bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalent pH Controls the Capacity of Galdieria maxima to Use Ammonia and Nitrate as a Nitrogen Source
Authors: Iovinella Manuela , Carbone Dora Allegra , Cioppa Diana , Davis Seth J , Innangi Michele , Esposito Sabrina , Ciniglia Claudia
Published: October 2019

Galdieria maxima is a polyextremophilic alga capable of diverse metabolic processes. Ammonia is widely used in culture media typical of laboratory growth. Recent reports that this species can grow on wastes promote the concept that G. maxima might have biotechnological utility. Accordingly, there is a need to know the range of pH levels that can support G. maxima growth in a given nitrogen source. Here, we examined the combined effect of pH and nitrate/ammonium source on the growth and long-term response of the photochemical process to a pH gradient in different G. maxima strains. All were able to use differing nitrogen sources, despite both the growth rate and photochemical activity were significantly affected by the combination with the pH. All strains acidified the NH4+-medium (pH<3); only G. maxima IPPAS P507 showed reduced capacity in lowering the pH from 6.5. pH was a limiting factor in nitrate uptake at pH≥6.5; noteworthy, at pH 5 on nitrate G. maxima ACUF551 showed a good growth performance, despite the alkalization of the medium.
Análise comparativa entre as normas ABNT NBR ISO 9001:2015 e a ABNT NBR ISO 31000:2009: a mentalidade de riscos nos sistemas de gestão da qualidade
Authors: Simão Victor Gomes , Bonina Noemi , Lima Gilson Brito Alves , Quelhas Osvaldo Luiz Gonçalves , Meiriño Marcelo Jasmim
Published: October 2019

A nova revisão da norma ISO 9001 foi lançada em 2015 e incorporou ao seu acervo de requisitos para a implantação de um sistema de gestão da qualidade novos conceitos, tais como o relacionamento com partes interessadas, a gestão do conhecimento e a gestão de riscos no âmbito organizacional, ampliando o seu foco de abrangência. Neste sentido, e prevendo-se que mudanças ocorrerão nas organizações a partir dessa nova perspectiva, o presente artigo tem por objetivo apresentar a utilização da mentalidade de risco nos sistemas de gestão da qualidade, por meio de uma análise comparativa entre as normas ABNT NBR ISO 9001:2015 e ABNT NBR ISO 31000:2009. A pesquisa se caracteriza como qualitativa, e foi realizada com base em pesquisa documental e revisão sistemática da literatura. Os achados sugerem que o conceito de pensamento baseado em risco sempre esteve implícito na ISO 9001, manifestado sob a forma de ações preventivas e que a pretensão de incorporar a mentalidade de risco como requisito na versão de 2015 é estimular as organizações a adotarem o risco como critério em suas decisões. Evidencia-se que a literatura de prevenção e riscos está alinhada com os métodos dos sistemas de gestão da qualidade mais avançados, os quais são baseados mais nos princípios de prevenção do que em ações corretivas.
Novas tecnologias aplicadas em estudos de viabilidade econômica e financeira: uma revisão integrativa da literatura
Authors: Gomes Nairon Nicolas da Silva , Lavina Maria Eduarda , Gruber Vilson , Marcelino Roderval
Published: October 2019

As novas tecnologias da informação e comunicação (NTIC) possuem um papel fundamental dentro da sociedade contemporânea e, neste estudo, é apresentada uma revisão da literatura mundial, de forma integrativa, evidenciando suas aplicações para área da gestão, mais especificamente em relação aos estudos de viabilidade econômica e financeira. Para isto, foi realizada uma pesquisa exploratória em bases de dados indexadas no Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a fim de se buscar o referencial teórico, e uma revisão integrativa nas bases Scopus, Web of Science e IEEE Xplore, para o levantamento das NTIC utilizadas em estudos de viabilidade econômica e financeira. Além de elencá-las, pode-se verificar que, além de possibilitarem a resolução dos problemas quando utilizadas de forma isolada, possuem ainda mais eficiência quando utilizadas de forma conjunta, potencializando suas capacidades e possibilidades de emprego de forma complementar.
DA SALA DE AULA PARA A COMUNIDADE EMPRESARIAL: ANÁLISE CRÍTICA DE LAYOUT DE UM SALÃO DE BELEZA
Authors: Piñol Susana , Frizon Amanda Albarello , Silva Ana Carolina Pereira da , Suzena Milena Cardoso , Costa Victória de Oliveira
Published: October 2019

