bluuebunny/crossref_metadata_2025 huggingface dataset:
Educating Children in Our Care
Authors: Levine Kathryn Ann , Sutherland Dawn , Janzen Melanie
Published: September 2020

In Canada, there is increasing recognition that poor educational outcomes of children and adolescents involved with the child welfare system represent an emerging crisis for youth, their families, and the broader society. Interprofessional education and collaboration between educators and social workers may facilitate better outcomes for children in care. Although interprofessional education (IPE) and interprofessional collaboration (IPC) are well established in the allied health fields, there is not an equivalent acceptance within the applied social sciences, specifically in education and child welfare contexts. This may partially be attributed to the “siloed” nature of these professions, which limits both capacity and opportunities for professionals to understand each other’s mandates, roles, and policies. The purpose of this paper is to describe the development, implementation, and evaluation of a graduate elective course for social workers and educators that was geared toward educational outcomes of children in care. Thirty-eight students from both disciplines participated in a summer institute. Although participants valued the content and process of the course, it is unclear whether these types of initiatives facilitate enhanced IPC. Findings do however suggest that IPE initiatives targeted toward a specific population may have more positive outcomes, compared to general IPC.
Ethical Deception? Responding to Parallel Subjectivities in People Living with Dementia
Authors: Carter Matilda
Published: September 2020

Many caregivers feel that they need to lie or withhold the truth from people living with dementia, but worry that, in doing so, they are violating a duty to tell the truth. In this article, I argue that withholding the truth from and, in limited circumstances, lying to people living with dementia is not only morally permissible, but morally required by a more general requirement that we treat each other as persons worthy of respect. I do so through an analysis of the groundings of the duty to tell the truth, and a critical reflection on its cognitively ableist construction.
Imagining Accessibility: Theorizing Disability in Disabled People Destroy Science Fiction
Authors: Holder Matthew
Published: September 2020

With its emphasis on futurity, its close association with scientific plausibility, and its dedicated interrogation of contemporary ideologies, science fiction stands as a genre ripe with possibilities for disability studies. Many scholars have used the genre and its texts as platforms from which to either condemn or laud representations of disability within a field explicitly concerned with a society's future. My essay contributes to this discussion by foregrounding a science fiction text to theorize what a disabled future looks like. I take as my primary text a selection of short fiction from Uncanny Magazine, an online magazine that published a disability-themed issue Disabled People Destroy Science Fiction in 2018. The stories contained are penned exclusively by authors that identify as disabled; their visions of a disabled future, then, emerge from the contemporary experience of the disabled community. In addition to centering themselves in the discourse, these writers envision a disabled future as one that emphasizes community and frequently critiques and interrogates the costs, emotional and physical, inherent in the medical model of disability, announcing that a truly disabled future is one that features rather than erases the disabled mind and body. Running with the banner of destroying SF, these writers challenge the conventional, harmful tropes that SF has perpetuated and erects in its place an inclusive, intersectional, and disabled future.
Stasis-Maintenance-(Un)productive-Presence: Parenting a Disabled Child as Crip Time
Authors: Davidson Adam W.
Published: September 2020

In what follows, I represent and analyze time as "crip time" in the context of parenting a child with disabilities. That is, I seek to challenge, reimagine, and even upend, the normalized structures that often order our lives in time and our expectations of what makes for a meaningful life in the present, and as a result, a desirable, or even possible future. Using Alison Kafer's Feminist, Queer, Crip as a foundation, in four autoethnographic accounts, recounting a typical day in my life with my 15-year-old son, I consider time as Stasis, Maintenance, (Un)productive, and Presence.
Rethinking Citizenship, Self-Help, and Disability in Local Context: Solidaridad as disability citizenship in Nicaragua
Authors: Meyers Stephen
Published: September 2020

The concept of citizenship was instrumental to the formation of the disability movement in the West by recasting disability as the denial of equal citizenship of persons with impairments. The disability movement expanded notions of citizenship by not only focusing on nondiscrimination and the protection of civil and political rights, but also the necessity of self-directed, but state-provided, social rights as prerequisite for substantive equality. With the passage of the Convention on the Rights of Persons with Disabilities, Western approaches to disability citizenship as state protected rights have globalized. Critical disability scholars are increasingly arguing that Western theories of disability, citizenship, and rights are inappropriate in local contexts in the Global South where weak welfare states are the reality. In such cases, self-help and mutual support are more determinative in the lives of disabled persons than formal rights. I extend these arguments by analyzing three grassroots disability associations in Nicaragua that assist their members achieve citizenship through self-help, service and solidaridad with the community.
Rethinking Rights, Responsibilities, and Relationships
Authors: Brueggemann Brenda , Olson Elizabeth Brewer
Published: September 2020

No abstract available.
Procedural Justice in the Courtroom: The Factor Structure and Psychometric Properties of the Revised Procedural Justice Scale
Authors: Prusiński Tomasz
Published: September 2020

