bluuebunny/crossref_metadata_2025 huggingface dataset:
Gêneros oclusos na telecolaboração: a variação na estrutura retórica da sessão oral de teletandem inicial
Authors: Rampazzo Laura
Published: December 2019

O projeto Teletandem Brasil (TELLES, 2006) proporciona a estudantes universitários o contato intercultural entre falantes de línguas distintas em um ambiente telecolaborativo em que cada participante auxilia seu par na aprendizagem de sua língua. O presente artigo apresenta os resultados de uma investigação da estrutura retórica de um evento comunicativo que ocorre neste contexto, a sessão oral de teletandem inicial (SOTi), compreendida como um gênero (RAMPAZZO; ARANHA, 2018, 2019b), a fim de verificar se há relação entre a variação em sua estrutura e o fato de os participantes não terem acesso ou experiência anterior com esse evento comunicativo nem conhecimento de sua estrutura retórica esperada, considerando que a SOTi possa ser um gênero ocluso (LOUDERMILK, 2007; SWALES, 1996). Nossos resultados indicam que a variação pode estar associada à oclusão da SOTi, uma vez que os participantes devem recorrer a outros gêneros e experiências prévias para a produção da sessão oral de teletandem inicial.
A questão terminológica dos organofosforados na química de pesticidas: uma abordagem baseada em corpus
Authors: Souza José Victor de
Published: December 2019

Neste artigo é discutida a problemática terminológica da Química de Pesticidas, levantando-se a questão da falta de consenso nas traduções, do inglês para o português, de alguns nomes de compostos químicos e de termos técnicos, e como esta questão pode prejudicar a tradução e produção de textos científicos quanto a sua aceitabilidade e naturalidade. A partir dessa premissa, é proposta uma investigação terminológica da área, com a intenção de compreender melhor como funcionam os termos dentro de seu domínio, em ambas as línguas, e identificar possíveis problemas de equivalência. Com a abordagem teórico-metodológica da Linguística de Corpus, termos foram selecionados de um corpus bilíngue de especialidade, criado para esta finalidade, sendo seus significados analisados diante do contexto. Como resultados imediatos, as inconsistências conceituais entre os termos organophosphate e organophosphorus utilizados em inglês e os seus respectivos equivalentes em português foram observadas e estudadas.
Derivações prefixais do tipo não-x, quase-x, além-x e mil-x na poética cabralina: marca de expressividade na neologia estilística
Authors: Cotrim Rosana Maria Sant'Ana
Published: December 2019

Este artigo apresenta uma análise de criações lexicais encontradas na poética de João Cabral de Melo Neto que, concebidas como neologia estilística, engendram grande expressividade no discurso em que se inserem. São unidades léxicas criadas por processo de derivação prefixal, as quais comportam uma estrutura singular pela ligação de bases nominais e verbais a elementos prefixais não constituídos pelos tradicionais prefixos. Partindo-se do pressuposto de que a poética cabralina é pautada no rigor da “forma construída” pela manipulação da linguagem, compreende-se que elas revelam uma marca de expressividade, pelo inusitado das combinações empregadas, capaz de fazer sentido tanto pelo que as unidades lexicais criadas enunciam, quanto pela exploração do próprio processo derivacional que as cria.
A construção modal facultativa [ter_como]
Authors: Souza Cibele Naidhig de
Published: December 2019

Comprometido com uma perspectiva construcional, o objetivo deste artigo é examinar o esquema [ter_como] como forma de expressão da modalidade na língua portuguesa, descrevendo-se suas regularidades de uso, como uma construção. A pesquisa serve-se de textos do português brasileiro contemporâneo, de fala e de escrita, retirados do Corpus do Português (disponível em corpusdoportugues.org.br). Utiliza-se a classificação das modalidades de Hengeveld (2004), em que dois parâmetros se cruzam, o alvo (orientado para o participante, orientado para o evento e orientado para a proposição) e o domínio (facultativo, deôntico, volitivo, epistêmico e evidencial). A análise das ocorrências, apoiada em pressupostos teóricos da Gramática de Construções (GOLDBERG, 1995; CROFT, 2001; TRAUGOTT; TROUSDALE, 2013), revela que a fórmula [ter_como] é padrão fixo de expressão de modalidade facultativa, configurando-se como um esquema construcional, fórmula rotineira, convencionalizada, na língua portuguesa do Brasil.
A PRODUÇÃO DE UVA ORGÂNICA NO ESTADO DO RIO GRANDE DO SUL: AS EXPERIÊNCIAS DOS VITICULTORES DE COTIPORÃ, RS/ The Production of Organic Grape in the State of the Rio Grande do Sul: the experiences of the Cotiporã, RS grape growers
Authors: Pierozan Vinício Luís
Published: December 2019

