bluuebunny/crossref_metadata_2025 huggingface dataset:
Herstory in Young Adult Fiction by Joanna Rudniańska Based on the Examples of „Rok Smoka” and „Kotka Brygidy”
Authors: Slany Katarzyna
Published: October 2020

The paper discusses young adult fiction by Joanna Rudniańska, whose works belong to the stream of non-conformist coming-of-age novels marked by experiences of exclusively teenage girls/women, developing in Poland since the 1990s. Both Rok Smoka and Kotka Brygidy emphasise the personal quality of teenage girls and women, and present their fates with a particular consideration of their fairly individualised processes of maturation and intentional development of their identities. The author of this paper employs feminist methodologies to emphasise the ambivalent, borderline, and negative female experiences in the analysed texts. She offers a detailed interpretation of how the protagonists of the above-mentioned novels experience the world; she applies a metaphorical and fantastic perspective of telling herstories, while searching for matrilineal traces, the phenomenon of sisterhood, drastic rituals inscribed in the feminine domain, and the special kind of coming-of-age which constitutes the starting point for personal and subjective herstories.
Zbigniew Herbert’s Journeys to the South. A Conversation with Andrzej Franaszek and Francesco Matteo Cataluccio, Conducted by Krystyna Pietrych (during the discussion panel at the 12th ‘Puls Literatury’ Festival in Łódź, 8 December 2018)
Authors: Cataluccio Francesco Matteo , Franaszek Andrzej , Pietrych Krystyna
Published: October 2020

The topic of a conversation of three literary scholars which took place in the last months of the Zbigniew Herbert Year (2018) is the experience recorded in the poet’s poems and essays of the Mediterranean culture, antiquity as a tool of cognition, an important code as well as the experience of his real journeys to the south of Europe being a kind of dividing line in his literary output and resonating in it.
“A novel that does not uncover a hitherto unknown segment of existence is immoral”. A Conversation with Marek Bieńczyk on Milan Kundera’s Works (Conducted by Olga Żyminkowska)
Authors: Bieńczyk Marek , Żyminkowska Olga
Published: October 2020

The interview with Marek Bieńczyk covers, in general, the subject of the philosophy of novel by Milan Kundera and the reception of his works nowadays in Poland and abroad. Marek Bieńczyk – the French translator of Milan Kundera’s novels – talks about the history of his first translations and the beginnings of scientific thinking about Kundera. Moreover, he explains the problems connected with Kundera’s authorial and elaborate philosophy of novel: the conception of narrator, hero and composition. Bieńczyk also narrates his own memories with M. Kundera. What is more, he indicates the inspirations he draws in his own work from innovative prose by Czech novelist, who is celebrating his 91st anniversary this year.
‘The translator’s extraordinary artistry’. An Interview with Magdalena Heydel, Conducted by Karolina Król
Authors: Król Karolina
Published: October 2020

The interview focuses mostly on Stanisław Barańczak’s methods of translation and his translation oeuvre. Similarities between Polish and American literary life also play a significant role in the text. Another important issue is Barańczak’s and Czesław Miłosz’s correspondence which has not been fully published and remains stored in Beinecke Library archives.
HEAVY METALS CONTENT (Ba, La, Ce) IN THE SOILS OF CHEREPOVETS TECHNOGEACHEMICAL ANOMALY
Authors: Vodianitsky Yu. , Savichev A. , Rogova O.
Published: October 2020

With the help of X-ray radiometric method modified for diagnostics of superheavy metals Ba, La, Ce, their content in soils of Cherepovets geochemical anomaly is studied. Values Ultra-heavy metal technogeneities reach their maximum nearness of the Severstal mill. This is especially true for La and Ce, the share of whose technogenicity reaches up to 30-43%. This reflects the accumulative nature of the profile distribution of La and Ce, while in the background areas in humidal landscapes the distribution is eluvial.
GENESIS, GEOGRAPHY OF NANOSCOPIC MATTER AND ITS IMPORTANCE FOR FERTILITY AND ECOLOGICAL FUNCTIONING OF SOILS
Authors: Gradusov B.
Published: October 2020

The questions of using the concepts and methods of nanoscopic research in soil science are considered. These include the concept of nanoscopic particles, fundamental features of nanoscopic substances, genesis and geography of a large number of minerals with pronounced nanoscopic properties in soils. A number of regularities of nanoscopic minerals placement in soils of Russia and neighboring countries have been revealed. The differences between the main soil types from a nanoscopic point of view. The problem of introduction of nanoscopic research methods in soil science is discussed, and the prospects of using nanosized minerals and formations in improvement of land productivity, including fertilizer production and reclamation, as well as assessment of environmental situations, and design of soil protection measures.
IMPACT OF AGROMETEOROLOGICAL CONDITIONS TO CHANGE OF PROPERTIES OF THE RECLAIMED SOLONETZES IN THE DRY STEPPE ZONE
Authors: Lyubimova I. , Aksenov A. , Gorobets A.
Published: October 2020

