bluuebunny/crossref_metadata_2025 huggingface dataset:
Strong Families: A new family skills training programme for challenged and humanitarian settings: a single-arm intervention tested in Afghanistan
Authors: Haar Karin , El-Khani Aala , Molgaard Virginia , Maalouf Wadih
Published: August 2019

Background

Children living in challenged humanitarian settings are at greater risk of mental health difficulties or behavioural problems, with caregivers acting as their main protective factors. While many family skills programmes exist, very few were developed for or piloted in families living in low resource settings. We therefore designed a brief and light programme and conducted an effectiveness trial in Afghanistan.

Methods

We recruited female caregivers and children aged 8-12 years via schools and drug treatment centres in Afghanistan and enrolled them in a family skills programme over three weeks. Demographic data, emotional and behavioural difficulties of children and parental skills and family adjustment measures were collected from caregivers before, two and six weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire) and PAFAS (Parenting and Family Adjustment Scales).

Results

We enrolled 72 families in the programme and followed 93·1% up overall. Mean age of caregivers was 36·1 years, they had 3·8 children on average and 91·7% of them had experienced war/armed conflict in their past. The total difficulty score of the SDQ of the 72 children reduced significantly, from 17.8 at pre-test to 12.9 at post-test and 10.6 at follow-up, with no difference in gender and mostly in those with highest scores at baseline. Likewise, PAFAS scores improved significantly after the programme, again with caregivers with the highest scores at baseline improving most.

Conclusions

The implementation of a brief family skills programme was feasible in a resource-limited setting and had an impact on child mental health and parenting practices and family adjustment skills. This indicated the value of such programme and the feasibility to move it to scale. The effects need to be verified through an RCT and with longer follow-ups.
Drinking patterns and the distribution of alcohol-related harms in Ireland: Evidence for the prevention paradox
Authors: O'Dwyer Claire , Mongan Deirdre , Millar Seán R. , Rackard Marion , Galvin Brian , Long Jean , Barry Joe
Published: August 2019

Background

According to the prevention paradox, the majority of alcohol-related harms in the population occur among low-to-moderate risk drinkers, simply because they are more numerous in the population, although high-risk drinkers have a higher individual risk of experiencing alcohol-related harms. In this study we explored the prevention paradox in the Irish population by comparing alcohol-dependent drinkers (high-risk) to low-risk drinkers and non-dependent drinkers who engage in heavy episodic drinking (HED).

Methods

Data were generated from the 2013 National Alcohol Diary Survey (NADS), a nationally representative cross-sectional survey of Irish adults aged 18–75. Data were available for 4,338 drinkers. Respondents dependent on alcohol (as measured by DSM-IV criteria), respondents who engaged in monthly HED or occasional HED (1–11 times a year) and low-risk drinkers were compared for distribution of eight alcohol-related harms.

Results

Respondents who were dependent on alcohol had a greater individual risk of experiencing each harm (p<.0001). The majority of the harms in the population were accounted for by drinkers who were not dependent on alcohol. Together, monthly and occasional HED drinkers accounted for 62% of all drinkers, consumed 70% of alcohol and accounted for 59% of alcohol-related harms.

Conclusions

Our results indicate that the majority of alcohol consumption and related harms in the Irish population are accounted for by low- and moderate-risk drinkers, and specifically by those who engage in heavy episodic drinking. A population-based approach to reducing alcohol-related harm is most appropriate in the Irish context. Immediate implementation of the measures in the Public Health (Alcohol) Act (2018) is necessary to reduce alcohol-related harm in Ireland.
Transcriptome analysis of the fungal pathogen Rosellinia necatrix during infection of a susceptible avocado rootstock identifies potential mechanisms of pathogenesis
Authors: Zumaquero Adela , Kanematsu Satoko , Nakayashiki Hitoshi , Matas Antonio , Martínez-Ferri Elsa , Barceló-Muñóz Araceli , Alfaro Fernando Pliego , Lopez-Herrera Carlos , Cazorla Francisco , Prieto Clara Pliego
Published: August 2019