A produção de uva orgânica é pouco representativa frente o cultivo convencional em todo o mundo. A Itália com seus 60.000 (ha) de vinhedos orgânicos, que equivalem a aproximadamente 5,8% de toda a área cultivada com parreiras do país se constitui no maior produtor mundial de uva orgânica. No Brasil, o estado do Rio Grande Sul, responsável pela produção de 85% da uva e 90% do vinho nacional, tem sua produção concentrada na Serra Gaúcha, a produção de uva orgânica, por sua vez, é de aproximadamente 2% apenas. Porém, no município de Cotiporã, localizado na região serrana, vários agricultores familiares estão realizando o processo de conversão dos parreirais do sistema convencional para o orgânico. Assim, o objetivo deste artigo é analisar quais são as motivações que estão estimulando os agricultores a mudarem da produção de uva convencional para a produção de uva orgânica. O estudo foi baseado em pesquisa bibliográfica, trabalho de campo, aplicação de entrevistas semiestruturadas e coleta de dados em diferentes instituições. Concluiu-se que a produção de uva orgânica está se expandindo no município e os agricultores familiares que estão migrando para o cultivo orgânico buscam neste sistema de produção uma melhor valorização do seu trabalho e da fruta por eles produzida, que por consequência, traz maior rentabilidade e estabilidade financeira para o agricultor.
Palavras-chave: viticultura orgânica; agricultura familiar; Cotiporã-RS.
UMA REFLEXÃO SOBRE A PRÁTICA DE DOCÊNCIA ORIENTADA COMO UMA EXPERIÊNCIA PROFISSIONAL NO ÂMBITO DA GEOGRAFIA / A reflection on the teaching practice oriented as a professional experience in geography
Authors: Manfio Vanessa
Published: December 2019

A formação de um professor é um processo que envolve uma longa caminhada, partindo das experiências vividas e das compartilhadas, do estudo acadêmico e diário e da prática docente. Ela é de fundamental importância para a construção das habilidades pedagógicas, superar dificuldades e para segurança do futuro profissional. Estas práticas precisam ocorrer no contexto de formação do professor, principalmente pela participação de estágios, obrigatórios e espontâneos, não somente nas escolas, mas nas universidades, já que muitos pós-graduados seguiram a docência universitária. Assim, o Estágio Docência favorece a interação entre teoria e prática e aprofunda os conhecimentos previamente aprendidos, estabelecendo trocas entre professor, estagiário e alunos. Pensando nisso, o presente artigo se propôs relatar a experiência docente realizada em estágios de docência orientada no curso de Graduação em Geografia, para contribuir com a discussão acerca da formação do professor e da importância da docência orientada nos cursos de pós-graduação.
USO DO ALGORITMO EXPECTATION-MAXIMIZATION (EM) PARA A ANÁLISE DA VARIABILIDADE PLUVIOMÉTRICA TEMPORAL NA BACIA DO RIO PIQUIRI/ Analysis of the temporary pluviometric variability of the piquiri river basin under the extreme events
Authors: Silva Ana Claudia Guedes , Trevisan Gabriel de Menezes
Published: December 2019

O presente trabalho teve como objetivo identificar a distribuição espacial da precipitação pluviométrica e a variabilidade temporal na Bacia do Rio Piquiri, no Estado do Paraná, identificando eventos extremos ocorridos no período de 1982 a 2018. As séries históricas foram adquiridas no sistema de informações hidrológicas Hidroweb. A metodologia utilizada teve como base o processo Knowledge Discovery in Database - KDD. Foram definidas áreas pluviometricamente homogêneas para os períodos de 1982-1994 (Período 1), 1995-2006 (Período 2) e 2007-2018 (Período 3). Constatou-se associação entre a existência de eventos extremos e as características físicas da bacia através da distribuição espacial da precipitação com distintas interações entre os conjuntos de dados analisados ao longo da variabilidade temporal. No sul e sudeste da bacia estudada se concentrou altos volumes de precipitação no decorrer de todos os períodos estudados. Com relação aos menores volumes de precipitação, o Período 1 apresentou o menor valor, porém o Período 3 se destacou dos demais com a maior quantidade de estações classificadas como baixa, e para as máximas altas, o Período 2 ganhou destaque. Diante disso, comprova-se a existência de eventos extremos de precipitação, apontando a alta variabilidade temporal e espacial na bacia ao longo da série, podendo interferir nas atividades econômicas locais.
ANÁLISE QUALI-QUANTITATIVA DA SUSTENTABILIDADE DE CASTANHAL (PA) DE ACORDO COM SEU PLANO DIRETOR PARTICIPATIVO (2007-2016)/ Quali-quantitative analysis of sustainability in castanhal city (pa) by its master urban plan (2007 – 2016)
Authors: Lima Gabriel Villas Boas de A. , Pereira Marina Morhy , Crispim Diêgo Lima , Fernandes Lindemberg Lima
Published: December 2019

