bluuebunny/crossref_metadata_2025 huggingface dataset:
ISTIKHDAMU BITHAQATI AL-WASA`ILI AL-BASHARIYYATI "POP-UP" FI TA'LIMI AL-LUGHATI AL-'ARABIYYATI BI MADDATI AL-CHIWARI WA ATSARUHU FI QUDRATI AL-TALAMIDZI 'ALAIHI
Authors: Anisa Astri , Marlina Lina , Wahyudin Dedih
Published: August 2020

The purpose of this research is to study students' abilities in hiwar before and after using Pop Up Card visual media and understand the relationship between the two. This research method is an Experiment with Quasi-Experimental Design. The results of this study are about the ability of students before using visual media Pop Up Cards to achieve sufficient ability with an average value of 63.82. And finally it can reach 70, 00. And the importance of students' ability towards hiwar where the calculated T value is greater than the T table value which is 7.55> 2.00.  الأغراض من هذا البحث هي معرفة قدرة التلاميذ على الحوار   قبل و بعد استخدام بطاقة الوسائل البصرية “Pop Up” ومعرفة الأثر بينهما. والمنهج في هذا البحث هي المنهج التجريبية بتصميم التجريبية القبلية. ومن النتائج المحصولة من هذا البحث هي أن قدرة التلاميذ قبل استخدام بطاقة الوسائل البصرية “Pop Up” تدل على درجة كافية بقيمة المتوسط 63.82. و بعد استخدامها تدل على درجة جيدة بقيمة المتوسط 70.00. و يؤثر في قدرة التلاميذ على الحوار حيث إن قيمة "ت" الحسابية أكبر من قيمة "ت" الجدولية يعني 7.55 > 2.00 .
Measurement and Improvement of the happiness. Case Study: Engineering Projects Employees
Authors: Arroyo Moya Lady Mariana , Santiago Duque Cesar Danilo , Troncoso Mendoza Blass , Troncoso Palacio Alexander
Published: August 2020

The construction of civil works is the development index of a nation, in countries like Colombia, this sector depends on the human factor, which is why it is of utmost importance that employees are happy in carrying out their daily activities. Due to this, this study was developed to measure the degree of job satisfaction on a scale of five response levels in a civil works construction company, where the concepts of the vertical workload theory were applied, through the which, they indicated their degree of satisfaction. The results obtained reveal that, at the beginning of each workday, the boss should hold meetings with the intention of motivating. In addition, he should carry out group recreational activities or active breaks so that the work environment improves continuously and a better performance of the workers, which will allow a high probability of increasing the company's productivity.
Diseño de Equipo para la Separación Primaria de los Sólidos de las Aguas Residuales en las Empresas Porcinas en Cuba
Authors: Goytisolo Espinosa Rafael Antonio , Cabello Eras Juan José
Published: August 2020

En el Trabajo se profundiza en la literatura acerca de los aspectos que caracterizan la generación de residuales en las Granjas Porcinas en general y en particular las existentes en Cuba. Se revisaron algunos aspectos vinculados con el equipamiento empleado en la separación primaria de los sólidos de las aguas residuales de las Empresas Porcinas, para seleccionar el más adecuado desde el punto de vista de la capacidad necesaria, economía, sencillez de operación y mantenimiento y efectividad. Se selecciona en definitiva como equipo base para la separación un Transportador / Colador por Tornillo Sin Fin, se calcula la capacidad necesaria, sus dimensiones básicas y parámetros fundamentales de operación y se selecciona el moto reductor para su accionamiento. Finalmente se diseña y calcula el árbol del transportador utilizando el esquema de análisis de viga sobre fundación elástica y se diseñan y calculan los cojinetes empleando un material plástico FEROFOM.
El paseo arquitectónico y cinco puntos de la arquitectura en una verdadera maquina mágica para habitar.
Authors: Tirado Diana Milena
Published: August 2020

Al analizar y conocer en persona toda la dinámica actual de la Villa Savoye a las afueras de Paris, su estética, su funcionalidad y la evidencia de los cinco puntos que revolucionaron la arquitectura y que aportaron al desarrollo de la arquitectura moderna, surge la inquietud acerca del por qué ha sido malinterpretado este icónico arquitecto en los talleres de enseñanza de arquitectura. De igual manera se estudia si las características formales y funcionales son una respuesta sensata al racionalismo o si también las experiencias ambientales personales junto a los direccionamientos conductuales fueron de gran importancia en su concepción. Por este motivo, este artículo tiene como objetivo analizar su estética, la experiencia en el espacio interior y comprobar el sentido en que se aplicaron los cincos puntos de la nueva arquitectura. El artículo destaca las fortalezas de la Villa Savoye y logra concluir que, en este proyecto, Le Corbusier, no solo pensó racionalmente, sino que lo pensó como un recorrido o paseo espiritual que ayuda a la meditación y donde la belleza existe aportando una calma necesaria.
GAMING: UNA APROXIMACIÓN CRÍTICA DESDE LA NARRATIVA SOCIAL CONTEMPORÁNEA DEL NUEVO ORDEN MUNDIAL
Authors: Vera Rodríguez Josué Nelson
Published: August 2020