Estimation of the impact of weather conditions on the change in the content of readily soluble salts and metabolic bases and humus in the reclaimed automorphic high-carbonate solonetzes of the dry-steppe zone at different of types of meliorative effects. The given results of researches show that weather conditions first of all render effects on rapidly changing soil properties, such as readily soluble salt content and exchangeable elements. There is no evidence of reliable correlations between humus content and weather conditions. Directionality and the share of the impact of climate indicators on different properties of reclaimed solonetzes is different, but in most cases it's is less than 30% of the share of influence of other factors.
CHANGES IN THE MICROSTRUCTURE OF SOLONETZES DURING IRRIGATION
Authors: Tursina T. , Lukyanov I.
Published: October 2020

Changes in the microstructure of steppe and meadow-steppe solonetzes of the Caspian Sea, occupying flattened elevated micro-relief elements in the three-dimensional soil complex in the area of chestnut soils in the area of the Kislovskaya irrigation system, under the influence of irrigation on the background of planning and gypsum plastering are described. Loss of aggregated humus material during the planning of saline soils is the cause of low structural properties of irrigated saline soils. Their development requires the introduction of meliorants, changes in the microstructure of solonts during gypsum plastering are shown.
MINERALOGICAL COMPOSITION OF ELUVIAL-GLEY ZHELTOZEMS AS EXEMPLIFIED BY SOILS OF THE ARBORETUM IN SOCHI CITY
Authors: Chizhikova N. P. , Gurov I. A.
Published: October 2020

The composition of fine-dispersed fractions (<1, 1-5 5-10 mkm) extracted from zheltozems located in the northern part of humid-subtropical zone in the North-Western Caucasus is represented by clay and accompanying minerals,  which have been fixed earlier in weathering crusts and their derivates characteristic of the given natural zone. The clay  fraction consists of a set of mixed-layer minerals, in which chlorite-vermiculite and mica-smectite are dominating within the soil profile. Hydromicas of dioctahedric type and kaolinite are subordinates. In the course of soil formation the  profile became differentiated according to the content of the fraction < 1 mkm and the composition of minerals in it. In the  eluvial part of the profile the individual smectite is absent but hydromicas, kaolinite, chlorite-vermiculite reveal  accumulation. Among destruction products the lepidocrocite is segregated in the AYEL horizon to a considerable extent.. The 1-5, 5-10 mkm fractions are evenly distributed, quartz is dominated.
Soil classification is not quite in place for discussion
Authors: Rozhkov V. A.
Published: October 2020

As the theory and mathematical methods have been so far introduced insufficiently into elaborating the soil classification nowadays, an attempt is made to demonstrate some available approaches. An aphoristic title of this paper is used not to dethrone an “aristocratic” pattern of this significant problem that has being constantly discussed in soil science but to show how the up-to-date means of informatics allow solving numerous tasks related to the elaboration, investigation and utilization of classification structures based upon a description of soil objects. The research in preparing any classification should be carried out in the way described in this paper in order to consider it as complicated and open for discussion, investigation and further development.
The using pilotless vehicle pictures for urban ecosystem soil-vegetable cover ecological condition estimating
Authors: Gorokhova I. N. , Borisochkina T. I. , Shishkonakova E. A.
Published: October 2020

A soil-environmental analysis of the urbanized ecosystem represented by the key site “Kurilovo” in New Moscow has been made using the images obtained by pilotless air-craft and modern GIS-technologies. In the course of this study the decoding of remote materials and field soil survey were conducted to describe the vegetation and soils; the geochemical analysis of soil samples was made with the aim at compiling an electronic ecological map of the area under study. These studies allowed us to specify the boundaries of the key area, to evaluate the vegetation and soil status in forests, residential and industrial areas as well as to identify the areas covered by contaminated soils.
Perfil e funcionamento de comitês municipais de prevenção da mortalidade materna, infantil e fetal
Authors: Lodi Gabriela Souza França , Lima Ediene Dayane , Ribeiro Liliane Da Consolação Campos , Guedes Helisamara Mota
Published: October 2020

Objetivo: Analisar os comitês municipais de prevenção da mortalidade materna, infantil e fetal das regiões de saúde de Sete Lagoas e Curvelo- Minas Gerais quanto ao perfil dos seus membros e funcionamento. Método: Estudo de corte transversal em 35 comitês dos municípios jurisdicionados à Superintendência Regional de Saúde de Sete Lagoas. Foram aplicados questionários para as referências técnicas e secretários municipais de saúde, sendo a análise dos dados realizada por meio de estatística descritiva. Resultados: Encontrou-se formação predominante em enfermagem, média de idade acima de 30 anos e tempo no cargo superior a quatro anos. A maioria dos municípios possui comitê implantado, oficializado e atuante, mas muitos não realizam cronograma, nem registro das reuniões. Foram encontradas fragilidades no funcionamento, como inexistência de discussão entre os membros, não correção da causa básica do óbito, falta de divulgação dos dados e dos relatórios e ausência de atividades de mobilização social. Dentre os entraves, os mais citados foram: dificuldade de acesso a documentos para a investigação, falta de suporte da Superintendência Regional de Saúde e necessidade de capacitação. Conclusão: Existe a necessidade de qualificação das ações dos comitês, objetivando o aumento da sua efetividade na redução da mortalidade materna, infantil e fetal.
Interface entre saúde e educação no processo de inclusão escolar
Authors: De Souza Meriele Sabrina , De Souza Rhillary Lorrayne , De Paula Nayara Cristine Protte , Braga Patrícia Pinto
Published: October 2020

Objetivo: Analisar como se configura a articulação entre profissionais da educação, da saúde e familiares no processo de inclusão

escolar. Método: Estudo qualitativo interpretativo, orientado pelo referencial de Boaventura de Sousa Santos que contou a com

participação de 43 entrevistados. As entrevistas guiadas por roteiro semiestruturado foram submetidas à análise de conteúdo.

