bluuebunny/crossref_metadata_2025 huggingface dataset:
Propuesta de implementación del marco Universal Design for Learning usando narrativas transmedia
Authors: Pineda Acero Julia , Valetts Laura Mancera , Baldiris Navarro Silvia , Rivera Franco Olga , López Martínez Javier
Published: June 2019

La implementación de estrategias pedagógicas para proveer prácticas educativas inclusivas representa una tarea difícil para los docentes, por ello, con el fin de minimizar la complejidad  de dicha inclusión este artículo propone dos estrategias: la primera orientada hacia implementación del marco de trabajo Universal Design for Learning (UDL), que ofrece al docente insumos y mecanismos de relación de la información recolectada para facilitar la identificación de barreras en el currículo y generar soluciones de acuerdo a las plantillas que propone el UDL; y la segunda, basada en los fundamentos transmediales en la educación, que permiten utilizar con sentido interactivo las tecnologías digitales para expandir el conocimiento a partir de narrativas difundidas desde múltiples medios y plataformas, logrando abordar diversas formas de aprendizaje y facilitando la elaboración de la plantilla tres del UDL. El resultado de esta implementación conjunta es un grupo de posibilidades transmediales que permiten discernir la puesta en marcha de un contenido inclusivo desde diferentes medios y múltiples plataformas.
Uso de simuladores de negocio como estrategia de aprendizaje adaptativo: una experiencia en el aula
Authors: Mendoza Vargas Francisco Daniel
Published: June 2019

Actualmente el uso de juegos como apoyo a los procesos de enseñanza-aprendizaje y al modelo de la educación adaptativa es muy aceptado. En este contexto, la relación entre docente, estudiante y currículo deriva en una interacción distinta, en el que los parámetros de evaluación se modifican en concordancia con la experiencia de aprendizaje que se obtiene en el aula.Una forma de relacionar la teoría con la práctica en el aula es el uso de simuladores, herramientas que permiten enfatizar en los saberes teóricos, prácticos y valorativos, y promueven la transferibilidad de un ambiente académico a un lugar similar de trabajo.Partiendo de allí, el objetivo del presente artículo es evidenciar el uso de un simulador como experiencia de aula en el marco de la asignatura de simulación gerencial, analizando su modelo de evaluación con respecto a las actividades y resultados alcanzados por los alumnos, a partir del aprovechamiento del software de la licencia adquirida por la Universidad de la Salle a la empresa Company Game.
Collaborative work and eHealth in Colombia
Authors: Said-Hung Elias , Gertrudis Casado María Del Carmen , Jabba Molinares Daladier
Published: June 2019

This study analyzes the profiles of professionals and students from the health sector in Colombia, and describes how their socio-demographic characteristics and their technological skills affect the use of Information and Communication Technologies —ICT— in their professional and collaborative work. The study applied a correlational-explanatory research with a random population of 420 individuals, a margin of error of +/- 4.8, and a confidence level of 95 %. The results allow establishing a context of low promotion of collaborative work mediated by technology within the studied population, as well as the low level of harnessing of the opportunities offered by the different technological devices and resources for the purposes related to the topic proposed in this work.
Tamoxifen in Duchenne muscular dystrophy (TAMDMD): study protocol for a multicenter, randomized, placebo-controlled, double-blind phase 3 trial
Authors: Nagy Sara , Hafner Patricia , Schmidt Simone , Rubino-Nacht Daniela , Schädelin Sabine , Bieri Oliver , Fischer Dirk
Published: June 2019

BACKGROUND

Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder of childhood with a devastating disease course. Several targeted gene therapies and molecular approaches have been or are currently tested in clinical trials; however, a causative therapy is still not available and best supportive care is limited to oral glucocorticoids with numerous long-term side effects. Tamoxifen is a selective estrogen receptor regulator, and shows besides its antitumor activity also antioxidant actions and regulatory roles in the calcium homeostasis. In a mouse model of DMD, oral tamoxifen significantly improved muscle strength and reduced muscle fatigue. This multicenter, randomized, double-blind, placebo controlled phase 3 trial aims to demonstrate safety and efficacy of tamoxifen over placebo in pediatric patients with DMD. After completion of the double-blind phase, an open label extension of the study will be offered to all participants.

METHODS/DESIGN

At least 71 ambulant and up to 20 non-ambulant patients with DMD are planned to be enrolled at multiple European sites. Patients will be randomly assigned to receive either tamoxifen 20mg or placebo daily over 48 weeks. In the open-label extension phase, all patients will be offered to receive tamoxifen for further 48 weeks. The primary endpoint of the double-blind phase is defined as the change of the D1 domain of the motor function measure in ambulant patients or a change of the D2 domain in non-ambulant patients under tamoxifen compared to placebo. Secondary outcome measures include change in timed function tests, quantitative muscle testing, and quantitative MRI of thigh muscles. Laboratory analyses including biomarkers of tamoxifen metabolism and muscle dystrophy will also be assessed.

DISCUSSION

The aim of the study is to investigate whether tamoxifen can reduce disease progression in ambulant and non-ambulant DMD patients over 48 weeks. Motor function measure comprises the primary endpoint, whereas further clinical and radiological assessments and laboratory biomarkers are performed to provide more data on safety and efficacy. An adjacent open label extension phase is planned to test if earlier initiation of the treatment with tamoxifen (verum arm of double blind phase) compared to a delayed start can reduce disease progression more efficiently.
Can clinical risk factors predict functional recovery in ischemic stroke patients with pre-stroke depression?
Authors: Wormack Leah , Blum Brice , Bailes Benjamin , Nathaniel Thomas
Published: June 2019

Background. Specific clinical risk factors that may be associated with ambulatory outcome following thrombolysis therapy in ischemic stroke patients with pre-stroke depression is not fully understood. This was investigated.