Este estudo teve por objetivo analisar a influência dos fundamentos do Desenvolvimento Sustentável na implantação do Plano Diretor Participativo do município paraense de Castanhal. Com isso, optou-se por uma metodologia de caráter qualitativo para abordar as dimensões histórico-cultural e socioambiental, de modo a avaliar os efeitos da implementação de dispositivos público-administrativos por meio de registros na literatura e na mídia local. Já o caráter quantitativo do estudo foi implementado nas dimensões socioeconômica, socioespacial e sociodemográfica, introduzindo a ferramenta estatística de regressão linear simples para analisar a tendência dos dados coletados nas plataformas do IBGE (Instituto Brasileiro de Geografia e Estatística). Dessa forma, pôde-se avaliar se a introdução de mecanismos principiológicos do Desenvolvimento Sustentável foram satisfatórios e adequados à realidade vivida do município em questão.
MAPEAMENTO DASIMÉTRICO E INTERPOLAÇÃO DE DADOS CENSITÁRIOS E IMAGEM ORBITAL PARA ANÁLISE DA DILATAÇÃO DO SÍTIO URBANO DA CIDADE DE BELÉM DO PARÁ/ Dasimetric mapping and interpolation of censory data and orbital image for analysis of the urban site dilatio
Authors: Morais Junior Hélio de Souza , Silva Sérgio Luis Barbosa da
Published: December 2019

o objetivo deste trabalho é apresentar uma análise da expansão urbana da cidade de Belém do Pará mediante a imbricação de duas variáveis: primeiro, a interpolação dos dados censitários da população de Belém a uma classificação semiautomática utilizando técnicas de geoprocessamento sobre imagens de satélites de alta resolução. E em um segundo momento, uma classificação de uso e ocupação do solo para o sítio urbano de Belém para os últimos 45 anos evidenciando a dilatação da mancha urbana sobre as áreas verdes. A partir dos dados obtidos foi possível realizar uma reflexão que pode ajudar na compreensão do complexo urbano da capital paraense.
Analysis of MADS-box genes revealed modified flowering gene network and diurnal expression in pineapple
Authors: Zhang Xiaodan , Fatima Mahpara , Zhou Ping , Ma Qing , Ming Ray
Published: December 2019

Background Pineapple is the most important crop with CAM photosynthesis, but its molecular biology is underexplored. MADS-box genes are crucial transcription factors involving in plant development and several biological processes. However, there is no systematic analysis of MADS-box family genes in pineapple ( Ananas comosus ).Results Forty-eight MADS-box genes were identified in the pineapple genome. Based on the phylogenetic studies, pineapple MADS-box genes can be divided into type I and type II MADS-box genes. Thirty-four pineapple genes were classified as type II MADS-box genes including 32 MIKC-type and 2 Mδ-type, while 14 type I MADS-box genes were further divided into Mα, Mβ and Mγ subgroups. A majority of pineapple MADS-box genes were randomly distributed across 19 chromosomes. RNA-seq expression patterns of MADS-box genes in four different tissues revealed that more genes were highly expressed in flowers, which was confirmed by our quantitative RT-PCR results. There is no FLC and CO orthologs in pineapple. The loss of FLC and CO orthologs in pineapple indicated that modified flowering genes network in this tropical plant compared with Arabidopsis . The expression patterns of MADS-box genes in photosynthetic and non-photosynthetic leaf tissues indicated the potential roles of some MADS-box genes in pineapple CAM photosynthesis. The 23% of pineapple MADS-box genes showed diurnal rhythm, indicating that these MADS-box genes are regulated by circadian clock.Conclusions MADS-box genes identified in pineapple are closely related to flowering development. Some MADS-box genes are involved in CAM photosynthesis and regulated by the circadian clock. These findings will facilitate research on the development of unusual spiral inflorescences on pineapple fruit and CAM photosynthesis.
The transfer of knowledge on integrated care among five European regions: a qualitative multi-method study
Authors: Grooten Liset , Vrijhoef Hubertus Johannes Maria , Alhambra-Borrás Tamara , Whitehouse Diane , Devroey Dirk
Published: December 2019

