bluuebunny/crossref_metadata_2025 huggingface dataset:
Elementos que favorecen la producción textil transnacional y relación con su responsabilidad social empresarial
Authors: Luque González Arturo
Published: August 2019

El objetivo de esta investigación, es analizar los elementos que facilitan y contribuyen al desarrollo del sector textil transnacional teniendo en cuenta factores exógenos, así como su relación con la responsabilidad social empresarial (RSE), a través de un análisis Delphi. Se han utilizado dos paneles de cincuenta y cinco expertos, relacionados con las temáticas objeto de estudio, los cuales respondieron a las hipótesis planteadas, con la finalidad de clasificar y analizar los resultados obtenidos, identificándolos según su influencia económica, tecnológica, social, política y legal, dando como resultado la existencia de un nuevo paradigma de posibilidades en el sector textil, circunstancias que contribuyen a mejorar la producción de una manera más ética y sostenible.
Análisis de la oferta educativa superior de pregrados universitarios de marketing en Colombia, en 2017
Authors: Rueda Vega Juan David , Robert González Mario Andrés , Alonso González Antonio , Collazos Hernández Iulderc
Published: August 2019

La presente investigación, se desarrolló como un proyecto conjunto realizado en 2017, por estudiantes del programa de Marketing y Negocios Internacionales de la Universidad Sergio Arboleda, pertenecientes al semillero Young Marketeers’ Research Group – YMRG, y directivos de la Asociación de Programas de Mercadeo (ASPROMER), contando dicha entidad como asociados, con el 47% de participación de los programas de pregrado activos en marketing, en Colombia. El objetivo de la investigación, fue el realizar un estudio y análisis del estado de la oferta educativa de programas de pregrado del área de marketing y afines, a través de datos secundarios provenientes del Sistema Nacional de Información de la Educación Superior – SNIES y bases de datos de ASPROMER.
El estudio se dividió en dos partes. La primera, dedicada al Análisis Estructural de los programas de marketing y afines en Colombia, permitió identificar en el SNIES, 82 programas universitarios, de los que 71 se encuentran activos y 11 inactivos, contando dichos programas con un amplio rango de valores de matrícula, concentrándose la mayoría de los programas en el segmento bajo y medio de hasta $5’000.000 COP, y localizándose 4 programas en el segmento premium por encima de $8’000.000 COP. La concentración geográfica de la oferta académica de dichos programas, también se detectó como muy localizada en 5 ciudades: Bogotá, Medellín, Cali, Barranquilla y Bucaramanga, concentrándose en estas 5 ciudades 54 de los 82 programas estudiados. Adicionalmente, un 87% de estos programas se ofrecían de manera presencial, y tan solo 13% en metodología virtual, siendo la duración de dichos programas de nueve semestres en su mayoría. En la segunda parte del estudio, dedicada al Análisis de Tendencias y Enfoques Conceptuales en los Contenidos, se utilizaron dos documentos desarrollados por investigadores de la Asociación de Programas de Mercadeo para identificar cuáles están siendo las generalidades y enfoques conceptuales de los diferentes programas de marketing y afines.
COMPARAÇÃO ENTRE OS BENEFÍCIOS CONCEDIDOS PELA PREVIDÊNCIA SOCIAL BRASILEIRA À POPULAÇÃO RURAL E URBANA
Authors: Saraiva Caroline Estefanie do Amaral Brasil , Fernandes Alice Munz , Cunha Claussia Neumann da , Costa Lucas Teixeira
Published: August 2019

O objetivo desse estudo consistiu em comparar o valor dos benefícios fornecidos pela previdência social à população rural e à população urbana do Brasil, nos últimos anos. Também buscou-se comparar os valores totais dos benefícios concedidos aos produtores/trabalhadores rurais conforme a divisão geopolítica do país. Para tanto, empregou-se uma pesquisa quantitativa com dados secundários provenientes do conjunto de Anuários Estatísticos da Previdência Social. Após a atualização dos valores nominais, conforme o Índice de Preço ao Consumidor Amplo, empregaram-se análises estatísticas uni e multivariadas. Por meio de uma sequência de testes t de Student constatou-se que existe diferença estatisticamente significativa nos valores totais das aposentadorias concedidas à população urbana e rural do país, considerando um nível de significância de 5%, apesar do conjunto total de benefícios previdenciários não apresentar diferença. Mediante a realização da análise de variância observou-se também que o valor total dos benefícios fornecidos pela previdência social à população rural nos últimos anos difere entre as regiões do país. Por fim, através do teste Tukey constatou-se que a Região Nordeste difere estatisticamente de todas as demais regiões, o que pode ser explicado por configurar-se como aquela que detém maior proporção da população residindo em áreas rurais.
Tüketicilerin Yatak Seçim Davranışlarının İncelenmesi
Authors: Kaplan Sibel , Tokgöz Havva
Published: August 2019

