bluuebunny/crossref_metadata_2025 huggingface dataset:
XI. YÜZYIL MÛSİKÎ NAZARİYESİNDE KULLANILAN TERİMLER: “KEMÂLÜ EDEBİ’L-GINÂ VE EL-KÂFÎ Fİ’L-MÛSİKÂ” ÖRNEĞİ
Authors: ÖNCEL Mehmet
Published: December 2019

Mûsikîye
dair meselelerin anlaşılması adına yapılan ansiklopedik ve sözlük çalışmaları alana
katkı sağlaması bakımından önem arz etmektedir. Bulunduğumuz coğrafi konum
itibariyle özellikle Arapça ve Farsça kökenli müzik terimlerinin tarihsel
süreçte nasıl bir evrim geçirdiği konusu ele alınması gereken mühim
meselelerdendir. Bu ihtiyaca binaen XI. yüzyılda Hasan b. Ahmed b. Ali el-Kâtib
tarafından kaleme alınan Kemâlü Edebi’l-Gınâ ve İbn Sînâ’nın gözde
talebelerinden İbn Zeyle’nin telif ettiği el-Kâfî fi’l-mûsikâ adlı
eserlerde kullanılan ıstılahlar bu çalışmada ele alınmıştır. Şüphesiz her
terimin tam manasıyla karşılığını güncel mûsikî dağarcığıyla ifade etmek bazen
yanlış olabilir. Bu makalede elden geldiğince bu ibarelerin günümüzdeki
karşılığı bulunmaya çalışıldı. Bu makalenin ana hedefi XI. yüzyıl mûsikî
nazariyesinde kullanılan müzikal terimlerin ortaya çıkarılması ve özellikle Arapça
ve Farsça bilmeyen müzik araştırmacılarına yol göstermesine yardımcı olmaktır.  Bu makale nitel araştırma yöntemlerinden
doküman taraması, veriler ise içerik analizi ve karşılaştırma yöntemi ile ele
alınmıştır.
MAĞRİB'DE MEVLİD-İ NEBÎ MERÂSİMLERİ
Authors: GÖZÜTOK TAMDOĞAN Zehra
Published: December 2019

Tarih boyunca hemen her toplumda çeşitli zaman ve mekânlarda, sembolik anlamları, dinî pratikleri olan, kültürel öğeler içeren çeşitli merasimler, kutlamalar yapılmış ve yapılmaktadır. Bu merasimler bir taraftan kişinin kutsalla olan bağını güçlendirirken bir yandan da yaşadığı toplumla bütünleşmesini sağlayabilmektedir. Bu çalışmaya konu olan merâsimler ise ilk dönemlerde medhiyelerle ifade edilen sevginin kutlamalara dönüşmüş hali olarak Hz. Muhammed’in doğumunun çeşitli semboller, kaside ve dualarla ifade edildiği mevlid merâsimleridir. Bu merâsimler Fâtımî devlet törenleriyle başlayıp, Erbil’de Begteginli Kökböri ile şekillenerek, Mağrib ve Endülüs’e de taşınmış ve adeta geleneksel hale gelmiştir. Bu çalışmada mevlid kutlamalarının Mağrib’e gelişi, yapılan kutlamaların içeriği, burada hüküm sürmüş Merinî ve Abdülvadî sultanlarının ve halkın kutlamalara yükledikleri anlam, dönemlerinin tarihçi, devlet adamları ve ediplerinin kitaplarında ayrıntılı olarak anlatılan ve böylece de yüzyıllarca korunan mevlidi- nebî merasimleri konu edilecektir.  Bu bölgede resmî olarak kutlanan mevlid-i nebîye özel yazılan kasideler ve bu geceler için sultanların tören salonuna özenle koydurdukları saatler de bu çalışmanın konuları arasında yer alacaktır.
KUR’ÂN-I KERÎM’DE KAT‘ ÜSLUBU: LÜGAVÎ BİR ÜSLUP OLARAK TÂBİ‘-METBÛ‘ UYUMSUZLUĞU
Authors: MARANGOZOĞLU İzzet
Published: December 2019

