bluuebunny/crossref_metadata_2025 huggingface dataset:
INDICADORES DE SUSTENTABILIDADE E A GESTÃO PÚBLICA, NOVOS CAMINHOS EM BUSCA DA EFICIÊNCIA E DO ATENDIMENTO DAS NECESSIDADES SOCIAIS: ESTUDO DE CASO DOS MUNICIPIOS PARAIBANOS
Authors: Almeida Sabrina Ribeiro , Curi Wilson Fadlo , De Castro Lucena Vieira Zedna Mara , Lucena de Medeiros Luísa Eduarda
Published: August 2019

Diante da complexidade da sociedade moderna e das mudanças decorrentes do século XX, faz-se necessário repensar as formas impostas de desenvolvimento. Agora, esse desenvolvimento precisa melhorar a qualidade de vida das pessoas, preservar o meio ambiente e garantir o crescimento econômico, ou seja, ser sustentável. Essa mudança, passa necessariamente pela gestão pública, que é responsável pela instituição das políticas públicas, sobretudo o poder local que está em maior proximidade a comunidade. Nessa perspectiva, o objetivo deste estudo é desenvolver um índice de sustentabilidade social (ISS) e enquadrar os municípios em níveis de sustentabilidade social, buscando avaliar o desempenho quanto a fatores sociais e institucionais e fornecendo informações relevantes para a tomada de decisão. Para isso, foram utilizados indicadores de sustentabilidade, pois estes simplificam o entendimento dos dados e das informações, facilitando a tomada de decisão e democratizando o conhecimento. Os municípios selecionados como caso de estudo foram os da Região Administrativa de Campina Grande, devido à sua relevância para o Estado da Paraíba. Os resultados encontrados, com a aplicação do índice, evidenciaram que a maioria dos municípios se enquadra nas faixas de “baixa sustentabilidade” e “média sustentabilidade”. Esses resultados alertam para a necessidade de melhorias na gestão e no planejamento dos fatores ligados à dimensão social, através da percepção dos anseios e problemas da população, com o objetivo de melhorar a qualidade de vida dessas comunidades.
O QUE VOCÊ FAZ COM SEU TEMPO? UM ESTUDO SOBRE WORK-LIFE BALANCE
Authors: De Andrade Lucas , Schafer Joice Denise , Lunkes Rogério João
Published: August 2019

A presente pesquisa se propôs a ampliar os estudos acerca da temática Work-Life Balance. Para tanto, buscou verificar se as características dos funcionários e a flexibilidade da jornada de trabalho proposta por uma empresa de tecnologia da Grande Florianópolis refletem na percepção de gestão adequada de tempo e, respectivamente, no equilíbrio entre vida pessoal e laboral (Work-Life Balance) dos colaboradores. A metodologia utilizada caracteriza-se quanto ao objetivo como descritiva, sendo a coleta de dados realizada com a aplicação de um questionário, por meio da plataforma virtual do “Google Forms”. Os dados foram analisados inicialmente de forma descritiva, o que permitiu identificar um perfil jovem e sem filhos dos funcionários, e a percepção dos mesmos sobre a gestão adequada do tempo e de equilíbrio entre vida pessoal e laboral. Enquanto a diferença da área de formação e idade foram estatisticamente significativas no que se refere a uma das variáveis de gestão de tempo (tempo para o sono), bem como, no caso da formação, para o equilíbrio entre vida pessoal e laboral (para a variável redução de carga horária com redução proporcional de salário); a flexibilização da carga horária de trabalho por parte da empresa não parece exercer influência sobre a percepção dos funcionários quanto a gestão de tempo e equilíbrio da vida pessoal e laboral. Este resultado pode ser justificado pela política de promoção de um ambiente de trabalho descontraído por parte da empresa a todos os funcionários.
ANÁLISE DE RISCO DAS EMPRESAS LISTADAS NO ISE 2018 DA B3
Authors: Tiozo Evandro , Leismann Edison Luiz
Published: August 2019

Este estudo tem por objetivo analisar se as empresas listadas no Índice de Sustentabilidade Empresarial (ISE) 2018 da B3 apresentam risco diferente em relação ao seu tamanho. Para realização desta pesquisa quantitativa, foram analisados 120 demonstrativos financeiros, referentes aos períodos de 2013 a 2017, das 24 empresas listadas no índice, excluídas as instituições financeiras. A pesquisa se classifica como descritiva e exploratória quanto aos seus objetivos e quanto aos procedimentos é uma pesquisa documental. Os indicadores utilizados foram o saldo de tesouraria de Fleuriet, liquidez corrente, endividamento geral, fator de insolvência de Kanitz e Valor Econômico Agregado. Os resultados obtidos por meio da análise dos dados com os indicadores financeiros, indicam que as empresas do ISE, em sua maior parte, apresentam baixo risco, e que ao dividir as empresas em dois grupos, um com os maiores ativos e outro com os menores do índice, consegue se verificar que os que tem menores ativos se sobressaem em relação ao outro, em relação ao saldo de tesouraria, liquidez corrente e no fator de solvência, que indicam que essas empresas apresentam risco menor. Como sugestão para novas pesquisa, seria importante comparar o risco das empresas do ISE com os demais índices, também se tem a possibilidade de utilizar outros indicadores para análise de risco.
GERENCIAMENTO DE PROJETOS DE OBRAS PÚBLICAS: COMPREENSÃO DESSES INVESTIMENTOS PÚBLICOS.
Authors: Bordignon Fernando Junqueira , Arenas Marlene Valerio dos Santos
Published: August 2019