Background White root rot disease caused by Rosellinia necatrix is one of the most important threats affecting avocado productivity in tropical and subtropical climates. Control of this disease is complex and nowadays, lies in the use of physical and chemical methods, although none have proven to be fully effective. Detailed understanding of the molecular mechanisms underlying white root rot disease has the potential of aiding future developments in disease resistance and management. In this regard, this study used RNA-Seq technology to compare the transcriptomic profiles of R. necatrix during infection of susceptible avocado `Dusa´ roots with that obtained from the fungus cultured in rich medium. Results The transcriptomes from three biological replicates of R. necatrix colonizing avocado roots (RGA) and R. necatrix growing on potato dextrose agar media (RGPDA) were analyzed using Illumina sequencing. A total of 12,104 transcripts were obtained, among which 1,937 were differentially expressed genes (DEG), 137 exclusively expressed in RGA and 160 in RGPDA. During the root infection process, genes involved in the production of fungal toxins, detoxification and transport of toxic compounds, hormone biosynthesis, gene silencing and plant cell wall degradation were overexpressed. Interestingly, 24 out of the 137 contigs expressed only during R. necatrix growth on avocado roots, were predicted as candidate effector proteins (CEP) with a probability above 60%. The PHI (Pathogen Host Interaction) database revealed that three of the R. necatrix CEP showed homology with previously annotated effectors, already proven experimentally via pathogen-host interaction. Conclusions The analysis of the full-length transcriptome of R. necatrix during the infection process is suggesting that the success of this fungus to infect roots of diverse crops might be attributed to the production of a wide range of compounds which, singly or in combination, interfere with defense or signaling mechanisms shared among different plant families. The transcriptome analysis of R. necatrix during the infection process provides useful information and facilitates further research to a more in -depth understanding of the biology and virulence of this emergent pathogen. In turn, this will make possible to evolve novel strategies for white root rot management in avocado.
Assessment of branch point prediction tools to predict physiological branch points and their alteration by variants
Authors: Leman Raphael , Tubeuf Hélène , Raad Sabine , Tournier Isabelle , Derambure Céline , Lanos Raphaël , Gaildrat Pascaline , Castelain Gaia , Hauchard Julie , Killian Audrey , Baert-Desurmont Stéphanie , Legros Angelina , Goardon Nicolas , Quesnelle Céline , Ricou Agathe , Castera Laurent , Vaur Dominique , Gac Gérald Le , Ka Chandran , Fichou Yann , Bonnet-Dorion Françoise , Sevenet Nicolas , Guillaud-Bataille Marine , Boutry-Kryza Nadia , Schultz Ines , Caux-Moncoutier Virginie , Rossing Maria , Walker Logan C , Spurdle Amanda B , Houdayer Claude , Martins Alexandra , Krieger Sophie
Published: August 2019

Branch points (BPs) map within short motifs upstream of acceptor splice sites (3’ss) and are essential for splicing of pre-mature mRNA. Several BP-dedicated bioinformatics tools, including HSF, SVM-BPfinder, BPP, Branchpointer, LaBranchoR and RNABPS were developed during the last decade. Here, we evaluated their capability to detect the position of BPs, and also to predict the impact on splicing of variants occurring upstream of 3’ss. We used a large set of constitutive and alternative human 3’ss collected from Ensembl (n = 264,787 3’ss) and from in-house RNAseq experiments (n = 51,986 3’ss). We also gathered an unprecedented collection of functional splicing data for 120 variants (62 unpublished) occurring in BP areas of disease-causing genes. Branchpointer showed the best performance to detect the relevant BPs upstream of constitutive and alternative 3’ss (99.48 % and 65.84 % accuracies, respectively). For variants occurring in a BP area, BPP emerged as having the best performance to predict effects on mRNA splicing, with an accuracy of 89.17 %. Our investigations revealed that Branchpointer was optimal to detect BPs upstream of 3’ss, and that BPP was most relevant to predict splicing alteration due to variants in the BP area.
Randomized Controlled Trials for Comparison of Laparoscopic Versus Conventional Open Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis
Authors: Sun Mei-lan , Wang Bo , Zhang Piao , zhang yong
Published: August 2019

Aim

The application of laparoscopic catheterization technology in peritoneal dialysis (PD) patients has recently increased. However, the advantages and disadvantages of laparoscopic versus conventional open catheterization are still controversial. The aim of this meta-analysis is to assess complications of catheterization in PD patients and to provide a reference for the clinical choice of PD catheter placement technique.

Methods

We searched numerous databases, including Embase, PubMed, CNKI and the Cochrane Library, for published randomized controlled trials (RCTs).

Results

Eight relevant studies (n=646) were included in the meta-analysis. The pooled results showed a lower incidence of catheter migration (P: 0.03, OR: 0.42, 95% CI: 0.19 to 0.90) and malfunction (P: 0.008, OR: 0.41, 95% CI: 0.21 to 0.79) but a higher incidence of bleeding (P: 0.02, OR: 3.25, 95% CI: 1.18 to 8.97) with a laparoscopic approach than with a conventional approach. There was no significant difference in the incidence of obstruction (P: 0.24, OR: 0.32, 95% CI: 0.05 to 2.10), hernia (P: 0.20, OR: 0.38, 95% CI: 0.09 to 1.68), leakage (P: 0.23, OR: 0.69, 95% CI: 0.38 to 1.26), mechanical dysfunction (P: 0.90, OR: 0.96, 95% CI: 0.48 to 1.91), malfunction (P: 0.008, OR: 0.41, 95% CI: 0.21 to 0.79), perforation (P: 0.97, OR: 0.95, 95% CI: 0.06 to 15.42), peritonitis (P: 0.13, OR: 0.95, 95% CI: 0.42 to 1.12) or tunnel or exit-site infections (P: 0.49, OR: 0.95, 95% CI: 0.71 to 2.02).

Conclusion

Laparoscopic catheterization and conventional open catheter placement in PD patients have unique advantages, but laparoscopic catheterization may be superior to conventional open catheter placement. However, this conclusion needs to be confirmed with further large-sample-size, multi-centre, high-quality RCTs.
Comparing the accuracy and reliability of detecting intensity of spinal inflammation on STIR sequence with ADC values in axial spondyloarthritis
Authors: Chung Ho Yin , Cheung Tommy Tsang , Lau Vince Wing Hang , Lee Kam Ho , Chan Florence King Pui , Tsang Helen Hoi Lun , Chan Shirley Chiu Wai , Lau Chak Sing
Published: August 2019

Objective

To compare the accuracy and reliability of detecting the intensity of spinal inflammation on short tau inversion recovery (STIR) with the apparent diffusion coefficient (ADC) values of the active MRI lesions in axial spondyloarthritis (axSpA).