Background To examine how the knowledge transfer processes unfolded within SCIROCCO, a EU funded project (3rd Health Programme (2014-2020)) that aimed to facilitate the process of knowledge sharing across five European regions, to speed up adoption and scaling-up of integrated care initiatives.
Methods A qualitative multi-method design was used. Data collection methods included focus groups, project documents and action plans of the regions. The data was analysed using a qualitative content-analysis procedure, which was guided by the frameworks of knowledge exchange and the why, whose, what, how framework for knowledge mobilisers
Results All five components (including the themes) of knowledge exchange could be identified in the approach developed on the knowledge transfer processes. The four questions and accompanying categories of the framework of knowledge mobilisation were also identified to a large degree.
Conclusions The observed incorporation of distinct forms of knowledge from multiple sources and the observed dynamic and fluid knowledge transfer processes both suggest that SCIROCCO developed a comprehensive knowledge transfer approach aiming to enable the adoption and scaling-up of integrated care. Overall, the multi-method qualitative nature of this research has allowed some new and practical insights in the knowledge transfer activities on integrated care between several European regions. To obtain a clear understanding of the content of the knowledge transfer approaches, which could assist the operationalising of models to support the evaluation of knowledge transfer activities, it is strongly recommended that further research of this type should be conducted in other research settings.
WITHDRAWN: Evaluation of PAX8 Expression Promotes the Proliferation of Stomach Cancer cells
Authors: Bie Liang-Yu , Li Ning , Deng Wen-Ying , Lu Xiao-Yu , Guo Ping , Luo Su-Xia
Published: December 2019

Background PAX8 was not only a mitotic factor, but identified as a transcription factor involved in the prognosis of human tumor patients. Elucidating the function of PAX8 on the pathology of stomach cancer was meaningful. Results: PAX8 was found to be upregulated in primary stomach cancer tissue and the TCGA stomach cancer dataset. Interestingly, SOX13 and PAX8 showed consistent expression patterns, and the combined high PAX8 and SOX18 expression induced a worse prognosis of stomach cancer patients. SOX13 was further identified as a transcription factor of PAX8, and further affect Aurora B and Cyclin B1 expression, two cell cycle related factors of the downstream of PAX8, including. Furthermore, PAX8 depletion inducted G1-phase arrest and the decrease of EdU incorporation, cell viability and colony formation can be rescued by SOX13 overexpression. Conclusions: SOX13 participated in the elevated expression of PAX8, which promote the proliferation of stomach cancer cells. Therefore, SOX13 mediated PAX8 expression was recognized as a tumor-promoting role in stomach cancer.
A Comparison of Contiguous Two-level Anterior Cervical Discectomy and Fusion using a Structural Allograft versus a Polyetheretherketone (PEEK) Cage: The Results of a Three-Year Follow-up
Authors: MOO ING HOW , Kam Carmen Jia Wen , Lai Maksim Wen Sheng , Yeo William , Soh Reuben Chee Cheong
Published: December 2019

Background: Allografts and polyetheretherketone (PEEK) cages are the two most commonly used material in anterior cervical discectomy and fusion (ACDF). However, their effectiveness in in two-level ACDF remains controversial. The primary aim of this retrospective study is to compare the clinical and radiological outcomes of two-level ACDF with plate fixation using either a structural allograft or a PEEK cage. Methods: From 2010 to 2015, 88 consecutive patients underwent a two-level ACDF of which 53 used an allograft and 35 patients with a PEEK cage. All PEEK cages were filled with local autografts. All clinical outcomes were prospectively collected preoperatively, at six months and at two years after surgery. Clinical efficacy was evaluated using visual analogue scale for neck pain and limb pain, the Neck Pain and Disability Score, Neck Disability Index, Neurogenic Symptom Score, and the Japan Orthopedic Association score. Radiological outcomes were assessed preoperatively, immediately after surgery, and at the final follow-up. Results: A preoperative comparison revealed no difference between the two patient groups in terms of age, gender, body mass index, smoking status, preoperative symptoms, operated levels, and follow-up (mean= 42.8 months). No difference in improvements in the clinical outcome between the two groups was observed. Both groups showed significant improvement in mean disc height, segmental height, and segmental lordosis postoperatively. The fusion rates for PEEK cage was 100% at both levels while the fusion rates for allograft group was 98.1% at cephalad level and 94.2% at caudad level (p>0.05). Subsidence at the cephalad level occurred in 22.9% (8/35) segments in the PEEK group and 7.7% (4/52) segments in the allograft group (p=0.057). At the caudal level, a higher cage subsidence was noted in the PEEK group compared to the allograft group [37.1% (13/35) versus 15.4% (8/52)] (p=0.02). Overall, subsidence was noted in 30% (21/70) of the PEEK group and in 11% (12/104) of the allograft group (p<0.05). Conclusion: The use of PEEK cages resulted in a higher rate of subsidence in two-level ACDF as compared to allograft. Two-level ACDF using either allografts or PEEK cages resulted in similar clinical outcomes, radiological improvements in alignment and fusion rates.
Prevalence of Shiga toxin-producing and Enteropathogenic Escherichia coli Isolated from Chicken Meat in the west of Iran
Authors: zarei omid , Shokoohizadeh Leili , Hossainpour Hadi , Alikhani Mohammad Yousef
Published: December 2019