Esta pesquisa buscou compreender a forma do investimento público em obras públicas sob o aspecto da eficiência e eficácia que deve pautar a ação estatal. Utilizando como principal base o Gerenciamento de projetos, a pesquisa buscou em três grandes empreendimentos rodoviários públicos avaliar a aplicação de ferramentas de gestão e de gerenciamento de projetos por partes dos gestores públicos. As ferramentas de pesquisas foram baseadas em entrevistas semiestruturas, análise documental e observação direta. Para as entrevistas foram selecionados profissionais públicos de alta gerência, bem como os profissionais públicos que atuam diretamente nas obras, esta seleção teve a capacidade de captar com fidedignidade a realidade investigada. Os resultados demonstraram que, processos que têm alta exigência legal e dos órgãos de controle, têm alta aderência com as melhores práticas de gerenciamento de projetos, por outro lado existiram processos prejudicados por terem menor exigência da legislação e também por restrições de pessoal e recursos. Também foram realizadas recomendações aos administradores públicos com o intuito de alavancar o atingimento de resultados na área pesquisada, trabalho este materializado em uma cartilha orientativa que será disponibilizada aos administradores públicos.

Palavras chaves: Eficiência do gasto público. Obras públicas. Projetos complexos.
RELIGION AND FINANCE
Authors: El Khatib Ahmed Sameer , Lisboa Nahor Plácido
Published: August 2019

Despite the increasing attention to ethical investments, the empirical studies on Islamic indices are scarce. The principles of Islamic indices are similar to those of other ethical indices in terms of the screening process; both of them are also characterized by their short histories. So, after Islamic indices were introduced in the late nineties, many financial markets and index providers launched their own Islamic indices for investors looking for investment opportunities without compromising their beliefs. Analysing the financial performance of Islamic equity indices from all relevant providers, we document these indices to outperform their conventional benchmarks on a global and developed market level after controlling for investment styles and a potential back-testing bias. To explain this outperformance puzzle, we investigate fundamental (i.e., risk factors), behavioural (i.e., Ramadan) and research design (i.e., sample length) related explanations but the overall results persist. When eliminating the effect of the financial services industry from conventional benchmarks, however, the outperformance of all indices except the Dow Jones Islamic Market (DJIM) world index disappears. This implies that Islamic equity indices have outperformed due to their critical position towards risk-free interest and the financial services industry. We conclude that they represent a viable alternative for risk-averse passive investors, especially during periods of high uncertainty around financial services. Further research is needed to fully understand the abnormally good performance of the DJIM.
Selenium species in selenium-enriched malt
Authors: Revenco Diomid , Vomáčková Marie , Jelínek Lukáš , Mestek Oto , Koplík Richard
Published: August 2019

Selenium-enriched malts were prepared by an application of sodium selenite solution to steeped barley grain and following germination and kilning. The changes of selenium valency and the biotransformation of inorganic selenium were investigated by selenium speciation analysis in enzyme-hydrolysed malt samples using liquid chromatography-inductively coupled plasma mass spectrometry. Both inorganic compounds (selenate, selenite) and Se-containing amino acids (selenocystine, Se-methyl-selenocysteine, selenomethionine) were found in green and kilned barley malt.
Hate the Players, or the Game? The Role of Court Mediators and Hearing Officers in the Civil Protection Order Process
Authors: Carcirieri Ava T. , Fleury-Steiner Ruth E. , Miller Susan L.
Published: August 2019

Civil Protection Orders (CPOs) are among the most common legal tools that victims of intimate partner violence and abuse (IPV/A) use to protect themselves. The current study adds to the CPO research by using quantitative data to look at how female survivors' experiences with court personnel (attorneys, mediators, and hearing officers) shape their satisfaction with the court process, and what types of individual and court-related factors are related to perceived fairness of court personnel. The current study uses in-depth quantitative data collected from women over the age of 18 who sought a CPO due to violence from a male current or former partner. The findings indicate that women's satisfaction with the court process is significantly impacted by the perceived fairness of court personnel. In turn, specific behaviors by court personnel predict women's ratings of fairness of those personnel. Additionally, women's socioeconomic status impacts how fair they perceive the hearing officers to be. Court personnel play an integral role in helping victims navigate the legal system in ways that could protect their safety and influence how they perceive the CPO system as it relates to the abuse they have experienced.
Şuhut (Afyonkarahisar) Batısı Su Kaynaklarının Hidrojeoloji ve Hidrojeokimyasal İncelemesi
Authors: Davraz Ayşen , Bal Yaşar , Aksever Fatma , Varol Simge
Published: August 2019