Methods. Multivariate analyses were performed to identify predictors of functional ambulatory outcomes. Patient demographics and clinical risk factors served as predictive variables, while improvement or no improvement in ambulatory outcome was considered as the primary outcome.
Results. A total of 595 of these patients received rtPA of which 310 patients presented with pre-stroke depression, 217 had no improvement in functional outcome, while 93 patients presented with an improvement in functional outcome. Carotid artery stenosis (OR= 11.577, 95% CI, 1.281 – 104.636, P=0.029) and peripheral vascular disease (OR= 18.040, 95% CI, 2.956-110.086, P=0.002) were more likely to be associated with an improvement in ambulation. Antihypertensive medications (OR= 7.810, 95% CI, 1.401 –43.529, P=0.019),previous TIA (OR= 0.444, 95% CI, 0.517 –0.971, P=0.012), and congestive heart failure (OR= 0.217, 95% CI, 0.318 –0.402, P=0.030) were associated with a no improvement in ambulation.
Conclusion. After adjustment for covariates, more clinical risk factors were associated with no improvement when compared with improvement in functional outcome following thrombolysis therapy in an acute ischemic stroke population with pre-stroke depression.
Adaptation and Validation of a Spanish version of the Treatment Burden Questionnaire in Patients with Multiple Sclerosis
Authors: Ysrraelit Maria Celica , Fiol Marcela Paula , Peña Fernando Vazquez , Vanotti Sandra , Terrasa Sergio Adrián , Tran Viet Thi , Montori Victor M , Correale Jorge
Published: June 2019

Background: The Treatment Burden Questionnaire (TBQ) is a self-reported measure of the effect of treatment workload on patient wellbeing. We sought to validate the TBQ in Spanish and use it to estimate the burden of treatment in Argentinian patients with multiple sclerosis (MS).
Methods: The TBQ was forward-backward translated into Spanish. Two focus groups and 25 semi-structured interviews focused on wording and possible item exclusion. Validation was performed in 2 steps. First, 162 patients across a range of MS severity completed the questionnaire. Confirmatory factor analysis assessed the dimensional structure of the TBQ. Construct validity was assessed by studying correlations with fatigue and quality of life (QoL). Then, in a second cohort of 171 patients, we evaluated the association between TBQ scores and patients’ sex, age, education level, employment status, type of MS, disease duration, comorbidities, EDSS, pharmacological treatment and medication adherence.
Results: The questionnaire presented a 3-factor structure in which burden was related to pharmacological treatment; comprehensive health assistance; and psycho-social-economic context. Composite reliability was > 0.8 for all factors. TBQ showed positive correlation with fatigue (rs= 0.467, p=0.006), negative correlation with QoL (rs -0.446, p=0.009). For the second cohort, total TBQ score was 43 (SD 29). Lowest scores were observed on self-monitoring (0.53, SD 1.3) and highest for administrative load (4.2, SD 3.4). Inverse association was found between the TBQ score and medication adherence (r 0.243 p=0.001). TBQ scores also correlated with daily patient pill/injection requirements (r 0.175 p=0.020). Individuals receiving injectable treatment scored higher than patients on oral drugs (total TBQ 51 (SD 32) vs 39 (SD 27) p=0.002).
Conclusions: The TBQ in Spanish is a reliable instrument and showed adequate correlation with QoL and adherence scales in MS patients. TBQ may benefit health resources allocation and provide tailor therapeutic interventions to construct a minimally disruptive care.
Long non-coding RNA MEG3 alters neuronal apoptosis and is associated with poor prognosis in ischemic stroke: based on basic and prospective studies
Authors: Wang Meiping , Chen Wenjuan , Geng Yu , Xu Chenghua , Tao Xiaoxiao , Zhang Yi
Published: June 2019

Background: Ischemic stroke (IS) is a highly heterogeneous disease with variable pathogenesis. Due to the lack of early predictive markers, the mortality rate of IS remains high worldwide. This study focused on the expression pattern of long non-coding RNA (lncRNA) maternally expressed gene 3 (MEG3) and its prognostic value in IS.
Methods: Twenty-four ICR mice (30-35g, 12 males and 12 females) were involved in this study. Middle cerebral artery occlusion (MCAO) was established to simulate an IS environment. Oxygen-glucose deprivation/reoxygenation (OGD/R) in cells were also performed. A total of 215 IS patients and 153 age and gender-matched controls were included. Quantitative Real-time PCR (qRT-PCR) was performed to detect the expression of MEG3 in peripheral blood leukocytes.
Results: The MEG3 expression in MCAO group was significantly higher than control group (P=0.004), and the survival time of high MEG3 group was significantly lower than that of the low MEG3 group (P=0.042). OGD/R promotes cell apoptosis, while si-MEG3 inhibits apoptosis. Results of WB showed that, expression level of Bax was down regulated by si-MEG3, while OGD/R increased its expression level. MEG3 was significantly up-regulated in IS patients and associated with the National Institutes of Health Stroke Scale (NIHSS) (r=0.347, P<0.001), modified Rankin Scale (mRS) (r=0.385, P<0.001), high sensitivity C-reactive protein (Hs-CRP) (r=0.221, P=0.002) level and infarct volume (r=0.201, P=0.006). Overall survival analysis showed that patients with higher MEG3 expression had a relatively poor prognosis (P<0.001). Meanwhile, multivariate analysis revealed that MEG3 was an independent prognostic marker of functional outcome and death in patients with IS.
Conclusions: Current study suggested that MEG3 might be considered as a potential prognostic indicator in IS.
Wheat phyllosphere yeasts degrade propiconazole
Authors: Kucharska Katarzyna , Wachowska Urszula , Czaplicki Sylwester
Published: June 2019