Objective: Shiga toxin-producing Escherichia coli (STEC) is known as a crucial zoonotic foodborne pathogen. Totally, 257 raw chicken meat were collected from markets in Hamadan, west of Iran. The samples were cultured on selective media and the virulence genes of E. coli isolates were analyzed by PCR. The antibiotic resistance patterns were determined by the disk diffusion method. The genetic relatedness of the E. coli O157 isolates was analyzed by ERIC-PCR. Results: Totally, 93 (36%; 95% CI 41.9- 30.1%) isolates were identified as E. coli. Based on microbiological tests, 36 (38.7%; 95% CI 48.6-28.8), 7 (7.5%; 95% CI 12.8-2.2%), and 12 (12.9%; 95% CI 19.7- 6.1%) of the E. coli isolates were characterized as STEC, Enteropathogenic E. coli, and attaching and effacing E. coli (AEEC) strains, respectively. A high level of resistance to nalidixic acid (91.4%; 95% CI 97.1- 85.7%), tetracycline (89.8%; 95% CI 96.2-83.5%), ampicillin (82.8%; 95% CI 90.2-75.1%), and sulfametoxazole-trimotoprime (71%; 95% CI 80.2-61.8%) was detected among the E. coli isolates. The analysis of ERIC-PCR results showed five different ERIC types among the E. coli O157 isolates. Based on findings. Control and check-up of poultry meats should be considered as a crucial issue for public health.
ROS as a Novel Indicator to Predict Anticancer Drug Efficacy
Authors: Zaidieh Tarek , Smith James , Ball Karen , An Qian
Published: December 2019

Background Mitochondria are considered a primary intracellular site of reactive oxygen species (ROS) generation. Generally, cancer cells with mitochondrial genetic abnormalities (copy number change and mutations) have escalated ROS levels compared to normal cells. Since high levels of ROS can trigger apoptosis, treating cancer cells with low doses of mitochondria-targeting / ROS-stimulating agents may offer cancer-specific therapy. This study aimed to investigate how baseline ROS levels might influence cancer cells’ response to ROS-stimulating therapy. Methods Four cancer and one normal cell lines were treated with a conventional drug (cisplatin) and a mitochondria-targeting agent (dequalinium chloride hydrate) separately and jointly. Cell viability was assessed and drug combination synergisms were indicated by the combination index (CI). Mitochondrial DNA copy number (mtDNAcn), ROS and mitochondrial membrane potential (MMP) were measured, and the relative expression levels of the genes and proteins involved in ROS-mediated apoptosis pathways were also investigated. Results Our data showed a correlation between the baseline ROS level, mtDNAcn and drug sensitivity in the tested cells. Synergistic effect of both drugs was also observed with ROS being the key contributor in cell death. Conclusions Our findings suggest that mitochondria-targeting therapy could be more effective compared to conventional treatments. In addition, cancer cells with low levels of ROS may be more sensitive to the treatment, while cells with high levels of ROS may be more resistant. Doubtlessly, further studies employing a wider range of cell lines and in vivo experiments are needed to validate our results. However, this study provides an insight into understanding the influence of intracellular ROS on drug sensitivity, and may lead to the development of new therapeutic strategies to improve efficacy of anticancer therapy.
Social networks and quality of life among female breast cancer patients at Tikur Anbessa Specialzed Hospital, Addis Ababa, Ethiopia 2019
Authors: Author) Rahel Aberaraw(Former Corresponding , Boka Abdisa , Teshome Roza , Author) Addisu Yeshambel(New Corresponding
Published: December 2019