In Polish psychology there has been no systematic research so far on the experience of contact with courts and on the evaluation of this experience using the theory of procedural justice. Polish psychologists do not have Polish instruments measuring procedural justice at their disposal. The Procedural Justice Scale is a measure operationalizing the dimensions of procedural justice according to Tyler’s model: respect, neutrality, voice, understanding, and influence. The aim of the present article is to present the work on the revised version of the Procedural Justice Scale, measuring procedural justice operationalized exclusively in psychological terms, and to present the psychometric properties of this scale. In particular, the author tested the reliability of the instrument and verified its validity based on confirmatory factor analysis, scale intercorrelations, and intergroup differences. The results confirmed the five-factor structure of procedural justice. They also confirmed the criterion validity of the measure, reflected in correlations with validation instruments.
Chronic abnormal uterine bleedings and quality of women’s life. How to significantly improve the result?
Authors: Н. Ю. Педаченко  , Т. М. Тутченко  , Р. А. Тухтарян
Published: September 2020

Purpose of the study: to determine the effect of iron and vitamin D subsidies on the quality of women’s life who receive pathogenetic therapy for abnormal uterine bleedings (AUB) caused by adenomyosis and/or endometrial polyps.Materials and methods. 114 patients with chronic AUB were randomized into two groups. The main group consist of 58 women, including 46 women with chronic AUB and adenomyosis (AUB-A), 12 women with adenomyosis and endometrial polyps (AUB-A,P). Women with AUB-A were prescribed 2 mg dienogest daily for the treatment of adenomyosis, similarly to patients with AUB-A,P after hysteroresection. All women in the main group also took a vitamin complex (iron, folate, iodine, vitamin D3, docosahexaenoic acid). The control group included 56 patients (43 women with AUB-A, 13 women with AUB-A,P) who were prescribed etiopathogenetic treatment (dienogest 2 mg per day and/or hysteroresection for endometrial polyps) without a vitamin complex subsidy. Quality of life was assessed using the SF-36 questionnaire. All patients received serum concentrations of hemoglobin, ferritin and 25(OH)D before and 3 months after treatment.Results. Iron-free dienogest therapy led to an increase serum hemoglobin levels after 3 months (p = 0.001). After three months vitamin complex Pregna-5 added there were significantly increased of hemoglobin levels, ferritin and 25(OH)D. This is accompanied by an improvement in the overall indicator of physical (r = 0.421, p <0.05) and psychological health (r = 0.385, p <0.05) on the SF-36 scale. An increase in serum ferritin greatly improves the psychological (r = 0.660, p <0.05) and physical components of women’s health (r = 0.522, p <0.05). Optimization of serum vitamin D levels improves physical health (r = 0.494, p <0.05). Conclusions. It is necessary to combine etiopathogenetic therapy with additional sources of vitamin D and iron for successful therapy of AUB and restoration of deficient conditions. This is significantly improves the quality of life.
The state of the fibrinolytic system in HIV-infected pregnant women and parturient women with thrombohemorrhagic risk factors
Authors: С. Є. Савченко  , О. І. Гервазюк  , Л. М. Онищик  , Ю. С. Мудра  , Г. Б. Бойко
Published: September 2020

Purpose of the study: to explore the status of the fibrinolytic system in HIV-infected pregnant women and parturient women.Materials and methods. 120 HIV-positive pregnant women with risk factors of thrombohemorrhagic complications were examined. The main group included: IA-O subgroup – 10 patients with HIV-infection stage I who received high-activity antiretroviral therapy before this pregnancy, IB-O subgroup – 20 patients with HIV-infection stage I who started high-activity antiretroviral therapy during this pregnancy, II-O – 21 pregnant women with HIV infection II clinical stage, III-O subgroup – 24 women with HIV-infection III clinical stage. Comparison group consisted of 45 patients with HIV infection without thrombohemorrhagic complications; control group consisted of 40 pregnant women and parturient women without HIV. D-dimer, soluble fibrin-monomer complexes, antithrombin III and XIIa-dependent fibrinolysis time were evaluated.Study results. In II-O and III-O subgroups there were changes of fibrinolytic system state in 18–22 weeks of pregnancy – increased D-dimer and soluble fibrin-monomer complexes, XIIa-dependent fibrinolysis time prolongation and antithrombin III decreased. With pregnancy progression the main group with HIV stage III showed a significant increase of soluble fibrin-monomer complexes and D-dimer with a tendency to XIIa-dependent fibrinolysis time reduction and antithrombin III decreasing. In all women of the main group there were thrombosis signs. In subgroup III-O there were laboratory signs of fibrinolysis activation (shortening the time of XIIa-dependent fibrinolysis) and a tendency to antithrombin III decrease. Parturient women who started taking high-activity antiretroviral therapy during this pregnancy show a slowing of the fibrinolysis processes (shortening of XIIa-dependent fibrinolysis) and a tendency to antithrombin III decrease. In IB-O subgroup there was a further suppression of fibrinolysis (prolonging the time of XIIa-dependent fibrinolysis).Conclusions. Changes in the fibrinolytic system toward suppression of the fibrinolysis process during pregnancy and it activation during labor are significantly present in HIV-infected pregnant women and in women with risk factors for thrombogemorrhagic complications.
Modern possibilities of preterm birth prediction
Authors: Hychka M. , Beniuk V. O. , Goncharenko V. M. , Dyndar O. A. , Oleshko V. F.
Published: September 2020