Resultados: A análise permitiu identificar três categorias: a família no contexto da inclusão escolar e a relação com a escola; a

atenção à criança no Sistema Único de Saúde na perspectiva dos profissionais da educação e a desarticulação entre profissionais da

educação e da saúde. Conclusão: Há ausência de interação entre a enfermagem e outros profissionais de saúde com a educação.

Na perspectiva dos profissionais da educação e dos cuidadores, as dificuldades relacionadas aos atendimentos de saúde no SUS,

como a demora dos procedimentos e a falta de especialistas, constituem-se em desafios para o processo de inclusão, considerando

que conhecer a condição da criança é um aspecto que favorece adaptações ao seu processo de aprendizagem. Os profissionais

reconhecem que, no cenário de investigação, a articulação entre profissionais da educação e da saúde poderia contribuir,

consideravelmente, para o aprendizado infantil. Entretanto este estudo ressalta a importância da atuação do enfermeiro no

cenário da inclusão escolar com equipe multidisciplinar.
O PORTO COMO INTEGRANTE DA CADEIA LOGÍSTICO-PORTUÁRIA: UM ESTUDO DE CASO EM SC
Authors: Luz Evandro Moritz , Taboada Rodriguez Carlos Manuel
Published: October 2020

O objetivo deste trabalho é identificar o porto como um integrante de uma cadeia logístico-portuária de produtos refrigerados e/ou congelados no Estado de Santa Catarina. Nos procedimentos metodológicos utiliza-se elementos de estudo de caso aplicado em SC, e como instrumento de pesquisa utiliza-se um questionário para legitimar a proposta de reconhecer na cadeia o porto como um integrante, com experts no setor. Os objetivos propostos foram alcançados ao se estabelecer a construção por intermédio de uma sustentação teórica e legitimada com experts do mercado profissional, da formação de uma cadeia logístico-portuária em um cenário com informações de um caso em SC, reconhecendo o porto como um elemento integrante desta cadeia.
ESTUDO COMPARATIVO DA EFETIVIDADE PORTUÁRIA PARA IMPORTAÇÃO DE PRODUTOS CONTEINERIZADOS EM SANTA CATARINA
Authors: Simão Luiz Eduardo , Rocha Luís Eduardo , Petry Marcelo , Schmitt Neto Julio Cesar , Souza Mayara
Published: October 2020

O presente artigo tem como objetivo geral determinar o recinto alfandegado de zona primária entre o Porto de Itapoá, Portonave Terminais Portuários APM Terminals Itajaí que consiste em melhor alternativa para a empresa “ABC” - importador de filtros para automóveis, localizada em Joinville, SC. Como objetivos específicos tem-se: (a) mensurar os custos portuários nos três recintos, considerando as parametrizações em canal verde, amarelo e vermelho; (b) verificar qual terminal é mais ágil perante as liberações no Comex e (c) aferir distância e custo de transporte rodoviário até a planta do cliente nos três cenários. Em termos metodológicos, a pesquisa caracterizou-se como quali-quantitativa (mista), exploratória quanto aos objetivos e estudo de caso único. Conclui-se que a tomada de decisão mais coerente é optar pelo Porto de Itapoá, considerando sua competitividade em termos de custos, bem como agilidade na liberação.
ANÁLISE DA EFICIÊNCIA DE TERMINAIS DE GRANÉIS SÓLIDOS UTILIZANDO O MÉTODO DEA
Authors: Giacomin Jully Anne , Silva Vanina Macowski Durski
Published: October 2020

brasileiros utilizando o método de análise envoltória de dados (Data Envelopment Analysis – DEA). Para isso foram selecionados 27 terminais, sendo que oito importam carvão, nove exportam minério de ferro e dez exportam soja, e adotados quatro inputs e dois outputs. Os resultados mostraram uma tendência de superioridade de eficiência de terminais exportadores diante dos importadores.
Uso de la bicicleta como transporte alternativo: implicaciones de la cuestión cultural en la preservación del medio ambiente
Authors: Ferreira Adalci dos Anjos , Frias Danila Fernanda Rodrigues
Published: October 2020