Background : Breast cancer is a major life-threatening public health problem in the world. It is the most common form of cancer on females in many developing countries including Ethiopia. Social networks could change the course of cancer and can influence the quality of life among breast cancer patients. Therefore, the purpose of this study was to assess social networks and quality of life among female breast cancer patients attending in Tikur Anbassa Specialized Hospital, Addis Ababa, Ethiopia 2019. Methods : An institutional-based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia from March to April 2019. A total of 214 female breast cancer patients were included and a systematic sampling method was used. A structured and pre-tested questionnaire was used. Data entry was done using epi data version 4.2. Data analysis was done using Statistical Package for the Social Sciences version 25. Binary and multiple logistic regression was used to show the association of social networks and quality of life. The strength of association was declared P-value <0.05 and 95%CI was used. Result: A total of 214 female with breast cancer were recruited with a mean age of 41.85. From participants, 13(6%), 65(30%) and 136(64%) had limited, medium and diverse social networks respectively. However, 198(92.52%) of them had affected the quality of life. It was found that participants who had children (AOR=5, 95%CL:1.3,21 COR=6), and other relatives(AOR=6, 95%CI: 1.2,30, COR=7), were more likely to have good social networks. In addition, it was found that participants who had systematic therapy side effects(AOR=3.8, 95%CI: 1.1,13, COR=4, p value=0.035), problem of appetite loss(AOR=3.5, 95%CI: 1.02,12 COR=4, p-value= 0.047) were more likely to have affected Quality of life. Conclusion: In this study finding, the quality of life and social networks on breast cancer females was relatively low. Healthcare providers especially working at the oncology department need to focus on addressing the side effects of therapy and social networks which may help to improve the quality of life of females with breast cancer.
“I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.
Authors: Dzomeku Millicent Veronica , Bemah Boamah Mensah Adwoa , Nakua Emmanuel Kweku , Agbadi Pascal , Lori Jody R. , Donkor Peter
Published: December 2019

Background

Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods

An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results

The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion

The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.

Keywords

Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative
“I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.
Authors: Dzomeku Millicent Veronica , Bemah Boamah Mensah Adwoa , Nakua Emmanuel Kweku , Agbadi Pascal , Lori Jody R. , Donkor Peter
Published: December 2019

Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative
Effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors in adults with central obesity: study protocol for a randomized controlled study
Authors: Zhou Juan , Zhao Dan , Wang Ning , Zeng Zhiwei , Wang Changyi , Hao Liping , Peng Xiaolin
Published: December 2019

Background: The prevalence of central obesity is increasing consistently, and visceral fat is associated with increased production of inflammatory factors and metabolic risk factors. Lutein might retard the development of metabolic disease through its antioxidant and anti-inflammatory properties. Furthermore, epidemiological studies have associated higher dietary intake and serum levels of lutein with decreased adiposity. However, few randomized controlled trials (RCTs) have shown the effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors, especially in adults with central obesity. Methods: This study will be conducted as a double-blinded, parallel placebo-controlled clinical trial in which 120 people with central obesity aged 18-60 years old and willing to provide informed consent will be randomly assigned to the intervention or placebo group in a 1:1 ratio according to sex, age and waist circumference. The intervention group will receive 10 mg daily lutein supplementation for 12 weeks to explore the effect of lutein supplementation on serum lutein, glycaemic and lipid profiles, inflammatory factors and body composition. Two populations (intention-to-treat population and per-protocol population) will be used in the data analyses. Discussion: Our findings from this trial will contribute to the knowledge of the association between lutein supplementation and inflammatory biomarkers and metabolic risk factors in people with central obesity, which will offer a possibility for the prevention of inflammatory diseases.
A Retrospective Analysis on Metastatic Rate of the Internal Mammary Lymph Node and Its Clinical Significance in Adjuvant Radiotherapy of Breast Cancer Patients
Authors: Li Li , Zhang Hongyan , Wang Linwei , xie Conghua , Zhou Yunfeng , Zhong Yahua
Published: December 2019

Background : There is a discrepancy about the metastatic rate of internal mammary lymph nodes (IMNs) between clinical and pathologic findings. We aimed to investigate the metastatic rate of IMNs and to provide recommendations on target volume delineation of IMNs for adjuvant radiotherapy in breast cancer patients. Methods : We retrospectively analyzed data from 114 breast cancer patients treated with surgery without adjuvant radiotherapy who developed local and/or regional lymph node recurrence/metastasis at our institute from January 2015 to January 2019. Patients with widely lung or pleural metastases were excluded. We first analyzed the recurrence rate with the chest wall, the metastatic rate of internal mammary/anterior mediastinal, ipsilateral axillary and supraclavicular lymph nodes, and then investigated the distribution of the IMNs. Results : Among the 114 included patients, the recurrence rate with the chest wall, metastatic rate of IMNs, IMNs/anterior mediastinal lymph nodes, ipsilateral axillary lymph nodes, and the ipsilateral supraclavicular lymph nodes was 43%, 37.7%, 59.6%, 12.3%, and 22.8%, respectively. The metastatic IMNs were mainly located from the first to the second intercostal space. However, metastatic lymph nodes could also be observed above the upper edge of the first rib.Conclusions : The metastatic rate is high in the IMNs and irradiation of the internal mammary lymphatic chain is required. It is suggested that the upper bound of the internal mammary lymphatic chain should be up to the subclavian vein with a 5-mm margin, thus connecting to the caudal border of supraclavicular clinical target volume in breast cancer patients at high risk of recurrence.
Comparison of dental plaque reduction after use of electric toothbrushes with and without QLF-D-applied plaque visualization: A 1-week randomized controlled trial
Authors: Akifusa Sumio , Isobe Ayaka , Kibata Kanako , Oyama Akinori , Oyama Hiroko , Ariyoshi Wataru , Nishihara Tatsuji
Published: December 2019