Materials and methods

Fifty active lesions in STIR sequence of spinal MRI were identified. With reference to sites of active lesions in STIR, the corresponding region of interest (ROI) on ADC map was drawn to determine the maximum ADC (ADCmax), mean ADC (ADCmean), normalized maxium (nADCmax) and mean (nADCmean). Four independent readers scored the identified active lesions as “intense” or “non-intense” according to the SPARCC MRI index. They were compared to various ADC parameters for assessment of accuracy and reliability. Regression analyses were used to adjust potential factors that could affect ADC.

Results

Significant differences were found in ADCmax between “intense” and “non-intense” lesions scored by 3 of the 4 readers (1405.7±271.4 vs 1165.8±223.8, p=0.01; 1420.7±272.1 vs 1209.0±248.5, p=0.01; 1438.0±307.2 vs 1213.6±231.0, p=0.01). Only 1 reader could differentiate a difference in “intense” and “non-intense” lesions with respect to ADCmean (899.2±248.3 vs 711.0±222.6, p=0.01) and nADCmean (4.4±2.1 vs 3.4±1.4, p=0.05). Inter-reader agreements were slight to moderate (Kappa=0.07-0.45). Reliability substantially improved when only the lowest and highest 25th percentiles of ADC values were included (Kappa=0.17-0.75). Regression analyses showed the “intense” lesions were associated with higher ADC values after adjustment for confounders.

Conclusion

Reading of STIR MRI is limited by the lack of ability in differentiating subtle differences of spinal inflammation. ADC could be an alternative method.
Clinical outcomes of over-the-scope-clip system for the treatment of acute upper non-variceal gastrointestinal bleeding: a systematic review and meta-analysis
Authors: Zhong Chunyu , Tan Shali , Ren Yutang , Lü MuHan , Peng Yan , Fu Xiangsheng , Tang Xiaowei
Published: August 2019

BackgroundConventional endoscopic treatments can’t control bleeding in as many as 20% of patients with non-variceal gastrointestinal (GI) bleeding. Recent studies have shown that over-the-scope-clip (OTSC) system allowed for effective hemostasis for refractory GI bleeding lesions. So we aimed to conduct a systematic review to evaluate the effectiveness and safety of the OTSC system for management of acute non-variceal upper GI bleeding.MethodA comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2007 to May 2019. The search terms included “gastrointestinal bleeding” AND “OTSC OR over the scope clip”. The literature was selected independently by two reviewers according to the inclusion and exclusion criteria. The statistical analysis was carried out using Comprehensive Meta-Analysis software version 3.0.ResultsA total of 16 studies including 769 patients with 778 GI bleeding lesions were identified. Pooled technical success was achieved in 761 lesions [95.7%; 95% confidence interval (CI), 93.5%-97.2%], and the pooled clinical success was achieved in 666 lesions (84.2%; 95% CI, 77.4%-89.2%). The incidence of re-bleeding was reported in 81 patients and the post-procedure mortality was 10.9% (n=84). Only 2 (0.3%) patients occurred complications after OTSC system procedure.ConclusionsOur study demonstrated that the OTSC system was a technically feasible modality and highly efficacious in achieving hemostasis in acute non-variceal upper gastrointestinal bleeding.
PS4DR: a multimodal workflow for identification and prioritization of drugs based on pathway signatures
Authors: Emon Mhammad Asif , Domingo-Fernández Daniel , Hoyt Charles Tapley , Hofmann-Apitius Martin
Published: August 2019

Background:
During the last decade, there has been a surge towards computational drug repositioning owing to constantly increasing -omics data in the biomedical research field. While numerous existing methods focus on the integration of heterogeneous data to propose candidate drugs, it is still challenging to substantiate their results with mechanistic insights of these candidate drugs. Therefore, there is an unmet need for more innovative and efficient methods which can enable better integration of the data and knowledge for drug repositioning.

Results:
Here, we present a customizable workflow (PS4DR) which not only integrates high-throughput data such as genome-wide association study (GWAS) data and gene expression signatures from disease and drug perturbations but also takes pathway knowledge into consideration to predict drug candidates for repositioning. We have collected and integrated publicly available GWAS data and gene expression signatures for several diseases and hundreds of FDA-approved drugs in this study. Additionally, different pathway databases were used for mechanistic knowledge integration in the workflow. Using this systematic consolidation of data and knowledge, the workflow computes pathway signatures that assist in the prediction of new indications for approved drugs.