Background: Yeasts, which are ubiquitous in agroecosystems, are known to degrade various xenobiotics. The aim of this study was to analyze the effect of fungicides on the abundance of natural yeast communities colonizing winter wheat leaves, to evaluate the sensitivity of yeast isolates to fungicides in vivo, and to select yeasts that degrade propiconazole.
Results: Fungicides applied during the growing season generally did not affect the counts of endophytic yeasts colonizing wheat leaves. Propiconazole and a commercial mixture of flusilazole and carbendazim decreased the counts of epiphytic yeasts, but the size of the yeast community was restored after 10 days. Epoxiconazole and a commercial mixture of fluoxastrobin and prothioconazole clearly stimulated epiphyte growth. The predominant species isolated from leaves were Aureobasidium pullulans and Rhodotorula glutinis. In the disk diffusion test, 14 out of 75 yeast isolates were not sensitive to any of the tested fungicides. After 48 hours of incubation in an aqueous solution of propiconazole, the Rhodotorula glutinis Rg 55 isolate degraded the fungicide in 85%. Isolates Rh. glutinis Rg 92 and Rg 55 minimized the phytotoxic effects of propiconazole under greenhouse conditions. The first isolate contributed to an increase in the dry matter content of wheat seedlings, whereas the other reduced the severity of chlorosis.
Conclusion: Not sensitivity of many yeast colonizing wheat leaves on the fungicides and the potential of isolate Rhodotorula glutinis Rg 55 to degrade of propiconazole was established. Yeast may partially eliminate the ecologically negative effect of fungicides.
Keywords: wheat leaves, fungicide, Aureobasidium, Rhodotorula.
Microorganisms involved in Deep Neck Infection (DNIs) in Greece: detection, identification and susceptibility to antimicrobials
Authors: Beka Despoina , Lachanas Vasileios A. , Doumas Stergios , Xytsas Stelios , Kanatas Anastasios , Petinaki Efi , Skoulakis Charalampos E.
Published: June 2019

Background

To determine, from October 2010 to October 2018, the epidemiology of Deep Neck Infections (DNIs), regarding the detection, the identification and the susceptibility to antimicrobials of causative microorganisms, in Thessaly-Central Greece.

Methods

An analysis of data from a prospective database was conducted on 610 consecutive patients with DNIs treated in the Otolaryngology / Head & Neck Surgery Department of University Hospital of Larissa. Demographics, clinical features and microbiological data were analyzed.

Results

Among the 610 patients (1,9/1 male to female ratio, mean age: 39,24±17,25) with DNIs, 584 had a single space (95,7%), while the remaining had a multi-space (4,3%) DNI. The most common areas affected were the peritonsillar space (84,6%) followed by the submandibular space (6,5%). Clinical samples were obtained in 462 patients, and were tested by culture and by the application of 16S rRNA PCR. One hundred fifty-five samples (55,2%) gave positive cultures, in which Streptococcus pyogenes and Staphylococcus aureus were predominant. The application 16S rRNA PCR revealed that 183 samples (39,6%) were positive for bacterial DNA; 22 of them were culture negative and were positive for anaerobic (Fusobacterium necrophorum, Actinomyces israellii etc) and for fastidious microorganisms (Brucella mellitensis, Mycobacterium avium).

Conclusion

DNIs represent a medical and surgical emergency and evidence-guided empirical treatment with intravenous infusion of antibiotics at the time of diagnosis is mandatory, highlighting the importance of epidemiological studies regarding the causative microorganisms. Although, in our study, the predominant pathogens were S. pyogenes and S. aureus, the combination of culture and molecular assay revealed that anaerobic bacteria play also a significant role in the pathogenesis of DNIs.
Therapeutic drug monitoring of infliximab compared to standard clinical treatment with infliximab: study protocol for a randomised, controlled, open, parallel-group, phase IV study (The NOR-DRUM study)
Authors: Syversen Silje Watterdal , Goll Guro Løvik , Jørgensen Kristin Kaasen , Olsen Inge Christoffer , Sandanger Øystein , Gehin Johanna Elin , Warren David John , Sexton Joseph , Mørk Cato , Jahnsen Jørgen , Kvien Tore Kristian , Bolstad Nils , Haavardsholm Espen A.
Published: June 2019

Background

Infliximab (INX) and other TNF-inhibitors (TNFi) have revolutionised the treatment of several immune mediated inflammatory diseases. Still, many patients do not respond sufficiently to therapy or loose efficacy over time. The large individual variation in serum drug concentrations on standard doses and the development of anti-drug antibodies are thought to be major reasons for treatment failures. Therapeutic drug monitoring (TDM), an individualised treatment strategy based on systematic assessments of serum drug concentrations, has been proposed as a clinical tool to optimise efficacy of INX treatment. TDM seems reasonable both from a clinical and an economical point of view, but the effectiveness of this treatment strategy has not yet been demonstrated in randomised clinical trials. The NORwegian DRUg Monitoring study (NOR-DRUM) aims to assess the effectiveness of TDM, both with regard to achieve remission in patients starting INX treatment (part A) as well as to maintain disease control in patients on INX treatment (part B).