Bölgede
kaynak sularının sulama suyu olarak kullanıma uygun olduğu tespit edilmiştir. Bu çalışmada, Şuhut (Afyonkarahisar) ilçesi
batısında bulunan su kaynaklarının hidrojeokimyasal özellikleri incelenmiştir. Kaynak
sularından Eylül-2017 ve Nisan-2018 dönemlerinde yapılan analiz sonuçlarına
göre CaMgHCO3, CaNaSO4, CaNaHCO3 ve CaHCO3
su tipleri tespit edilmiştir. Su kaynaklarının Eylül-2017 ve Eylül-2018
arasında aylık periyodik debi ölçümleri yapılmıştır. Kaynakların yıllık baz
akım değerleri 311.04–4302.72 m3/yıl
ve ortalama debi değerleri 0.01-1.81 l/s arasında değişmektedir. Kaynak
sularının genel olarak fiziksel özellikleri ve anyon-katyon içerikleri
açısından içme suyu sınır değerlerini aşmadığı görülmektedir. Ancak, kaynak
sularının As konsantrasyonu 6.1-22.9 μg/l arasında değişmektedir. Kumalar kaynağı ve
Deveyatağı kaynağı dışındaki bütün kaynak sularında kaya-su etkileşimine bağlı
olarak As artışı tespit edilmiştir. Kayabelen’de bulunan Dedecik kaynağının Fe,
Mn ve Ni içerikleri de içme suyu standart değerlerinin üzerindedir. Kaynak sularındaki ağır metal artışları
genelde volkanik kayaçlarla ilişkili olarak jeojenik kökenlidir. Kumalar
kaynağı içmesuyu olarak kullanıma en uygun kaynaktır.
Pyrolysis of Biomass Waste as The Project Based Learning in Community Assistance Course
Authors: Sahroni Imam
Published: August 2019

Community assistance course is a special course for undergraduate student level which need to be finished before doing final thesis project. This course aims to apply the student knowledge which is gained during six semesters in the class. This course is followed by fourty eight students from different department e.g. science, engineering, psychology, law, medicine, and also Islamic studies. We applied a pyrolysis of biomass waste as the tools for Project based learning in community area. We divide fourty eight student into eight teams. Each team was assigned to do some task e.g. literature study, project design, project implementation, and project report based on the pyrolysis project. After the project was finished, we evaluate the grade of each student using the learning outcome which was defined as the goal of the study. Fourty six students acquired grade A, while the other two students acquired grade B. This achievement related to the project based learning that we used in the Community Assistance Course.   Keywords: project-based learning, pyrolysis, community assistance course
The ZIKA Virus Controls Cell Death through the Anti-Apoptotic Bcl-2 Family Proteins
Authors: Turpin Jonathan , Frumence Etienne , Desprès Philippe , Viranaïcken Wildriss , Krejbich-Trotot Pascale
Published: August 2019

Zika virus (ZIKV) is an emerging human mosquito-transmitted pathogen of global concern, known to cause severe complications such as congenital defects and neurological disorders in adults. ZIKV infection is associated with cell death. However, previous studies suggest that the virally-induced apoptosis occurs at a slower rate compared to the course of viral production. In this present study, we investigated the capacity of ZIKV to delay host cell apoptosis. We provide evidence that ZIKV has the ability to control programmed cell death whether it is intrinsically or extrinsically induced. In cells expressing viral replicon-type constructions, we show that this control is achieved through replication. Finally, our work highlights an important role for anti-apoptotic Bcl-2 family protein in the ability of ZIKV to control apoptotic pathways, avoiding premature cell death and thereby promoting virus replication in the host-cell.
Nature Rx: Reemergence of Pediatric Nature-Based Therapeutic Programs From the Late 19th and Early 20th Centuries
Authors: Crnic Meghan , Kondo Michelle C.
Published: August 2019

Across the United States, physicians are prescribing patients nature. These “Nature Rx” programs promote outdoor activity as a measure to combat health epidemics stemming from sedentary lifestyles. Despite the apparent novelty of nature prescription programs, they are not new. Rather, they are a reemergence of nature-based therapeutics that characterized children’s health programs in the late 19th and early 20th centuries. These historic programs were popular among working-class urban families, physicians, and public health officials. By contrast, adherence is a challenge for contemporary programs, especially in socially disadvantaged areas. Although there are differences in nature prescription programs and social context, historical antecedents provide important lessons about the need to provide accessible resources and build on existing social networks. They also show that nature—and its related health benefits—does not easily yield itself to precise scientific measurements or outcomes. Recognizing these constraints may be critical to nature prescription programs’ continued success and support from the medical profession.
Housing Instability Characteristics Among Transgender Veterans Cared for in the Veterans Health Administration, 2013–2016
Authors: Carter Sarah P. , Montgomery Ann E. , Henderson Emmett R. , Ketterer Bryan , Dichter Melissa , Gordon Adam J. , Shipherd Jillian C. , Kauth Michael R. , Blosnich John R.
Published: August 2019

Objectives. To characterize housing instability among transgender veterans using Veterans Health Administration (VHA) health care in the United States.

Methods. We used administrative data on veterans screened for housing instability from 2013 to 2016; participants included 5717 transgender veterans and 17 133 cisgender veterans. We defined housing instability by a positive screen or VHA Homeless Program use. We identified gender from medical records, reflecting either birth sex or gender identity. We identified transgender identity through transgender-related International Classification of Diseases, Ninth Revision and Tenth Revision codes. A multiple logistic regression assessed the association of transgender identity with housing instability.