Purpose of the study is to improve the method of preterm deliveries onset predicting in pregnant women at 24–34 weeks.Materials and methods. 49 pregnant women with gestational age 24–34 weeks and with diagnosis of “threatening premature deliveries" were comprehensively examined using transvaginal ultrasound. Pregnant women with a shortened cervix ≤25 mm were given a qualitative determination of fetal fibronectin. The average age of pregnant women ranged from 26–34 years and averaged out 31.2 ± 0,6 years.Study results. Clinically significant structural changes in the cervix were only in 21 (42.9%) pregnant women. The average value of the cervix length varied between 16–24 mm and averaged 18.2 ± 0.4 mm. Positive test on fetal fibronectin in vaginal secretions was in 7 (33.3%) of 21 pregnant women with clinically significant structural changes in the cervix. During 10 days premature birth occurred in 3 (42.9%) of 7 pregnant women with clinically significant cervix shortening and a positive test for fetal fibronectin in the gestation period of 32 weeks. Hospitalization in an obstetric hospital was found to be unjustified in 28 (57.1%) cases.Conclusions. Combination of a comprehensive assessment of the cervix state and vaginal fetal fibronectin evaluation in pregnant women with risk of preterm deliveries at the outpatient stage allows to predict the manifestation of preterm birth in critical terms also determine the volume and direction of therapy in obstetric department. Combination of this methods help to prevent unwarranted hospitalization of a pregnant woman in an obstetric hospital and as a result it limits the conduct of glucocorticoid therapy and prevent a prolong stay of a pregnant woman in a hospital and the associated contamination with nosocomial bacteria strains.
Changes in procoagulant activity during pregnancy in women with drug addiction
Authors: Л. В. Суслікова  , І. В. Малишева  , В. В. Камінський  , К. В. Чайка  , А. В. Камінський  , А. В. Сербенюк
Published: September 2020

Objective: to study hemostatic features of procoagulant link in pregnant women with drug addiction.Materials and methods. 156 pregnant women were examined: 96 women with drug addiction (main group) and 60 pregnant women in control group. All patients tests for hemostatic system by avaluation of total fibrinogen, prothrombin by Quick, activated partial thromboplastin time, and the mother-placenta-fetus system state. Ultrasound (Doppler ultrasound) was performed to estimate of  fetoplacental complex.Results. Shifts of coagulation system to the hypercoagulation state in women with drug addiction were noted, it was manifested by an increase in fibrinogen, prothrombin by Quick and a decrease in activated partial thromboplastin time. Significant difference in these indicators was revealed in drug-dependent pregnant women compared with the control group (p <0.05). There were also changes in the mother-placenta-fetus system with doppler ultrasound, which manifested by a clinically significant deterioration in blood flow in the uterine arteries (p <0.05).Conclusions. The course of pregnancy in women with drug addiction is characterized by the development of a hypercoagulable state. It causes thrombosis, diapedetic hemorrhage. This condition without correction subsequently leads to bleeding, as a result of intrauterine growth retardation, antenatal fetus death in the worst case.Pregnant with drug addiction in the third trimester characterized hypercoagulation state, that is as indicated by an increase in fibrinogen, prothrombin by Quick and shortening of the activated partial thromboplastin time in comparison with pregnant women in the control group. A high proportion of gestational and perinatal complications was revealed in women of the main group (placental structural changes, hemodynamic disturbances of the second and third stages in the mother-placenta-fetus system and fetal growth retardation).
Effect of Cimicifuga racemosa on metabolic parameters in women with menopausal symptoms. A retrospective observational study (CIMBOLIC)
Authors: L. Friederichsen  , L. Friederichsen  , S. Nebel  , S. Nebel  , C. Zahner  , C. Zahner  , L. Bütikofer  , P. Stute  , L. Bütikofer
Published: September 2020

Purpose. To compare the influence of Cimicifuga racemosa extract (CR, Ze 450) and menopausal hormone therapy (MHT) on metabolic parameters and body weight in symptomatic menopausal women.Methods. In this monocentric retrospective cohort study, women over 40 years old with a first consultation between 2009 and 2016 were screened. Included in the final analysis were women treated with either MHT or CR and having at least one follow-up consultation. Metabolic serum parameters (lipids, glucose, insulin, and HOMA-IR), body weight, and menopausal symptoms(Menopause Rating Scale (MRS)-II) were the main outcome measures. Statistical analysis by uni- and multi-variable linear mixed-effects regression models assuming a linear effect of time.Results. 174 women were included in the final analysis (CR n = 32, MHT n = 142). There was no difference between the groups regarding baseline characteristics (age, BMI, serum metabolic parameters, hormones, and blood pressure) and total MRS-II score, while reproductive stage differed significantly with more postmenopausal women treated with CR (83%) than MHT (55%)(p = 0.038). Median follow-up time was 12 months. In both groups, metabolic serum parameters and body weight did not change over the follow-up period, while total and MRS-II subscores improved.Conclusion. Menopausal symptoms improved significantly in both groups (MHT and CR), while serum metabolic parameters and body weight did not change in MHT- or CR-treated women.
Modern uterotonics: vitally required and dangerous... Literature review
Authors: Е. Н. Носенко
Published: September 2020