Kur’ân-ı Kerîm, dil ve üslubuyla her asırda
müfessirlerin ve belâgat âlimlerinin ilgi odağı olmuştur. Tenzil döneminden
günümüze kadar Kur’ân’ın dil ve üslup inceliklerine ağırlık veren çalışmalarla
bu ilgi daima diri tutulmuştur. Bu
çalışmada bazı müsteşriklerin Kur’ân’da gramer yanlışı (lahn) iddialarına zemin
oluşturan ancak Kur’ân’ın ilk muhataplarınca şiir ve nesirde sıkça kullanılan; belagat
ve nahiv kitaplarında da “kat‘u’t-tâbi‘ ‘ani’l-metbû (tâbi‘–metbû‘
uyumsuzluğu)” olarak bilinen kat‘
üslubu ele alınmıştır. Konuyu sınırlandırmak maksadıyla bu üslup, sıfat-mevsûf
uyumsuzluğu (kat‘u’t-na‘t ‘ani’l-men‘ût) özelinde incelenmiştir. Araplar çeşitli sebeplerden dolayı; ya
muhatabın dikkatini maktû sıfata çekmek ya da mevsûfun sıfatını pekiştirmek
için bu üslubu kullanmışlardır. Arapların şiir ve nesirde medih, zem ve terahhüm
üslubu olarak kullandıkları bu üslubun, Kur’ân’da da aynı maksatla kullanıldığı
görülmektedir. Kur’ân’ın dil ve metin yapısını yakından tanıma ve ilahî mesajı
doğru bir şekilde anlamayı amaçlayan bu çalışmada kat‘ üslubu ana hatlarıyla
ele alınmış; Kur’ân’dan ve Arap şiirinden aktarılan örneklerle konu
aydınlatılmaya çalışılmıştır.
Evaluation of a leadership development program to enhance university staff and student resilience
Authors: Brewer Margo Lee , Lane Murray , Carter Alice , Barnard Sue , Ibrahim Omar
Published: December 2019

University life presents challenges that can negatively affect the health and wellbeing of students and staff. Resilience is critical to managing challenges and thus is increasingly viewed as important for university students, graduates and employees. To date research on resilience has tended to adopt a view of resilience as an individual issue with little consideration of the socio-cultural factors that influence an individual’s resilience. To address this gap a leadership program to enhance both staff resilience and their capacity to lead resilience enhancements for students from an ecological perspective was developed. The program, piloted in three universities across Australia, assisted staff in understanding the nature and importance of resilience, the contextual factors that impact on resilience and the leadership practices that help drive change in the higher education context. Both academic staff and professional staff involved in leading co-curricula student experiences participated in the two-day leadership program. This study, part of a broader program evaluation, adopted a mixed methods approach to investigate university staffs’ levels of distress, resilience, and leadership practices. Pre- and post-intervention survey data indicated the program was positively received and most participants felt confident to lead curricula and co-curricula changes to enhance resilience within their work context. Implications for university educators, researchers and leaders are discussed.
Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial
Authors: Zhou Jian , Liu Chengwu , Man Shulei , Lyu Mengyuan , Liao Hu , Chen Nan , Cheng Yuhui , Liu Lunxu
Published: December 2019

Background: Pleural lavage is regularly performed before closing chest wall in pulmonary surgery to prevent pleural implantation of tumor cells and postoperative infection. However, no proper regimen of pleural lavage isdefinednow. To establish areliable volume of pleural lavage, weherein designed this randomized controlled trial. Methods: A total of 400 participants with non-small cell lung cancer (NSCLC) undergoing video-assisted thoracoscopic surgery (VATS) lobectomy and systematic mediastinallymph node dissection (MLND) will be randomly assigned into 2 groups: Group A (500ml pleural lavage fluid) and Group B (3000ml pleural lavage fluid). The primary outcomes include the levels of leukocytes, neutrophils, inflammatory factors on the first postoperative day. The secondary outcomes mainly include: (i) the levels of leukocytes, neutrophils, inflammatory factors on the second and third postoperative day; (ii) the incidence of postoperative fever on the first, second and third postoperative day; (iii) the volumes of chest drainage on 1 to 3 days after operation, the duration of drainage, and postoperative hospitalization; (iv) the incidence of postoperative complications (incision infection, pain, atelectasis, hemorrhage, etc.) and the incidence of pleural effusion requiring thoracic puncture or drainage within 30 days after surgery.The main content of the analysis includes effectiveness and safety analysis. We will perform subgroup analysis to identify potential influence factors. Discussion: This first randomized controlled trial isexpected to compare the clinical outcomes between different volume of pleural lavage fluid following VATS and MLND, and provide us evidence to develop a standardized procedure of pleural lavage before closing chest wall in lung cancer operation.
Nomogram for predicting the survival of gastric adenocarcinoma patients who receive surgery and chemotherapy
Authors: Wang Chao-Yang , Yang Jin , Zi Hao , Zheng Zhong-Li , Li Bing-Hui , Wang Yang , Ge Zheng , Jian Guang-Xu , Lyu Jun , Li Xiao-Dong , Ren Xue-Qun
Published: December 2019