Methods

The NOR-DRUM study is a randomised, open, controlled, parallel-group, comparative, multi-centre, national, superiority, phase IV study with two separate parts, NOR-DRUM A and NOR-DRUM B. Patients with rheumatoid arthritis, psoriatic arthritis, spondyloarthritis, ulcerative colitis, Crohn’s disease and psoriasis are included. In both study parts participants are randomised 1:1 to either TDM of infliximab (intervention group) or to standard treatment with infliximab without knowledge of drug levels or ADAb status (control group). 400 patients starting INX therapy will be included in NOR-DRUM A. The primary outcome is remission at 30 weeks. In NOR-DRUM B, 450 patients on maintenance treatment with INX will be included. The primary endpoint is occurrence of disease worsening during the 52 weeks study period.

Discussion

As the first trial to assess the effectiveness, safety and cost-effectiveness of TDM in patients receiving TNFi for a range of immune mediated inflammatory diseases, we hope that the NOR-DRUM study can contribute to the advancement of evidence based personalised treatment with biological medicines.
A clinical scoring system for the diagnosis of pediatric hand-foot-mouth
Authors: Huang Hui , Deng Li , Jia Liping , Zhu Runan
Published: June 2019

Background

The aim of the present study was to develop a clinical scoring system for the diagnosis of hand-foot-mouth disease (HFMD) with improved accuracy.

Methods

A retrospective analysis was performed on standardized patient-history and clinical-examination data obtained from 1435 pediatric patients under the age of three years who presented with acute rash illness and underwent enterovirus nucleic-acid-detection testing. Patients were then divided into the HFMD (1094 patients) group or non-HFMD (341 patients) group based on a positive or a negative result from the assay, respectively. Multivariate logistic regression was performed on 15 clinical variables (e.g. age, exposure history, number of rash spots in a single body region) to identify variables highly predictive of a positive diagnosis. Using the variables with high impact on the diagnostic accuracy, we generated a scoring system for predicting HFMD.

Results

Using the logistic model, we identified seven clinical variables (age, exposure history, and rash density at specific regions of the body) to be included into the scoring system. While the final scores ranged from −4 to 23 (higher score positively predicted a HFMD diagnosis), a cutoff score of 7 resulted in a sensitivity of 0.74 and specificity of 0.69.

Conclusions

This study establishes an objective scoring system for the diagnosis of typical and atypical HFMD using measures accessible through routine clinical encounters. Due to the accuracy and sensitivity achieved by this scoring system, it can be employed as a rapid, low-cost method for establishing diagnoses in children with acute rash illness.
A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018
Authors: Chen Dongwan , Li Yongjin , Lv Jinchang , Liu Xiufeng , Gao Peng , Zhen Guoxin , Zhang Wenzeng , Wu Dan , Jing Hongbo , Li Ying , Zhao Yao , Ma Xiaochen , Ma Huilai , Zhang Lijie
Published: June 2019

Background

On 4 September 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 affected students developed the symptoms of diarrhea and vomiting. Investigations were conducted to identify the agent and source of this outbreak, and to implement controls to prevent further transmission.

Methods

A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that food served at the school canteen. We collected information on demographics, refectory records at the canteen and contact to ill persons or vomit, using a uniform epidemiological questionnaire. Risk ratios (RR) and 95% conﬁdence intervals (CI) were calculated. Stool specimens of cases and canteen employees, food served, water, and environmental swabs were investigated by laboratory analysis.

Results

We identiﬁed 209 cases(including 28 laboratory-confirmed cases) that occurred from August 29 to September 10. All cases were students, and the median age was 20 years, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks window and Rice flour window on 1 September(RR: 3.4, 95% CI: 1.5-7.8, and RR: 7.6, 95% CI: 2.8-20.2), Rice flour window and Fish meal window on 2 September(RR: 4.0, 95% CI: 1.2-13.6, and RR: 4.6, 95% CI: 1.7-12.5), Moslem meal window on 4 September(RR: 2.7, 95%CI: 1.3-5.4), Barbeque window on 5 September(RR: 3.0, 95%CI: 1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Rectal swabs or stool samples from twenty-five cases and ten canteen employees were positive for norovirus GI.6. Five cases were positive for Bacillus cereus, among them, two stool samples were detected by a mixed infection of Norovirus and Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria.