Günümüzde
insanların hayat standartlarının artmasıyla, günümüzün üçte birini geçirdiğimiz
uyku ortamını oluşturan tekstil ürünlerinden beklentileri de artmıştır. Konfor
kavramı, giysiler için olduğu gibi yatak mikroklimasını oluşturan tekstil
bileşenleri için de önemlidir. Bu çalışmada, bir grup tüketicinin yatak seçiminde
önem verdiği parametreler, konforlu uyku için gerekli şartlar, reklamların
satın alma davranışları üzerindeki etkileri, tercih edilen yatakların kullanım
süreleri, uyku sırasında yaşanan fizyolojik problemler konularındaki görüşleri
anket yöntemiyle alınmıştır. Literatürde genellikle belirlenen yatakların
sertlik-yumuşaklık algısı, yarattığı sağlık problemleri ile ilgili anketler ve
subjektif denemeler mevcuttur. 320 kişinin katıldığı ankette kaliteli
uyku için önem verilen parametreler incelendiğinde, en önemli faktörün yatak
konforu olduğu, hammadde ve bitim işlemleri ile sağlanan fonksiyonelliklerin de
ön planda olduğu tespit edilmiştir. Termal konforun yanında, çoğunluğun
hissettiği sırt/omurga ve bel ağrılarına yönelik mekanik desteklerin de yatak
tasarımında önemli olduğu tespit edilmiştir. Tüketicilerin yatak tercihinde
reklamlardan özellikle ortopedik özellikler, kullanım kolaylığı ve sağlıkla
ilgili özellikler konusunda etkilendikleri tespit edilmiştir.
Alzheimer Hastalığı ile İlişkilendirilen APH1A Genindeki Zararlı SNP’lerin In Silico Yöntemler ile Belirlenmesi
Authors: Özkan Oktay Ebru , Kaman Tuğba , Karasakal Ömer Faruk , Ulucan Korkut , Konuk Muhsin , Tarhan Nevzat
Published: August 2019

Alzheimer
hastalığı (AH), β-amiloid (Aβ) senil plakların ve nörofibriler yumakların
patolojik birikimi ile karakterize olan ilerleyici bir nörodejeneratif
hastalıktır. γ-sekretaz, AH nedeni olan amiloid β peptidi (Aβ) üretmektedir.
γ-sekretaz makromoleküler bir komplekstir ve APH1A geninin kodladığı protein bu
komplekste yer almaktadır. Bu çalışmada, APH1A genindeki yanlış anlamlı
(missense) tek nükleotid polimorfizmlerinin (SNP) proteinin yapısı ve
stabilizasyonu üzerindeki olası zararlı etkilerinin in silico yöntemler kullanılarak belirlenmesi amaçlanmıştır.
Zararlı SNP’lerin tahmin edilmesi için PolyPhen-2 ve SIFT yazılım araçları,
protein stabilizasyonu değişimlerinin tespit edilmesi için I-Mutant 2.0
yazılımı, yabanıl ve mutant tip proteinlerin üç boyutlu modellemeleri için
Project HOPE yazılım aracı kullanılmıştır. Sonuçlar, APH1A geninde yer alan
toplam 3567 SNP’nin 257 tanesinin yanlış anlamlı SNP olduğunu göstermiştir. 257
SNP’nin in silico analizlerine göre,
rs11548266, rs74126634, rs145324799, rs199961673, rs370361277, rs370719475 ve
rs376071112 polimorfizmlerinin zararlı etkilerinin olabileceği belirlenmiştir.
Çalışmamızda gerçekleştirdiğimiz in
silico analizler, Alzheimer hastalığı ile ilgili APH1A geninde yer alan
3567 SNP’nin tamamının genotiplenmesi yerine proteinin yapısı ve
stabilizasyonuna zararlı etkisi olabilecek SNP’lerin genotiplenmesine ilişkin
veri sağlamaktadır. Dolayısıyla, zararlı olduğu tespit edilen SNP’ler
genotipleme çalışmalarının en önemli basamağı olan SNP seçiminde ve deney
tasarımında kullanılabilecektir. Bu nedenle, elde ettiğimiz sonuçların
Alzheimer hastalığı ile ilgili gelecekte yapılacak olan hem deneysel hem de in silico çalışmalara katkı sağlayacağı
düşünülmektedir.
Karasu Nehri Su Kalitesinin Farklı Su Kalitesi İndeksleri Açısından Değerlendirilmesi
Authors: Alver Alper , Baştürk Emine
Published: August 2019