Uterotonics are widely used in obstetrics for pre-induction and induction of labor, for prevention and treatment of postpartum hemorrhages. Oxytocin, carbetocin and misoprostol are used as uterotonic agents for prevention of postpartum hemorrhages. Oxytocin, ergometrine, syntomethrin and misoprostol are used for treatment of postpartum hemorrhages. Subject to the principle of active management of the third stage of labor, prophylactic use of uterotonics reduces the postpartum hypotonic bleeding risk by 60%.This review provides current data on the pharmacokinetics, doses, modes of use and possible complications of oxytocin drugs, prostaglandin E1 and E2 analogues, ergot alkaloids in obstetric practice. International consensus statement on the use of uterotonic agents during caesarean section (2019) are presented, taking into account the differences between their dose for planned and urgent Caesarean section.In addition to the uterotonic effect of oxytocin it has parasympathetic neuromodulation, vasodilation, negative inotropic and chronotropic effects, lowers blood pressure, and in large doses and fast administration can have a negative effect on the fetus. The author emphasizes that uterotonics of the second row should be considered as early as possible if the oxytocin/carbetocin does not give a good uterine tone, but remember that the combined use of oxytocin with ergometrine increases the risks of cardiac complications.Methylergometrine can lead to an increase in central venous pressure, as well as an increase in blood pressure, in some cases it can provoke ischemia and necrosis of the heart muscle.Misoprostol is used for labor pre-induction, induction and for prevention and off-label treatment of postpartum bleeding. Misoprostol increases the risk of uterine hyperstimulation and increased heart rate in fetus, and the mother's body temperature rises. Therefore the key to the effectiveness and safety of uterotonics is the correct use of the method, dose, route and administration speed, taking into account indications and contraindications, careful monitoring of the condition of pregnant woman, fetus, woman in childbirth, compliance with the recommended storage conditions for drugs.
Treatment experience of late acne in active reproductive aged women
Authors: Т. В. Проценко  , А. Б. Гордийчук
Published: September 2020

Current guidelines of acne treatment are not effective in different women. Dissatisfaction with the esthetic results of treatment creates the need to optimize the treatment of late acne in active reproductive aged women.Objective of the study: to evaluate the effectiveness of developed comprehensive method for the treatment of late acne in active reproductive aged women.Materials and methods. 32 patients with acne tarda aged 25–40 years were examined and treated, including women with acne of I degree of severity – 18.8%, II degree – 30.6%, III degree – 46.8%. Biophysical parameters of skin (fat, moisture, elasticity and erythema degree) were determined before treatment, after 3 and 6 months and expressed in arbitrary units. The control group consisted of 8 conditionally healthy women of the corresponding age without acne. Treatment efficacy was evaluated in 3 comparison groups: group 1 – 10 patients who received conventional therapy; group 2 – 12 patients in whom traditional therapy was combined with combined oral contraceptive (COC) Belara, group 3 – 10 patients in whom traditional therapy was combined with COC Belara and Richter CycloBalance.Results. A comparative analysis of the inflammatory dynamics (papules, pustules, nodes, cysts) and non-inflammatory rash elements (open and closed comedones), skin biophysical parameters (fat, porosity, hydration, erythema, elasticity) before treatment, after 3 and 6 months of therapy showed the advantage of combined use COC Belara and Richter CycloBalance in the complex treatment of late acne in active reproductive aged women.Conclusion. Complex therapy of late acne in active reproductive aged women with COC Belar and Richter CycloBalance increases the effectiveness of therapy and aesthetic skin status.
Vaginal discharge syndrome. Problem with many unknowns
Authors: Т. Ф Татарчук  , Л. В. Калугіна  , Г. А. Петрова  , В. В. Радченко  , В. В. Шаверська  , А. М. Сорокіна  , О. В. Смирнова
Published: September 2020