Objetivo: El artículo tiene como propósito exaltar la cualidad necesaria del Gaming, como proceso socioevolutivo, ante los escenarios que sobrevienen en el nuevo orden mundial, tras los acontecimientos por los que la humanidad transita a razón del COVID-19. Materiales y métodos: La presente investigación estuvo orientada a la profundización teórica y reflexiva del fenómeno referido, ante la nueva realidad social: relativa, controlada, como la única posibilidad de seguir existiendo. Se trata de un artículo documental, con diseño bibliográfico y método bibliográfico, donde la técnica aplicada fue la documentación. Resultados y discusión: Luego de analizar los contenidos relativos al contexto contemporáneo, el gaming, así como otros fenómenos con lugar al uso de las Tecnologías de la Información y Comunicación, logró generarse un conglomerado de laudos epistémicos, que le elevan como desafío y alternativa resolutoria en época de cambios. Conclusiones: En los últimos meses con el impacto ejercido por la pandemia del coronavirus, las TIC’s se erigieron como herramientas necesarias, más allá del ocio productivo, la recreación o el divertimento, en la complejidad itinerante que permea a la sociedad contemporánea.
Comparative study of anterior cervical discectomy and fusion by anterior cervical plate and stand-alone cervical cage
Authors: Abdul Aziz Ansari Muqtadeer , Sonkawade Venktesh Dattatray , Abdul Aziz Ansari Ishtyaque , Sasidharan Nair Pradeepkumar
Published: August 2020

Background: Anterior cervical discectomy (ACD) was used for management of degenerative cervical disc disorders (DCDD) in previous days. Further research and developments in management of DCDD led to evolution of standard and widely used operative technique as anterior cervical discectomy and fusion (ACDF) by either anterior cervical plate (ACDF-ACP) with bone grafting or stand-alone cage (ACDF-SAC). There is less data available in literature regarding when and where to use ACDF-ACP and ACDF-SAC.

Methods: The study was conducted on 20 patients operated in Government Medical College and Hospital and Pacific Hospital and Research Centre, Aurangabad from June 2018 to March 2020. These patients divided into group A - 10 patients, operated by ACDF-SAC which are further divided as group Aa - 6 patients - operated for single level ACDF-SAC and group Ab - 4 patients - operated for two level ACDF-SAC, group B - 10 patients, operated by ACDF-ACP which are further divided as group Ba - 5 patients - operated for single level ACDF-ACP and group Bb - 5 patients - operated for two level ACDF-ACP. Patients evaluated preoperatively and postoperatively using X-ray cervical spine anteroposterior (AP) and lateral views, MRI cervical spine, visual analogue scale (VAS) for pain, Robinson’s criteria and Cobb’s angle.

Results: In our study we found, ACDF-SAC has small incision size, less intraoperative time, easy to carry out for surgeons, less intraoperative complications and better clinical outcome as compared to ACDF-ACP. Whereas only radiological results were better in ACDF-ACP than ACDF-SAC.

Conclusions: ACDF-SAC is superior to ACDF-ACP for appropriately selected patients and in well experienced hands.
Alu-repeat polymorphism in the tissue plasminogen activator (t-PA) gene, seminal t-PA concentration, and male fertility impairment: A case-control study
Authors: Hamid Tahtamouni Lubna , Nael Hamdan Mahmoud , Ali Al-Mazaydeh Zainab , Mahmoud Bawadi Randa , Sobhi Rammaha Majdoleen , Mohammad Zghoul Ahmad , Ahmad Ahram Mamoun , Refat Yasin Salem
Published: August 2020

Background: Tissue plasminogen activator (t-PA) is a protein involved in the fibrinolytic system that catalyzes the conversion of plasminogen into the active plasmin. The activity of t-PA is controlled by plasminogen activator inhibitor-1. t-PA has crucial functions during spermatogenesis. One polymorphism was reported for t-PA gene, either the presence of a 300-bp Alu-repeat (Alu+) or its absence (Alu−).
Objective: The current work aimed at studying the association between Alu polymorphism in the t-PA gene and male infertility.
Materials and Methods: Using polymerase chain reaction on genomic DNA isolated from the blood of 79 participants, a region polymorphic for Alu element insertion in t-PA gene was amplified. In addition, total t-PA concentration, plasminogen activator inhibitor-1/t-PA complex concentration, and t-PA activity in seminal plasma were measured by enzyme-linked immunosorbent assay.
Results: The results indicate that the percentage of infertile participants (n = 50) who were homozygous for t-PA Alu insertion (Alu+/+), heterozygous Alu+/− or homozygous for t-PA Alu deletion (Alu−/−) did not change significantly (p = 0.43, 0.81, and 0.85, respectively) when compared with the control participants (n = 29). On the other hand, a significant decrease (p = 0.0001) of t-PA total concentration in seminal plasma was observed in the infertile group in comparison with the control group. However, the results indicate that there is no association between the t-PA Alu different genotypes and the total t-PA seminal concentration in the infertile group when compared to the control group (p = 0.63).
Conclusion: Data obtained from the current study does not support an association between t-PA Alu polymorphism and t-PA seminal concentration or male infertility.
Key words: Alu element, Male infertility, Semen, Spermatogenesis, t-PA.
Vaginal compared oral administration of estradiol in women with thin endometrium: A cross-sectional study
Authors: Davar Robab , Hoseini Masrooreh , Saeed Lida
Published: August 2020