Este estudo ilustra a aplicabilidade de conteúdos do componente curricular Gestão de Serviços do primeiro ano do Curso Técnico em Administração Integrado ao Ensino Médio junto à comunidade empresarial. O desafio vivenciado pelos alunos foi ode convidar uma empresa de médio ou pequeno porte e aplicar junto a mesma algumas das principais ferramentas de gestão da qualidade para o segmento de serviços. Neste sentido apresenta-se a aplicação da análise de layout junto a um salão de beleza considerando-se o comportamento do consumidor.Terpe (2014) destaca que layout significa mais que a estética da empresa. Um bom arranjo físico permite a funcionalidade do processo produtivo, a segurança e o bom aproveitamento do espaço considerando economia e tempo. O comportamento doconsumidor costuma ser afetado pelo layout. Mudanças no espaço empresarial que o cliente tem acesso podem promover uma maior sensação de conforto, uma exposiçãomelhor dos produtos, um aumento nas vendas, um aumento da compra por impulso entre outros efeitos.O objetivo geral deste trabalho é aplicar a análise crítica de layout no âmbito da gestão de serviços junto a um salão de beleza. E os objetivos específicos são: verificar o atual layout adotado pela empresa para atender os clientes; analisar criticamente o atual layout considerando os conceitos de estudo de layout; e propor melhorias.
Evolution of Open-Hole Gravel Pack Methodology in a Low Frac-Window Environment: Case Histories and Lessons Learned From the Kraken Field Development
Authors: Alexander Kevin , Bruce Dave , Williamson Colin , Moses Nicholas , Ismayilov Elnur , Sallis Jonathan , De Kock Tertius , Sendel Honore , Beldongar Maye , Gadiyar Bala , Parlar Mehmet
Published: October 2019

The Kraken field development was planned and executed through several batch drilling and completion phases to allow a review of each phase and incorporate the lessons learned in the next phase. All producers were drilled with an oil-based reservoir drilling fluid (OB-RDF). The lower completion with shunted sand control screens was installed in conditioned OB-RDF, followed by displacements to water-based fluids after the packer was set. Gravel packing was performed with a visco-elastic surfactant fluid, and a breaker treatment was spotted across the open hole prior to isolating the open hole with a fluid loss control valve.

This paper discusses the design, execution and evaluation of the lower completion phase for the development of the Kraken field in the North Sea. This includes detailed reservoir evaluation, methodology followed for sandface completion selection, steps taken to improve efficiency through lessons learned and continuously extend well lengths to be gravel packed in a low frac-window environment, and well performance results in this 24-well field development, with focus on the 7 out of 13 oil producers, detailing 3 of them.
A Systematic Review to Assess the Effectiveness of Technology-Based Interventions to Address Obesity in Children
Authors: McMullan Megan , Millar Rachel , Woodside Jayne
Published: October 2019

Background

Childhood obesity is associated with a multitude of co-morbidities, including hypertension, hyperlipidaemia, cardiovascular disease and type 2 diabetes. Childhood obesity can also affect a young person’s social, emotional and mental health if they encounter negative prejudice and social marginalisation. Given the prevalence of overweight and obese children globally, it is imperative that effective interventions are developed. Children are receptive to information conveyed via digital means, therefore, the use of technology may play a crucial role in interventions to reduce childhood obesity. This systematic review aimed to review and critically appraise the literature published to date in relation to the effectiveness of technology-based interventions, employed as secondary prevention, in addressing childhood obesity.Methods

An electronic search strategy was undertaken in Medline and Embase, covering publications up to and including 12th July 2018. Randomised controlled trials assessing the effectiveness of technology-based interventions on weight-related outcomes in children, aged 8 to 18, published only in the English language, were included.Results

From an initial search total of 1,012 studies, 11 met the inclusion criteria. They were assessed for methodological quality using the Cochrane Risk of Bias Tool for Randomised Controlled Trials and were analysed using a narrative approach. The findings of this review showed a limited potential of technology-based interventions, employed as secondary prevention, to address childhood obesity. Of the eleven studies reviewed, three (27%) showed a positive relationship between technology-based interventions and weight-related outcomes in overweight or obese children.Conclusions

This review suggests that technology-based interventions, primarily active video games, as well as internet or web-based interventions and mobile phone communications, may, with further research, have the potential to impact positively on weight-related outcomes. It is difficult to determine the degree of efficacy of these technology-based interventions, as only two databases were searched, selecting only English language articles. Moreover, the included studies demonstrated a lack of high-quality evidence. The lack and heterogeneity of studies with technology-based interventions is a further limitation.
Cost Objects: The ED Dilemma. How is your ED performing?
Authors: Fuentes Verónica , Neriz Liliana , Nunez Alicia , Mateo Ricardo
Published: October 2019