The main reason for visiting an obstetrician-gynecologist is the vaginal discharge syndrome (VDS) of infectious etiology. The most common causes of infectious vaginitis wich are identifed by European researchers are bacterial vaginosis (BV), aerobic vaginitis, vulvovaginal candidiasis and mixed infections. Treatment of VDS is a serious problem not only because of the pathogens’s resistance and frequent recurrences, but especially due to the COVID-19 pandemic which can complicate further patient`s examination for determination of infectious agent and the choice of individual approach to etiotropic therapy.Purpose of study: to investigate the structure of causes of pathological vaginal discharge in Ukrainian women, as well as assess the compliance and effectiveness of their treatment.Methods: 472 doctors of women's consultation centres, gynecological hospitals and centers of reproductive medicine from 23 regions of Ukraine were enrolled in multi-center study of vulvovaginal infections management. During the study, which lasted from August to December 2019, were examined 45,295 patients aged 18 to 59 years who complained for pathological vaginal discharge.Results: analysis of the structure of nosologies that caused VDS showed that the examined patients were most often diagnosed with BV (41.1%), colpitis of mixed etiology (26.59%) and vulvovaginal candidiasis (19.22%), trichomoniasis was confirmed in 8.44%. The interviewed gynecologists preferred topical therapy in 95,99% cases of BV and colpitis of mixed etiology. Topical combined medications were prescribed in 85,21% of cases, monoforms – in 14.79%. Among the combined vaginal dosage forms the combination of metronidazole 750 mg /miconazole 200 mg was preferred in 48.81% of cases with clinical efficacy 87.1% in patients with BV and 86,9% in women with mixed infection. Normalization of the vaginal biocenosis was observed in 93.50% of the examined patients. The study demonstrated the safety, good tolerability and compliance of patients to therapy with the combined medications metronidazole 750 mg / miconazole 200 mg in vaginal suppositories.Conclusion: BV, colpitis of mixed etiology and vulvovaginal candidiasis are predominated in structure of main causes of VDS in Ukraine. In the treatment of VDS, priority is given to vaginal forms with the most compliant (89.8%) regimen: once a day for a short period (7 days). The obtained high bacteriological (93.50%) and clinical (86,9%) efficacy of therapy of BV and vaginal mixed infections with the combined drug metronidazole 750 mg / miconazole 200 mg allows to recommend it as the drug of choice.
Inventário Turístico: constatações e considerações
Authors: Moraes Claudia Corrêa de Almeida , Fogaça Isabela Fátima , Lidízia Soares Carlos Alberto
Published: September 2020

Entre 2015 e 2017, no Estado do Rio de Janeiro, foi desenvolvido por duas instituições públicas, a Secretaria de Turismo do Estado do Rio de Janeiro (SETUR RJ) e a Universidade Federal Fluminense (UFF), um projeto de Inventariação da Oferta Turística (IOT-RJ) em 23 municípios que participavam do Programa Regional de Desenvolvimento do Turismo do Rio de Janeiro (PRODETUR RJ). O projeto apontou para alguns aspectos positivos e para fragilidades que levaram a reflexão sobre as vantagens e limitações das metodologias empregadas, os sucessos e percalços na organização da pesquisa e a alimentação e divulgação dos dados. Apesar dos avanços tecnológico e dos resultados positivos obtidos, a experiência apontou para limitações, especialmente quanto a logística, ao uso da tecnologia, a disposição dos dados finais, a divulgação e a compreensão por parte dos usuários dos inventários, de seu valor no processo decisório de planejamento do turismo e necessidade de atualização constante.Palavras chave: Inventário da oferta turística; PRODETUR; IOT-RJ; Rio de Janeiro.
Editorial
Authors: Fratucci Aguinaldo Cesar , Moraes Claudia Corrêa de Almeida , Lidizia Soares Carlos Alberto
Published: September 2020

Editorial do Dossiê: Experiências e reflexões sobre o projeto de inventário da oferta turística do estado do Rio de Janeiro (IOT-RJ) 2014-2019
Interações de Sheldon Cooper no episódio piloto de “Big Bang: a Teoria”: análise conforme a Teoria da Relevância
Authors: Rauen Fábio José , Michels João Augusto Campos
Published: September 2020

Analisamos neste artigo processos ostensivo-inferenciais em interações comunicacionais da personagem Sheldon Cooper na versão dublada do episódio piloto da Série “Big Bang: a Teoria” a partir do ponto de vista da teoria da relevância de Sperber e Wilson. Para dar conta desse objetivo, aplicando o mecanismo de compreensão orientada pela noção de relevância, encaixamos os enunciados das personagens em formas lógicas e desenvolvemos as respectivas explicaturas e implicaturas sempre que necessário. Os resultados sugerem pistas de expertise em relações sociais dissonantes das características que definem a personagem no decorrer da série como alguém com graves problemas de empatia, arrogância intelectual, intolerância à ignorância intelectual alheia e parca compreensão de ironias e sarcasmos.
Efeito racional e efeito emocional: um estudo pragmático da cognição humana
Authors: Dos Santos Sebastião Lourenço , Godoy Elena
Published: September 2020

O interesse pela influência das emoções sobre a linguagem humana remonta à Grécia antiga, sendo que, ao longo da história, a dicotomia corpo/mente mostrou-se bastante aguda, principalmente na Filosofia, com Espinosa, Santo Agostinho, Kant e Descartes, para quem as emoções seriam sinal de distúrbio e uma mente sadia seria aquela que estivesse livre das paixões. Tomando como referência a Teoria da Relevância (SPERBER; WILSON, 2001), emparelhada aos estudos de Damásio (1994, 2004), o objetivo deste estudo é advogar em favor de uma integração mental que congrega razão e emoções na interpretação discursiva. A motivação que norteia o estudo parte do pressuposto de que, na interpretação de enunciados conversacionais, o efeito do significado interpretado não é apenas um produto da razão, mas é também, em alguma medida, afetado pelas emoções e sentimentos. As conclusões apontam para a ideia de que o desejo é o gatilho mental disparador do processo inferencial humano
A construção da identidade do usuário em chamadas para serviços telefônicos de empresas públicas do Uruguai
Authors: Gabbiani Beatriz
Published: September 2020