Background: Endometrial thickness is regarded as an indicator of the receptivity of the endometrium. Patients preparing for frozen embryo transfer need some interventions in case their endometrium is thin.
Objective: This study aimed to compare the clinical outcomes of oral administration of estradiol valerate with its vaginal type in women with inappropriate endometrial thickness.
Materials and Methods: This cross-sectional study comprised of 79 women (cycles) who had undergone frozen-thawed embryo transfer. On the 13th day of the cycle, vaginal sonography was performed in case the thickness of the endometrium was < 7 mm; in the oral group, the patients continued using oral estradiol valerate tablet. However, in the vaginal group, the participants applied estradiol valerate tablet vaginally. Finally, the chemical and clinical pregnancy rate, also, early miscarriage rate were compared between the two groups.
Results: The early miscarriage rate was lower in the vaginal group in comparison with the oral group (p = 0.040). Women in the vaginal group showed a lower rate of chemical pregnancy compared to the oral group, but this difference was not statistically significant (25.0 vs. 34.4%, p = 0.440). The rate of clinical pregnancy in the two groups was not statistically significant, although the vaginal group had a higher pregnancy rate (22.5% vs. 15.6%, p = 0.464), especially in women older than 34 years (37.5% vs. 11.1%, p = 0.355).
Conclusion: Vaginal administration of estradiol tablet in women with thin endometrium leads to a lower rate of early miscarriage.
Key words: Endometrium, Thickness, Frozen, Embryo transfer, Estradiol valerate.
Sulforaphane response on aluminum-induced oxidative stress, alterations in sperm characterization and testicular histomorphometry in Wistar rats
Authors: Ogunlade Babatunde , Adelakun Sunday , Iteire Kingsley
Published: August 2020

Background: The exposure of male individual to environmental toxicant is regarded as a channel that results in reduced sperm counts and infertility.
Objective: This study investigated the ameliorative response of Sulforaphane (SFN) on Aluminum trichloride (AlCl3) induced testicular toxicity in adult male Wistar rats.
Materials and Methods: A total of 32 adult male Wistar rats (180-200 gm between 8-10 wk) were divided into four groups (n = 8/each). Group A) received distilled water orally as placebo; Group B) received 100 mg/kgbw AlCl3 only orally; Group C) received 100 mg/kgbw AlCl3 and 100 mg/kgbw SFN orally; and Group D) received 100 mg/kgbw SFN only orally. After 28 days of experiment, animals underwent cervical dislocation, blood serum was obtained for analysis, and testes were harvested for biochemical assays, histology, hormonal profile, and sperm characterization.
Results: The sperm parameters showed a significant difference within the AlCl3 only group compared with the control and SFN only groups (p = 0.02). However, AlCl3 and SFN co-treatment showed improvement in the motility, viability, and sperm count compared with the AlCl3 only group (p = 0.02). Furthermore, there was a significant decline in the levels of hormones profile and antioxidant status in AlCl3 only group compared to the control and SFN only (p = 0.02). The testicular histoarchitecture of the AlCl3 only group showed shrinkage of seminiferous tubules, spermatogenesis disruption, and empty lumen compared to the control and SFN only groups.
Conclusion: The present study revealed the ameliorative response of SFN on AlCl3-induced testicular toxicity on serum hormone profiles, antioxidant status, lipid peroxidation, and histomorphometric analysis through oxidative stress.
Key words: Sulforaphane, Aluminum trichloride, Oxidative stress, Testis, Histology.
The effects of metformin on stereological and ultrastructural features of the ovary in streptozotocin-induced diabetes adult rats: An experimental study
Authors: Mehrabianfar Parisa , Dehghani Farzaneh , Karbalaei Nargess , Mesbah Fakhroddin
Published: August 2020