Background The aim of this study is to propose a list of cost objects that can be used by any ED to compute costs considering that the resulting data must facilitate unit management by improving the information available for decision-making. Methods This study considers two stages, first, We analyzed the case-mix of two hospitals collecting their data to define and diagram their processes, activities and to obtain their cost objects, second, we used four additional hospitals to validate our initial findings. Results We recognized 59 cost objects. Hospitals may have all these cost objects or just a subset of them depending on the services they provide. Conclusions Among the main benefits of our cost objects definition are: the possibility of tracing the processes generated by the services delivered by EDs, the economic sense in its grouping, the chance of using any costing methodology, the flexibility with other classification systems such as DRGs and ICDs, and the opportunity of costing for both diseases and treatments. Furthermore, cost comparison among hospitals using our final 59 cost objects list is more accurate and based on comparable units. In different EDs, each cost object will be the result of a similar combination of activities performed. We also present the results of applying this cost objects list to a particular ED. A total of 54 out of 59 cost objects were identified for that particular unit within a calendar year.
Association Between Early Childhood Caries And Malnutrition In A Sub-Urban Population In Nigeria
Authors: Folayan Morenike Oluwatoyin , Arije Olujide , Tantawi Maha El , Kolawole Kikelomo Adebanke , Obiyan Mary , Arowolo Olaniyi , Oziegbe Elizabeth O
Published: October 2019

Background: To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria.
Methods: This study is a secondary analysis of a larger cross-sectional data generated through a household survey. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study conducted in the Ile-Ife, Nigeria, were adjusted for in the models. We used Poisson regression analysis to determine the association between ECC and malnutrition (stunting, overweight and underweight). We reported the adjusted prevalence ratio (APR).
Results: Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03-0.69; p=0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83-25.85; p<0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0-0; p<0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female.
Conclusions: For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC, while the frequency of sugar consumption was not a significant risk indicator. Further studies are needed to identify if there are other mediators of associations between ECC and nutrition status apart from sugar consumption.
Validation of the Clinical Frailty Score (CFS) in French language
Authors: ABRAHAM PAUL , COURVOISIER Delphine S. , ANNWEILER Cedric , LENOIR Cliff , MILLIEN Thomas , DALMAZ Francoise , FLATTEN Hans , MORENO Rui , CHRISTENSEN Steffen , De Lange Dylan , GUIDET Bertrand , Bendjelid Karim , WALDER Bernhard , PINTO Bernardo BOLLEN
Published: October 2019

Background
Very old critical ill patients are a rapid expanding group. To better understand the magnitude of the challenges involved in intensive care practice for an ageing population and discuss a rational allocation of resources, healthcare practitioners need a reliable evaluation of frailty.
In order to promote the adequate use of the Clinical Frailty Scale (CFS) in a wider panel of countries, we aimed to develop, validate and characterise a French (FR) version from the originale English (EN) CFS.
Methods
We included participants recruited prospectively for the observational “The very old
intensive care patient: A multinational prospective observation study” (VIP Study)
at Geneva University Hospitals (FR speaking hospital). A FR version of the CFS was obtained by translation (EN->FR) and back translation (FR->EN). The final CFS-FR was then evaluated twice on the same participants with at least a 2-week interval by FR-speaking doctors and nurses.
Results
Inter-rater reliability was 0.87 (95%CI: 0.76-0.93) between doctors for the original CFS version and 0.76 (95%CI: 0.57-0.87) between nurses for the FR version. Inter-rater variability between doctor and nurse was 0.75 (95%CI: 0.56-0.87) for the original version, and 0.73 (95%CI: 0.52-0.85) for the FR version.
Test-retest (stability) with the original vs the FR version was 0.86 (95%CI: 0.72-0.93) for doctors and 0.87 (95%CI: 0.76-0.93) for nurses.
Differences between the evaluations of the CFS-EN and CSF-FR were not different from 0, with a mean difference of 0.06 (95%CI -0.24, 0.36) for the EN version and -0.03 (95%CI -0.47, 0.41) for the FR version. Average original version ratings were slightly lower than FR version ratings, though this difference did not reach significance: -0.29 (95%CI -0.54, 0.04).
Conclusion
In this prospective cohort of very old intensive care participants we developed and tested the basic psychometric properties (internal consistency, reproducibility) of a French version of the CFS. This manuscript provides clinically meaningful psychometric properties that have not been previously reported in any other language, including in the original EN version.
The French cultural adaptation of this CFS has adequate psychometric properties for doctors or nurses to evaluate frailty in very old intensive care patients.
Client perceived quality of the postnatal care provided by public sector specialized care institutions following a normal vaginal delivery in Sri Lanka: A cross sectional study
Authors: Wickramasinghe Sashimali , Gunathunga Wasantha , Hemachandra Nilmini
Published: October 2019

Background:
Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes.
Methods:
A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions.
Results:
The median score obtained for the questionnaire was 108, (Inter Quartile Range 96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38-45), 33 (IQR 30-35) and 32 (IQR 28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing Kangaroo Mother Care (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions.
Conclusions:
Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.