O presente trabalho se insere na sociopragmática que, conforme Leech (1983), ocupa-se da forma com que os interlocutores constroem suas crenças sobre valores sociais e culturais relevantes. O objetivo central foi verificar a interação entre os clientes e fornecedores de serviços de teleatendimento de duas empresas estatais do Uruguai (UTE e OSE – fornecedores de luz e saneamento), a fim de comparar, pelo histórico de reclamações registradas, as formas de tratamento utilizada por cada estatal, a partir da análise de dois aspectos elementares: as diferenças culturais que regem a forma de tratamento empregada por cada uma das empresas e o resultado da interação comunicativa em cada caso analisado.
The Analysis of Serum Vitamin D (25[OH]D) Level in Psoriasis Patients Comparing with Control Subjects
Authors: Fernandes Ade , Listiawan Muhammad Yulianto , Ervianti Evy , Setyaningrum Trisniartami
Published: September 2020

Background: Vitamin D has been shown to have an immunomodulatory effect, and previous studies have proven that vitamin D deficiency contributed to several autoimmune diseases, including psoriasis. Purpose: The purpose of this study was to determine serum vitamin D levels in psoriasis vulgaris patients and compare them with control subjects. Methods: The research samples were sixteen adults with psoriasis vulgaris and 16 control subjects. Blood samples were taken, and the serum 25 (OH) D levels were measured using the Chemiluminescent Microparticle Immunoassay method. Result: The mean serum vitamin D in psoriasis vulgaris patients and controls were 14.36 ± 6.36 and 19.92 ± 7.59 ng/mL, respectively. No psoriasis vulgaris were observed in patients with normal 25(OH)D levels, and only 3 control subjects with normal serum 25(OH)D levels. These results were not statistically significant (p = 0.09). Conclusion: Most patients with psoriasis vulgaris were observed having vitamin D deficiency. However, the prevalence of vitamin D deficiency in the control subjects was high as well. Therefore, there were no differences in serum 25(OH)D levels between psoriasis vulgaris and control patients.
The Correlation Between Lipid Profile and Xanthelasma
Authors: Kampar Puridelko
Published: September 2020

Background: Xanthelasma is an abnormal lipid deposition on palpebrae, which is observable as yellowish plaque or nodules. Its incidence is 0.56–1.5% with onset of 15–73 years old and mostly occurs in the fourth and fifth decade. Few reports of xanthelasma did not cover the correlation between lipid profile and xanthelasma in Indonesia. Purpose: To find a correlation between lipid profile with xanthelasma in Dr. M. Djamil Hospital, Padang. Methods: This was an analytic cross-sectional study with consecutive sampling. There were 36 participants (18 xanthelasma and 18 control). Result: The highest age group was >36 - ≤45 years old (38.89%). More cases were observed in female (66.67%). Body mass index examination of xanthelasma revealed that most were overweight (55.56%). Grade I xanthelasma was the most common (72.22%). The cholesterol serum level of xanthelasma patients was higher than the subject controls (224.61±29.77 mg/dl versus­ 169.39±35.84 mg/dl) (p<0,05). The High Density Lipoprotein (HDL)  serum level of xanthelasma patients was lower than controls (46.44±14.19 mg/dl versus 51.78±15.9 mg/dl) (p>0,05). The Low Density Lipoprotein (LDL) serum level of xanthelasma patients was higher than control (139.39±29.73 mg/dl versus 106.50±35.43 mg/dl) (p<0,05). Triglyceride serum level of xanthelasma patients was higher than the controls (167.83±87.26 mg/dl versus 121.61±54.52 mg/dl) (p>0,05). Conclusion: There was a correlation between higher cholesterol and LDL serum level with xanthelasma. No correlation between lower HDL and a higher triglyceride serum level with xanthelasma.
THE SIMILAR CHANGES OF GLUCOSE LEVELS BEFORE AND AFTER MODERATE INTENSITY EXERCISE ACUTELY IN THE MORNING AND NIGHT
Authors: Kamal Ronik Harsono , Wigati Kristanti Wanito , Lefi Achmad
Published: September 2020

Background: There is a lot of research on the importance of exercise but studies on the effective time of exercise regarding regulation of blood glucose levels are not clearly known. Objective: This study aims to determine the comparison of changes in blood glucose levels before and after moderate intensity physical exercise in the morning and night. Material and method: Healthy men (n=34), Age between 17-22 years, Body Mass Index (BMI) between 18.5-22.9 kg/m2 (normal Asia Pacific), participating in the morning group (8.00 am) or the night group (20.00 pm) are asked to do moderate intensity physical exercise (55-70% of maximum heart rate) using ergocycle for a total of 40 minutes. Blood glucose levels 2 hours post prandial capillaries are taken before exercise and blood glucose levels after exercise are taken acutely. Result: The mean decrease in blood glucose levels in the morning group was -8.353±9.16 mg/dL and in the night group was -6.294±10.10 mg/dL. Blood glucose levels decreased significantly for the morning group (p=0.002) and the night group (p=0.021). The comparison of changes in blood glucose levels between the morning and night groups was not significant (p=0.538). Conclusion: There is no difference between morning or night exercise related to changes in blood glucose levels.
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: September 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.
Identification of major depressive disorder disease-related genes and functional pathways based on system dynamic changes of network connectivity
Authors: Geng Ruijie , Huang Xiao
Published: September 2020