Background: Diabetes is a chronic disease that can affect almost all of the body organs, including male and female reproductive systems.
Objective: This study was designed to investigate the preventive effects of metformin on stereological and ultrastructure characteristics of the ovary in the streptozotocin-induced diabetes adult female rats.
Materials and Methods: Seventy adult (8-10 wk) female Sprague-Dawley rats (180-200 gr) were equally divided, as follows: (n = 10/each) control; STZ-induced diabetes (single dose of 65 mg/kg STZ, IP); metformin-treated (50 mg/100 gr of body weight, orally); diabetic-metformin-treated; sham 1, (single dose of sodium citrate); sham 2, (0.5 ml of daily oral distilled water); and sham 3, (sodium citrate + distilled water treated). The body mass index, ovarian weight, blood sugar level, cholesterol, and triglyceride were measured. The stereological and ultrastructural features of ovary were assessed.
Results: The blood sugar of induced-diabetic rats was increased (p < 0.01). The BMI (p < 0.01), number of granulosa cells (p = 0.04), primordial, primary and secondary follicles (p = 0.03), total volume of ovary (p < 0.01) and cortex, nucleus diameter ratio to the ooplasm were decreased. The number of atretic follicles in the diabetic and diabetic + metformin-treated rats were increased (p < 0.01). The ultrastructural characteristics of ovary were more damaged in diabetic rats.
Conclusion: Diabetes has destructive effects on ovarian follicles and causes follicular atresia. Also, the size of oocytes, numbers of granulosa cells and ooplasmic organelles, which are involved in the folliculogenesis are affected by diabetes and metformin has no preventive effects.
Key words: Diabetes, Metformin, Ovary, Tissue.
Developing Cultural Humility During Short-Term Study Abroad Immersion
Authors: Fernandez Katheryn R.
Published: August 2020

Background: Cultural humility is an essential part of nursing education and practice today. We often teach cultural competence but do not take it further to develop the cultural humility needed for an understanding of being and becoming in today’s global environment. Method: This article describes a ten-day immersive study abroad experience to Mexico using strategies to develop cultural humility. Cultural immersion is a high impact practice and was used along with reflective writing and debriefing. Results: Cultural humility did emerge because of the trip to Mexico. Strategies used to develop this were reflective writings, discussions, debriefing and cultural immersion. These emerged as strong strategies to use in study abroad experiences. Conclusion: Nursing students can develop cultural humility during short-term immersion trips to Mexico. Further study of these strategies are needed to develop further knowledge of cultural humility and its impact on developing culturally congruent health care, reducing health disparities and promoting health equity.
The Environmental Health Impact of Hurricane Katrina on New Orleans
Authors: Diaz James H. , Brisolara Kari F. , Harrington Daniel J. , Hu Chih-yang , Katner Adrienne L.
Published: August 2020

Hurricane Katrina caused unprecedented flood damage to New Orleans, Louisiana, and has been the costliest hurricane in US history. We analyzed the environmental and public health outcomes of Hurricane Katrina by using Internet searches to identify epidemiological, sociodemographic, and toxicological measurements provided by regulatory agencies.

Atmospheric scientists have now warned that global warming will increase the proportion of stronger hurricanes (categories 4–5) by 25% to 30% compared with weaker hurricanes (categories 1–2).

With the new $14.6 billion Hurricane Storm Damage Risk Reduction System providing a 100-year storm surge–defensive wall across the Southeast Louisiana coast, New Orleans will be ready for stronger storms in the future.
Water and Sanitation in Urban America, 2017–2019
Authors: Capone Drew , Cumming Oliver , Nichols Dennis , Brown Joe
Published: August 2020

Objectives. To estimate the population lacking at least basic water and sanitation access in the urban United States.

Methods. We compared national estimates of water and sanitation access from the World Health Organization/United Nations Children’s Fund Joint Monitoring Program with estimates from the US Department of Housing and Urban Development on homelessness and the American Community Survey on household water and sanitation facilities.

Results. We estimated that at least 930 000 persons in US cities lacked sustained access to at least basic sanitation and 610 000 to at least basic water access, as defined by the United Nations.

Conclusions. After accounting for those experiencing homelessness and substandard housing, our estimate of people lacking at least basic water equaled current estimates (n = 610 000)—without considering water quality—and greatly exceeded estimates of sanitation access (n = 28 000).

Public Health Implications. Methods to estimate water and sanitation access in the United States should include people experiencing homelessness and other low-income groups, and specific policies are needed to reduce disparities in urban sanitation. We recommend similar estimation efforts for other high-income countries currently reported as having near universal sanitation access.
Disability, Ethics, and Health Care in the COVID-19 Pandemic
Authors: Sabatello Maya , Burke Teresa Blankmeyer , McDonald Katherine E. , Appelbaum Paul S.
Published: August 2020

This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician–patient communication, nondiscrimination and reasonable accommodations, and rationing of medical goods), and indicate possible solutions. Finally, we suggest clinical and public health policy measures to ensure that people with disabilities are included in the planning of future pandemic-related efforts.