Results. Prevalence of housing instability was nearly 3 times higher among transgender veterans than among cisgender veterans (19.9% vs 6.7%; P < .001). The difference persisted when we adjusted for sociodemographics (adjusted odds ratio = 2.32; 95% confidence interval = 2.09, 2.57). Transgender veterans experiencing housing instability were more likely than cisgender veterans to be women, younger, unmarried, and White.

Conclusions. Transgender veterans experience housing instability more frequently than do cisgender veterans. An increased focus on transgender identity is critical for reducing veteran homelessness.
A Framework for Increasing Equity Impact in Obesity Prevention
Authors: Kumanyika Shiriki K.
Published: August 2019

One of the most pressing unmet challenges for preventing and controlling epidemic obesity is ensuring that socially disadvantaged populations benefit from relevant public health interventions. Obesity levels are disproportionately high in ethnic minority, low-income, and other socially marginalized US population groups. Current policy, systems, and environmental change interventions target obesity-promoting aspects of physical, economic, social, and information environments but do not necessarily account for inequities in environmental contexts and, therefore, may perpetuate disparities.

I propose a framework to guide practitioners and researchers in public health and other fields that contribute to obesity prevention in identifying ways to give greater priority to equity issues when undertaking policy, systems, and environmental change strategies. My core argument is that these approaches to improving options for healthy eating and physical activity should be linked to strategies that account for or directly address social determinants of health.

I describe the framework rationale and elements and provide research and practice examples of its use in the US context. The approach may also apply to other health problems and in countries where similar inequities are observed.
The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000–2016
Authors: Zewde Naomi , Eliason Erica , Allen Heidi , Gross Tal
Published: August 2019

Objectives. To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansions on national rates of home eviction and eviction initiation in the United States.

Methods. Using nationally representative administrative data from The Eviction Lab at Princeton University, we estimated the effects of the ACA Medicaid expansions on county-level evictions and filings from 2000 to 2016 with a difference-in-difference regression design.

Results. We found that Medicaid expansions were associated with an annual reduction in the rate of evictions by 1.15 per 1000 renter-occupied households (P < .001), a reduction of 1.59 eviction filings per 1000 renter-occupied households (P < .001), and a reduction in the average number of evictions by 46 (P < .05). We found additional evidence that increasing rates of African American residents in a county was associated with a greater rate of evictions filed, and increased rates of poverty and rent burdens relative to income were associated with more evictions both filed and completed.

Conclusions. Evictions decreased after Medicaid expansion, demonstrating further evidence of the substantive financial protections afforded by this coverage. The reduction in the eviction filing rate suggests that Medicaid expansion could be reducing evictions by preventing the court proceeding entirely.
The Relationship of the Terms Vape and E-Cigarette With Newspaper Content
Authors: Cross Kandice , Wu Joshua , Roberts Megan E. , Ferketich Amy K.
Published: August 2019

Objectives. To conduct a content analysis of news articles to investigate the relationship between language used to describe e-cigarettes, how the news articles framed (conveyed information to influence a certain perception of the news read by its audience) e-cigarettes, and the Food and Drug Administration’s (FDA’s) oversight of e-cigarettes.

Methods. We searched a database of articles published across the United States from February 1, 2016, to February 28, 2017, using the headline terms “e-cigarette,” “e-cig,” and “vape.” We then dichotomized terms into 2 categories: technical (“e-cigarette” or “e-cig”) and nontechnical (“vape”). We coded the frame of each article body as positive, negative, or neutral or mixed.

Results. Articles containing the term “vape” in the headline were more likely to positively frame e-cigarettes (P ≤ .001) and negatively frame FDA oversight (P ≤ .001) in the body than were those with “e-cigarette” or “e-cig” in the headline.

Conclusions. Omitting the word “cigarette” when describing tobacco products may reduce the negative perception associated with tobacco use, making it more appealing. It is important to know which terms are used to describe e-cigarettes and how these terms can make those products appear less harmful.
A Comparison of Treatment Effects for Nonsurgical Therapies and the Minimum Clinically Important Difference in Knee Osteoarthritis
Authors: Concoff Andrew , Rosen Jeffrey , Fu Freddie , Bhandari Mohit , Boyer Kevin , Karlsson Jon , Einhorn Thomas A. , Schemitsch Emil
Published: August 2019

Background:

The minimum clinically important difference (MCID) was developed to ascertain the smallest change in an outcome that patients perceive as beneficial. The objectives of the present review were (1) to compare the MCIDs for pain assessments used among guidelines and meta-analyses investigating different nonsurgical therapies for knee osteoarthritis and (2) to compare the effect estimates of different nonsurgical interventions against a single commonly-utilized MCID threshold.

Methods:

Systematic and manual searches were conducted to identify guidelines and meta-analyses evaluating pain outcomes for nonsurgical knee osteoarthritis interventions. Individual treatment effects for pain were presented on a common scale (the standardized mean difference [SMD]). To evaluate the perception of the relative benefit of each nonsurgical treatment, the variation in MCIDs selected from the published MCID literature was assessed.