Conclusion

Our investigation indicated that consumption of high-risk windows was the source of this outbreak. The high rate of infection of both pathogens was exacerbated by unhygienic manipulation and Inappropriate hygiene practices in canteen employees.
Intestinal schistosomiasis of Ijinga Island, north-western Tanzania: Prevalence, intensity of infection, hepatosplenic morbidities and their associated factors
Authors: Mueller Andreas , Fuss Antje , Ziegler Uwe , Kaatano Godfrey M. , Mazigo Humphrey D.
Published: June 2019

Background: Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project aims to introduce an intensified treatment protocol using a MDA approach combined with other public health interventions to demonstrate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting. In preparation of this project, we report about baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors.
Methods: A cross sectional study was conducted among 930 individuals aged 3-95 years living at Ijinga Island, north-western Tanzania. Single stool and urine samples were collected from each study participant and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen. Ultrasonographical examination for S.mansoni hepatosplenic morbidities was done to all participants.
Results: Overall based on KK technique and POC-CCA test, 68.9% (95%CI: 65.8-71.8) and 94.5% (95%CI: 92.8-95.8) were infected with S.mansoni. The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg (95%CI: 77.5-94.8). A total of 27.1%, 31.2% and 51.9% of the study participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR=1.08, 95%CI: 1.02-1.16, P<0.01), belong to the age group 16-25 years (aRR=1.23, 95%CI: 105-1.44, P<0.01), 26-35 years (aRR=1.42, 95%CI: 1.21-1.67, P<0.001), 36-45 years (aRR=1.56, 95%CI:1.31-1.84, P<0.001) and ≥ 46 years (aRR=1.64, 95%CI:1.41-1.92, P<0.001). The length of the left liver lobe was associated with being female (P<0.03), belong to the age group 1-5 years (P<0.013), 6-15 years (P<0.04) and S.mansoni intensity of infection (P<0.034). Similarly, being male (aRR=1.15, 95%CI:1.06-1.24, P<0.001), belonging to the age group 16-25 years (aRR=1.27, 95%CI:1.05-1.54, P<0.02), 26-35 years (aRR=1.32, 95%CI:108-1.61, P<0.01) were associated with splenomegaly.
Conclusion: Schistosoma mansoni infection and its related morbidities are common in the study area. The prevalence of S.mansoni was above 50% in each age group and based on the observed prevalence, we recommend MDA to the entire community.
Cerebral salt wasting in a patient with myeloproliferative neoplasm
Authors: Orlik Lea , Venzin Reto , Fehr Thomas , Hohloch Karin
Published: June 2019

Background

Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
MR Imaging Features of Orbital Langerhans Cell Histiocytosis
Authors: wu chunnan , Mu xuetao , Hei yan , lan pengyu , li kuncheng
Published: June 2019

Background: To investigate the magnetic resonance imaging (MRI) features of orbital Langerhans cell histiocytosis (LCH) to improve diagnostic accuracy.
Methods: We retrospectively reviewed clinical manifestations and MRI findings of 23 patients with histology-confirmed LCH of the orbit. The findings were evaluated for the following: (a) symptoms, (b) disease duration，(c) location, (d) configuration, (e) margin, (f) MR imaging signal intensity and enhanced performance.
Results: Eighteen patients (78%) in our series were male, only five (22%) patients were female, and the mean age at presentation was 6.3 years. The common symptoms include swollen eyelids, exophthalmos, and a palpable mass. Fourteen patients presented with swollen eyelids and/or exophthalmos. Twenty-two cases involved unilateral orbits, and one case involved bilateral orbits. In our study, there was one patient with cough and expectoration, and one patient with polydipsia and polyuria. Lesions were located in the superior or superlateral orbital roof of seventeen patients (74%). Lesions formed masses or irregular shapes. The majority of lesions appeared heterogeneous isointense and iso-hypointense on T1-weighted imaging and hyper-hypointense mixed signals on T2-weighted imaging. The appearance of hemorrhage and cystic change were usually seen in lesions. After enhancement, majority lesions presented marked enhancement at the edges and the surrounding tissues, and with heterogeneous obvious enhancement of the lesion center. Besides, several lesions were surrounded by a low circular signal.
Conclusion: There were several characteristics MRI features that can provide crucial information for clinicians and improve our understanding and the diagnostic accuracy of the orbital LCH
Self-administered acupressure for allergic rhinitis: Study protocol for a randomized, single blind, non-specific controlled, parallel trial
Authors: Liang Yaqun , Lenon George Binh , Yang Angela Wei Hong
Published: June 2019

Background

Allergic rhinitis (AR) is an IgE-mediated inflammatory disease. Current conventional therapies for AR are unsatisfactory. Acupuncture has been recommended as an optional treatment for AR patients who are interested in non-pharmacotherapy in the new clinical practice guidelines for AR. Acupressure is a sub-type of acupuncture which is non-invasive with a low risk and can be self-administered. However, the current limited evidence is compromised by the high risk of bias and heterogeneity of methodology. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. This proposed RCT aims to evaluate the efficacy and safety of self-administered acupressure for the management of AR.

Methods/design

We have designed a randomized, single blind, non-specific controlled, two-arm, parallel clinical trial involving a 2-week run-in period, a 4-week intervention period and an 8-week follow-up period. The eligible participants will be randomized into either specific or non-specific acupressure group. They will be required to perform self-administered acupressure on either 5 specific acupressure points or 5 non-specific acupressure points, one minute for each point, twice a day for 4 weeks. Participants will be asked to complete self-administered questionnaires for outcome measures including 7-point scale of symptom severity, Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQs), relief medication scores, adverse events and participants’ opinion of this study at the different assessment points throughout the trial period. Data will be analyzed by chi-square or t-test using Statistical Package for Social Science (SPSS) software.