Background: Surgery is the only way to cure gastric adenocarcinoma (GAC), and chemotherapy is the basic adjuvant management for GAC. A prognostic model for predicting the individual disease-specific survival (DSS) rates of GAC patients who receive surgery and chemotherapy has not been established. Objective: We aimed to establish a survival nomogram for GAC patients who receive surgery and chemotherapy. Methods: We identified 5764 GAC patients who had received surgery and chemotherapy from the SEER (Surveillance, Epidemiology, and End Results) database. Approximately 80% (n=4034) of the included patients were randomly assigned to the training set, and the remaining patients (n=1729) were assigned to the external validation set. Nomogram was established by the training set and validated by the validation set. Results: Based on the results of a multivariate analysis, a nomogram was developed that encompassed age at diagnosis, number of regional lymph nodes examined, number of positive regional lymph nodes, sex, race, grade, derived AJCC stage, summary stage, and radiotherapy status. The C-index (Harrell’s concordance index) of the model was higher than that of the traditional seventh AJCC staging system (0.707 vs 0.661). Calibration plots of the nomogram showed that the probability of DSS optimally corresponded to the survival rate. Integrated discrimination improvement (IDI) and categorical net reclassification improvement (NRI) showed visible improvement. IDI for 3-, 5- and 10- year DSS were 0.058, 0.059 and 0.058, respectively (P>0.05), and NRI for 3-, 5- and 10- year DSS were 0.380 (95% CI=0.316–0.470), 0.407 (95% CI=0.350–0.505), and 0.413 (95% CI=0.336–0.519), respectively. Decision curve analysis supported that the constructed nomogram was superior to the AJCC staging system. Conclusion: The proposed nomogram provides more-reliable DSS predictions for GAC patients who receive surgery and chemotherapy in the general population. According to validation, the new nomogram will be beneficial in facilitating individualized survival predictions and useful when performing clinical decision-making for GAC patients who receive surgery and chemotherapy.
AMAFRICA, a patient-navigator program for accompanying lymphoma patients during chemotherapy in Ivory Coast: a prospective randomized study
Authors: KOFFI Kouassi Gustave , Silué DA , Laurent C , Boidy K , Koui S , Compaci G , Adeba ZH , Kamara I , Botty RP , Bognini A.S , Sanogo I , Despas F , Laurent G
Published: December 2019

Background Previous studies have indicated that accompanying socially undeserved cancer patients through Patient Navigator (PN) or PN-derived procedures improves therapy management and reassurance. At the Cancer Institute of Toulouse-Oncopole (France), we have implemented AMA (Ambulatory Medical Assistance), a PN-based procedure adapted for malignant lymphoma (ML) patients under therapy. We found that AMA improve adherence to chemotherapy and safety. In low-middle income countries (LMIC), refusal and abandonment were documented as major adverse factors for cancer therapy. We reasoned that AMA could improve clinical management of ML patients in LMIC. Methods This study was set up in the Abidjan University Medical Center (Ivory Coast) in collaboration with Toulouse. Hundred African patients were randomly assigned to either AMA or control group. Main criteria of judgment were refusal and abandonment of CHOP or ABVD chemotherapy. Results We found that AMA was feasible and has significant impact on refusal and abandonment. However, only one third of patients completed their therapy in both groups. No differences were noted in terms of complete response rate (CRR) (16% based on intent-to-treat) and median overall survival (OS) (6 months). The main reason for refusal and abandonment was limitation of financial resources. Conclusion Altogether, this study showed that PN may reduce refusal and abandonment of treatment. However, due to insufficient health care coverage, its ultimate impact on OS remains limited.
The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening.
Authors: Otieno Frederick C. F. , Ogola Elijah N , Kimando Mercy W , Mutai Ken K
Published: December 2019

Background: Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances the cardiovascular risk profiles and disease, and is a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that would optimize outcomes including forestalling progression to end-stage kidney disease.
This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area.
Methods: A cross-sectional study was conducted at the out-patient of Nyeri County hospital. A total of 385 patients were enrolled over five months. Informed consent was obtained and clinical evaluation was done, a spot sample of urine obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative.
Main outcomes measure: Estimated Glomerular filtration rate and albuminuria as markers of chronic kidney disease.
Results: A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0 % (95%CI 34.3-44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8-37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age >50years, long duration with diabetes >5years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status.
Conclusion: Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over thirty percent of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.
Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases
Authors: Kalinauskaite Goda , Tinhofer Ingeborg , Kufeld Marcus , Kluge Anne Kathrin , Grün Arne , Budach Volker , Senger Carolin , Stromberger Carmen
Published: December 2019