The devastation evoked by the COVID-19 pandemic raises challenging dilemmas in bioethics. It also speaks to social justice issues that have plagued historically marginalized communities in the United States.

Responses to the pandemic must be bound by legal standards, principles of distributive justice, and societal norms of protecting vulnerable populations—core commitments of public health—to ensure that inequities are not exacerbated, and should provide a pathway for improvements to ensure equitable access and treatment in the future.
Reimagining Public Health in the Aftermath of a Pandemic
Authors: Brownson Ross C. , Burke Thomas A. , Colditz Graham A. , Samet Jonathan M.
Published: August 2020

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for society, affecting those already subject to unacceptable health inequalities and resulting in vast economic impacts. The pandemic reminds everyone of the value and necessity of public health.

In the context of an era that will be shaped by COVID-19, we outline the coming series of challenges and transitions in public health and the needed actions over the next 5 years to reinvent our public health systems. Multiple limitations in current US and global public health systems have been uncovered by the pandemic, including insufficient preparedness and surveillance capabilities complicated by long-standing and worsening health inequalities and the rapid spread of misinformation that needs to be countered. We foresee 3 phases for public health over the next 5 years: (1) reactive crisis management, (2) efforts to maintain initial gains, and (3) efforts to sustain and enhance progress.

A reinvented public health system will depend highly on leadership and political will, rethinking how we categorize and address population-level risk, employing 21st-century data sciences, and applying new communication skills.
Management of Comminuted Distal Radius Fractures
Authors: Meaike Joshua J. , Kakar Sanjeev
Published: August 2020

» Distal radius fractures occur in a bimodal age and sex distribution. Their incidence continues to rise with an increasingly active aging population.

» The current American Academy of Orthopaedic Surgeons guidelines for operative intervention are radial shortening of >3 mm, dorsal tilt of >10°, or intra-articular displacement or step-off of >2 mm.

» The method of reduction and fixation should be selected on a case-by-case basis with a focus on patient factors, fracture behavior, surgical proficiency, and functional outcomes.
Embedding the developmental approach in social work education and practice to overcome poverty: The case of Southern Africa
Authors: Nhapi Tatenda Goodman , Dhemba Jotham
Published: August 2020

The article examines the extent to which social work education and practice in Eswatini, Lesotho and Zimbabwe has embedded the developmental approach to address the problem of poverty and to bring about socio-economic transformation in these countries. This is particularly significant as social work has gained traction internationally as a problem-solving profession. However, it is argued that that there is a lack of clarity conceptually about how the developmental approach should be operationalised in order to deal with the social problems afflicting African countries in general and Southern Africa in particular. Furthermore the chapter examines challenges in the implementation of the developmental approach in economically fragile contexts such as Eswatini, Lesotho and Zimbabwe. The gaps and constraints in mainstreaming developmental social work are also examined in the context of poverty, globalisation and impacts of natural disasters. Challenges experienced by frontline social workers in mobilising communities through the application of a repertoire of developmental social work approaches have also received attention. The article is based on personal experiences of the authors in teaching and practicing social work in the three countries and this is complemented by reviews and analysis of research studies and policy documents and reports on the mitigation of poverty and the developmental approach. Importantly, the article also offers pathways on the embedment of the developmental approach in social work education and practice to promote the realisation of the Sustainable Development Goals (SDGs) especially the goal relating to the eradication poverty.
Targeted next-generation sequencing assays using triplet samples of normal breast tissue, primary breast cancer, and recurrent/metastatic lesions
Authors: Akahane Toshiaki , Kanomata Naoki , Harada Oi , Yamashita Tetsumasa , Kurebayashi Junichi , Tanimoto Akihide , Moriya Takuya
Published: August 2020

Background: Next-generation sequencing (NGS) has shown that recurrent/metastatic breast cancer lesions may have additional genetic changes compared with the primary tumor. These additional changes may be related to tumor progression and/or drug resistance. However, breast cancer-targeted NGS is not still widely used in clinical practice to compare the genomic profiles of primary breast cancer and recurrent/metastatic lesions.Methods: Triplet samples of genomic DNA were extracted from each patient’s normal breast tissue, primary breast cancer, and recurrent/metastatic lesion(s). A DNA library was constructed using the QIAseq Human Breast Cancer Panel (93 genes, Qiagen) and then sequenced using MiSeq (Illumina). The Qiagen web portal was utilized for data analysis.Results: Successful results for three or four samples (normal breast tissue, primary tumor, and at least one metastatic/recurrent lesion) were obtained for 11 of 35 breast cancer patients with recurrence/metastases (36 samples). We detected shared somatic mutations in all but one patient, who had a germline mutation in TP53. Additional mutations that were detected in recurrent/metastatic lesions compared with primary tumor were in genes including TP53 (three patients) and one case each of ATR, BLM, CBFB, EP300, ERBB2, MUC16, PBRM1, and PIK3CA. Actionable mutations and/or copy number variations (CNVs) were detected in 73% (8/11) of recurrent/metastatic breast cancer lesions.Conclusions: The QIAseq Human Breast Cancer Panel assay showed that recurrent/metastatic breast cancers sometimes acquired additional mutations and CNV. Such additional genomic changes could provide therapeutic target.
Exploring the reasons why women prefer to give birth at home in rural northern Ghana: A qualitative study
Authors: Adatara Peter , Strumpher Johanita , Ricks Esmeralda
Published: August 2020