Discussion

The findings from this study will provide scientific evidence for the efficacy and safety of self-administered acupressure for the management of AR. This study may assist to develop a non-cost, non-invasive self-management method for AR sufferers.
Analysis of nutrient composition and phytochemicals of wild yams Dioscorea pentaphylla L. and Dioscorea oppositifolia Griseb.
Authors: Vivek Singaravelan , Prakash Segar
Published: June 2019

Yam is common name for the genus Dioscorea and considered as good sources of essential dietary nutrients. It has nutritional superiority over the tropical root crops. Understanding the nutritional values of yams, the nutrient contents of two yams, Dioscorea pentaphylla and Dioscorea oppositifolia have been analysed in the present study. During the study, the higher amount of moisture, crude protein, nitrogen, free sugars and buffer protein were estimated and analysed. The rich carbohydrate and calorific value, higher amount of fat and amino acids were observed in D. pentaphylla as compared to D. oppositifolia. The crude fiber and ash contents were comparatively higher in D. oppositifolia. Preliminary phytochemical analysis reveals the presence of alkaloids, flavonoids, glycosides, phenol, reducing sugars, saponins, steroids, tannins and triterpinoids in methanolic extract of both tubers.
Ethnobotanical survey of plant species utilised as spices among the indigenous people of Bayelsa State, Nigeria
Authors: Olatokunbo Ihinmikaiye Samuel , Arowosegbe Sunday , Kayode Joshua , Oyedeji Ayodele
Published: June 2019

Plant species used as spices in Bayelsa State, Nigeria, were assessed in this study. A total of twenty four spicy plants were identified. This included a fungal species and twenty three plant species. These species were of diverse life forms (25% trees; 8% shrubs, 58% herbs and 4% grasses). The study also revealed that the spicy plants identified were heterogeneously distributed across the three senatorial zones of the State. Fruits/seeds were the most utilized parts of the indigenous spicy plants identified. 63% of the identified spicy plants were sourced from the wild and 38% were cultivated in the State. Parts of the plants utilized for spices were fruits, seeds, leaves, shoots, bulbs, rhizomes and in some cases the entire-part. Fruits and seeds dominated the parts used (46%), while rhizome and the entire-parts were the least utilized parts (4%) for spices in the study area. Most of the methods employed in harvesting the spicy plants were annihilative and inhibitory. Also environmental pollution among other factors threatens the existence of the spicy plants growing in the wild in the study area. In conclusion conservational strategies that will ensure sustainable use of the identified spicy plant species were proposed.
Congenital syphilis in the Municipality of Imperatriz, Maranhão State: Epidemiological characterization of a decade
Authors: Macedo Kecya Patricia Costa , Silva Matheus Costa , Vaz Jéssica Larissa Sousa , Costa Soliane Cristina Rodrigues , Verde Roseane Mara Cardoso Lima , Nascimento Matheus Hipólito do , Soares Leonardo Ferreira , Oliveira Evaldo Hipólito de
Published: June 2019

Congenital syphilis, caused by the bacterium Treponema pallidum, is one of most prevalent diseases in Brazil. The diagnosis is made through treponemal and non-treponemal tests during prenatal care, in which reagent results are necessary to initiate treatment in order to avoid fetal contamination, miscarriage, prematurity, neurological sequelae, among other fetal and maternal complications. The objective of this study was to investigate the prevalence of congenital syphilis to describe the epidemiological profile based on cases reported in the Municipality of Imperatriz, Maranhão State, Brazil. This is an exploratory, retrospective, descriptive and quantitative study developed between 2010 and 2017. The results obtained in the study reveal that in the period from 2010 to 2017, an accumulated total of 2,507 cases of congenital syphilis were reported in the state of Maranhão, and 514 cases were registered in Imperatriz, representing 20.50% of the total. The study demonstrated the need for effective measures to combat not only the infection of mothers, but also of partners; some of these diagnoses were only identified during or after childbirth/curettage. The lack of previous investigation or lack of adequate treatment during the gestation leading to maternal and fetal risk was evident.
Medina, J. (2017). Decir en Griego la novedad del Hebreo. Introducción a las lecturas talmúdicas de Emmanuel Levinas. Zaragoza: Riopiedras. 173pp.
Authors: García Roberto Casales
Published: June 2019

Cara a un mundo que privilegia el individualismo, la propuesta filosófica de Levinas, tal y como lo sugiere el título de la presente obra, tiene la virtud de traducir al Griego la novedad del Hebreo, en cuyas bases se encuentra una lógica de la alteridad que acoge la fragilidad humana y le devuelve su dignidad. El ser humano, en efecto, es un ser vulnerable, un ser necesitado cuyo rostro se vuelve un imperativo de amor: es a través del rostro que, según Levinas, me descubro como un ‘ser para otro’. El presente texto busca, sin embargo, releer a Levinas no desde una visión dicotómica de su pensamiento, i.e., escindiendo lo filosófico de lo confesional, sino desde una visión holística en la que se articulen filosofía y religión. Con esto en mente, Jorge Medina busca “explorar qué dijo el propio Levinas sobre el Talmud, y reconstruir a partir de sus cinco libros destinados a lecturas talmúdicas, una metodología de acceso filosófico a los textos talmúdicos” (p. 30).
Establishment of a large-diameter pipeline failure risk matrix in water distribution systems in Taiwan
Authors: Huang Kochin , Chuo Paul , Lin Kim-loong , Yu Mengsyu , Huang Chihpin
Published: June 2019