Objective: Major depressive disorder (MDD) is a leading psychiatric disorder that involves complex abnormal biological functions and neural networks. This study aimed to compare the changes in the network connectivity of different brain tissues under different pathological conditions, analyzed the biological pathways and genes that are significantly related to disease progression, and further predicted the potential therapeutic drug targets.Methods: Expression of differentially expressed genes (DEGs) were analyzed with postmortem cingulate cortex (ACC) and prefrontal cortex (PFC) mRNA expression profile datasets downloaded from the Gene Expression Omnibus (GEO) database, including 76 MDD patients and 76 healthy subjects in ACC and 63 MDD patients and 63 healthy subjects in PFC. The co-expression network construction was based on system network analysis. The function of the genes was annotated by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Human Protein Reference Database (HPRD, http://www.hprd.org/) was used for gene interaction relationship mapping.Results: We filtered 586 DEGs in ACC and 616 DEGs in PFC for further analysis. By constructing the Co-expression network, we found that the gene connectivity was significantly reduced under disease conditions (P=0.04 in PFC and P=1.227e-09 in ACC). Crosstalk analysis showed that CD19, PTDSS2 and NDST2 were significantly differentially expressed in ACC and PFC of MDD patients. Among them, CD19 and PTDSS2 have been targeted by several drugs in the Drugbank database. KEGG pathway analysis demonstrated that the function of CD19 and PTDSS2 were enriched with the pathway of Glycerophospholipid metabolism and T cell receptor signaling pathway. Conclusion: Co-expression network and tissue comparing analysis can identify signaling pathways and cross talk genes related to MDD, which may provide novel insight for understanding the molecular mechanisms of MDD.
The misdiagnosis of prolonged disorders of consciousness by a clinical consensus compared with repeated Coma-Recovery Scale-Revised assessment
Authors: Wang Jing , Hu Xiaohua , Hu Zhouyao , Sun Ziwei , Laureys Steven , Di Haibo
Published: September 2020

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high rates of misdiagnosis by clinical consensus. The aim of this study was to investigate the proportion of misdiagnosis by clinical consensus compared to repeated behavior-scale assessments in patients with prolonged disorders of consciousness (DOC).Methods: Patients with prolonged DOC during hospitalization were screened by clinicians, and the clinicians formed a clinical-consensus diagnosis. Trained professionals used the CRS-R to evaluate the consciousness levels of the enrolled patients repeatedly (≥5 times) within a week. Based on the repeated evaluation results, the enrolled patients with prolonged DOC were divided into unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS), and emergence from MCS (EMCS). Finally, the relationship between the results of the CRS-R and the clinical consensus were analyzed.Results: In this study, 137 patients with a clinical-consensus diagnosis of prolonged DOC were enrolled. It was found that 24.7% of patients with clinical UWS were actually in MCS after a single CRS-R behavior evaluation, while the repeated CRS-R evaluation results showed that the proportion of misdiagnosis of MCS was 38.2%. A total of 16.7% of EMCS patients were misdiagnosed with clinical MCS, and 1.1% of EMCS patients were misdiagnosed with clinical UWS. Conclusions: The rate of the misdiagnosis by clinical consensus is still relatively high. Therefore, clinicians should be aware of the importance of the bedside CRS-R behavior assessment and should apply the CRS-R tool in daily procedures. Keywords: Coma-Recovery Scale-Revised, Disorders of consciousness, Unresponsive wakefulness syndrome, Minimally conscious state, MisdiagnosisTrial registration: ClinicalTrials.gov ID: NCT04139239; Registered 24 October 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04139239
New vectors in northern Sarawak, Malaysian Borneo, for the zoonotic malaria parasite, Plasmodium knowlesi
Authors: De Ang Joshua Xin , Kadir Khamisah Abdul , Mohamad Dayang Shuaisah Awang , Matusop Asmad , Divis Paul Cliff Simon , Yaman Khatijah , Singh Balbir
Published: September 2020

