman Taha , Mohamed Nouh S. , Hassan Lamis Ahmed , Shafig Irene R. , Muneer Mohamed S. , Mohamed Areeg Magzoub , Fiamma Maura , Chacko Mintu Elsa , Ahmed Ayman , Siddig Emmanuel Edwar 
Published: July 2020

Abstract
Objectives

The persistence of high-risk Human Papilloma virus-16 (HPV-16) is considered as a predisposing factor for the development of the cervical carcinoma and the prognosis of the disease. However, other multifactorial risk factors including cell proliferation and apoptosis markers were also studied and linked to the development and progression of cervical carcinoma. This study is aiming at investigating the association between the presence of HPV-16 and the expression of p53 and Bcl-2 in benign and malignant cervical lesions using immunohistochemical staining methods.
Results

A total of 150 cases with different cervical lesions were studied, their age ranges from 34 to 67 years (mean 49.5 ± 6.9). Out of the 150 cases; 97 (64.7%) were malignant, 37 (24.7%) were pre-cancerous and 16 (10.7%) were benign lesions. The association between the expression of Bcl-2 and p53, the different histopathological diagnosis, and the type of lesion was statistically significant (p value < 0.0001) Furthermore the statistical analysis of Bcl-2 expression revealed a significant correlation with the cancer grade (p value = 0.018). Nevertheless, p53 expression showed no association with the cancer grade. Regarding the correlation between the presence of HPV-16 and the markers the results were found to be statistically significant.
Breast Papillary Lesions Diagnosed and Treated using Ultrasound-Guided Vacuum-Assisted Excision
Authors: Li Xiaohui , Gao Hua , Xu Minling , Wu Yang , Gao Dezong 
Published: July 2020

Abstract
Background: The management of papillary lesions of the breast remains controversial, and thus, we assessed the value of vacuum-assisted excision (VAE)-guided ultrasound in the diagnosis and treatment of breast papillary lesions. Methods: We retrospectively reviewed the data of 108 patients with papillary lesions diagnosed using VAE between August 2014 and January 2019. Cases without postoperative breast imaging in the follow-up were excluded, and 85 cases were eligible for the study. The follow-up period ranged from 6 to 53 months, with 38 months on average. All the papillary lesions were located away from the skin or nipple with a size less than or equal to 30 mm, and the lesions categorized as C2-4b were completely excised using VAE. All VAEs were per­formed using an 8-gauge vacuum-assisted biopsy nee­dle under the guidance of ultrasound using a 10 MHz linear probe. Results: Most patients with breast papillary lesions were asymptomatic (56.5%), and when the size of the breast papillary lesion was more than 20 mm on ultrasound imaging, atypical hyperplasia may have been concomitant. Breast lesions might have been pathologically diagnosed as papilloma after biopsy when they were categorized as BI-RADS 4a on ultrasound images. The rate of underestimation was 7.7% in papillary lesions diagnosed with VAE, and the recurrence rate of papilloma after VAE was low. Conclusions: Breast papilloma was a common lesion on ultrasonographic screening, and VAE was applicable for completely excising small papillomas, even papillomas with atypical hyperplasia, to obtain an accurate diagnosis with a low rate of underestimation and recurrence. We believe that papilloma diagnosed by VAE might not require immediate excision, and imaging follow-up may be safe for at least 3 years.
Group or Individual Lifestyle-Integrated Functional Exercise (LiFE)? A Qualitative Analysis of Acceptability
Authors: Reicherzer Leah , Kramer Franziska , Labudek Sarah , Jansen Carl-Philipp , Nerz Corinna , Nystrand Malin J. , Becker Clemens , Clemson Lindy , Schwenk Michael 
Published: July 2020