Conclusion:
We showcase PS4DR with applications on how this tool can be used for repurposing drugs as well as to propose drugs that can simulate disease dysregulations. We were able to validate our workflow by demonstrating its capability to predict FDA-approved drugs for their approved indications for several diseases. Further, PS4DR returned many potential drug candidates for repositioning that were backed up by epidemiological evidence extracted from the scientific literature. Source code is freely available at https://github.com/ps4dr/ps4dr.
The diffuse involvement of Anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report
Authors: Jiang Yun , Ma Jianpeng , Gong Tao , Hao Hongjun , Chen Haibo
Published: August 2019

Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had diffuse lesions in bilateral hemispheres with mild mass effects in left basal ganglia area.
Case presentations A 28-year-old female anti-NMDAR encephalitis patient mainly presented with headache and fever. Brain magnetic resonance image (MRI) showed slightly contrasted diffuse lesions, involving the left temporal and frontal lobes, left basal ganglia area and splenium of corpus callosum, as well as the right frontal lobe, with mild edema surrounded in the left basal ganglia area. Cerebrospinal fluid (CSF) revealed a moderate pleocytosis with normal protein and glucose levels. Anti-NMDAR antibodies were identified in CSF. Transvaginal ovarian ultrasound did not reveal an ovarian teratoma. The patient was treated with immunoglobulin and steroid, and had a good recovery.
Conclusions Anti-NMDAR encephalitis has no special clinical manifestations and brain MRI is highly variable, which could be unremarkable or abnormal involving white and grey matters. The extensive lesions in frontal and temporal lobes, and basal ganglia area, with mild mass effects, have not been described previously. Recognition of various changes in brain MRI will enable the early detection of anti-NMDAR antibody and then effective treatments.

Key words: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, clinic, brain, magnetic resonance image
A Case Report of two siblings with Alstrom syndrome without hearing loss associated with two new ALMS1 variants
Authors: Shurygina Maria Fedorovna , Parker Maria A. , Schlechter Catie , Chen Rui , Li Yumei , Weleber Richard G. , Yang Paul , Pennesi Mark E.
Published: August 2019

Background

Alström syndrome (AS) is a rare monogenic disorder characterized by progressive multi-organ pathology including retinal degeneration, hearing impairment and type 2 diabetes. Here we present clinical features in two siblings diagnosed with Alström syndrome associated with novel biallelic changes in ALMS1.

Case presentation

Two siblings originally diagnosed as having achromatopsia presented with mild light sensitivity, nonspecific otitis media, and mild developmental delay during the first decade of life with a relatively stable ocular appearance during second decade, late onset of nystagmus and dyschromatopsia (after 20 years) and preserved vision during the third decade of life. One sibling had late onset hearing loss and both siblings had symmetric high myopia, normal stature, and ptosis. Clinical findings revealed structural and functional tests consistent with a cone-rod dystrophy. Novel variants c.9894dupC (p.S3298fs) and c.10769delC (p.T3590fs) in ALMS1 gene were found.

Conclusions

Two North American siblings who presented with a mild clinical phenotype of Alström syndrome were found to have novel mutations in ALMS1. These two frame-shift mutations segregated with the disease phenotype lending evidence to their pathogenicity.
Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial
Authors: Kim Jong Chan , Kim Jihee , Kwak Hayeon , Ahn So Woon
Published: August 2019

Background: Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures.
Methods: In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group (n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 μ/kg over 10 min, pre-operatively). The primary endpoint was Aono's four-point scale scores after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints.
Results: Aono's four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1-1] vs. 1 [1-2], 95% confidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group.
Conclusions: Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery.
Risk factors for viral hepatitis C infection in Rwanda: Results from a Nationwide Screening Program
Authors: Makuza Jean Damascene , Liu Carol Y , Ntihabose Corneille Killy , Dushimiyimana Donatha , Umuraza Sabine , Nisingizwe Marie Paul , Umutesi Justine , Serumondo Janvier , Mugeni Soline Dusabeyesu , Semakula Muhamed , Gupta Neil , Hellard Margaret , Nsanzimana Sabin
Published: August 2019

Background: The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country’s public health approach to hepatitis C control.
Methods: A HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden. At the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with hepatitis C antibodies (HCVAb) seroprevalence.
Results: Out of a total of 326,263 individuals screened for HCVAb, 22,183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb Seroprevalence include history of traditional operation or scarification (OR=1.09, 95% CI: 1.05-1.14), presence of viral hepatitis in the family (OR=1.27, 95% CI: 1.15-1.40), widowed or separated/divorced (OR=1.36, 95% CI: 1.26-1.47), Southern province (OR=1.98, 95% CI: 1.88-2.08) and aged 65 years and older (OR=4.86, 95% CI: 4.62-5.11). Ubudehe category 3 (OR=0.97, 95% CI: 0.93-1.01) and participants using RAMA (Health insurances for employees of public and private sectors) insurance (OR=0.76, 95% CI: 0.70-0.85) had lower odds of HCV seroprevalence.
Conclusions: Our findings provide important information for Rwanda’s strategy on prevention and case-finding. Future prevention interventions should aim to reduce transmission through targeted messaging around traditional healing practices and case-finding targeting individuals with a history of exposure or advanced age.
Genome-wide identification of MAPKKK genes and their response to phytoplasma stress in Chinese jujube (Ziziphus jujuba Mill.)
Authors: Liu ZhiGuo , Wang Lixin , Xue Chaoling , Chu Yuetong , Gao Weilin , Zhao Yitong , Zhao Jin , Liu Mengjun
Published: August 2019

Backgrounds

Mitogen activated protein kinase (MAPK) cascades play vital roles in signal transduction in response to various biotic and abiotic stresses. In the previous study we have identified 10 ZjMAPKs and 5 ZjMAPKKs in Chinese jujube genome and found some crucial members of ZjMAPKs and ZjMAPKKs might function importantly in the process of phytoplasma infection. But how these ZjMAPKKs were modulated by ZjMAPKKKs during this process is still elusive and little information is known about the MAPKKKs in Chinese jujube.