Key words:
Client perceptions, Postnatal care, Quality of care, Client perceived care, institutional postnatal care
Association between ovarian reserve and preeclampsia: a cohort study
Authors: Erfani Hadi , Rahmati Maryam , Mansournia Mohammad Ali , Azizi Fereidoun , Montazeri Seyed Ali , Shamshirsaz Alireza A. , Tehrani Fahimeh Ramezani
Published: October 2019

Background The risk of cardiovascular disease in women increases after menopause. It has been shown that women with lower pre-menopausal ovarian reserve may experience increased cardiovascular risk. We sought to determine whether there is any association between ovarian reserve, as assessed by Anti-Mullerian hormone (AMH), and preeclampsia (PE).Methods Subjects of this study were selected from among participants of the Tehran Lipid and Glucose Study (TLGS), a population-based cohort with a 15-year follow-up (1998-2014). Out of 2412 women aged 20-50 years, there were 781 women who met eligibility criteria, including having comprehensive data on their reproductive assessment and ovarian reserve status, identified based on age-specific AMH levels according to the exponential–normal three-parameter model. There were 80 and 701 participants in the preeclampsia and non-PE groups, respectively. The association between dichotomous outcome variable PE and age-specific AMH quartiles was evaluated using pooled logistic regression.Results PE was observed in 23 (11.1%), 12 (6.4%), 26 (13.3%) and 19 (10%) women in the 1st, 2nd, 3rd and 4th quartiles of age-specific AMH, respectively (P = 0.16). Median and inter-quartile range of serum AMH levels was 1.05 (0.36 – 2.2) mg/L in women who experienced PE compared with 0.85 (0.28 – 2.1) mg/L in women with normotensive pregnancies (P = 0.53). Based on the pooled logistic regression analysis, the effect of age-specific AMH quartiles on PE progression (adjusted for age, BMI, smoking status, and family history of hypertension) were not significant (OR1st vs 4th: 1.5, P-value: 0.1, CI: (0.9, 2.4))Conclusions Age-specific AMH may not be a suitable marker for prediction of PE. Further longitudinal studies is highly recommended for precise interpretation of the association between ovarian reserve status and PE.
Transformation of internal head structures during the metamorphosis of Chrysopa pallens (Neuroptera: Chrysopidae)
Authors: Zhao Chenjing , Ang Yuchen , Wang Mengqing , Gao Caixia , Zhang Kuiyan , Tang Chufei , Liu Xingyue , Li Min , Yang Ding , Meier Rudolf
Published: October 2019

Background The metamorphosis is a complicated but very interesting process because of the highly dynamic transformation in sheath. Very few studies had coverage on the head muscles of larvae, pupae, and adults. Most of these studies were focusing on the model organisms about the rough changes of the external and internal tissues or the time of metamorphosis based on the traditional methods. In our study,the skeleto-muscular system of head, as well as the brain of Chrysopa pallens (Rambur, 1838) from larvae to adults are described in detail for the first time by the technology of micro computed tomography (µ-CT). The transformations of these systems during pupal stage are studied for the first time.Results The morphological differences and functional adaptations between the stages are assessed. Muscles are distinctly slender in larvae than in adults with a significantly larger quantity. A larger brain with improved sensory perception is suggested to be essential for dispersal, mating and flying for adults. For the pupae, the results show that the histolysis of the muscles happens in first third of the pupal period and their reconstruction happens in the following days. The brain exists all along.Conclusion We suggest the transformations of the skeleton occur earlier than the musculature. Most of the transformations are related to tasks they play in the developmental stages.
Treatment adherence and associated factors among glaucoma patients attending ophthalmic unit of Debre Markos Referral and Felege Hiwot Comprehensive Specialized Hospitals
Authors: Ayenew setarg , Alem Girma , Tesfa Mulugeta , Mulugeta Henok , Gedefaw Mihretie
Published: October 2019