Results:

Thirty-seven guidelines and meta-analyses were included. MCIDs were often presented as an SMD or a mean difference (MD) on a validated scale and varied in magnitude across sources. This analysis demonstrated that intra-articular hyaluronic acid, intra-articular corticosteroids, and acetaminophen all had relatively larger effect sizes than topical nonsteroidal anti-inflammatory drugs (NSAIDs). Higher-molecular-weight intra-articular hyaluronic acid had a greater relative effect compared with both non-selective and cyclooxygenase-2-selective oral NSAIDs. Evaluating the treatment effect estimates against a commonly utilized MCID revealed similarities in which observations attained clinical significance among treatments; however, this observation varied across the range of reported MCIDs.

Conclusions:

The present review confirmed the variability in the MCIDs for pain assessments that are used across guidelines and meta-analyses evaluating nonsurgical interventions for knee osteoarthritis. This variability may yield conflicting treatment recommendations, ranging from rejecting treatments that are indeed efficacious to accepting treatments that may not be beneficial. Additional research is required to determine why some nonsurgical therapies are more consistently recommended in knee osteoarthritis guidelines than others as these findings suggest similarities in their effect estimates for pain. Relevant stakeholders need to reach a consensus on a standard approach to determining the MCIDs for these therapies to ensure that appropriate and effective treatment options are available to patients prior to invasive surgical intervention.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Sarcopenia, Cerebral Palsy, and Botulinum Toxin Type A
Authors: Multani Iqbal , Manji Jamil , Tang Min Jia , Herzog Walter , Howard Jason J. , Graham H. Kerr
Published: August 2019

» Sarcopenia is common in both the elderly and children with cerebral palsy.

» Children with cerebral palsy have muscles that are much smaller than muscles in typically developing peers.

» Injections of botulinum toxin type A (BoNT-A) result in acute muscle atrophy in animal models and in human subjects.

» It is not known when or if muscles recover fully after injection of BoNT-A.

» These findings have implications for management protocols.
Proposal and Experimental Trials on an Autonomous Robot for Rigless Well Intervention
Authors: Santos Hugo , Paz Paulo , Krettli Igor , Reis Ney , Pinto Hardy , Galassi Maurício , Pozzani Daniel , Lanzilotta Alessandro , Castro Bruno , Ferreira André , Thomé Lincoln , Beal Valter
Published: August 2019

Well interventions, especially in offshore wells, are costly and usually very time-consuming to conduct. This is related mainly to the need for a rig or a similar unit to perform these operations. In this paper we propose the development of an autonomous robot for rigless well interventions. The robot will be inserted through the tree using a special tool. This proposal will result in significant cost reduction by eliminating the rig when performing light–workover operations in offshore locations. This reduces intervention time because a simpler unit might be used to deploy the robot. Examples of operations that could be performed by the robot are production logging, gas–lift valve replacement, sliding–sleeve opening and closing, and plug insertion or removal. To evaluate this proposal, a conceptual robot was designed. The feasibility of this conceptual robot was evaluated theoretically. After that, a simplified test robot was constructed to test critical aspects experimentally, in laboratories, and in a test well. The traction system, energy storage, and a positioning algorithm were evaluated. In this paper we will outline the intervention strategy proposed, perform a theoretical evaluation of this proposal on the basis of the conceptual robot, and present experimental results obtained with the simplified test robot.
Effectiveness of Steroids Vs Placebo in Preventing Upper Airway Obstruction After Extubation in Critically-ill Children: Rationale and Design of a Multicentric, Double-blind, Randomized Study
Authors: Manrique Gema , Laiseca Laura Butragueño , González Rafael , Rey Corsino , Martínez Zuriñe , Gil Javier , Rodriguez Antonio , Martínez Cecilia , Manrique Silvia , López-Herce Jesús
Published: August 2019

Background Post-extubation upper airway obstruction (UAO) is a frequent complication causing stridor and respiratory distress, which occasionally may require reintubation, thereby increasing morbidity and mortality rates. Contradictory results have been obtained in studies assessing the effectiveness of steroids in preventing post-extubation UAO, and the available evidence is limited. We designed a multicentric randomized, placebo-controlled study to explore the effectiveness of dexamethasone in preventing post-extubation UAO in children. Methods A multicentric, prospective, double-blind, randomized, placebo-controlled, phase IV clinical trial has been designed. The sample will include pediatric patients between 1 month and 16 years of age who have been intubated for more than 48 hours. Patients with airway disorders or who have received steroids within the last seven days will be excluded. Patients will be randomized to receive either placebo or a therapy with dexamethasone 0.25 mg/kg every 6 hours to be started 6-to-12 hours prior to extubation, to a total of four doses. Randomization will be performed at a 1:1 ratio. Follow-up of patients will be carried out for 48 h after extubation. The main objective of this study is to assess the reduction of UAO symptoms following extubation, as measured using the Taussig scale. Secondary objectives include assessing the decrease in the incidence of reintubation, evaluating the use of additional therapies for upper airway obstruction, and monitoring dexamethasone potential side effects. Discussion The results of this study will contribute to the existing evidence on prophylaxis for post-extubation airway obstruction.
Differential expression of IDA (INFLORESCENCE DEFICIENT IN ABSCISSION)-like genes in Nicotiana benthamiana during corolla abscission, stem growth and water stress
Authors: Ventimilla Daniel , Domingo Concha , Talon Manuel , Tadeo Francisco R.
Published: August 2019