Background: Patients with oligometastatic disease can potentially be cured by using an ablative therapy for all active lesions. Stereotactic body radiotherapy (SBRT) is a non-invasive treatment option that lately proved to be as effective and safe as surgery in treating lung metastases (LM). However, it is not clear which patients benefit most and what are the most suitable fractionation regimes. The aim of this study was to analyze treatment outcomes after single fraction radiosurgery (SFRS) and fractionated SBRT (fSBRT) in patients with lung oligometastases and identify prognostic clinical features for better survival outcomes.
Methods: Fifty-two patients with 94 LM treated with SFRS or fSBRT between 2010 and 2016 were analyzed. The characteristics of primary tumor, LM, treatment, toxicity profiles and outcomes were assessed. Kaplan-Meier and Cox regression analyses were used for estimation of local control (LC), overall survival (OS), progression free survival and distant metastases free survival (DMFS).
Results: Ninety-four LM in 52 patients were treated using SFRS/fSBRT with a median of 2 lesions per patient (range: 1–5). The median planning target volume (PTV)-encompassing dose for SFRS was 24 Gy (range: 17-26) compared to 45 Gy (range: 20-60) in 2-12 fractions in fSBRT. The median follow-up time was 21 months (range: 3-68). LC rates at 1 and 2 years for SFSR vs. fSBRT were 89% and 83% vs. 75% and 59%, respectively (p=0.026). LM treated with SFSR were significantly smaller (p=0.001). The 1 and 2-year OS rates for all patients were 84% and 71%, respectively. In univariate analysis treatment with SFRS, an interval of ≥ 12 months between diagnosis of LM and treatment, non-colorectal cancer histology and BED <100 Gy were significantly associated with better LC. However, none of these parameters remained significant in the multivariate Cox regression model. OS was significantly better in patients with negative lymph nodes (N0), Karnofsky performance status (KPS) >70% and time to first metastasis ≥12 months. There was no grade 3 acute or late toxicity.
Conclusions: We observed good LC and low toxicity rates after SFRS for small lung metastases. Longer time to first metastasis, good KPS and N0 predicted better OS.
Perceptions of pregnant women on reasons for late initiation of antenatal care: A qualitative interview study
Authors: Warri Denis , George Asha
Published: December 2019

Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for late initiation of antenatal by pregnant women in Nkwen Baptist Health Center, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and interviewed in a room at the antenatal care unit. Key informants were midwives working at the antenatal care unit. Participation in the study was voluntary. Participants were explained the purpose of the study and signed a consent form if they were willing to participate in the research. Data was collected using an audio tape and analyzed using Thematic Coding Analysis. Results: Pregnant women place low value on early antenatal care due to the fact that they perceive pregnancy as a normal health condition or not a serious issue that requires seeking health care. Furthermore previous pregnancy outcomes that were positive regardless of accessing care made them less motivated to initiate antenatal care early. The booking system is perceived as user-unfriendly with overcrowded conditions, long waiting times and rudeness of some service providers. Cost of services and distance to health facilities with uncomfortable transport and poor road network were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio cultural beliefs also have significant influence on timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities that engage communities to improve timing of care seeking for antenatal care and thereby improve the maternal health status of women.
The association between symptoms of depression during pregnancy and low birth weight:a prospective study
Authors: Li Xiu xiu , Gao Rui , Dai Xiaowei , Liu Hong , Zhang Jinxin , Liu Xuemei , Si Dongmei , Deng Te , Xia Wei
Published: December 2019

Objectives Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of the antenatal depression symptoms with pregnancy outcomes, especially for low birth weight. Methods A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≥12 scores in this study. Sociodemographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in patients with depression were determined by multivariate logistic regression and represented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight (odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age and macrosomia. Conclusion Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.
EFFECTIVENESS OF STEROIDS VS PLACEBO IN PREVENTING UPPER AIRWAY OBSTRUCTION AFTER EXTUBATION IN CRITICALLY-ILL CHILDREN: RATIONALE AND DESIGN OF A MULTICENTRIC, DOUBLE-BLIND, RANDOMIZED STUDY
Authors: Manrique Gema , Laiseca Laura Butragueño , González Rafael , Rey Corsino , Martínez Zuriñe , Gil Javier , Rodriguez Antonio , Martínez Cecilia , Manrique Silvia , López-Herce Jesús
Published: December 2019

Background: Post-extubation upper airway obstruction (UAO) is a frequent complication causing stridor and respiratory distress, which occasionally may require reintubation, thereby increasing morbidity and mortality rates. Contradictory results have been obtained in studies assessing the effectiveness of steroids in preventing post-extubation UAO, and the available evidence is limited. We designed a multicentric randomized, placebo-controlled study to explore the effectiveness of dexamethasone in preventing post-extubation UAO in children. Methods: A multicentric, prospective, double-blind, randomized, placebo-controlled, phase IV clinical trial has been designed. The sample will include pediatric patients between 1 month and 16 years of age who have been intubated for more than 48 hours. Patients with airway disorders or who have received steroids within the last seven days will be excluded. Patients will be randomized to receive either placebo or a therapy with dexamethasone 0.25 mg/kg every 6 hours to be started 6-to-12 hours prior to extubation, to a total of four doses. Randomization will be performed at a 1:1 ratio. Follow-up of patients will be carried out for 48 h after extubation. The main objective of this study is to assess the reduction of moderate-severe UAO symptoms following extubation, as measured using the Taussig scale. Secondary objectives include assessing the decrease in the incidence of reintubation, evaluating the use of additional therapies for upper airway obstruction, and monitoring dexamethasone potential side effects.Discussion: The results of this study will contribute to the existing evidence on prophylaxis for post-extubation airway obstruction.
Palliative home parenteral nutrition in patients with ovarian cancer and malignant bowel obstruction: experiences of women and family caregivers.
Authors: Sowerbutts Anne Marie , Lal Simon , Sremanak Jana , Clamp Andrew , Jayson Gordon C. , Teubner Antje , Hardy Lisa , Todd Chris , Raftery Anne-Marie , Sutton Eileen , Morgan Robert D. , Vickers Alexander J. , Burden Sorrel
Published: December 2019