Results

In the current study, 56 ZjMAPKKKs were identified in the jujube genome and all of them contain the key S-TKc (serine/threonine protein kinase) domain which distributed in all 12 chromosomes. Phylogenetic analysis showed that these ZjMAPKKKs could be classified into two subfamilies, of which 41 belonged to Raf, and 15 to MEKK subfamily. In addition, the ZjMAPKKKs in each subfamily share the same conserved motifs and gene structures, one pair of ZjMAPKKKs (15/16) was the only tandem duplication event on Chromosome 5. Furthermore, the expression profiles of these MAPKKKs in response to phytoplasma disease were investigated by qPCR. In the three main infected tissues (witches’ broom leaves, phyllody leaves, apparent normal leaves), the ZjMAPKKK26 and 45 were significantly up regulated and the ZjMAPKKK3, 43 and 50 were down regulated. While the ZjMAPKKK4, 10, 25 and 44 were significant highly induced in the sterile cultivated tissues infected by phytoplasma, and the ZjMAPKKK7, 30, 35, 37, 40, 41, 43 and 46 were significantly down regulated.

Conclusions

The identification and classification analysis of ZjMAPKKKs was firstly reported and some key individual ZjMAPKKKs genes might play essential roles in response to phytoplasma infection. This could provide initial understanding for the mechanism that how the ZjMAPKKKs were involved in jujube - phytoplasma infection.
Flipped classroom improves the results in Pathophysiology learning: results of a non-randomized controlled study
Authors: Herrero J. Ignacio , Quiroga Jorge
Published: August 2019

Background

The flipped classroom has become increasingly popular in health professions education. The aim of this study is to analyze its effect on learning in a Pathophysiology course.

Methods

Flipped classroom was introduced to teach Respiratory Pathophysiology in 2018. The results obtained in the exam were compared with the results of previous year students and with the evolution in Blood Pathophysiology (given by the same teacher, in a traditional way). Comparisons between groups were done with the Student’s T test. A survey was administered to the students after finishing the term.

Results

201 students were examined in 2018 (and 229 in 2017). Gender distribution and the qualifications obtained in General Pathology were comparable between them. The results in Respiratory Pathophysiology were significantly better in 2018 than in 2017 (mean: 48 versus 42 over 100; P=0.004), but the results in Blood Pathophysiology were comparable between both groups. The improvement was significant only in students that obtained scores below the median (mean: 40 versus 33; P=0.009) and was more evident in male than in female students (mean: 52 versus 44; P=0.010) and in those who had the same age (were not older) than the rest of their classmates (mean 51 versus 44; P=0.002). Most students considered that flipped classroom was more attractive and helped them to learn more and with less effort.

Conclusions

Flipped classroom increases medical students’ knowledge acquisitions in Pathophysiology. It benefits more to male students and those with lower qualifications who had not an academic delay.
Efficacy of verum and sham acupoint catgut embedding for treatment of obesity: Study protocol for a randomized controlled trial
Authors: zhou yumei , Yan Bing , Yuan Wei-Qu , Yu Hai-Bo , Yang Zhuo-Xin
Published: August 2019

Abstract
Background: Obesity has become a major public health hazard with epidemic proportions, influencing adults, adolescents and children of both genders. Previous studies suggested that acupoint catgut embedding (ACE) might be a potential therapeutic approach for obesity. The purpose of this study is to conduct a rigorous and normative trial to determine the efficacy of ACE for obesity.
Methods：A total of 99 eligible patients who diagnosed with obesity will be recruited in this study. They will be randomly allocated to either the verum ACE group, sham ACE group, or waiting- list (WL) group with 33 patients for each group. Each patient in the two ACE-based groups will receive 8 sessions of treatment, lasting over 8 weeks. The primary outcomes will the reduction of body mass index (BMI) after treatment. Secondary outcomes will include waist circumference (WC), hip circumference (HC), waist-hip ratio, body fat percentage, blood lipid level, subcutaneous fat area, visceral fat area, and the World Health Organization Quality of Life (WHOQOL). All the outcomes will be evaluated at baseline, ended at 8 weeks of treatments, and 3 months of follow-up. The evaluators and data analyzers will be blinded to group allocation.
Discussion: The findings of this randomized, sham- and waiting-list-controlled trial will help to investigate the influence of ACE on clinical variables as well as visceral fat area of obesity, which will provide high-quality evidence on the efficacy of ACE for obesity.
Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR1800020248. Registered on November 21, 2018.
Keywords: Acupoint catgut embedding, Obesity, Randomized controlled trial, Visceral fat area
LEVANTAMENTO FITOSSOCIOLÓGICO DE PLANTAS DANINHAS NA CULTURA DA PIMENTA-DO-REINO NA AMAZÔNIA ORIENTAL
Authors: Martins Mateus Pantoja , Parreira Mariana Casari , Martins Jefferson Dos Santos , Soares Jefferson Bruno Carvalho , Ribeiro Rafael Coelho
Published: August 2019