Background

IDA (INFLORESCENCE DEFICIENT IN ABSCISSION)-like signaling peptides and the associated HAE (HAESA)-like family of receptor kinases were originally reported in the model plant Arabidopsis thaliana (Arabidopsis) to be involved in the regulation of abscission. IDA peptides, as cell-to-cell communication elements, appear to be implicated in many developmental processes that rely on cell separation events, and even in the responses to abiotic stresses. However, the knowledge related to the molecular machinery regulating abscission and other cell separation processes in economically important crops is scarce. In this work, we determined the conservation and phylogeny of the IDA-like and HAE-like gene families in relevant species of the Solanaceae family and analyzed the expression of these genes in Nicotiana benthamiana to identify members involved in abscission, stem growth and response to drought conditions.

Results

The phylogenetic relationships among the IDA-like members of the species of Solanaceae studied, grouped the NbenIDA1 (A and B) and NbenIDA2 (A and B) pairs of genes with the Arabidopsis prepropeptides related to abscission. In silico analyses of the regulatory elements of the promoter region of IDA-like members showed that these two pairs of genes, NbenIDA1 and NbenIDA2, contained drought and hormonal response elements, although NbenIDA2A lacked the hormonal regulatory elements. Expression analyses showed that both NbenIDA1 genes were upregulated during corolla abscission. NbenIDA1 and NbenIDA2 genes showed tissue differential expression under water stress conditions, since NbenIDA1 genes were highly expressed in stressed leaves while NbenIDA2 genes, especially NbenIDA2B, were highly expressed in stressed roots. In non-stressed active growing plants, nodes and internodes were the tissues with the highest expression levels of all members of the IDA-like family and their putative HAE-like receptors.

Conclusion

The results suggest that NbenIDA1A and NbenIDA1B are both involved in the natural process of corolla abscission while the NbenIDA1 and NbenIDA2 pair of genes are implicated in the response to water stress. The data also suggest that IDA peptides may be important during stem growth and development. These results add new evidence that the functional module formed by IDA peptides and its receptor kinases, as defined in Arabidopsis, may also be conserved in Solanaceae.
Users’ Acceptance of Electronic Patient Portals in Lebanon
Authors: Honein-AbouHaidar Gladys , Antoun Jumana , Badr Karim , Hlais Sani , Nazaretian Houry
Published: August 2019

Background
Acceptance of Electronic patient portal (EPP) is instrumental for its success. Studies on users’ acceptance in the Middle East region are scarce. This study aims to explore factors influencing users’ acceptance of EPP, both patients and providers, at a tertiary care center in Lebanon using the Technology Acceptance Model (TAM). We concurrently test the internal construct validity and the reliability of the TAM.
Methods
A cross-sectional survey design and the vignette approach were used. For validation, we needed a minimum of 180 patients; all 35 attending physicians and 11 registered nurses were targeted. We used descriptive statistics to calculate the intention to use EPP and its determinants based on the TAM constructs. Exploratory factor analysis (EFA) and structural equation modeling (SEM) were employed to estimate significant path coefficients for patients only as the sample size of providers was too small.
Results
We had 199 patients, half intended to use EPP; 73% of providers (N=17) intended to use EPP. Perceived ease of use and privacy concerns were significantly higher among providers than patients (Mean (M) = 0.77 vs M= 0.42 (CI: -0.623 ; -0.081)) and (M=3.67 vs M=2.13, CI: -2.16; -0.91) respectively; other constructs were not significantly different. Reliability of TAM revealed a Cronbach Alpha of α=.91. EFA showed that three components explained 73.48% of the variance: Behavioral Intention of Use (14.9%), Perceived Ease of Use (50.74%), Perceived Usefulness (7.84%). SEM found that perceived ease of use increased perceived usefulness (standardized regression weight=0.49); perceived usefulness (0.51) had more predictive value than perceived ease of use (0.27) to explain the behavioral intention of use of the EPP.
Conclusions
We found that providers valued the usefulness of EPP and were mostly intending to use it. This finding has yet to be tested in future studies testing actual use as intention and actual use may not be concordant. The intention to use among patients was lower than those reported in developed countries. We identified two factors that we need to address to increase use, namely perceived ease and usefulness, and proposed practical implications to address them; future research directions were also discussed.
Factors Associated with Salmonella Infection in Patients with Gastrointestinal Complaints Seeking Health Care at Regional Hospital in Southern Highland of Tanzania
Authors: Ngogo Fadhili Ashery , Joachim Agricola , Abade Ahmed M , Rumisha Susan F , Mizinduko Mucho M , Majigo Mtebe Venance
Published: August 2019