Background: Skilled birth care during childbirth is reported in the literature as one critical strategy for reducing maternal morbidity and mortality. Despite the importance of birth care provided by skilled birth attendants, women in rural areas of northern Ghana still give birth utilising the birth services provided by Traditional Birth Attendants. The aim of this study,therefore, was to explore and describe the reasons why a small group of rural women chose homebirth in rural northern Ghana.Methods: A qualitative approach was adopted to explore the reasons why women prefer to deliver at home in rural areas of northern Ghana. Individual interviews were used to obtain a full description of factors and experiences of women associated with home births in rural areas in Ghana. The research population consisted of 10 women who utilised birth care services provided by Traditional Birth Attendants in a rural community of northern Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes.Results: This study, which was conducted among a small group of women, yielded interesting results on why these women still give birth at home in rural northern Ghana. It was found out that perceived poor quality of care and conduct of skilled birth attendants; the perception that women received better care from Traditional Birth Attendants; financial constraints and lack of access to healthcare facilities in the rural areas by these women accounted for majority of the reasons why women in rural northern Ghana still give birth at home.Conclusion: The study highlighted some barriers experienced by participants to the utilisation of birth care services provided by skilled birth attendants in rural northern Ghana. Management of healthcare facilities should facilitate the implementation of supportive supervision in the maternity units to improve the quality of care and attitude delivered by skilled birth attendants in maternity care in rural communities.
The regulatory role of the RANKL/RANK/OPG signaling pathway in the mechanisms of tooth eruption in patients with impacted teeth
Authors: Brodetska Ludmila , Natrus Larysa , Lisakovska Olha , Kaniura Olexandr , Iakovenko Liudmyla , Skrypnyk Irina , Flis Petro
Published: August 2020

Background: Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The study aimed to evaluate bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods: Bone samples from 18 patients (mean age 25.27±3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue, that was taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue, that was collected near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65 subunit, NFATc1, and caspase-3 were determined by western blotting. The difference between groups was assessed using ANOVA followed by Tukey’s post-hoc test. P-value ≤ 0.05 was considered statistically significant.Results: We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG, and OC content was demonstrated (1.46-, 1.48-, and 1.42-fold respectively), reflecting the high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 folds near the healthy tooth in patients with IT compared with control. In the area of ​​IT, we observed an increase in procaspase-3 and p17 levels (1.32 and 1.78 folds). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure.Conclusions: Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.
What makes advocacy work? Stakeholders’ voices and insights from prioritisation of Maternal and Child Health programme in Nigeria
Authors: Uzochukwu Benjamin , Onyedinma Chioma , Okeke Chinyere , Onwujekwe Obinna , Manzano Ana , Ebenso Bassey , Etiaba Enyi , Ezumah Nkoli , Mirzoev Tolib
Published: August 2020

Background : The Nigerian government introduced and implemented a health programme to improve maternal and child health (MCH) called Subsidy Reinvestment and Empowerment programme for MCH (SURE-P/MCH). It ran from 2012 and ended abruptly in 2015.This was followed by increased advocacy for sustaining the MCH (antenatal, delivery, postnatal and immunization) services as a policy priority. Advocacy is important in allowing social voice, facilitating prioritization, and bringing different forces/actors together. Therefore, the study set out to understand how advocacy works - through understanding what effective advocacy implementation processes comprise and what mechanisms are triggered by which contexts to produce the intended outcomes.

Methods: The study used Realist Evaluation design through a mixed methods case study approach. The programme theory was developed from three substantive social theories (power politics, media influence communication, and the three-streams theory of agenda-setting), data and programme design documentation, and subsequently tested. We report information from 22 key informant interviews including national and State policy and law makers, policy implementers, CSOs, Development partners, NGOs, health professional groups, media practitioners and review of relevant documents on advocacy events post-SURE-P.

Results: Key advocacy organizations and individuals were involved in advocacy activities. The nature of their engagement included organizing workshops, symposiums, town hall meetings, individual meetings, press conferences, demonstrations, and engagements with media. Effective advocacy mechanism involved alliance brokering to increase influence, the media supporting and engaging in advocacy, and the use of champions, influencers, and spouses (Leadership and Elite Gendered Power Dynamics). The key contextual influences which determined the effectiveness of advocacy measures for MCH included the political cycle, availability of evidence on the issue, networking with policy champions, and alliance building in advocacy. All these enhanced the entrenchment of MCH on the political and financial agenda at the State and Federal levels.