Background Glaucoma is one of the common eye disorders resulting from optic neuropathy which leads to irreversible blindness if left untreated. Poor adherence to glaucoma medical treatments leads to serious consequences such as progressive visual impairment and blindness. Despite its serious consequences, the level of glaucoma treatment adherence and associated factors have been poorly explored in Ethiopia particularly in the selected study areas. Hence, the objective of this study was to assess the level of adherence to treatment and associated factors among glaucoma patients attending at Debre Markos referral and Felege Hiwot comprehensive specialized Hospitals.Methods Institution based cross-sectional study was conducted from March 1st 2019 to April 30th 2019 among 414 consecutive glaucoma patients attending at ophthalmic units of Debre Markos Referral and Felege Hiwot Comprehensive Specialized hospitals. Data about adherence to glaucoma treatment was collected by using Morisky Medication adherence scale-8. Each collected data were coded and entered into Epi-Data version 4.2 and analysis was done using STATA version 14.0 statistical software. Descriptive analysis was done and binary logistic regression model was fitted to assess the effect of independent variable on the dependent variable. This was done using odds ratio within 95% confidence limits. A p-value < 0.05 was considered to declare statistically significant association.Results this study revealed that 189 (49.5%) of participants were adherent to glaucoma medical treatment. The result of multivariate logistic regression analysis showed that factors such as occupation (farmer), good knowledge, favorable attitude, a short distance from patients’ home to hospitals, and schedule problems for glaucoma medical follow-up visits were significantly associated with adherence to glaucoma medical treatments.Conclusion In this study almost one in two patients were adherent to glaucoma medical treatment which is low. Patient-related and health care system-related factors were significantly associated with adherence to glaucoma treatments. Policy-makers need to give attention to patient education and develop strategies to improve patients’ adherence to glaucoma medical treatment.
Estimation of LOS level in hospitalization with multiple attributes: taking patients with kidney disease as an example
Authors: Zhang Xinli , Shen Xue
Published: October 2019

Abstract: Aim: Thinking of the relationship between Multiple attributes and length of stay(LOS).This paper provide LOS level prediction method with applying a classification estimation of multi-avariables statistic,also provides suggestions of diversion management for kidney disease patients. Methods: We use three steps to finish the estimation. Firstly, Using the correlation-coefficient between the variable and LOS to find some sensitive factors; secondly,using projection pursuit clustering analysis to find the weight of each factor, then calculation the weighting value to discriminant the LOS level.thirdly, using mean test to give the multi-level classification of LOS based on the most sensitive factor. Results: We use 12547 kidney disease patients’ data in the year 2016 from a large hospital in the Department of Nephrology to applying the estimation method. The correlations results shows that the influence of variables on LOS are ranked as disease types>age>cost.The means test results demonstrate that patients with kidney disease are divided into 3 levels between 2-20 days of los. Short-term patients (los=2-9) are mainly treated with regular treatment; medium-term patients (los=10-15) are accompanied by emergency and acute attacks; long-term patients (los=16-20) need more treatments and long hospital observation period.Tested by multi-attribute multi-level discriminant model, Indicated that the kidney patients sample data can be modeled well by the builded models. Conclusion: We build the multi-variable multi-level discriminant model for LOS estimation, which is successively applied in kidney disease. The research offers a new way for LOS estimation through the Multi-variables. Key words:LOS; Multi-variable multi-level; Projection pursuit; Clustering and discriminant
Level of Awareness, Perception And Uptake Of Interventions For Computer Vision Syndrome Among University Students, Maseno, Western Kenya
Authors: Muma Shadrack , Aduda Dickens Omondi , Onyango Patrick
Published: October 2019

Background Computer vision syndrome is a multi-factorial condition of the eye that results in symptoms of stress and discomfort among computer users. It causes chronic vision-related morbidity and reduced work productivity. Ninety percent and 75% of computer users globally and in Africa respectively suffer from CVS. It is an insidious chronic condition that however, has hitherto received little attention, both by health providers as well as computer users. Also, it is likely to be under diagnosed as it mimics other eye conditions. The risk factors for CVS include prolonged period of electronic device use and glare. In Kenya, lack of awareness of the disease is a key barrier to early detection, health seeking and use of interventions. The burden of CVS and how much computer users in learning institutions are aware of and perceive CVS remains unknown.Methods This study adopted cross-sectional study design to determine the level of awareness, perception of CVS, uptake of preventive measures by students at Maseno University. In total, we administered questionnaires to 384 randomly selected students.Results The mean age was 19.5 years (SD= 0.747) with 18-24 years as the modal age group. Females comprised 51.3% (n=197) and males 48.7%. Participants who had at least 5 symptoms of CVS were 60.4% (n= 232). Awareness level was classified as low in 47.8%; medium level in 38.2% and high level in 13.8% of respondents . Sixty percent of respondents did not perceive CVS as an issue of public health concern compared to 39.8% who perceived CVS as an issue of public health concern ( p=0.001). In terms of precautionary measures, only duration of computer use (46.2%, p = 0.001 ) were practiced. The study results show that at least 3 out of 5 students have at least five symptoms of CVS, whereas awareness of the disease and related risks remain low.Conclusion The results of the present study indicate that CVS is a less recognized health concern among university students. Consequently, screening for the disease sensitization of students on CVS and awareness campaigns to improve early recognition and diagnosis of disease as well as uptake of interventions is recommended.
Active Learning Through Discussion: ICAP Framework for Education in Health Professions
Authors: Lim Jaeseo , Ko Hyunwoong , Yang Jiwon , Kim Songeui , Lee Seunghee , Chun Myungsun , Ihm Jungjoon , Park Jooyong
Published: October 2019