The bursting of large-diameter water pipelines in distribution systems will lead to industrial, economic, and public safety impacts. Therefore, multi-criteria analysis (MCA) was applied in this study, which utilizes a series of quantifiable parameters to establish the mathematical method of a risk model. The risk matrix of a pipeline was defined as the multiple of the probability of pipeline failure and potential consequences of pipeline failure. By combining the GIS (geographic information system), each evaluation unit was assigned to different risk levels. The large-diameter (above 800 mm) pipeline length statistic for various risk evaluation units of Taiwan Water Corporation reveals the length of high risk is 171 km (7.7%), secondary high risk 574.6 km (25.8%), middle risk 714.3 km (32%), low risk 701.5 km (31.5%), and the unranked length is 67.8 km (3.0%). Finally, the detection frequencies were classified as high risk with a term check of every five years, sub-high risk with planned check every five to ten years, medium risk with checking/monitoring if needed, and low risk with quick repair and no need to take measurements and monitoring. Therefore, we can significantly lower the probability of bursting for large-diameter pipelines in the water distribution system.
Utilization, Safety, and Technical Performance of a Telemedicine System for Prehospital Emergency Care: Observational Study (Preprint)
Authors: Felzen Marc , Beckers Stefan Kurt , Kork Felix , Hirsch Frederik , Bergrath Sebastian , Sommer Anja , Brokmann Jörg Christian , Czaplik Michael , Rossaint Rolf
Published: June 2019

BACKGROUND

As a consequence of increasing emergency medical service (EMS) missions requiring an EMS physician on site, we had implemented a unique prehospital telemedical emergency service as a new structural component to the conventional physician-based EMS in Germany.

OBJECTIVE

We sought to assess the utilization, safety, and technical performance of this telemedical emergency service.

METHODS

We conducted a retrospective analysis of all primary emergency missions with telemedical consultation of an EMS physician in the City of Aachen (250,000 inhabitants) during the first 3 operational years of our tele-EMS system. Main outcome measures were the number of teleconsultations, number of complications, and number of transmission malfunctions during teleconsultations.

RESULTS

The data of 6265 patients were analyzed. The number of teleconsultations increased during the run-in period of four quarters toward full routine operation from 152 to 420 missions per quarter. When fully operational, around the clock, and providing teleconsultations to 11 mobile ambulances, the number of teleconsultations further increased by 25.9 per quarter (95% CI 9.1-42.6; P=.009). Only 6 of 6265 patients (0.10%; 95% CI 0.04%-0.21%) experienced adverse events, all of them not inherent in the system of teleconsultations. Technical malfunctions of single transmission components occurred from as low as 0.3% (95% CI 0.2%-0.5%) during two-way voice communications to as high as 1.9% (95% CI 1.6%-2.3%) during real-time vital data transmissions. Complete system failures occurred in only 0.3% (95% CI 0.2%-0.6%) of all teleconsultations.

CONCLUSIONS

The Aachen prehospital EMS is a frequently used, safe, and technically reliable system to provide medical care for emergency patients without an EMS physician physically present. Noninferiority of the tele-EMS physician compared with an on-site EMS physician needs to be demonstrated in a randomized trial.
ANTI-TUMOUR ACTIVITY OF BROMOPYRROLE ALKALOIDS AGAINST HUMAN BREAST TUMOUR (MCF-7) THROUGH APOPTOSIS INDUCTION
Authors: MANIKANDAN S. , GANESAPANDIAN S. , SINGH MANOJ , KUMARAGURU A. K.
Published: June 2019

Objective: The present study was conducted to screen the cytotoxicity and initiation of apoptosis in MCF-7 human breast tumour cells using the Indian sponge Acanthostylotela cornuta of the Gulf of Mannar.

Methods: The crude methanol extract of A. cornuta was fractionated using a reversed phase silica gel column chromatography. The purity of the active fraction of bromopyrrole alkaloids was confirmed with Gas Chromatography-Mass Spectrometry (GCMS). The bromopyrrole alkaloids induce apoptotic changes in MCF-7 cells were studied with electrophoresis, caspase assay, and different staining analysis. The MCF-7 cells were analyzed by Flow cytometry to determine their DNA content.

Results: Bromopyrrole alkaloids of A. cornuta showed cytotoxicity against MCF-7 human breast tumour cells with the IC50 value of 8.0μg/ml. The bromopyrrole compounds induced cells exhibited scatted red fluorescence, showing the presence of several residual bodies and condensation of chromatin. Caspase-3, pro-caspase-9, caspase-9 and Poly-ADP-Ribose-Polymerase (PARP) activity were occurred in bromopyrrole alkaloids treated tumour cell. The cell cycle arrest is conceivable that the compound prevented the progression of cell cycle through the G phase resulting from inhibition of survival, leading them to undergo apoptosis.

Conclusion: Bromopyrrole alkaloids of A. cornuta possess antitumor activity which was arrested the G phase in cell cycle that clearly indicated its nature as that of antitumour drugs.
IN VITRO EVALUATION OF ANTI-CANCER POTENTIAL OF A3 ADENOSINE RECEPTOR AGONIST ON A549 HUMAN LUNG CANCER CELL LINE
Authors: Solanki Nilay D , Patel Alkesh , Patel Leena
Published: June 2019

Objective: The objective of this study was to evaluate the cytotoxic potential of A3AR agonist (ABMECA) against human lung cancer cell line A549 by using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay.

Methods: Adenocarcinoma cell line A549 was used to assess MTT based cells viability. In vitro cytotoxic activity was evaluated for 3 different concentration of doxorubicin and A3AR by MTT cytotoxicity assay. Cytotoxicity assay carried out for 3 consecutive days that involves culturing cells into Dulbecco’s MEM medium modified with 10% FBS for 24 h then treatment with different dose of standard and test drug with incubation period of 24 h followed by treatment with MTT for estimation of cytotoxicity and finally, optical density (OD) was measured at 570-630 nm.