Conclusions: Our result suggest that advocacy can be a useful tool to bring together different forces by allowing expression of voices and ensuring accountability of different actors. In the context of poor health outcomes, interest from policymakers and politicians in MCH, combined with advocacy from key policy actors, can improve prioritization and sustained implementation of MCH services.
The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the Global Postural System.
Authors: Yu Qiuhua , Huang Huanjie , Zhang Zhou , Hu Xiaoqian , Li Wenfeng , Li Le , Chen Min , Liang Zhenwen , Lo Wai Leung Ambrose , Wang Chuhuai
Published: August 2020

Background: Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking.Objective: To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults.Design: A cross-sectional, regression study.Methods: People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP.Results: Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio=1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio=1.21) were associated with NCLBP.Limitation: This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population.Conclusions: The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required.
Validating and Updating GRASP: An Evidence-Based Framework for Grading and Assessment of Clinical Predictive Tools
Authors: Khalifa Mohamed , Magrabi Farah , Gallego Blanca
Published: August 2020

Background: When selecting predictive tools, clinicians are challenged with an overwhelming and ever-growing number, most of which have never been implemented or evaluated for comparative effectiveness. The authors developed an evidence-based framework for grading and assessment of predictive tools (GRASP). The objective of this study is to update GRASP and evaluate its reliability.Methods: A web-based survey was developed to collect responses of a wide international group of experts, who published studies on clinical prediction tools. Experts were invited via email and their responses were quantitatively and qualitatively analysed using NVivo software. The interrater reliability of the framework, to assign grades to eight predictive tools by two independent users, was evaluated.Results: We received 81 valid responses. On five-points Likert scale, experts overall strongly agreed with GRASP evaluation criteria=4.35/5, SD=1.01, 95%CI [4.349, 4.354]. Experts strongly agreed with six criteria: predictive performance=4.88/5, SD=0.43, 95%CI [4.87, 488] and evidence levels of predictive performance=4.44/5, SD=0.87, 95%CI [4.44, 4.45], usability=4.68/5, SD=0.70, 95%CI [4.67, 4.68] and potential effect=4.62/5, SD=0.68, 95%CI [4.61, 4.62], post-implementation impact=4.78/5, SD=0.57, 95%CI [4.78, 4.79] and evidence direction=4.25/5, SD=0.78, 95%CI [4.25, 4.26]. Experts somewhat agreed with one criterion: post-implementation impact levels=4.18/5, SD=1.14, 95%CI [4.17, 4.19]. Experts were neutral about one criterion; usability is higher than potential effect=2.96/5, SD=1.23, 95%CI [2.95, 2.97]. Sixty-four respondents provided recommendations to six open-ended questions regarding updating evaluation criteria. Forty-three suggested potential effect is higher than usability. Experts highlighted the importance of quality of studies and strength of evidence. Accordingly, GRASP concept and its detailed report were updated. The framework’s interrater reliability was tested, and two independent reviewers produced accurate and consistent results in grading eight predictive tools using the framework.Conclusion: Before implementation, internal and external validation of predictive performance of tools is essential in evaluating sensitivity and specificity. During planning for implementation, potential effect is more important that usability to evaluate acceptability of tools by users. Post-implementation, it is crucial to evaluate tools’ impact on healthcare processes and clinical outcomes. The GRASP framework aims to provide clinicians with a high-level, evidence-based, and comprehensive, yet simple and feasible, approach to evaluate, compare, and select predictive tools.
Benchmarking the research track record and level of appointment of Australian medical laboratory science academics
Authors: Donkin Rebecca , Broome Kieran , Swanepoel Libby
Published: August 2020

Background

Benchmarking across and within universities is a common tool to evaluate performance of a program and maintain accreditation requirements. While teaching remains a primary responsibility of many academics, academic research performance is a major contributor towards career advancement and standards in the medical laboratory science profession. While anecdotal evidence suggests academics are active contributors to the evidence base of the profession, there is a high variability in research output in relation to institution and level of appointment. The aim of the study was to benchmark the research track record of Australian medical laboratory science academics and provide insight into how research productivity informs the level of appointment of academics across their career pathway.

Methods

A bibliographic analysis of Australian medical laboratory science faculty websites and corresponding Scopus citation database profiles was conducted. A description of current research track record and relationships with holding a doctorate, academic appointment level, research and teaching interests, and institutional characteristics were explored. Quantitative data and frequencies were analysed using IBM SPSS version 26 to benchmark research track records by academic appointment level.