Background Malnutrition is a problem is advanced cancer, particularly ovarian cancer where malignant bowel obstruction (MBO) is a frequent complication. Parenteral nutrition is the only way these patients can received adequate nutrition and is a principal indication for palliative home parenteral nutrition (HPN). Giving HPN is contentious as it may increase the burden on patients. This study investigates patients’ and family caregivers’ experiences of HPN, alongside nutritional status and survival in patients with ovarian cancer and MBO. Methods This mixed methods study collected data on participant characteristics, clinical details and body composition using computed tomography (CT) combined with longitudinal in-depth interviews underpinned by phenomenological principles. The cohort comprised 38 women with ovarian cancer and inoperable MBO admitted (10/2016 to 12/ 2017) to a tertiary referral hospital. Longitudinal interviews (n=57) were carried out with 20 women considered for HPN and 15 of their family caregivers. Results Of the 38 women, 32 received parenteral nutrition (PN) in hospital and 17 were discharged on HPN. Nutritional status was poor with 31 of 33 women who had a CT scan having low muscle mass, although 10 were obese. Median overall survival from admission with MBO for all 38 women was 70 days (range 8 - 506) and for those 17 on HPN was 156 days (range 46 – 506). Women experienced HPN as one facet of their illness, but viewed it as a “lifeline” that allowed them to live outside hospital Nevertheless, HPN treatment came with losses including erosion of normality through an impact on activities of daily living and dealing with the bureaucracy surrounding the process. Family caregivers coped but were often left in an emotionally vulnerable state. Conclusions: Women and family caregivers reported that the inconvenience and disruption caused by HPN was worth the extended time they had at home.
Users’ Acceptance of Electronic Patient Portals in Lebanon
Authors: Honein-AbouHaidar Gladys , Antoun Jumana , Badr Karim , Hlais Sani , Nazaretian Houry
Published: December 2019

Background Acceptance of Electronic patient portal (EPP) is instrumental for its success. Studies on users’ acceptance in the Middle East region are scarce. This study aims to use the Technology Acceptance Model (TAM) as a framework to quantitatively describe potential users' intention to use and factors influencing the intention to use EPP. We concurrently test the internal construct validity and the reliability of the TAM. Methods A cross-sectional survey design and the vignette approach were used. For validation, we needed a minimum of 180 patients; all 35 attending physicians and 11 registered nurses were targeted. We used descriptive statistics to calculate the intention to use EPP and its determinants based on the TAM constructs. Exploratory factor analysis (EFA) and structural equation modeling (SEM) were employed to estimate significant path coefficients for patients only as the sample size of providers was too small. Results We had 199 patients, half intended to use EPP; 73% of providers (N=17) intended to use EPP. Perceived ease of use and privacy concerns were significantly higher among providers than patients (Mean (M) = 0.77 vs M= 0.42 (CI: -0.623 ; -0.081)) and (M=3.67 vs M=2.13, CI: -2.16; -0.91) respectively; other constructs were not significantly different. Reliability of TAM revealed a Cronbach Alpha of α=.91. EFA showed that three components explained 73.48% of the variance: Behavioral Intention of Use (14.9%), Perceived Ease of Use (50.74%), Perceived Usefulness (7.84%). SEM found that perceived ease of use increased perceived usefulness (standardized regression weight=0.49); perceived usefulness (0.51) had more predictive value than perceived ease of use (0.27) to explain the behavioral intention of use of the EPP. Conclusions We found that providers valued the usefulness of EPP and were mostly intending to use it. This finding has yet to be tested in future studies testing actual use as intention and actual use may not be concordant. The intention to use among patients was lower than those reported in developed countries. We identified two factors that we need to address to increase use, namely perceived ease and usefulness, and proposed practical implications to address them; future research directions were also discussed.
Changes in perceived knowledge about childbirth among pregnant women participating in the Senses of Birth Intervention in Brazil: A cross-sectional study
Authors: Fernandes Luísa M M , Lansky Sônia , Oliveira Bernardo J , Friche Amélia A L , Bozlak Christine T. , Shaw Benjamin A.
Published: December 2019