Fue analizada la cultura de la utilización de la bicicleta como medio de transporte en el municipio de Uberlândia. Se realizó el levantamiento de datos por medio de la observación de documentos e informaciones del Secretaría de Tráfico y Transportes, Universidad Federal de Uberlândia y Ayuntamiento local. También se aplicó un cuestionario electrónico, con participación de 109 ciclistas. La falta de infraestructura es un grave problema en el municipio, que posee cerca de 98.119 metros de ciclovías y tiene alto índice de accidentes que involucran a los ciclistas, lo que hace que la adhesión al uso de la bicicleta sea disminuida. Se concluye que la deficiencia de infraestructura cicloviaria ha ocasionado número elevado de accidentes. De esta forma, se acentuó la necesidad de discusiones sobre acciones que apunten a aumentar el uso de la bicicleta y la necesidad de implementar medidas para disminuir las ocurrencias de accidentes de tránsito involucrando a ciclistas.
The Medical Community Perspectives Regarding the Egyptian Medical License Exam: Mixed-Method Study
Authors: Abdel Nasser Asmaa , Sharif Asmaa , Elkhamisy Fatma , Adel Hadeer , Hussein Ahmed , Handoka Nesrin , Ali Ahmed , Abouzeid Enjy
Published: October 2020

Background: Although National Licensing Examinations (NLEs) may be a costly process, they can predict better performance for many following years. The current licensing requirements will not entail and new requirements will be requested. Therefore, this study suggests a framework for the development of the Medical Licensing Exam by exploring the opinions of Egyptian medical practitioners and educators regarding the exam format and criteria. Objective and methods: to describe the needed steps to develop the EMLE through a two-phase exploratory mixed-method study that had been conducted among the Egyptian medical sectors: medical practitioners and educators. Results: There were 50 clinical and academic educators shared in the online discussion about EMLE development. Then, a survey was carried out on 266 participants with various working places in which 198 of the participants were staff in the Higher Education Ministry and 68 physicians in the Ministry of Health. The input from both had contributed to the development of the following framework that is divided into two main sections; the Exam Logistics and the Exam Set up. The exam Logistics included the exam committee, prerequisites for the exam, the admission criteria and fees, and the validity of the license. While the Exam Set up included exam setting, structure, standard-setting, pass marks and reset policy. Conclusion: A Multidisciplinary team resources for the exam setting. Fairness and objectivity were highlighted through several factors; development of the exam blueprint, types of assessment methods, post-exam analysis, and standard-setting. Finally, the reset policy, fees, and validity of the license were recommended with a student-centered perspective that was suggested for the exam committee.
Batıyı Anlatan İlk Osmanlı Metinlerinde “Batı Bilgisi"nin Yorumlanışı
Authors: ÖLMEZ Adem
Published: October 2020

Batı’nın Osmanlı ile teması iki şekilde olmuştur. Bunlardan birisi iki kültür havzasının coğrafi olarak yan yana gelmesinin bir sonucu olarak kurulan temastır. Bu etkileşim denk kültürlerin birbirinden etkilenmesini sağlamıştır. Bu tür kültürel temasta üstün olan taraf olmadığından hegemonik bir etki yoktur. İkinci temas biçimi, üstün bir kültür olarak Batı’nın diğer toplumlarla karşılaşmasıdır. Bu tür karşılaşma farklı toplumlarda farklı tepkilerin oluşmasına neden olmuştur. Bu da Batı dışı toplumlarda farklı modernleşme biçimlerinin ortaya çıkmasını sağlamıştır. Osmanlı’nın, Rusya’nın, Japonya’nın ve dünyanın diğer Batı dışı toplumlarının modernleşmesi buna örnek olarak verilebilir. Osmanlı’da birinci tür temasın 16. Yüzyıla kadar devam ettiğini söylemek mümkündür. Ancak, 16. Yüzyılın son çeyreğinden itibaren geri kalmışlığın farkedilmesiyle birlikte, ikinci tür temasın yani üstün bir kültürle geri kalmış bir kültürün karşılaşmasının görülmeye başladığını söyleyebiliriz. Osmanlı toplumu içinden çıkan entelektüeller bu ikinci süreci inceleyerek değişik biçimlerde yorumlamışlardır. Siyasetnâmeler, sefaretnâmeler, seyahatnâmeler ve layihalarda bu yorumların izlerine rastlanmaktadır. Osmanlı modernleşmesini anlayabilmek için bu ilk metinlerin tematik analizlerinin özel bir önemi olduğunu söylemek mümkündür. Batıdaki gündelik hayat, teknolojik ve bilimsel gelişmeler ve devlet sistemi Osmanlı entelektüellerinin ilgilendikleri konular olmuştur. Biz bu çalışmamızda Batı’dan bahseden ilk metinlerde “Batı bilgisi”nin nasıl yer aldığını tespit etmek istiyoruz. Bu çerçevede örnek olarak belirlediğimiz Hasan el Kafi’nin 1596’da yayımladığı Usûl’l-hikem fi-nizâmü’l-âlem adlı eserini, İbrahim Müteferrika’nın 1732’de yayımladığı Usûl’ül-hikem fî Nizâmü’l-ümem adlı eserini ve Reisü’l-küttap Atıf Efendi’nin 1798’de yazdığı layihasını tematik olarak analiz etmek istiyoruz. Bu ve benzeri eserlerin Batı’ya yaklaşımının tespit edilmesi, Osmanlı’nın Batılılaşma serüveninin temel kodlarının anlaşılması açısından önemli katkılar sağlayacaktır.
Concurrent administration of oxytocin with Foley catheter versus Misoprostol for induction of labor: A systematic review and meta-analysis
Authors: Aziz Mohamed A. Abdel , Jahanfar Shayeste , Abedi Parvin , Faal Shahla
Published: October 2020