Background

The ICAP framework based on Cognitive Science posits four modes of cognitive engagement: Interactive, Constructive, Active, and Passive. Focusing on the wider applicability of discussion as interactive engagement in medical education, we investigated the effect of discussion when self-study preceded it and further investigated the effect of generating questions before discussions.

Methods

This study was conducted in the second semester of 2018, and 129 students majoring in health professions, including medicine, dentistry, veterinary medicine, and nursing, participated. The students were assigned into four different trial groups, who were asked to fill out a Subjective Mental Effort Questionnaire after completing each session. Their performance in post-test scores and their mental efforts were analyzed.

Results

A Bonferroni test for group comparison indicated that the self-study and question-generated group had the highest performance and that the lecture and question-received group had the lowest performance when comparing the total score. By using a mediation model, it was confirmed that the participants who showed a higher level of testing mental effort also showed higher levels of studying and discussion mental effort.

Conclusions

Our findings support the ICAP framework and provide practical implications for medical education, representing the fact that students learn more when they are involved in active learning activities, such as self-study and question generation, prior to discussions.
Surgical site infection and predictors among adults in specialized hospital: prospective observational study
Authors: kebede bezie , asredaw biset
Published: October 2019

Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.
Systematic analysis of the basic/helix-loop-helix (bHLH) transcription factor family in pummelo (Citrus grandis) and identification of the key members involved in the response to iron deficiency
Authors: Zhang Xiao-Yong , Qiu Jie-Ya , Hui Qiu-Ling , Xu Yuan-Yuan , He Yi-Zhong , Peng Liang-Zhi , Fu Xing-zheng
Published: October 2019

Background As the second largest superfamily of transcription factors (TFs), the basic/helix-loop-helix (bHLH) proteins participate in regulating of a series of biological and developmental processes in plants. Although several bHLH genes of citrus have been identified and previously characterized, a large number of bHLH members are still unknown.Results In this study, we genome-widely identified a total of 128 CgbHLHs from pummelo (Citrus grandis) that were classified into 18 subfamilies by phylogenetic comparison with Arabidopsis thaliana bHLH proteins. All of these CgbHLHs were randomly distributed on nine known (125 genes) and one unknown (3 genes) chromosomes, and 12 and 47 of them were identified to be tandem and segmental duplicated genes, respectively. Sequence analysis showed detailed characteristics of their intron-exon structures, bHLH domain and conserved motifs. Gene ontology (GO) analysis suggested that most of CgbHLHs were annotated to the nucleus, DNA-binding transcription factor activity, response to abiotic stimulus, reproduction, post-embryonic development, flower development and photosynthesis. In addition, 37 CgbHLH proteins were predicted to have direct or indirect protein-protein interactions. Based on GO annotation, RNA sequencing data in public database and qRT-PCR results, 22 of CgbHLHs were identified as the key candidates that respond to iron deficiency.Conclusions In total, 128 CgbHLH proteins were identified from pummelo, and their detailed sequence and structure characteristics and putative functions were analyzed. This study provides comprehensive information for further functional elucidation of CgbHLH genes in citrus.
Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan
Authors: Liang Kai-Shun , Chen Chieh-Chang , Liao Wei-Chih , Kuo Yu-ting , Tseng Liang-Wei , He Wen-Tsung , Wang Hsiu-Po
Published: October 2019

Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF. Aims To investigate the success rate and complications of NKF and TPS in patients with difficult biliary access. Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, succesfs rate of biliary cannulation, and the rate of adverse events were assessed. Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred. Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.
Description of the targeted WASH response strategy implemented during the cholera outbreak of 2017-2018 in Kinshasa, DRC
Authors: Bompangue Didier , Moore Sandra , Taty Nadège , Impouma Benido , Sudre Bertrand , Manda Richard , Balde Thierno , Mboussou Franck , Vandevelde Thierry
Published: October 2019