Background: To evaluate the efficacy of a newly developed electric toothbrush in reducing dental plaque via a quantitative light-induced fluorescence-digital (QLF-D)-applied visualisation system in the brush head.Methods: Participants included 20 adults aged 19 to 28 years. Participants were randomly assigned either (i) an electric toothbrush with a monitor to visualise red-fluorescent dental plaque via a camera built into the brush head (monitor usage group, n = 10) or (ii) an electric toothbrush without a monitor (monitor-non-use group, n = 10). The amount of dental plaque was assessed by personal hygiene performance (PHP) at baseline and 1 week later.Results: In the monitor-usage group, PHP score was significantly lower at the 1-week follow-up than at baseline (6 vs 16; range, 0–12 vs 13–21; P = 0.029). This change was not observed in the monitor-non-use group (14 vs 13; range, 6-21 vs 2-26; P = 0.778). After 1 week, the change in PHP scores in the monitor usage group was significantly greater than that in the monitor non-use group (−10 vs 0; range, -21 to 9 vs -8 to 16; P = 0.021).Conclusions: Our results clearly demonstrate that brushing teeth while looking at a monitor that depicts red-autofluorescent dental plaque via application of QLF-D improved the efficacy of dental-plaque removal relative to brushing teeth without a monitor.
Percutaneous Coronary Intervention in Diabetic versus Non-diabetic Patients with Prior Coronary Artery Bypass Grafting: A Propensity Score Matching Study
Authors: Ma Xiaolong , Dong Ran , Chen Pengfei , Zhao Yichen , Zeng Caiwu , Xin Meng , Ye Qing , Wang Jiangang
Published: December 2019

Background: The target of this study was to explore the outcomes of percutaneous coronary intervention (PCI) in diabetic versus non-diabetic patients with prior coronary artery bypass grafting (CABG) surgery.
Methods: Seven hundred and twenty four patients who had previously received CABG and had been treated using PCI combined with drug-eluting stents (DES) between 2009 and 2017 were selected for a retrospective study and allocated into either a diabetes mellitus (DM) or non-diabetes mellitus (No DM) group. A 1:1 propensity score-matched evaluation was conducted and risk adjusted for analysis. The primary outcomes were cardiac death, myocardial infarction, heart failure and revascularization, with a median follow-up duration of 5.13 years.
Results: After matching, two-, 5- and 8-year event rate of overall major adverse cardiac events (MACEs) were found to be higher in the DM group (No DM vs DM:15.3%, 30.9%, 38.5% vs 19.8%, 37.8%, 52.2%, respectively), although no significant difference was found in the event rate of overall MACEs (hazard ratio [HR]: 1.35; 95% confidence interval [CI]: 1.00 to 1.83 for DM vs No DM; P=0.052), cardiac death (HR: 0.94; 95% CI: 0.45 to 1.95; P=0.871), MI (HR: 1.49; 95% CI: 0.95 to 2.32; P=0.080), HF (HR: 1.54; 95% CI: 0.90 to 2.63 for; P=0.120) or revascularization (HR: 1.07; 95% CI: 0.72 to 1.59; P=0.747). Subgroup analysis of PCI in only the NCA showed MACEs (adjusted HR: 1.13; 95% CI: 0.85 to 1.49 for DM vs No DM; P=0.325), cardiac death (adjusted HR: 0.85; 95% CI: 0.41 to 1.78 for DM vs No DM; P=0.781), MI (adjusted HR: 1.32; 95% CI: 0.84 to 2.01 for DM vs No DM; P=0.069), HF (adjusted HR: 1.41; 95% CI: 0.87 to 2.27 for DM vs No DM; P=0.211) or repeated revascularization (adjusted HR: 0.93; 95% CI: 0.64 to 1.37 for DM vs No DM; P=0.836).
Conclusions : Compared with non-diabetic patients with prior CABG, subsequent implantation of DES in the native coronary artery of diabetic patients resulted in apparently similar outcomes.
Trial registration : This study was not registered in an open access database.
Key Words: Percutaneous coronary intervention; Diabetic; Non-diabetic; Coronary artery bypass grafting.
Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke
Authors: Wang Yanan , Song Quhong , Cheng Yajun , Wei Chenchen , Ye Chen , Liu Junfeng , Wu Bo , Liu Ming
Published: December 2019