Background: Senses of Birth (SoB) is a health education intervention in Brazil that addresses reproductive rights, the benefits and risks of normal birth and cesarean, and use of evidence-based practices (EBP) during labor and childbirth, aiming to reduce unnecessary cesareans in the country. This study evaluates the impact of the SoB intervention on pregnant women’s perceived knowledge about normal birth, cesarean, and use of EBP in childbirth. Method: 1,287 pregnant women answered a structured questionnaire, immediately after their visit to the exhibition, between March 2015 and March 2016, in four cities. To identify the impact of the intervention on women’s perceived knowledge and possible association with socioeconomic and demographic characteristics, statistical analyses were performed including paired T-tests, ANOVA, and logistic and linear regressions. Results: The mean score (MS) of perceived knowledge after the intervention was higher than the mean score before experiencing the SoB for all three knowledge domains: Normal Birth (MS Before= 3.71 x MS After= 4.49), Cesarean (MS Before= 3.54 x MS After= 4.26) and EBPs (MS Before= 3.14 x MS After= 4.14). The results suggest that SoB intervention was more effective for low income women (B = 0.206; p < 0.001 for EBP), women without private health insurance (OR 2.47, 95% CI: 1.49- 4.09 for normal birth), women with private prenatal care (OR 2.42, 95% CI: 1.59- 3.66 for normal birth), women experiencing their first pregnancy (OR 1.92, 95% CI: 1.31-2.82 for EBP; OR 1.37, 95% CI: 1.03-1.84 for normal birth; OR 1.37, 95% CI: 1.03-1.84 for cesarean), and women in their first or second trimester at the time of the intervention (OR 1.64, 95% CI: 1.13-2.39 for EBP; OR 1.48, 95% CI: 1.11-1.97 for normal birth; OR 1.85, 95% CI: 1.40-2.41 for cesarean). Conclusion: The study showed opportunities to increase knowledge among Brazilian pregnant women for the three knowledge domains, and a need to focus the discussion on how to achieve a positive experience of birth using EBP. The intervention gains relevance considering the lack of evidence of the efficacy of non-clinical interventions to reduce unnecessary cesareans in middle and low-income countries targeting women.
Effect of Lactobacillus spp. on adhesion, invasion, and translocation of Campylobacter jejuni in chicken and pig small-intestinal epithelial cell lines
Authors: Pogačar Maja Šikić , Langerholc Tomaž , Mičetić-Turk Dušanka , Možina Sonja Smole , Klančnik Anja
Published: December 2019

Background: Campylobacter spp. are a major cause of bacterial food-borne diarrhoeal disease. This mainly arises through contamination of meat products during processing. For infection, Campylobacter spp. must adhere to epithelial cells of the mucus layer, survive conditions of the gastrointestinal tract, and colonise the intestine of the host. Addition of probiotic bacteria might promote competitive adhesion to epithelial cells, consequently reducing Campylobacter jejuni colonisation. Effect of Lactobacillus spp. (PCS20, PCS22, PCS25, LGG, PCK9) on C. jejuni adhesion, invasion and translocation in pig (PSI cl.1) and chicken (B1OXI) small-intestine cell lines, as well as pig enterocytes (CLAB) was investigated.Results Overall, in competitive adhesion assays with PSI cl.1 and CLAB cell monolayers, the addition of Lactobacillus spp. reduced C. jejuni adherence to the cell surface, and negatively affected the C. jejuni invasion. Interestingly, Lactobacillus spp. significantly impaired C. jejuni adhesion in three-dimensional functional PSI cl.1 and B1OXI cell models. Also, C. jejuni did not translocate across PSI cl.1 and B1OXI cell monolayers when co-incubated with probiotics. Among selected probiotics, Lactobacillus rhamnosus LGG was the strain that reduced adhesion efficacy of C. jejuni most significantly under co-culture conditions.Conclusion The addition of Lactobacillus spp. to feed additives in livestock nutrition might be an effective novel strategy to targets Campylobacter adhesion to epithelial cells, and thus prevents colonisation, reduces the transmission, and finally lowers the incidence of human campylobacteriosis.
The relationship between caesarean section and breastfeeding: evidence from the 2013 Turkey demographic and health survey
Authors: Erbaydar Nuket Paksoy , Erbaydar Tuğrul
Published: December 2019