O cultivo de pimenta-do-reino (Piper nigrum L.) no território brasileiro teve origem na década de 1930 por meio da imigração japonesa, e desde então perdura como um dos principais cultivos agrícolas de interesse econômico na região amazônica. Este trabalho teve como objetivo avaliar a comunidade infestante, na cultura da pimenta-do-reino, na região da Amazônia Oriental. As coletas de dados ocorreram em cinco áreas com cultivo de pimenta-do-reino na localidade de Belos Prazeres, localizada na zona rural do município de Cametá, estado do Pará. Para a avaliação da comunidade infestante, em cada área de cultivo avaliada, foram adotadas quatro amostras de 1 m2. Com base nos dados coletados das espécies foram determinados os índices fitossociológicos: densidade, densidade relativa, frequência, frequência relativa, abundância, abundância relativa, massa fresca relativa, índice de valor de importância e o índice de valor de importância relativo. Entre as espécies que consistiram a comunidade infestante nas áreas avaliadas com cultivo de pimenta-do-reino, a Spergula arvensis, assim como a Galinsoga parviflora, a Tarenaya spinosa e a Cabomba furcata foram as mais significativas, integrando a maioria dos parâmetros analisados. Sendo que a S. arvensis foi a única espécie a ser representada em todos os índices fitossociológicos avaliados
DESEMPENHO AGRONÔMICO E QUALITATIVO DE CULTIVARES DE CEVADA CERVEJEIRA NO ESTADO DO ESPÍRITO SANTO
Authors: SOUZA JACIMAR LUIS DE , Minella Euclydes , Guarçoni Rogério Carvalho , Favarato Luiz Fernando , Teixeira Camila Santos
Published: August 2019

Com a expansão do mercado de cervejas artesanais, a recomendação de cultivares de cevada cervejeira com bom potencial produtivo no estado do Espírito Santo poderá se tornar uma nova alternativa tecnológica para os agricultores. Assim, objetivou-se avaliar o comportamento agronômico e a qualidade de três cultivares de cevada oriundas do programa de melhoramento genético da Embrapa, na região serrana do estado do Espírito Santo, a 950m de altitude, município de Domingos Martins. O número de grãos por espiga não se diferenciou entre as cultivares, mas o peso de mil grãos variou significativamente, com destaque para a cv. BRS Kalibre, com média de 59,3 g, contra 55,6 g e 51,8 g das cultivares BRS Brau e BRS Sampa, respectivamente. Os níveis de produtividade de grãos obtidos foram satisfatórios comparados aos rendimentos observados em outras regiões, com médias de 4.870, 4.977 e 5.593 kg ha-1 para as cultivares BRS Sampa, BRS Brau e BRS Kalibre, respectivamente. Os grãos de cevada mostraram-se adequados à transformação em malte cervejeiro, uma vez que todas as cultivares apresentaram mais que 85% dos grãos classe 1 (maior que 2,5mm), poder germinativo acima de 95% e teores de proteína na faixa de 9,0 a 12,0%.
EFEITO DE BIOATIVADOR COM ADUBAÇÃO ORGÂNICA NO DESENVOLVIMENTO DA ALFACE AMERICANA cv. LUCY BROWN
Authors: Lopes Allan Remor , Dotto Marcelo , De Mello Carlos Rodinei , Pirola Kelli , Zanella Alessandro Paggiarin , Giarola Camila Moreno , Carvalho Acir Felipe Grolli , Freddo Alvaro Rodrigo
Published: August 2019

A alface possui grande consumo nacional e mundial, e necessita de novas técnicas que otimizem sua produção. Os bioativadores são substâncias orgânicas que atuam no desenvolvimento vegetal podendo atuar nos fatores de transcrição e expressão gênica das plantas. Assim, objetivou-se verificar o efeito de bioativador associada a adubação orgânica no desenvolvimento da alface americana “Lucy Brown”. Utilizou-se o delineamento experimental em blocos ao acaso, com 8 tratamentos e 4 repetições, sendo estes: (T1: Esterco bovino (EB); T2: Esterco bovino + bioativador (EBB); T3: Cama de aviário (CA); T4: Cama de aviário + bioativador (CAB); T5: Palhada (PA); T6: Palhada + bioativador (PAB); T7: Solo (SO); T8: Solo + bioativador (SOB). Foram avaliadas as seguintes características: Peso da raiz, diâmetro do caule, altura da planta, massa verde da parte aérea, massa total e número de folhas. A adição do bioativador na palhada não melhorou o desenvolvimento da alface Lucy Brown. O melhor desenvolvimento da alface Lucy Brown foi obtido pelas adubações com EBB e CAB.
Metallic and insulating stripes and their relation with superconductivity in the doped Hubbard model
Authors: Tocchio Luca Fausto , Montorsi Arianna , Becca Federico
Published: August 2019