Results

There were 124 academics identified from thirteen universities who had a teaching and research position in an undergraduate medical laboratory science program in Australia. Academics at the level of lecturer or higher typically held a doctorate (89%). Holding a doctorate strongly influenced the number of publications. The top 20% of researchers authored around half of the overall publications. The majority of academics did not have alignment of their major research and teaching areas however, alignment had no influence on number of publications. There was, however, an inconsistent relationship between metropolitan or regional university location and the number of publications.

Conclusion

Data from this study provides academics with benchmarks for the research track record required at each level of appointment. When drawing conclusions on academic progression, promotion and tenure through research track record it would be mindful to assess each on a case by case basis. Institution (metropolitan versus regional) and research interest appears to influence publication number, h -index and citation scores.
JARID1B promotes colorectal cancer proliferation and Wnt/β-catenin signaling via decreasing CDX2 level
Authors: Huang Da , Xiao Fan , Hao Haibin , Hua Fuzhou , Luo Zhenzhong , Huang Zhaoxia , Li Qing , Chen Sha , Cheng Xiuzhi , Zhang Xinyue , Fang Weilan , Hu Xiaoyun , Liu Fanrong
Published: August 2020

Background: Jumonji AT-rich interactive domain 1B(JARID1B) has been shown to be upregulated in many human cancers and plays a critical role in the development of cancers cells. Nevertheless, its functional role in colorectal cancer (CRC) progression is not fully understood.Methods: Herein, JARID1B expression levels were detected in clinical CRC samples by western blotting and qRT-PCR. DLD-1 cells with JARID1B knockdown or overexpression by stably transfected plasmids were used in vitro and in vivo study. Colony formation, 5-ethynyl-20-deoxyuridine (EdU) and Real Time Cellular Analysis(RTCA) assays were used to detect cell proliferation and growth. Transcriptome and CHIP assays were used to examine the molecular biology changes and molecular interaction in these cells. Nude mice was utilized to study the correlation of JARID1B and tumor growth in vivo.Results: Here, we first observed that JARID1B was significantly upregulated in CRC tissue compared to adjacent normal tissues. In CRC patients, JARID1B high expression was positively relation with poor overall survival. Multivariate analyses revealed that high JARID1B expression was an independent predictive marker for the poor prognosis of CRC. In addition, we found that JARID1B promoted CRC cells proliferation by Wnt/β-catenin signaling pathway. Further studies demonstrated CDX2 as a downstream target of JARID1B, and our data demonstrated that CDX2 is crucial for JARID1B -mediated Wnt/β-catenin signaling pathway. Mechanistically, we demonstrated that JARID1B regulated CDX2 expression through demethylation of H3K4me3.Conclusions: CDX2 inhibited by JARID1B-derived H3K4me3 methylation promoted cells proliferation of CRC via Wnt/β-catenin signaling pathway. Therefore, our studies provided a novel insight into the role of JARID1B in CRC cells proliferation and potential new molecular target for treating CRC.
Discrimination between human populations using a small number of differentially methylated CpG sites: A preliminary study using lymphoblastoid cell lines and peripheral blood samples of European and Chinese origin.
Authors: Daca-Roszak Patrycja , Jaksik Roman , Paczkowska Julia , Witt Michal , Zietkiewicz Ewa
Published: August 2020

Background Epigenetics is one of the factors shaping natural variability observed among human populations. A small proportion of heritable inter-population differences are observed in the context of both the genome-wide methylation level and the methylation status of individual CpG sites. It has been demonstrated that a limited number of carefully selected differentially methylated sites may allow discrimination between main human populations. However, most of the few published results have been performed exclusively on B-lymphocyte cell lines. Results The goal of our study was to identify a set of CpG sites sufficient to discriminate between European and Chinese populations based on the difference in the DNA methylation profile not only in cell lines but also in primary cell samples. The preliminary selection of CpG sites differentially methylated in these two populations (pop-CpGs) was based on the analysis of two groups of commercially available ethnically-specific B-lymphocyte cell lines, performed using Illumina Infinium Human Methylation 450 BeadChip Array. A subset of ten pop-CpGs characterized by the best differentiating criteria (|Mdiff|>1, q<0.05; lack of the confounding genomic features), and ten additional CpGs in their immediate vicinity, were further tested using pyrosequencing technology in both B-lymphocyte cell lines and in the primary samples of the peripheral blood representing two analyzed populations. To assess the population-discriminating potential of the selected set of CpGs (further referred to as “ composite pop(CEU-CHB)-CpG marker ”) , three classification methods were applied. The predictive ability of the composite 8-site pop(CEU-CHB)-CpG marker was assessed using 10-fold cross-validation method on two independent sets of samples. Conclusions Our results showed that less than 10 pop-CpG sites may distinguish European and Chinese populations; importantly, this small composite pop-CpG marker performs well in both lymphoblastoid cell lines and in non-homogenous blood samples regardless of a gender .