Background: Plasmodium knowlesi is a significant cause of human malaria in Sarawak, Malaysian Borneo. Only one study has been previously undertaken in Sarawak to identify vectors of P. knowlesi, where Anopheles latens was incriminated as the vector in Kapit, central Sarawak. A study was therefore undertaken to identify malaria vectors in a different location in Sarawak.Methods: Mosquitoes found landing on humans and resting on leaves over a 5-day period at two sites in the Lawas District of northern Sarawak were collected and identified. DNA samples extracted from salivary glands of Anopheles mosquitoes were subjected to nested PCR malaria-detection assays. The small subunit ribosomal RNA (SSU rRNA) gene of Plasmodium was sequenced, and the internal transcribed spacer 2 (ITS2) and mitochondrial cytochrome c oxidase subunit 1 (cox1) gene of the mosquitoes were sequenced from the Plasmodium-positive samples for phylogenetic analysis.Results: Totals of 65 anophelines and 127 culicines were collected. By PCR, 6 An. balabacensis and 5 An. donaldi were found to have single P. knowlesi infections while 3 other An. balabacensis had either single, double or triple infections with P. inui, P. fieldi, P. cynomolgi and P. knowlesi. Phylogenetic analysis of the Plasmodium SSU rRNA gene confirmed 3 An. donaldi and 3 An. balabacensis with single P. knowlesi infections, while 3 other An. balabacensis had two or more Plasmodium species of P. inui, P. knowlesi, P. cynomolgi and some species of Plasmodium that could not be conclusively identified. Phylogenies inferred from the ITS2 and/or cox1 sequences of An. balabacensis and An. donaldi indicate that they are genetically indistinguishable from An. balabacensis and An. donaldi, respectively, found in Sabah, Malaysian Borneo. Conclusions: Previously An. latens was identified as the vector for P. knowlesi in Kapit, central Sarawak, Malaysian Borneo, and now An. balabacensis and An. donaldi have been incriminated as vectors for zoonotic malaria in Lawas, northern Sarawak.
Predictors of Poor Postoperative Outcomes in Pediatric Surgery Patients in Rural Ghana
Authors: Peiffer Sarah , Ssentongo Anna E. , Keeney Laura , Amponsah-Manu Forster , Yeboako Richard , Ofosu-Akromah Richard , Arkorful Temitope Ebenezer , Agyemang Eric , Tsai Anthony , Oh John , Ssentongo Paddy
Published: September 2020

Background/Purpose: Perioperative complications cause significant pediatric morbidity and mortality in low- and lower middle -income countries. This study investigates factors associated with prolonged length of stay, 90-day readmission and in-hospital mortality among pediatric patients at Eastern Regional Hospital (ERH) in Ghana. Methods: This is a retrospective review of perioperative morbidity and mortality in children <18 years at ERH in Koforidua, Ghana. All pediatric surgeries performed between January 2015 and December 2017 were included in this study. Univariate analysis was performed using Pearson’s chi-square tests or Fisher’s exact tests. Variables that were significant on univariate analysis were included in multivariable logistic regression models adjusted for age and gender.Results: We analyzed 468 patients <18 years of age with a median length of stay (LOS) of 3 days. The 90-day readmission and in-hospital mortality rates were 138 and 17 per 1000 patients, respectively. The most common procedures were herniorrhaphy (19%) and appendectomy (15%). Gastrointestinal surgery, surgical trauma, surgical infection and lack of insurance were significantly associated with prolonged LOS. Young age and female gender were significantly associated with in-hospital mortality. Malaria was significantly associated with 90-day readmission. Conclusions: Malaria infection is a significant risk factor for readmission, which should be investigated and treated in pediatric surgical patients in rural Ghana. Ensuring that all patients have insurance may result in shorter hospital stays. Provision of laparoscopic equipment may reduce hospital stays for patients undergoing gastrointestinal surgery. Expansion of the surgical work force, particularly pediatric surgeons, could improve perioperative survival in the very young population.
Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol
Authors: delmas philippe , fiorentino Assunta , antonini matteo , Vuilleumier severine , Stotzer guy , Kollbrunner Aurélien , Jaccard Dominique , Hulaas Jarle , Rutschmann Olivier , simon josette , Hugli Olivier , de Keranflec’h Charlotte Gilart , pasquier jerome
Published: September 2020

Background: The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/Design: A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A: noise, B: task interruptions, C: noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within two hours. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion: Study results will inform the design of large-scale investigations and will help identify teaching, training and research areas that require further development.
The effect of the Presence of Children on Adult Smoking Behaviour: Empirical Evidence Based on China Family Panel Studies
Authors: LIN Haoxiang , Chang Chun , LIU Zhao , Tan huaqing
Published: September 2020

Background: Despite a number of studies linking family and marriage factors with health behaviour, the effects of children on the health behaviour of parents are still understudied. This study explored the association between the presence of children and adults’ smoking behaviours. Methods: This study used panel data from the China Family Panel Studies 2010 and 2012, and the data set included 23157 households and 45513 adults. Logistic regression was performed to analyse the association of the presence of children on adults’ smoking behaviours. Subgroup regression was used to examine heterogeneous effects. Results: Full sample regressions showed that the number of children was significantly inversely associated with smoking behaviour (OR=0.93; 95% 0.90-0.96). Further subsample regression finds that such effect is only significant among the high-education group (OR= 0.92; 95% 0.87-0.97), high-skill workers (OR= 0.89; 95% 0.80-0.99) and couples who had an age gap greater than 2 years (OR=0.91; 95% 0.88-0.95). Conclusions: Our findings confirm the existence of the upward intergenerational effect of the presence of children on adults’ smoking behaviour in China. However, such effects are not equal across all demographic characteristics. Future research could explore other parts of the upward mechanism and possible pathways for a stronger effect. In resource-poor areas, targeting cessation activities at those who have children at an early age may be an effective strategy.