Background: Around one- third of pregnancies require labor induction due to several reasons such as post-term pregnancy, stillbirth, and medical complications. This systematic review aimed to evaluate the effect of concurrent administration of Foley catheter plus oxytocin versus Misoprostol on labor induction.Methods: The search was conducted in April 2019 and updated in September 2020. The following databases were searched: PubMed, SCOPUS, Cochrane Central Register of controlled trials, and Web of Science. Primary outcome included cesarean section rate. Secondary outcomes were the mean duration of induction to delivery and delivery in less than 12 hours from induction. Data were analyzed using RevMan. For binary outcomes, the odds ratio with 95% confidence intervals (CI), and for continuous outcomes, the mean difference (MD) with 95% CI was measured.Results: Four studies were included in this review. The cesarean section rate in Foley plus oxytocin was not significantly different from vaginal Misoprostol (OR = 0.95; 95 % CI: 0.70, 1.30) and (OR = 0.92; 95 % CI: 0.66, 1.29) respectively. Foley plus oxytocin decreased the mean duration of induction to delivery compared to vaginal Misoprostol in nuligravida (MD = -6.74; 95% CI -9.20, -4.28), and increased delivery in less than 12 hours from induction (OR = 2.08; 95 % CI: 1.43, 3.02).Conclusion: Although the rate of cesarean and vaginal delivery was not different in two groups of Foley catheter plus oxytocin and vaginal Misoprostol, the mean time of induction to delivery reduced and delivery in less than 12 hours from induction increased in the Foley plus oxytocin.
Palliative treatment of endometrial cancer: which is the role of Anastrozole in elderly women?
Authors: Gardella Barbara , Dominoni Mattia , Bogliolo Stefano , Cassani Chiara , Carletti Giulia Vittoria , De Silvestri Annalisa , Spinillo Arsenio
Published: October 2020

Background: Type I endometrial cancer is the most common gynaecological tumour in developed countries and its incidence is increasing also because of population aging. The aim of this work is to test the feasibility and safety of anastrozole as palliative treatment of endometrial cancer in elderly women ineligible for standard surgical treatment. Methods: Patients with histological diagnosis of type I endometrial cancer not suitable for surgical treatment were enrolled in this pilot study. Anastrozole was administered 1 mg daily orally after performing an accurate clinical and radiological staging. Validated questionnaire and self-reported outcomes were used to evaluate quality of life and compliance during the study period.Results: Eight patients with a mean age of 85 (range 80-88years) were enrolled. All patients had endometrial cancer confined to the uterus, and none progression of disease was observed during the study period. A partial response to the therapy was reported in seven patients, while one patient had stable disease. Tumour symptoms improvement such as pain, vaginal bleeding and vaginal discomfort was reported. The endometrial thickness after twelve months has showed a reduction of 9.25 ± 4.77 mm. The average follow-up time was 18.25 months. Four women died for non oncological reasons, none death related to endometrial cancer was reported. Evaluation of symptoms showed a significant reduction of appetite loss and insomnia, while a significant increase of global health status and fatigue was reported. Conclusions: Our preliminary data suggested that the palliative use of anastrozole may be a suitable therapy for the proper management of early stages endometrial cancer in elderly women not suitable for surgical treatment with good compliance and tolerance.Trial registration: 20130008401, 21/09/2013
Validation of the Psychometric Properties of the Malay Advance Care Planning Questionnaire
Authors: Lim Mun Kit , Lai Pauline Siew Mei , Wong Pei Se , Othman Sajaratulnisah , Mydin Fadzilah Hanum Mohd
Published: October 2020

Background There is a growing interest among the developing countries on advance care planning (ACP) due to the reported benefits of planning ahead in the developed countries. Validated instruments in various languages have been developed to facilitate study on the views of public prior to its implementation. However, instrument to explore the views on ACP in Malay has not been developed and validated yet, even though Malay is spoken extensively by approximately 220 million people in the Malay Archipelago. There is also a need for instrument in Malay language to facilitate the assessment of knowledge, attitude and practice (KAP) of Malaysians regarding ACP. Therefore, the aim of this study was to validate the psychometric properties of the Malay Advance Care Planning Questionnaire (ACPQ-M). Methods The ACPQ was translated according to international guidelines. This validation study was conducted from January to June 2018. Participants who were ≥21 years old, and able to understand Malay were recruited from an urban primary care clinic and a tertiary education institution in Malaysia. A researcher administered the ACPQ-M to participants via a face-to-face interview at baseline and two weeks later. Each interview took approximately 15-20 minutes. Results A total of 222/232 participants agreed to participate (response rate=96.0%). Exploratory factor analysis and confirmatory factor analysis found that the ACPQ-M was a 4-factor model. The Cronbach’s α values for the four domains ranged from 0.674-0.947. Only 157/222 participants completed the test-retest (response rate=71%). At test-retest, quadratic weighted kappa values for all domains ranged from 0.340-0.674, except for two domains which ranged from -0.200-0.467. Conclusions The ACPQ-M was found to be a 4-factor model, and a valid and reliable instrument to assess the KAP regarding ACP. This instrument can contribute to profound understanding of the KAP of Malaysians regarding ACP, and assist policy makers in determining the readiness for legislation of ACP in Malaysia.
Seroprevalence of the hepatitis E virus among blood donors in the Qassim Region, Saudi Arabia
Authors: Alhatlani Bader , Aljabr Waleed , Almarzouqi Mohammed , Alhatlani Sami , Alzunaydi Rayan , Alsaykhan Abeer , Almaiman Sulaiman , Aleid Ahmed , Alsughayir Ammar , Beshawri Yara , Almusallam Abdulrahman
Published: October 2020