Background The mode of delivery influences breastfeeding practices. High caesarean section and low breastfeeding rates are important public health concerns for all developing countries. This study aimed to determine the relationship between caesarean section and early breastfeeding practices among primiparas. Methods Data for primiparas with a singleton birth (n = 777) obtained from the 2013 Turkish Demographic and Health Survey were used in this retrospective cohort study. Early initiation of breastfeeding within one hour of delivery and exclusive breastfeeding during the first three days after delivery were evaluated. Standardized incidence rates and standardized rate ratios of non-early initiation of breastfeeding and non-exclusive breastfeeding were calculated according to mode of delivery. Results The late initiation of breastfeeding and non-exclusive breastfeeding incidence rates were 42.7% and 41.0%, respectively. The standardized incidence rate of late initiation of breastfeeding among women with vaginal delivery was 35.34%, versus 50.49% for those with caesarean delivery. The standardized rate ratios for late initiation of breastfeeding and non-exclusive breastfeeding were 1.428 (95% CI: 1.212, 1.683) and 1.468 (95% CI: 1.236-1.762), respectively. Women that underwent caesarean section had a higher risk of late initiation of breastfeeding and non-exclusive breastfeeding during the three days following delivery, after controlling for socio-demographic and delivery-related factors. Conclusions This study provides evidence useful for implementing strategies to prevent unnecessary caesarean sections, which negatively affect not only maternal health, but also neonatal health as well. Promotion of mother-friendly policies by healthcare institutions that are implemented in a baby-friendly manner are essential.
Lipopolysaccharide Worsens the Prognosis of Experimental Cerebral Ischemia via Interferon Gamma-Induced Protein 10 Recruit in the Acute Stage
Authors: Wang Ping , ZHANG Jiaqi , GUO Feifei , Wang Shuang , ZHANG Yi , LI Defeng , XU Haiyu , YANG Hongjun
Published: December 2019

Background: Infection is an important clinical complication facing stroke-patients and triples the risk of death within 30 days post-stroke via mechanisms which are poorly understood. Aims: We tried to explore the mechanisms that inflammation caused by infections aggravated the ischemic brain injury after middle cerebral artery occlusion (MCAO). Methods: We used lipopolysaccharide (LPS) as systemic inflammatory stimuli to explore the mechanisms of aggravated ischemic brain injury after Sprague-Dawley male rats subjected to MCAO.Brain damage was evaluated by cerebral blood perfusion, Longa-5 scores, infarct volume and edema degree. Systemic cytokine responses and inflammatory changes in the plasma and brain were analyzed by ELISA kit, RT 2 Profiler TM PCR array, and quantitative real-time PCR.The differential genes were subjected to Gene Ontology enrichment analysis and Protein-Protein interaction (PPI) network construction. Results: LPS profoundly aggravated the brain damage after 24 hrs post-MCAO. At the acute stage (Ischemia/Reperfusion 90min/3h), the brain homogenate gene expression of Interleukin 6 (IL-6), Tumor necrosis factor a(TNF-a), Interleukin 1b(IL-1b)and Interferon Gamma-Induced Protein 10 (IP-10)was significantly up-regulated and the contents in plasma and brain homogenate were significantly increased in MCAO and MCAO+LPS group. IP-10 was the only gene with significant difference between MCAO and MCAO+LPS group, which was also in an important position with degrees of ³14 in PPI network. Conclusions: It was possible that trace LPS aggravated the ischemic brain injury by induction of excessive IP-10 secretion in the acute stage, leading to excessive inflammatory response, which consequently increased the infarct volume and edema degree 24 hrs post-MCAO.
Tobacco and electronic cigarette cues for smoking and vaping: an online experimental study
Authors: Blackwell Anna K M , De-loyde Katie , Brocklebank Laura A , Maynard Olivia M , Marteau Theresa M , Hollands Gareth J , Fletcher Paul C , Attwood Angela S , Morris Richard W , Munafò Marcus R
Published: December 2019

Objective

This study examined whether exposure to smoking and vaping cues the urge to smoke or vape. It extends previous studies on first-generation cigalikes (visually similar to cigarettes) and second-generation devices (visually similar to pens) by including third-generation tank system devices (larger bulky units). In an online experiment, participants were randomly assigned to view one of four videos, which included smoking, vaping (cigalike or tank system), or neutral cues. The primary outcome was urge to smoke. Secondary outcomes were urge to vape, desire to smoke and vape, and intention to quit or remain abstinent from smoking.Results

UK adults varying in smoking (current or former) and vaping (user or non-user) status (n=1120) completed the study: 184 (16%) failed study attention checks meaning 936 were included in the final analysis. Urges to smoke were similar across cue groups. Urges to vape were higher following exposure to vaping compared to neutral cues. There was no clear evidence of an interaction between cue group and smoking or vaping status. The lack of cueing effects on smoking urges is inconsistent with previous research, raising questions about the ability to assess craving in online settings.
Repeated intravitreal injections of antivascular endothelial growth factor in patients with neovascular age-related macular degeneration may increase the risk of ischemic optic neuropathy
Authors: Chen Yu-Yen , Chou Pesus , Huang Yu-Fang , Chien Hung-Jen , Wu Yu-Chieh , Lee Chia-Chi , Huang Li-Ying , Chen Hsin-Hua
Published: December 2019