Background
Rapid control of cholera outbreaks is a significant challenge in overpopulated urban settings, and documented results on field interventions are scarce. During the 2017-2018 period, Kinshasa, the capital ofDemocratic Republic of the Congo, experienced a sharp increase in cholera cases that showed potential to quickly spread throughout the city. A novel targeted WASH (Water, Sanitation and Hygiene) strategy was implemented to quickly stem the cholera outbreak.
Methods
We carried out a descriptive study of the cholera outbreak in Kinshasa from 2017 to 2018. Cholera surveillance databases from the Ministry of Health were analyzed to assess the spatiotemporal dynamics of the cholera outbreak using epidemic curves and cartography. Weekly precipitation levels in Kinshasa were also assessed. We also described the targeted cluster grid WASH strategy, which was implemented to quickly target case clusters at the household and community level, carrying out interventions focused on emergency water supply, household water treatment and safe storage, home disinfection and hygiene promotion. We also examined the evolution of the outbreak following implementation of the response strategy.
Results
From January 2017 to November 2018, a total of 1,712 suspected cholera cases were reported in Kinshasa. During this period, the health zones most affected included Binza Météo, Limeté, Kokolo, Kintambo and Kingabwa. Following implementation of the response strategy, the weekly cholera case numbers in Binza Météo, Kintambo and Limeté decreased by an average of 57% in two weeks and 86% in four weeks. The total weekly case numbers throughout Kinshasa Province dropped by 71% at four weeks after the outbreak peak.
Conclusion
During the 2017-2018 period, Kinshasa experienced a sharp increase in cholera cases that showed potential to quickly spread throughout the city. To contain the outbreak, WASH response interventions targeted case households, nearby neighbors and public areas in case clusters using a grid approach. Following implementation of the WASH response, the outbreak in Kinshasa was quickly brought under control. A similar approach may be useful to quickly interrupt cholera transmission in other urban settings.
Ancient Urban Gardens of Persia: Concept, History, and Influence on Other World Gardens
Authors: Fallahi Esmaeil , Fallahi Pontia , Mahdavi Shahla
Published: October 2019

The history of Persian gardens goes back to a few millennia before the emergence of Islam in Iran (Persia). Designs of Persian gardens have influenced and are used extensively in the gardens of Al-Andalus in Spain, Humayun’s Tomb and the Taj Mahal in India, and many gardens in the United States and other countries around the globe. Bagh in the Persian language (Farsi) means garden and the word Baghdad (the capital city of Iraq) is rooted from the words bagh and daad (meaning “the garden of justice”). Pasargadae, the ancient Persian capital city, is the earliest example of Persian garden design known in human civilization as chahar bagh or 4-fold garden design. Bagh-e-Eram, or Garden of Eden or Eram Garden, is one the most attractive Persian gardens and is located in Shiraz, Iran. There are numerous other urban ancient gardens in Iran, including Bagh-e-Shahzadeh (Shazdeh), meaning “The Prince’s Garden” in Mahan, Golestan National Park near the Caspian Sea; Bagh-e-Fin in Kashan; Bagh-e-El-Goli in Tabriz; and Bagh-e-Golshan in Tabas. The design of each Persian garden is influenced by climate, art, beliefs, poetry, literature, and romance of the country and the region where the garden is located. In addition, each garden may have a gene bank of fruits, flowers, herbs, and vegetables. Although countless gardens were destroyed in the hands of invaders throughout the centuries, Persians have attempted either to rebuild or build new gardens generation after generation, each of which has become a favorite destination to tourists from around the world.
The Role of the Eaeu Tariff Preferences Provided to the Goods of Developing Countries in Modern World Trade
Authors: Manushina A. P. , Efimov A. V.
Published: October 2019

Nowadays the trade policy of different countries is characterized by an increased spread of preferential trade regimes. These regimes serve as the initial stage of the creation of integration groups, contribute to the solution of economic and political problems. A striking example of the implementation of preferential trade regimes is the practice of granting tariff preferences, including to developing countries. These preferences are the benefits of the customs tariff in the implementation of trade and political relations with foreign countries and are provided in the form of a reduction in the rate of import customs duty on goods originating from developing countries-users of the Unified system of tariff preferences of the Eurasian economic Union (EAEU USTP). The article considers the role of tariff preferences in modern world trade. The study was conducted on the example of developing countries-using of the EAEU USTP. The article analyzes the practice of granting tariff preferences to developing countries, as well as the features of declaring goods originating from these countries.The relevance of the article lies in the fact that today the role of tariff preferences in the trade of the EAEU with third countries is constantly growing, stimulating foreign trade turnover. The findings of the study can be used to adjust the list of developing countries-users of the EAEU USTP and the list of preferential goods, taking into account the peculiarities of the development of modern world trade.
Foreign Trade of the European Union : Dominant Fluctuations
Authors: Gladkov I. S.
Published: October 2019