Background
Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries experiencing poor hygiene and lack of access to clean and safe water. There was an increase of 1.2% reported cases of Salmonellosis between 2015 and 2016 in Njombe region, Southern Highland of Tanzania. Nevertheless, little is known on the factors contributing to transmission of this disease in the region. This study was conducted to bring up to date the prevalence, antibiotic susceptibility and factors associated with Salmonella infection in-patient having gastrointestinal complaints.
Methods
A cross-sectional study was conducted from December 2017 to February 2018 among patients with gastrointestinal complaints at Njombe Regional Hospital. Stool samples were submitted for culture on Xylose Lysine Deoxycholate Agar, intended for isolation of Salmonella spp. Identification was based on conventional biochemical tests and sero-typing. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Factors associated with occurrence of Salmonella infection were determined by regression analysis using Epi Info software version 3.5.4.
Results
The prevalence of Salmonella infection among 297 study participants with gastrointestinal features was 16.5%. All isolates were sensitive to ceftriaxone and ciprofloxacin, whereas 27.8% and 100% were resistant to co-trimoxazole and ampicillin respectively. The odds of Salmonella infection was fourfold higher among participants with formal employment than others (AOR=3.8, 95% CI, 1.53-9.40). Use of water from wells or river (AOR 2.2, 95% CI, 1.07-4.45), drinking untreated water (AOR 2.6, 95% CI, 1.21-5.48) and often eating at restaurant (AOR 3.4, 95% CI, 1.28-8.93) had increased probability of Salmonella infection. Likewise, having abdominal pain (AOR 8.5, 95% CI 1.81-39.78) and diarrhea (AOR 2.3, 95% CI 1.12-4.68) were independently associated with Salmonella infection.
Conclusion
Salmonella infection in Njombe is high, contributed by often eating at restaurant and drinking unsafe water from well and river. In addition, Salmonella spp causing gastroenteritis has developed resistance to commonly used antibiotics. It is high time to emphasize on hygienic practices in order to control and prevent Salmonella infection.
Enterococcal periprosthetic joint infection: Clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej
Published: August 2019

Background: Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to heterogeneous pathogenesis, non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI.
Methods : Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test.
Results: Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 1 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery.
Conclusion: About half of enterococcal PJI were polymicrobial infections. The treatment success was unexpected high (84%), suggesting that enterococcal PJI are not difficult to treat. All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
Trial registration: The study was retrospectively registered with the public clinical trial identification NCT0253022 at https://www.clinicaltrials.gov.
Creating cell model of phenylketonuria disease by CRISPR-Cas9 mediated genome editing method
Authors: aliabadi Bahram Elmi , sarbandi Farahnaz Farahani , moradi Sepide , falahi jafar , Tabei Seyed Mohammad Bagher
Published: August 2019

Phenylketonuria (PKU) is a monogenic disorder resulting from Phenylalanine hydroxylase (PAH) enzyme deficiency in liver hepatocytes. Untreated patients have clinical signs including growth retardation, microcephaly, short stature and low IQ. As the production of tyrosine from Phenylalanine is generally dependent on this enzyme, mutant PAH will result in accumulation of byproducts (liver cells), that is generated during deficient phenylalanine metabolism.

This study aimed to produce a liver cell model harboring deletion in PAH, which could be applied to investigate mutations and their effect on cell metabolism as well as response to drugs and supplement administration. A large deletion in exon 6 of PAH was created by CRISPR/Cas9 system, using pSpCas9(BB)-2A-Puro (PX459) V2.0 and pSpCas9(BB)-2A-GFP (PX458) vectors.

HPLC method was used to measure the level of phenylalanine and tyrosine in the cell with deleted PAH gene. Contrary to our expectation, a decrease in the phenylalanine level was observed in the culture medium and inside the cell, but the tyrosine level exhibited an anticipated decrease in the culture medium and inside the cell.
Use of the rSpaA415 antigen for detection of IgG anti-Erysipelothrix rhusiopathiae in farmed cattle indicates a low prevalence in dairy and feedlot cattle in the United States of America and Great Britain
Authors: Atienzar Ana Isabel Cubas , Gerber Priscilla F. , Opriessnig Tanja
Published: August 2019

Background
Clinical cases of Erysipelothrix rhusiopathiae, a zoonotic gram-positive bacterium, have been reported in many ruminant species, including in cattle, deer, moose and muskoxen. Fatal cases have been repeatedly reported in cattle over the years but to date there is only one Japanese study investigating the seroprevalence of this bacterium in bovine using the growth agglutination test (GAT). This technique is subjective, time-consuming, expensive and hazardous compared to modern serological tests such as enzyme-linked immunosorbent assays (ELISA) or the newly developed fluorescent microbead-based immunoassays (FMIA).
Results
A FMIA based on the surface protein SpaA (rSpaA415) antigen of E. rhusiopathiae developed in this study had an almost perfect agreement with the GAT (k=0.83) and showed a sensitivity of 89.7% and a specificity of 92.9% when compared to the GAT. Overall, detection rates of E. rhusiopathiae antibody positive samples were 13.8% (51/370) in British herds and 6% (12/200) in US herds. Positive cattle were present in 34.3% (24/70) of the investigated British farms and in 34.7% (8/23) of the US farms with an on-farm prevalence of 7.1% to 100% for the British and 8.3-30% for the US.
Conclusions
FMIA is a fast, safe and economic alternative to the GAT for the diagnosis of E. rhusiopathiae in cattle. This work is the first seroprevalence study of E. rhusiopathiae in healthy farmed cattle in the Great Britain and the US and revealed that infection occurs at a low level. Further investigations to evaluate risks of zoonotic transmission when handling cattle are needed.
The prognostic significance of NLR in non-metastatic renal cell carcinoma undergoing nephrectomy, A meta-analysis
Authors: Na Li , Feng Huimin , Wu Ligang , Han Xuebo , Cao Jia , Wang Danni , Li Xiaohan , Ma Fang , Hua Yongqiang , Wang Libin
Published: August 2019