Background: Previous case reports have demonstrated the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD). Methods: A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the study period were enrolled in the study cohort. Enrollees were divided into three groups according to the categorized levels of injection number (first level: < 10 times, second level: 10–15 times, and third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyses were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to the different levels of injection numbers. The confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma). Results: In total, the study cohort included 77210 patients. Of these, 26520, 38010, and 12680 were in the first-, second-, and third-level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second- and third-level groups were 1.91 (95% confidence interval [CI], 1.32–2.76) and 2.20 (95% CI, 1.42–3.43), respectively, compared with those in the first-level group. Conclusions: Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections have a significantly higher risk of developing ION compared with individuals who receive a lower number of injections.
Effects of sevoflurane exposure on oligodendrocyte differentiation and myelination in white matter of preterm-equivalent rats
Authors: Wu Ziyi , Gao Qiushi , Li Xingyue , Xue Hang , Zhao Ping
Published: December 2019

The authors have withdrawn this preprint from Research Square
A Randomized Double-Blind Comparison of Double-Space Technique versus Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section
Authors: Chun Eun Hee , Cho Sooyoung , Woo Jae Hee , Kim Youn Jin
Published: December 2019

Background: Combined spinal-epidural anesthesia (CSEA) can be performed as either a single-space technique or a double-space technique for Cesarean section. We performed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on the sensory block level and side effects. Methods: Parturients undergoing elective Cesarean section under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 20) or single-space technique (single group, n = 20). In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. In the single group, the procedure was performed at the L3–4 interspace using the needle-through-needle technique.Results: There were no differences in time to readiness or the intraoperative level of sensory block between the two groups. The postoperative sensory level was maintained higher in the double group (postoperative 1 h, P = 0.029; postoperative 6 h, P = 0.016). There was no difference between the two groups in side effects. The parturients’ satisfaction scores at 48 h postoperative were significantly different (9.5 in the double group vs. 8 in the single group, P = 0.004).Conclusions: We conclude that there were no differences in intraoperative variables between double -space technique and single space-technique for CSEA. However, double-space CSEA may be beneficial for postoperative pain control and parturients’ satisfaction scores of for Cesarean section.Trial registration: The study was registered at https://cris.nih.go.kr under the trial ID, KCT0002514, retrospectively registered. Date of registration: October 27, 2017.
What could be the main levers to promote a timely diagnosis of neurocognitive disorders?
Authors: Garnier-Crussard Antoine , Vernaudon Julien , Auguste Nicolas , Dauphinot Virginie , Krolak-Salmon Pierre
Published: December 2019

Background: Neurocognitive disorders (NCD) are a growing health issue and the importance of diagnosis is still debated despite the benefits of making a diagnosis appearing to be greater than the risks. The aim of the present study was to explore the perception of the main benefits and risks to perform a diagnosis workup of NCD in a population of general practitioners (GPs), specialized physicians (SPs), other healthcare professionals (OHPs) and informal caregivers (ICs), and to identify the lowest perceived benefits and the highest perceived risks that could be levers to promote a diagnosis of NCD. Methods: A standardized questionnaire was submitted to GPs, SPs, OHPs, and ICs aiming to evaluate the importance of eight benefits and eight risks related to NCD diagnosis (selected from the literature) for four prototypical clinical cases at different stages of the disease: subjective cognitive impairment/mild NCD, major NCD at mild/moderate stage, moderate stage with behavioral and psychotic symptoms, and severe stage. Results: The lowest perceived benefits of making a NCD diagnosis were “access to medical research”, “patient’s right to know” and “initiation of symptomatic drug treatment”. The highest perceived risks of making a NCD diagnosis were “negative psychological impact for the patient”, “absence of disease-modifying treatment” and “absence of suitable institution”. Conclusions: This study highlights the lowest perceived benefits and the highest perceived risks of making a NCD diagnosis. These benefits and risks could be modified to become levers to promote a personalized diagnosis of NCD.
The change of color by whiteness indexes and its psychosocial and self-perception effects when using low vs. high concentration whitening gels: a one-year follow-up.
Authors: Estay Juan , Angel Pablo , Bersezio Cristian , Peña Manuel , Fernandéz Eduardo
Published: December 2019

Background: Dental bleaching in traditional concentrations generates greater sensitivity, in this respect new systems of lower concentration of hydrogen peroxide for tooth whitening appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel including their effects on psychosocial and esthetic self-perception at one year. Methods: Patients (n=25) were assessed at 12 months post bleaching treatment ( whitening with 6% activated chemo gel of alkaline formula v/s traditional concentration 37.5% ). Color changes were measured objectively using total variation in color (ΔE) and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa=0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were administered to measure self-perception and the psychosocial impact of the whitening procedure. Results: The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound at one year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleching versus the one-year post-whitening time points; positive effects were maintained. Conclusions: Low concentration (6%) achieved effective bleaching with good stability at one year. This was accompanied by a positive psychosocial impact and enhanced self-perception at follow-up. Trial registration: NCT03217994 Keywords: Bleaching, Randomized clinical trial, Low concentration, OHIP-14 , PIDAQ