The article analyzes the most important changes that have taken place over the past five years in the dynamics and geographical structure of foreign trade relations of the European Union (EU) as the largest entity in the system of modern international commodity trade. It is shown that, despite such rather unfavorable external factors as the increase in general turbulence in world commodity trade, the expansion of the zone of protectionist and sanctions measures, trade conflicts, the EU was able to maintain its dominant position in international commodity exchange. At the same time, the European Union has pushed the main competitors, as the latest statistics show a significant decrease in the share of the North American free trade Association (NAFTA, consisting of the United States, Canada, Mexico) and Japan in international exports. Continuing to pursue a balanced foreign trade policy, the EU used its traditional instruments not only to increase its activity in general and outside the European region, but also to maintain a positive balance of foreign trade. In addition, there are hopes for the resumption of goodneighbourly trade relations between the European Union and the Russian Federation, which have been complicated in recent years by the introduction and extension of sanctions measures by the EU and Russia's response. The author presents new statistical materials, numerous calculated data, for the first time introduced into the domestic scientific circulation.
Aplicação da pegada ecológica como indicador de sustentabilidade para análise da geração de resíduos sólidos urbanos
Authors: Da Silva Filho José Adalberto , De Oliveira Santos João Paulo , Silva Soares Francisco Jeanes , Vieira Fernandes José Normand , Carneiro da Silva José Luiz , De Araújo Moraes Ferreira Jonathan
Published: October 2019

A sociedade moderna apresenta um modelo insustentável de consumo, que busca de modo constante crescer economicamente, visando à obtenção de maiores lucros, acima da capacidade limite dos recursos naturais, baseado em um sistema que promove grande geração de resíduos sólidos. Tal modelo tem propiciado uma série de impactos ambientais e vem trazendo consequências negativas para a população. Este trabalho propôs verificar a aplicabilidade de uma metodologia de pegada ecológica como ferramenta para avaliar a sustentabilidade, quanto ao montante total de resíduos sólidos urbanos produzidos em 11 municípios no estado de Alagoas. Os resultados indicaram que, em 2016, a área de estudo apresentou uma pegada ecológica per capita de 0,1925 hectare global. No município de Olho d’Água das Flores, a pegada ecológica total mostrou que em 2016 seria necessária uma área de 3.400 hectares globais para sustentar o atual sistema de geração de resíduos sólidos. A pesquisa tornou notória a preocupação acerca da temática, visto que o cenário para 2035 é ainda mais alarmante.
Diversidade de espécies arbóreas regenerantes em fragmento de floresta atlântica de Jaboatão dos Guararapes, Pernambuco
Authors: Silva Nelio Domingos da , Marangon Luiz Carlos , Marangon Ana Lícia Patriota Feliciano , Silva José Antônio Aleixo da
Published: October 2019

O objetivo deste trabalho foi analisar a composição florística e a riqueza de espécies arbóreas regenerantes em um fragmento de floresta atlântica de Jaboatão dos Guararapes, Pernambuco. Foram instaladas 40 parcelas de 10 m x 10 m, sendo 20 em cada ambiente (borda e interior da floresta), totalizando 4.000 m2 de área amostral. Foram catalogados e identificados todos os indivíduos com altura igual ou maior que 1,0 metro e circunferência à altura do peito a 1,30 m do solo, menor que 15,0 cm. Registraram-se 123 espécies, pertencentes a 38 famílias e 74 gêneros. Em todo o fragmento, Fabaceae, Myrtaceae e Melastomataceae apresentaram o maior número de espécies, enquanto os gêneros Miconia e Myrcia foram mais representativos tanto na borda como no interior da floresta. Os ambientes de borda e interior florestal apresentaram H’ = 3,59 e 3,40, J’ = 0,80 e 0,76 e D’ = 0,04 e 0,05, respectivamente, e o índice de similaridade de Sorensen foi de 0,64 para os ambientes pesquisados. Pode-se inferir que o fragmento estudado possui elevada riqueza e diversidade de espécies, evidenciando alta heterogeneidade ambiental e baixa dominância ecológica.