The dualism between superconductivity and charge/spin modulations
(the so-called stripes) dominates the phase diagram of many
strongly-correlated systems. A prominent example is given by the Hubbard
model, where these phases compete and possibly coexist in a wide regime
of electron dopings for both weak and strong couplings. Here, we
investigate this antagonism within a variational approach that is based
upon Jastrow-Slater wave functions, including backflow correlations,
which can be treated within a quantum Monte Carlo procedure. We focus on
clusters having a ladder geometry with MM
legs (with MM
ranging from 22
to 1010)
and a relatively large number of rungs, thus allowing us a detailed
analysis in terms of the stripe length. We find that stripe order with
periodicity \lambda=8λ=8
in the charge and 2\lambda=162λ=16
in the spin can be stabilized at doping \delta=1/8δ=1/8.
Here, there are no sizable superconducting correlations and the ground
state has an insulating character. A similar situation, with
\lambda=6λ=6,
appears at \delta=1/6δ=1/6.
Instead, for smaller values of dopings, stripes can be still stabilized,
but they are weakly metallic at \delta=1/12δ=1/12
and metallic with strong superconducting correlations at
\delta=1/10δ=1/10,
as well as for intermediate (incommensurate) dopings. Remarkably, we
observe that spin modulation plays a major role in stripe formation,
since it is crucial to obtain a stable striped state upon optimization.
The relevance of our calculations for previous density-matrix
renormalization group results and for the two-dimensional case is also
discussed.
El Consejo de Defensa Suramericano y la creación de una política común de seguridad regional
Authors: Narváez Jaimes Ginneth Esmeralda
Published: August 2019

El presente artículo esboza el avance que se ha desarrollado en el marco del proyecto de investigación «El Consejo de Defensa Suramericano y la creación de una política común de Seguridad Regional». Se retoman artículos publicados en revistas especializadas, así como textos teóricos que permiten determinar el origen de este órgano regional y sus objetivos; al tiempo que se vislumbran sus posibilidades prácticas y sus retos actuales en materia de integración. Artículo de investigación científica que presenta los resultados del proyecto de investigación «El Consejo de Defensa Suramericano y la creación de una política común de Seguridad Regional».
El ocaso del paradigma estatocéntrico: la redefinición del Estado a la luz del derecho internacional y las relaciones internacionales contemporáneas
Authors: Cuestas Zamora Edgard Junior
Published: August 2019

La naturaleza del derecho internacional clásico fue eminentemente pública y se limitó a la regulación de las relaciones entre Estados como únicos actores del sistema internacional. Entre tanto, las relaciones internacionales fueron forjadas como el estudio de la sociedad global, cuya piedra angular fueran los conflictos interestatales y la seguridad internacional. Para mediados del siglo XX, los estudios internacionales ampliaron su espectro de análisis como consecuencia del auge y la diversificación de sujetos internacionales, lo que provocó el desarrollo de nuevas áreas del derecho internacional y la interrelación de las relaciones internacionales con otras disciplinas.  Este artículo tiene como finalidad presentar las discusiones teóricas de los últimos cuarenta años, a través de las cuales el paradigma estatocéntrico profesado por ambas disciplinas ha perdido legitimidad. Pese a la proliferación de sujetos internacionales y el proceso de regulación que acompaña su surgimiento, el Estado sigue siendo el actor más poderoso que define la estructura del sistema internacional contemporáneo.  Este artículo de investigación es el resultado de una parte del trabajo de grado titulado Aproximaciones al estatus jurídico en derecho internacional público de las provincias separatistas de Abjasia y Osetia del Sur ante la guerra de Osetia de 2008, escrito por el mismo autor.
Les Politiques Culturelles en Colombie et les Acteurs Locaux
Authors: Dermer Wodnicky Miriam
Published: August 2019

La Colombie est un des pays ayant dû gérer la tension entre les sphères commerciale et culturelle. Larticle porte sur les politiques culturelles en Colombie et les définitions de la culture des acteurs locaux. On part des questions suivants: quel est le discours sur les politiques culturelles de la Colombie et de la politique de la diversité culturelle et quelles sont les définitions des acteurs locaux sur la culture, la diversité culturelle et le débat commerce-culture? Lon constatequil y a des différents définitions sur la diversité culturelle à partir des acteurs locaux. Cest pour lantérieur que lon aborde des acteurs locaux tel que lÉtat colombien, les indigènes, les afro-descendants, la coalition colombienne pour la diversité culturelle. La conclusion est que les grands enjeux de la diversité culturelle sont la «gestion» de la diversité culturelle en lien avec lexploitation des ressources naturelles et de la consultation préalable des communautés ciblées relativement aux décisions concernant les territoires communs. En dautres mots, la gestion des tensions entre les secteurs commerciaux et culturels. Certains auteurs pensent que la culture fait partie des produits commerciaux. Alors que dautres exposent que la culture est différente des autres biens et services, car il porte des identités et des valeurs. La révision du français a été faite par Veronique Prenovost, maitre en relation internationale de lUQAM. Artículo de investigación científica que aborda el tema de las políticas culturales en Colombia desde una aproximación a la diversidad cultural del país.
Análisis de la política pública implementada con los niños desplazados de 10 a 14 años por el Ministerio de Educación Nacional de Colombia (MEN). (Círculos de aprendizaje)
Authors: Nivia Latorre María Angélica
Published: August 2019