INTRODUCTION

Neutrophil to Lymphocyte ratio (NLR) has been reported to correlate with poor survivals in many tumors. However, the association between preoperative NLR elevation and survival outcome in non-metastatic renal cell carcinoma (RCC) underdoing nephrectomy remains controversial. The aim of this meta-analysis was to investigate the prognostic significance of elevated NLR in non-metastatic RCC.

EVIDENCE ACUISITION

We systematically searched PubMed, EmBase, and the Cochrane Library databases in may 2018. Cancer specific survival (CSS), disease-free survival (DFS) and overall survival (OS) were pooled by hazard ratio (HR) with corresponding 95% confidence interval.

EVIDENCE SYNTHESIS

A total of 3,175 patients from 8 studies were analyzed. The results demonstrated that elevated pretreatment NLR was significantly related to poor CSS (HR 1.91, 95% CI=1.53-2.40), DFS (HR 1.38, 95% CI=1.09-1.74), and OS (HR 1.84, 95% CI=1.58-2.14) in patients with non-metastatic RCC.

CONCLUSION

Elevated NLR indicates a poor long-term survival (CSS, DFS and OS) in non-metastatic RCC. Patients with elevated NLR are more likely to have poor prognosis than those with lower NLR.
Effect of cervical curvature reduction after ACCF on adjacent segmental lesions
Authors: Li Lifeng , Li Na , Zhou Jiahui , Li Handong , Du Xianping , He Haibo , Rong Pengfei , Liu Yin , Wang Wei
Published: August 2019

Objective: To investigate the relationship of adjacent segment degeneration (RASP) and the variation of cervical curvature and vertebral height after Anterior Cervical Corpectomy and Fusion (ACCF).
Methods: A retrospective analysis of 80 patients with cervical spondylotic myelopathy (CSM) who had been followed up for at least 1 year after ACCF. The patients were divided into RASP group and no RASP group according to whether the RASP occured after surgery. On the standing cervical lateral radiograph of all patients before and after surgery at the short-term and final follow-up, the C2-7 Cobb angle of the cervical vertebrae, the Cobb angle of the surgical segment and the height of the fusion segment for the anterior and posterior segments of the vertebral body were measured. The difference between the two groups of patients before and after surgery was calculated, as well as its correlation with the occurrence of RASP.
Result: there were 37 patients in the RASP group and 43 patients in the no-RASP group. In RASP group, the short-term average curvature of cervical vertebra was significantly reduced after surgery. However, there was no significant difference in no RASP group. The height of the anterior and posterior fusion segments in two groups was significantly higher than that before surgery, however, which was significantly lower during the final follow-up than that in the short-term after surgery. Cox regression analysis showed that only the variation of postoperative C2-7Cobb angle was associated with RASP.
Conclusion: The reduction of cervical curvature after ACF may be related to postoperative RASP. Maintaining good cervical curvature after operation may be expected to reduce the occurrence of RASP after ACF.
Social acceptance of alcohol use in Uganda.
Authors: Ssebunnya Joshua , Kituyi Caroline , Nabanoba Justine , Nakku Juliet , Bhana Arvin , Kigozi Fred
Published: August 2019

Abstract:
Background: Alcohol use is part of many cultural, religious and social practices, and provides perceived pleasure to many users. In many societies, alcoholic beverages are a routine part of the social landscape for many in the population. Relatively low rates were reported for Alcohol Use Disorders (AUD) in a community based survey and facility detection survey conducted in the study site contrary to findings in earlier formative studies where alcohol use was reported to be a major health problem. The aim of this study was to understand reasons for under-reporting and the low detection rate for AUDs, exploring the societal perceptions of alcohol use in the study district.
Methods: The study was conducted in Kamuli District (implementation site for the PRIME project). Semi-structured interviews and focus group discussions were conducted with purposively selected participants that included local and religious leaders, lay people, health workers as well as heavy alcohol drinkers and their spouses. Interviews were tape-recorded and transcribed verbatim. The analysis followed 4 thematic areas, which include the extent and acceptability of alcohol use, patterns of alcohol use, perceived health problems associated with alcohol use and help-seeking behavior for persons with alcohol related problems.
Results: The findings indicate that alcohol consumption in the study site was common and widely acceptable across all categories of people, with minimal restrictions. Society tends to overlook problems associated with alcohol use except when it is life-threatening. Help-seeking for such problems was therefore reported to be relatively rare.
Conclusion: Alcohol was readily available in the community and its consumption widely acceptable with minimal restrictions to the minors. There is low recognition of alcohol use related health problems, resulting in poor help-seeking behavior.
Key words: Alcohol, Kamuli, Alcohol Use Disorder, PRIME acceptability