Abstract
Background: The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE.Methods: Programs were delivered in seven group sessions (gLiFE) or seven individual home visits (LiFE) within a multi-center, randomized non-inferiority trial. Four structured focus group discussions (90 – 100 minutes duration; one per format and study site) on content, structure, and subjective effects of gLiFE and LiFE were conducted. Qualitative content analysis using the method of inductive category formation by Mayring was applied for data analysis. Coding was managed using NVivo.Results: In both formats, participants (N=30, 22 women, ngLiFE=15, nLiFE=15, mean age 78.5±6.6 years) were positive about content, structure, and support received by trainers. Participants reflected on advantages of both formats: the social aspects of learning the program in a peer group (gLiFE), and benefits of learning the program at home (LiFE). In gLiFE, some difficulties with the implementation of activities were reported. In both formats, the majority of participants reported positive outcomes and successful implementation of new movement habits.Conclusion: This is the first study to examine participants’ views on and experiences with gLiFE and LiFE, revealing strengths and limitations of both formats that can be used for program refinement. Both formats were highly acceptable to participants, suggesting that gLiFE may have similar potential to be adopted by adults aged 70 years and older compared to LiFE. Trial registration: ClinicalTrials.gov, NCT03462654. Registered on March 12, 2018. https://clinicaltrials.gov/ct2/show/NCT03462654.
Inhibitory Effect of Phytochemicals from Azadirachta indica A Juss. and Tinospora cordifolia (Thunb.) Miers against SARS-CoV-2 Mpro and Spike Protease- An In Silico Analysis
Authors: CH RAMAKRISHNAMACHARYA , MURALIKUMAR VANITHA , S CHANDRASEKAR 
Published: July 2020

Abstract
COVID 19 caused by SARS-CoV-2 is spreading worldwide and affected 10 million people with a mortality rate between 0.5 % to 5%. Medicinal plants from China, Morocco, Algeria, Africa and India were tested for antiviral efficacy in SARS-CoV-2. Ayurveda Medicine described many medicinal plants. The Nimba (Azadirachta indica A. Juss) is used in fever, bacterial and viral infections, and Amrita (Tinospora cordifolia (Thunb.) Miers) is used as antiviral, antipyretic, and anti-inflammatory purposes. The combination of both these plants is called Nimbamritam, and it is widely used in pyrexia, dermatitis, viral infections, etc. Spike protease (PDB ID 6VXX) and Mpro (PDB ID 6LU) were retrieved from RCSB and 16 ligands from A. indica and 6 ligands from T. cordifolia were obtained from IMPPAT and PubChem. AutoDock Vina embedded PyRx was used for docking. Remdesivir was taken as a reference drug. In silico study of Cordifolide A of T cordifolia showed the highest scores with -8.2 Kcal/mol and -10.3Kcal/mol with Mpro protease and Spike protease respectively. Cordifolide A had 4 H bonds and Kaempferol had 7 non-conventional bonds, including van der Waal with Mpro (6LU7) protease. The interactions with 6VXX had 5 H bonds in each ligand Cordifolide A and Azadirachtin B. The prevention of virus entry by targeting spike protease host receptor ACE2 and restricting replication of the viral genome by targeting Mpro residues were identified in our study. A. indica and T. cordifolia are promising therapeutic agents in COVID 19.
São Paulo drought: trends in streamflow and their relationship to climate and human-induced change in Cantareira watershed, Southeast Brazil
Authors: de Freitas Gabriela Nicoleti 
Published: July 2020

AbstractThe 2013–2015 drought in the Metropolitan Region of São Paulo exposed the lack of resilience of the regional water supply system, highly dependent on the Cantareira reservoirs. In this paper, inflows to each of the four main Cantareira reservoirs are tested for systematic change. Persistent trends in streamflow, rainfall, temperature and evapotranspiration are first evaluated. Streamflow was also tested for step change. Double-mass curves were employed to assess modification in the precipitation–runoff relationship. Subsequently, we used the climate elasticity method and the ABCD model to quantify the relative contribution of climate and human activities into the detected trends. Only Cachoeira and Atibainha sub-basins showed a significant downward trend in streamflow. The results for step change were also significant, and the year of occurrence coincided with breakpoints in precipitation–runoff relationship. For both Cachoeira and Atibainha, human activities had a more significant impact on streamflow reduction than climate variability. Land use and cover maps suggest that the reduction of pasture/abandoned land parallel to an increase in reforestation/silviculture is behind streamflow reduction. The results highlight the importance of coordinating land-use patterns and water management, as an important contributor beyond any considerations of a changing climate. Implications for better managing regional water resources are discussed.
АНАЛІЗ ГЕНДЕР-ЗАЛЕЖНОГО РУХОВОГО ПАТТЕРНУ У ПАЦІЄНТІВ З МОРБІДНИМ ОЖИРІННЯМ ЗА РЕЗУЛЬТАТАМИ ТЕСТОВИХ ВПРАВ FUNCTIONAL MOVEMENT SCREEN
Authors: Аравіцька М. Г. 
Published: July 2020