El desplazamiento forzado se ha convertido en un tema primordialpara la creación e implementación de políticas públicas quepermitan el restablecimiento de los derechos de esta población. Estoha desencadenado el desarrollo de una serie de esfuerzos con el finde contribuir al bienestar de esta población y dentro de estos esfuerzosse cuentan los círculos de aprendizaje. Por eso, la intención deeste artículo es realizar un análisis de este programa aplicado por elMinisterio de Educación Nacional de Colombia (MEN) con el finde mejorar las condiciones de los desplazados en edades entre los 10y los 14 años. Para dicho análisis se realizó un estudio correlacionalque buscó entrelazar la información sobre políticas públicas, desplazamiento forzado y teorías del aprendizaje para obtener algunas de las falencias presentadas por dichos programas. Ahora bien, con elfin de obtener esta información se realizó una revisión documentalque comprendió los temas mencionados con anterioridad.Por consiguiente, este documento abordará, en primer lugar,el marco legislativo para la construcción de la política pública paraatención de la población desplazada y los programas diseñados, ahondando en los círculos de aprendizaje. Posteriormente se abordará ladefinición de políticas públicas y se relacionará con la construcción eimplementación de los círculos de aprendizaje. Finalmente se analizaránlos círculos de aprendizaje a través de la guía para una implementaciónde políticas más exitosa de Sabatier y Mazmanian desde la cualse planteará la cuestión de la fundamentación teórica de los círculosde aprendizaje a través de las diferencias en el contexto aplicado y lasteorías del aprendizaje psicodinámicas, personológicas y cognitivistas.
Low-Fat Butter: Production and Technological Features
Authors: Захарова Людмила , Zakharova Lyudmila , Абушахманова Любовь , Abushahmanova Lyubov’
Published: August 2019

Modern lifestyle is characterized by hypodynamy, hypokinesia, overnutrition, and high-calorie products consumption. Hence, food industry has to design low-caloric products. The present paper introduces a new production technology for low-fat butter with dietary fibers. The research featured Bio-fi Pro WR 400 beetroot fiber, namely its sensory, functional, and technological properties, as well as chemical composition. The research objective was to define its further use in low fat butter production. The fiber demonstrated neutral taste, colour, and smell. The sample contained up to 70% of dietary fibers, including 21% of cellulose and 20% of pectin. The research also studied the soaking process of cellulose in distilled water and skim milk at various temperatures. Fat-free milk proved to be the optimal environment, while the optimal temperature for the soaking process was 45 ± 1°C. Temperature experiments proved the samples of dietary fibers to be thermostable. A study of various pasteurization modes and their effect on the sensory properties of cream revealed the following optimal conditions: 95 ± 2°C for 10 minutes. The conditions allowed the samples of high-fat cream to acquire the necessary specific pasteurization taste. In addition, the study featured the effect of dietary fibers on the rheological and sensory properties of low fat butter, as well as its nutrition and energy value. The optimal share of the dietary fiber was determined as 2.5% of the finished product weight. The fat content in the low fat content butter was 1.17 times lower than in the control sample (Krestyanskoe butter brand). Thus, the obtained product demonstrated a low calorific value if compared to traditional butter.
An Electronic Health Intervention for Latina Women Undergoing Breast Cancer Treatment (My Guide for Breast Cancer Treatment): Protocol for a Randomized Controlled Trial
Authors: Yanez Betina , Baik Sharon H , Oswald Laura B , Buitrago Diana , Buscemi Joanna , Iacobelli Francisco , Perez-Tamayo Alejandra , Fajardo Precilla , Serrano Gabriela , Guitelman Judith , Penedo Frank J
Published: August 2019

Background

Among Latinas and Hispanics (henceforth referred to as Latinas), breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths. However, few interventions have been developed to meet the needs of Latina women undergoing active treatment for breast cancer.

Objective

This paper aims to describe the procedures and methods of My Guide for Breast Cancer Treatment and the plans for conducting a multisite randomized controlled trial to investigate the feasibility and preliminary efficacy of this smartphone-based app for Latina women in active treatment for breast cancer.

Methods

Study participants will be randomized to the My Guide for Breast Cancer Treatment intervention or the enhanced usual care control condition for 12 weeks. Participants will have access to innovative features such as gamification via virtual awards to reinforce usage and an adaptive section that presents targeted material based on their self-reported concerns and needs. Using a stepped-care approach, intervention participants will also receive telecoaching to enhance their adherence to the app. Study outcomes and intervention targets will be measured at study enrollment (before randomization), 6 and 12 weeks after initial app use. General and disease-specific health-related quality of life (HRQoL) and symptom burden are the study’s primary outcomes, whereas anxiety, depression, fear of cancer recurrence, physical activity, and dietary intake are secondary outcomes.

Results

Recruitment began in August 2019 and is expected to be completed by August 2020. We expect to submit study results for publication by fall 2020.

Conclusions

My Guide for Breast Cancer Treatment has the potential to improve HRQoL and reduce symptom burden, and increase access to supportive care resources among Latina breast cancer patients.

International Registered Report Identifier (IRRID)

PRR1-10.2196/14339