Background : It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT. Methods: We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis. Results: A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted Odds ratios [ORs] 1.74 [95% Confidence Interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend=0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age ( P for interaction=0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values (Non-HDL-C, net reclassification index [NRI] 0.24, 95%CI 0.17-0.31, P<0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P=0.03). Conclusions: Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT. Keywords: Non-high-density lipoprotein cholesterol, Haemorrhagic transformation, Acute ischaemic stroke
Treatment Patterns and Sequences of Pharmacotherapy for Patients Diagnosed with Depression in the United States: 2014 through 2019
Authors: Kern David M. , Cepeda M. Soledad , Defalco Frank , Etropolski Mila
Published: December 2019

Background: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. Methods: Patients with depression were identified from four large national claims databases during 1/1/2014-1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and three years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. Results: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29% to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. Conclusions: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.
Association of Maternal Ethnicity and Urbanicity on Severe Pediatric Disease: A Nationwide Cohort Study
Authors: Chang Ya-Ting , Wang Huei-Shyong , Liu Jia-Rou , Tseng Chi-Nan , Chou I-Jun , Luo Shue-Fen , Kuo Chang-Fu , See Lai-Chu
Published: December 2019

Background: A healthy migrant effect on birth outcomes has been reported, however, whether this protective effect persists throughout childhood is unknown. The effect of urbanicity on child health among an immigrant population is unclear. The objective of this study was to compare the incidence rate and cumulative incidence of severe diseases among urban children of Taiwan-born mothers, rural children of Taiwan-born mothers, urban children of foreign-born mothers, and rural children of foreign-born mothers.
Methods: A nationwide cohort study was conducted for children born in Taiwan during 2004-2011 and follow-up till age 4 to 11 years old by linkage the Taiwan Birth Registry 2004-2011, Taiwan Death Registry 2004-2015, and National Health Insurance Research Database 2004-2015. Cox proportional hazards model (multivariable) was used to examine differences among the four study groups.
Results: There were 682,982 urban children of Taiwan-born mothers, 662,818 rural children of Taiwan-born mothers, 61,570 urban children of foreign-born mothers, 87,473 rural children of foreign-born mothers. Children of foreign-born mothers had a lower incidence of vasculitis, mainly Kawasaki disease. The incidences of congenital disorders did not differ between children of foreign-born mothers and children of Taiwan-born mothers. The incidence of psychotic disorders was higher in urban children. However, children in rural areas had a higher incidence of major trauma/burn and a higher mortality rate.
Conclusions: A healthy migrant effect was only seen for Kawasaki disease. The mental health of urban children born to immigrant mothers warrants concern.
High-throughput sequencing analysis of intestinal flora changes in ESRD and CKD patients
Authors: Hu Jianguang , Zhong Xiaoshi , Yan Jing , Zhou Daoyuan , Qin Danping , Xiao Xiao , Zheng Yuanyuan , liu yan
Published: December 2019

Background Chronic kidney disease (CKD) disease affects gut flora by causing dysbiosis and lead to systemic inflammatory conditions. Here, we provide intestinal flora changes of CKD patients undertook different hemodialysis therapy.Methods Patients were recruited during 2017-2019 and divided into healthy control group (CT), CKD non-dialysis group (CKD), hemodialysis group (HD) and peritoneal dialysis group (PD). Intestinal flora genome 16S rDNA sequencing and further bio-informatic analysis were performed.Results Decreased diversity and altered communities of intestinal flora in PD patients, in which microbial diversity was positive correlated with the albumin level were observed. A total of 20 intestinal flora phyla were detected in 166 fecal samples, divided into 3 dominant intestinal types including Bacteroides-dominant gut type, Firmicutes-dominant type and Proteobacteria-dominant gut type. Further analyses found 198 genera, the abundance of 86 genera were significantly different. Butyrate-producing taxa as Faecalibacterium in genera level and Bifidobacteriaceae and Prevotellaceae in family level were dominant genus in CT, CKD, and HD groups, while urease containing-, indole- and p-cresol-forming taxa as Escherichia in genera and Enterobacteriaceae , Enterococcaceae in family level was dominated genus in PD group. Number of differential expressed genes in KEGG enrichment pathways were significantly different in PD group in carbohydrate metabolism, amino acid metabolism, energy metabolism, translation, and membrane transport.Conclusion Our results suggest peritoneal dialysis therapy could result in reduced diversity and altered microbial communities, with reduced probiotic butyrate-producing taxa and increased urease containing-, indole- and p-cresol-forming taxa. The disordered intestinal flora can seriously affect the nutrition level in CKD patients with PD therapy.
An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017
Authors: simusika paul , Tempia Stefano , Chentulo Edward , Polansky Lauren , Mazaba Mazyanga , Ndumba Idah , Mbewe Quinn K , Monze Mwaka Anna
Published: December 2019

Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.