Резюме. Цілі: визначення змін гендер-залежного рухового паттерну у пацієнтів з морбідним ожирінням (МО) із урахуванням рівня реабілітаційного комплаєнсу.
Методи. Обстежено 74 осіб із МО. За результатами визначення реабілітаційного комплаєнсу їх було поділено на дві групи. Групу порівняння склали особи з низьким рівнем комплаєнсу. Основну групу склали особи з високим рівнем комплаєнсу, які проходили річну програму корекції із застосуванням заходів для підтримки комплаєнсу, модифікації харчування, збільшення фізичної активності, лімфодренажу, психокорекції. Контрольну групу склали 63 особи з нормальною масою тіла.
Результати. У пацієнтів з МО всі результати вправ Functional Movement Screen були статистично значуще гіршими, ніж у осіб із нормальною масою тіла (p<0,05). Між чоловіками та жінками з МО не визначено різниці за результатами тестів «Крок через бар’єр» та «Лінійний випад» (р>0,05). Жінки показали кращий результат, ніж чоловіки, за тестами «Плечова мобільність», «Активне піднімання прямої ноги» (р<0,05). Результат чоловіків був кращим порівняно з жінками за вправами «Глибоке присідання», «Стабільність тулуба при розгинанні рук», «Колова стабільність» (р<0,05). Застосування створеної програми спричинило покращення за всіма тестами FMS в обох статевих групах порівняно з вихідним результатом та результатом групи порівняння (р<0,05). При цьому різниці у показниках між чоловіками та жінками не виявлялось (р>0,05). Пацієнти з низьким рівнем реабілітаційного комплаєнсу не продемонстрували ніяких позитивних змін порівняно з вихідним результатом (р>0,05).
Висновки. Тестові вправи Functional Movement Screen є простим і наочним методом реабілітаційного обстеження, який можна використовувати для демонстрації динаміки рухової дієздатності у програмах фізичної терапії хворих ожирінням.
PECULIARITIES OF TEACHING THE CLINICAL PHARMACOLOGY SUBJECT TO STUDENTS OF THE DENTAL FACULTY IN MODERN CONDITIONS REFORM OF MEDICAL EDUCATION
Authors: Virstyuk N. G. , Vasylechko М. М. , Vakalyuk І. І. , Kocherzhat О. І. , Chovganyuk О. S. 
Published: July 2020

Summary. The aim of the work is to study the effectiveness of using interactive teaching methods and practical skills in the educational process, which will help improve the quality of training for students of the dental faculty at the Department of Internal Medicine of the Dentistry Faculty named after Professor M.N. Berezhnitsky.
Based on the study of the effectiveness of using interactive teaching methods and the development of practical skills in clinical pharmacology in the educational process in the fourth year of study on the Dentistry Faculty under the medical education reform demonstrate, that only a comprehensive approach to the study of clinical pharmacology with the assimilation of modern theoretical material, the development of practical skills at the patient’s bedside, and by solving situational problems, self-awareness of classroom and extracurricular work allows students to explore clinical pharmacology in accordance with the modern requirements of medical reform. The knowledge acquired at the department about pharmacokinetics, pharmacodynamics, interaction and side effects of drugs, effectiveness, safety of prescribed drugs and acquired practical skills contribute to the development of professionalism of a future specialist.
The Role of Knowledge Management Operations in Developing Human Resources Capabilities
Authors: Mohammed Ahmed Sulaiman , Al-Azawy Muhamad Abdul Wahab 
Published: July 2020

Knowledge Management and its processes represent one of the recent conceptual development in the recent management philosophy , an one of its active practices , and the most consist with the speeding changes in the business world , and its reflects on different tasks and activities of organization which performed by human recourses in according to the abilities and capabilities which they acquired , this lead organizational management to have interest on Knowledge Management and its processes , there is an expect that these process will contribute in developing human recourse capabilities , so this study came to determine the role of the Knowledge Management processes in developing human recourse capabilities in a scientific methodology and field analysis in some industrial organizations in Dohuk Province \ Iraqi Kurdistan Region , by testing some hypotheses which reflect correlation and effect relationships between the Knowledge Management processes represents ( knowledge acquiring , participating , storing , and applying ) in developing human recourse capabilities in the researched organizations reaching to point down some relevant conclusions , as well as providing some necessary recommendations for the organizations in general and the researched especially.
The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial
Authors: Ding Hang , Jayasena Rajiv , Chen Sheau Huey , Maiorana Andrew , Dowling Alison , Layland Jamie , Good Norm , Karunanithi Mohanraj , Edwards Iain 
Published: July 2020

Background
Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied.

Objective
This study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF).

Methods
We conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis.

Results
A total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; P=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; P=.005).

Conclusions
ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care.

Trial Registration
Australian New Zealand Clinical Trial Registry ACTRN12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691