ObjectivesTo evaluate the seroprevalence of hepatitis E virus (HEV), a major public health issue worldwide with the potential for transmission via blood transfusion, in blood donors in the Qassim Region, Saudi Arabia. Serum samples (n = 1,078) were collected from volunteer blood donors from January to April 2019 and tested for the presence of anti-HEV IgG and IgM by indirect enzyme-linked immunosorbent assays.ResultsOverall, the seroprevalence of anti-HEV IgG among blood donors was 5.7%. Additionally, the seropositive rates of anti-HEV IgG and IgM were significantly higher in non-Saudi donors (22.1% and 35.3%) than in Saudi donors (3% and 7.4%). The seroprevalence of anti-HEV IgG increased with age; however, there was no correlation between gender and anti-HEV IgG and/or IgM. The seroprevalence of HEV among blood donors in the Qassim Region was lower than previous estimates for other regions of the country. Further studies covering a wider geographical area are needed to validate and expand the findings and to determine the importance of HEV screening in the region.
Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study
Authors: Yeh Kuang-Ting , Yu Tzai-Chiu , Lee Ru-Ping , Wang Jen-Hung , Liu Kuan-Lin , Peng Cheng-Huan , Chen Hao-Wen , Chen Ing-Ho , Hsu Chung-Yi , Wu Wen-Tien
Published: October 2020

Background: Osteoporotic hip fracture is a common general health problem with significant impact of human life because it debilitates the patients and largely decrease their life quality. Early prevention of the fracture is essential in the recent decades by finding out the related risk factors as reference of further intervention, especially for the vulnerable patient group with comorbidities. Hepatic encephalopathy, a major complication of liver cirrhosis, may increase the rate of falling down and weaken the bone quality. This paper is aimed to finding out the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged patients from our national population. Methods: This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We focus on people who were older than 50 years old, using hepatic encephalopathy as compare grouping accordance, and finding the influence of the other common chronic illness. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of comorbidities related to aging and poor lifestyle were calculated using Cox proportional hazard regression models. Results: The average age of the enrolled patients was approximately 66.5 years. The incidence ratio of hip fracture in HE group was 68/2496 (2.7%), which was significantly higher than that in non-HE group as 98/9984 (0.98%). Patients with hepatic encephalopathy were 2.15-times more likely to develop osteoporotic hip fractures than patients without hepatic encephalopathy in the whole group and the risk ratio was also significantly higher in female and older patients. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer and depression. Alcohol-illness seemed to be not confound the results of this study. Conclusions: Hepatic encephalopathy is significantly associated with an increased risk of osteoporotic hip fractures and the significance was not affected by the comorbidities in people aged more than 50 years old from the results of our study, and the fracture cumulative risk increased with age based on log-rank test.
Stakeholder perceptions about the establishment of medical simulation-based learning at a university in a low resource setting: A qualitative study in Uganda
Authors: Najjuma Josephine Nambi , Bajunirwe Francis , Twine Margaret , Namata Tamara , Kyakwera Catherine , Cherop Moses , Data Santorino
Published: October 2020

Background: Simulation based learning (SBL) is a technique where teachers recreate “real life” clinical experiences for health care teams for purposes of gaining clinical skills in a safe environment. There is evidence that SBL is superior to the traditional clinical teaching methods for acquisition of clinical skills. Although it is well established in resource rich settings, there is limited experience in resource limited settings and there is uncertainty regarding how SBL will be perceived among the stakeholders in medical education. As part of the steps leading to implementation of a SBL program at a university in Uganda, we sought to describe the perceptions of various stakeholders regarding the introduction of SBL methodology into learning at a medical school in Uganda. Methods: We conducted a formative qualitative assessment using key informant interviews (KIIs) among faculty members and university administrators and focus group discussions (FGDs) among medical and nursing students at Mbarara University of Science and Technology. Data were collected till saturation point and were transcribed and analyzed manually using open and axial coding approaches to develop themes. Results: We conducted 7 KIIs and 3 FGDs. Overall, findings were categorized into five broad themes: 1. Motivation to adopt simulation-based learning 2. Prior experience and understanding of simulation-based education 3. Outcomes arising from introduction of medical simulation 4. Drawbacks to establishment of medical simulation; and 5. Potential remedies to the drawbacks. Overall, our data show there was significant buy-in from the institution for SBL, stakeholders were optimistic about the prospects of having a new method of teaching, which they perceived as modern to complement the traditional methods. There was significant knowledge but very limited prior experience of medical simulation. Also, there was some concern regarding how students and faculty would embrace training on lifeless objects, the human resources needed and sustainability of simulation-based learning in the absence of external funding. Conclusion: Stakeholders perceive SBL positively and are likely to embrace the learning methods. Concerns about human resource needs and sustainability need to be addressed to ensure acceptability.
A Pilot Study on Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age
Authors: Sangare Modibo , Diarra Ya , Konate Djeneba , Haidara Mohamed S , Karembe Adama , Keita Boureima , Dolo Housseini , Kouyate Modibo , Doumbia Fatoumata , Sidibe Oumar , Diakite Seidina , Kayentao Kassoum , Traore Drissa , Toure Amadou , Doumbia Seydou , Diakite Mahamadou , Kim Hyung-Goo , Awandare Gordon A
Published: October 2020