Results: Different concentration of doxorubicin (1, 5, 10 µM) and ABMECA (10-6M, 10-5M and 10-4M) shown dose-dependent cytotoxicity. There was a significant decrease (p<0.05) in cell viability in both doxorubicin and ABMECA concentration in a dose-dependent manner. This study may guide further for in vivo evaluation of test drug in the lung cancer model.

Conclusion: A3 Adenosine Receptor agonist could be potential moiety for the treatment of lung cancer and it would require in vivo study for further research.
ANTI HYPERGLYCAEMIC AND ANTIOXIDANT ACTIVITY OF CATUNAREGAM SPINOSA (THUNB) AGAINST DEXAMETHASONE INDUCED DIABETES IN RATS
Authors: Basini Jyothi , SWETHA D. , MALLIKARJUNA G.
Published: June 2019

Objective: The study was aimed at evaluating the folkloric use of the Catunaregam spinosa (Thunb) bark for its hypoglycaemic and antioxidant activity against dexamethasone-induced diabetes in wistar rats.

Methods: Diabetes was induced in wistar rats by dexamethasone administration 10 mg/kg, b. wt., s. c for 11 consecutive days to all group animals (except Group I). After confirmation of diabetes, the animals were divided into 5 groups (n=6). Group I: Vehicle control treated with normal saline only, Group II: Diabetic control treated with dexamethasone only, Group III: Standard control treated with dexamethasone plus glibenclamide (5 mg/kg, b. wt., p. o), Group IV and V: Test control received dexamethasone plus ethanolic extract of Catunaregam spinosa (EECS) at graded doses of 200 mg/kg, b. wt. and 400 mg/kg, b. wt., p. o for 21days respectively. On the last day of the experiment, the effect of Catunaregam spinosa bark was measured by estimating the biochemical and antioxidant parameters.

Results: There was a significant alteration in the serum glucose, HbA1c, total proteins, serum lipid profile and tissue antioxidant parameters in dexamethasone-treated animals when compared to the normal control rats.

In test groups treated with glibenclamide and EECS, it was significantly ameliorated the altered parameters such as serum glucose, HbA1c, total proteins, serum lipid profile and the antioxidant parameters like SOD, CAT, GSH and MDA when compared to dexamethasone-treated animals with evidence of histopathological studies of the pancreas.

Conclusion: The results indicated that the ethanolic extract of Catunaregam Spinosa (Thunb) bark has shown the hypoglycemic and antioxidant property.
O caminho virtuoso das escolas paroquiais nas frentes agrícolas no Sul do Brasil: impactos da Lei da Nacionalização de 1938
Authors: Eidt Paulino
Published: June 2019

Vivemos em um tempo marcado por uma crise de paradigmas, em que não somente a ideia de verdade e a forma de acesso ao saber entram em crise, como também os ideais educacionais. O cenário do século XXI reclama respeito para com a diversidade e a singularidade, opondo-se à lógica da homogeneização. Ao abrir possibilidades de conciliação e mediação, rompe com antigos paradigmas da história da educação brasileira: trata-se de reminiscências que impedem que sejamos justos com o Outro. A educação no Brasil possui um histórico excludente e avesso a uma concepção laica. A lentidão no trato do ensino público contribui para a organização da escola paroquial em alguns estados brasileiros durante o século XIX e XX, que no seu ideário, possuíam elementos de segregação. A presente pesquisa teórica e documental acompanha a trajetória das escolas paroquiais nas frentes agrícolas da região Sul do Brasil e se atém mais especificamente à periodização destas no Oeste de Santa Catarina e no município de Itapiranga/SC. No final, retrata nuances da extinção destas escolas pela Lei da Nacionalização em 1938.
Distribution of Hermann’s tortoise across Serbia with implications for conservation
Authors: Golubovic Ana , Tomovic Ljiljana , Nikolic Marko , Nikolic Sonja , Andjelkovic Marko , Arsovski Dragan , Ikovic Vuk , Gvozdenovic Sladjana , Popovic Milos
Published: June 2019

Hermann?s tortoise (Testudo hermanni) is among the conservation priorities in the European Union. Consequently, it is included in Annexes II and IV of the EU Habitats Directive, Annex II of the Bern Convention, and Annex II of the CITES Convention. Hermann?s tortoise conservation programs compile insights on the threats affecting population viability, along with factors shaping the species? distribution. Serbian populations of the eastern subspecies (Testudo hermanni boettgeri) seem numerous and therefore prosperous, but recent population viability analyses revealed that they are susceptible to rapid demographic changes and/or habitat destruction. This implies the need for effective population monitoring and protection, as well as mapping and preservation of suitable habitats. In this paper we summarized current knowledge about the geographic distribution of Hermann?s tortoise in Serbia and modeled its ecological niche. Our results corroborate and uphold the known species? distribution in Serbia. Most suitable habitats are situated in the lowland areas of eastern, central and southern Serbia, under semi-open habitats, such as pastures and shrubs, broadleaf forests, and all successional stages in between. The results provided in this paper should be considered in the selection and shaping of NATURA 2000 sites in Serbia. [Projects of the
Serbian Ministry of Education, Science and Technological Development, Grant
no. 173043 and Grant no. 173025]