Background: In Mali, the health facility-based prevalence of autism spectrum disorders (ASD) in Mali was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. In this pilot study, our aim was to investigate if parental concerns were associated with early first medical visits and subsequent ASD diagnostic in Mali. Methods: We conducted a pilot study from November 2017 to July 2019. We surveyed 57 parents of autistic children aged 3-14 years old. Results: Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%. Conclusion: Parental concerns were not significantly associated with early first medical visit and ASD identification. This pilot study will help in the design of larger studies on the same topic in Mali.
Impact on place of death in cancer patients: a causal exploration in southern Switzerland
Authors: Kern Heidi , Corani Giorgio , Huber David , Vermes Nicola , Zaffalon Marco , Varini Marco , Wenzel Claudia , Fringer André
Published: October 2020

BackgroundMost terminally ill cancer patients prefer to die at home, but a majority die in institutional settings. Research questions about this discrepancy have not been fully answered. This study applies artificial intelligence and machine learning techniques to explore the complex network of factors and the cause-effect relationships affecting the place of death, with the ultimate aim of developing policies favouring home-based end-of-life care.MethodsA data mining algorithm and a causal probabilistic model for data analysis were developed with information derived from expert knowledge that was merged with data from 116 deceased cancer patients in southern Switzerland. This data set was obtained via a retrospective clinical chart review.ResultsDependencies of disease and treatment-related decisions demonstrate an influence on the place of death of 13%. Anticancer treatment in advanced disease prevents or delays communication about the end of life between oncologists, patients and families. Unknown preferences for the place of death represent a great barrier to a home death. A further barrier is the limited availability of family caregivers for terminal home care. The family’s preference for the last place of care has a high impact on the place of death of 51%, while the influence of the patient’s preference is low, at 14%. Approximately one-third of family systems can be empowered by health care professionals to provide home care through open end-of-life communication and good symptom management. Such intervention has an influence on the place of death of 17%. If families express a convincing preference for home care, the involvement of a specialist palliative home care service can increase the probability of home deaths by 24%.ConclusionConcerning death at home, open communication about death and dying is essential. Furthermore, for the patient preference for home care to be respected, the family’s decision for the last place of care seems to be key. The early initiation of family-centred palliative care and the provision of specialist palliative home care for patients who wish to die at home are suggested.
Tespa1 plays a role in the modulation of airway hyperreactivity through the IL-4/STAT6 pathway
Authors: Yang Ruhui , Wang Guangli , Li Lingyun , He Hanjiang , Zheng Mingzhu , Lu Linrong , Wu Songquan
Published: October 2020

Background: Thymocyte-expressed, positive selection-associated 1 (Tespa1) is a critical signaling molecule in thymocyte development. This study aimed to investigate the regulatory effect of Tespa1 on mast cells in the pathogenesis of asthma and its relationship with the interleukin (IL)-4 /signal transducers and activators of transcription 6 (STAT6) signaling pathway.Methods: Tespa1 mRNA expression analysis and IgE levels were carried out using the induced sputum of 33 adults with stable asthma and 36 healthy controls. Tespa1-knockout mice (Tespa1-/-, KO) and C57BL/6 background (wild-type, WT) mice were sensitized and treated with ovalbumin (OVA) to establish an asthma model. Pathological changes, number and activity of mast cells, and changes in activation of the IL-4 /STAT6 pathway in lung tissue were detected. The changes of tryptase expression and STAT6 activation after mast cell gene knockout were analyzed in vitro. The changes of enzyme expression and STAT6 activation after mast cell gene knockout were analyzed in vitro. The association between the Tespa1 and p-STAT6 was analyzed by co-immunoprecipitation method.Results: Compared with the healthy controls, Tespa1 expression was decreased, and IgE levels were elevated in the sputum of asthmatic patients. Animal experiments showed that Tespa1-/- mice exhibited more severe inflammation, higher quantity of goblet cells and mast cells in the bronchium, and greater expression of mast cell tryptase, which is induced by ovalbumin, than WT mice. And IL-4, IL-13, phospho-Janus kinase 1, and p-STAT6 expressions presented a higher increase in the Tespa1-/- mouse model than in the WT mouse model. Further in vitro studies confirmed that IL-4 could more significantly promote tryptase and p-STAT6 activities in Tespa1-/- mast cells than their WT counterparts. Correlation analysis results showed a negative correlation between Tespa1 and p-STAT6. Co-immunoprecipitation results demonstrated an association between Tespa1 and p-STAT6.Conclusions: Altogether, our results indicate that Tespa1 can negatively regulate mast cell activity, and this event is related to the mast cell IL-4/STAT6 signaling pathway and could be therapeutically exploited to treat asthma attacks.
Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction
Authors: Li Bing , Cai Shi-Lun , Lv Zhen-Tao , Zhou Ping-Hong , Yao Li-Qing , Shi Qiang , Qi Zhi-Peng , Sun Di , Yalikong Ayimukedisi , Xu En-Pan , Xu Jian-Min , Zhong Yunshi
Published: October 2020

Background: The use of a self-expandable metallic stent (SEMS) as a bridge to surgery has increased for patients with obstructing colorectal cancer. However, relatively few reports have compared SEMS as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC) vs. emergency surgery (ES). This study aimed to evaluate the benefits of elective surgery after SEMS placement vs. ES for patients (including stage IV cases) with acute MORC.Methods: Patients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups.Results: In total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%, P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%, P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days, P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. Also, there was no significant difference in PFS and OS rates between patients with stage II and III colon cancer. After colectomy for synchronous liver metastases among stage IV patients, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs. combined resection was 3.258 (95% CI 0.858–12.370; P = 0.041).Conclusion: Stent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.
Use Of Spinal Anaesthesia In Neonates And Infants In Antananarivo, Madagascar: A Retrospective Descriptive Study 
Authors: Randriamizao Harifetra Mamy Richard , Rakotondrainibe Aurelia , Razafindrabekoto Lova Dany Ella , Ravoaviarivelo Prisca Funken , Rajaonera Andriambelo Tovohery , Andriamanarivo Mamy Lalatiana
Published: October 2020

Objective : The aim of this study was to present the first cases of spinal anesthesia, in newborns and infants, preterm / ex-prematures, in order to determine its feasibility and its potential harmlessness, in Antananarivo – Madagascar. Indeed, spinal anesthesia is a low cost technique and can limit respiratory complications, postoperative apnea a contrario with pediatric general anesthesia which can lead to perioperative risks.
Results : In a retrospective, descriptive, seven-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, 69 patients’ data files planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28 - 52] days old. The smallest anesthetized child weighed 880g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (90%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1 - 2] attempts with hyperbaric bupivacaine of 4 [3.5 - 4] mg. Failure rate was 5.8%. The heart rate was stable throughout perioperative period and no complications were observed.
MazEF-rifampicin interaction suggests a mechanism for rifampicin induced inhibition of persisters
Authors: Alexander Cyrus , Guru Ankeeta , Pradhan Pinkilata , Mallick Sunanda , Mahanandia Nimai Charan , Subudhi Bharat Bhushan , Beuria Tushar Kant
Published: October 2020

Background: Persistence is a natural phenomenon whereby a subset of a population of isogenic bacteria either grow slow or become dormant conferring them with the ability to withstand various stresses including antibiotics. In a clinical setting bacterial persistence often leads to the recalcitrance of various infections increasing the treatment time and cost. Additionally, some studies also indicate that persistence can also pave way for the emergence of resistant strains. In a laboratory setting this persistent phenotype is enriched in nutritionally deprived environments. Consequently, in a batch culture the late stationary phase is enriched with persistent bacteria. The mechanism of persister cell formation and its regulation is not well understood. Toxin-antitoxin (TA) systems have been implicated to be responsible for bacterial persistence and rifampicin is used to treat highly persistent bacterial strains. The current study tries to explore a possible interaction between rifampicin and the MazEF TA system that furthers the former’s success rate in treating persistent bacteria. Results: In the current study we found that the population of bacteria in the death phase of a batch culture consists of metabolically inactive live cells resembling persisters, which showed higher membrane depolarization as compared to the log phase bacteria. We also observed an increase in the expression of the MazEF TA modules in this phase. Since rifampicin is used to kill the persisters, we assessed the interaction of rifampicin with MazEF complex. We showed that rifampicin moderately interacts with MazEF complex with 1:1 stoichiometry.Conclusion: Our study suggests that the interaction of rifampicin with MazEF complex might play an important role in inhibition of persisters.
First Report of Plum bark necrosis stem pitting-associated virus Infecting Grapevine in China
Authors: Yang Yang , Sun Yifan , Li Qingliang , Yufeng Wu , Wang Deya
Published: October 2020

Background: Virus disease is one of the main diseases in grapevine, and there has been no report on Plum bark necrosis and stem pitting-associated virus infecting grapevine in China.Objective: The leaf samples of grapevine cultivar 'Cabernet Gernischt' were collected from Shandong province, which the leaves suffered from viral-like symptoms with spotting and crinkle.Methods: Small RNA-seq combined with reverse transcription PCR (RT-PCR) were performed to detect the potential viruses in these field samples. Phylogenetic tree was constructed using the neighbor joining method in MEGA 5.1Conclusions: This is the first report of PBNSPaV infecting grapevine in China, contributing to a better understanding of the epidemiology and host range distribution of this pathogen.