Yağışların
azaldığı, tarımsal ve endüstriyel faaliyetlerin giderek arttığı İç Anadolu
bölgesinde, su kaynaklarının üzerindeki baskıda her geçen gün artmaktadır. Biyolojik
ihtiyaçlar, entegre çevre yönetimi ve sürdürülebilir kalkınma hedefleri için su
kaynaklarının kalitesi ve miktarı önemlidir. Su kalitesini etkileyen birçok
parametrenin aynı anda yorumlanarak su kalitesinin belirlenmesi hem karmaşık
hem maliyetli hem de uzun zaman almaktadır. Bu sebeple su kalitesinin daha
anlaşılabilir bir şekilde yorumlanmasını sağlayan su kalite indeksi modelleri
kullanılmaktadır. Bu çalışmada, Aksaray İlinin önemli içme su kaynaklarından
biri olan Karasu Nehri’nin su kalitesi Aralık 2015 ve Kasım 2016 tarihleri
arasında bir yıl süreyle izlenilmiş olup nehrin genel su kalitesi 3 farklı su
kalite indeksi modeli ile değerlendirilmiştir. İçme suyu elde
edilen veya elde edilmesi planlanan yüzeysel suların kalitesine dair yönetmeliğe
göre NH4-N, BOİ5, Co, fekal koliform, Ba, Cu, Zn ve
çözünmüş oksijen parametrelerinin sınır değerlerini aştığı ve suyun kalitesini
etkileyen ana parametreler olduğu saptanmıştır. Ayrıca su kaynağının yüzey su kalite
sınıfının NO2, B, Cd ve Zn parametrelerine bağlı olarak “IV” olduğu
tespit edilmiştir. Uygulanan model sonuçlarına göre ise Karasu Nehri’nin
su kalitesi, Ulusal Sanitasyon Vakfı Su Kalite İndeksine (USV SKİ) göre “orta”,
Kanada Çevre Bakanlığı Konseyi Su Kalite İndeksine (KÇBK SKİ) göre “kötü” ve
Oregon Su Kalite İndeksine (O SKİ) göre de “kötü” seviyede olarak tespit
edilmiştir.
LOS LÍPIDOS EN LOS PECES Y LOS APORTES BENÉFICOS EN LA SALUD HUMANA
Authors: Domínguez Lorenzo Juana , Cerino Frías Tila del Carmen , Martínez García Rafael , Álvarez González Carlos Alfonso , Contreras García María de Jesús , Macdonal Vera Alejandro , Cruz Rosado Leonardo
Published: August 2019

Las grasas y los lípidos se definen como compuestos químicos orgánicos solubles en solventes orgánicos. A diferencia de otros nutrientes, los lípidos no se mezclan con el agua, lo que provoca un proceso especial durante su digestión, absorción, transporte, almacenamiento y aprovechamiento. Dos décadas atrás, se descubrió que los lípidos son esenciales para el crecimiento y desarrollo normal tanto en animales como en humanos y cuando no hay suficiente en las dietas, se producen efectos negativos en los diversos procesos fisiológicos. Los ácidos grasos esenciales, después de que han sido ingeridos, se distribuyen entre las células del tejido graso, donde se almacenan y se incorporan con gran eficiencia a los tejidos del organismo. Evidencias epidemiológicas revelan que una dieta rica en ácidos grasos favorece una buena salud. En el presente manuscrito, presentamos la relevancia de estos nutrientes y su relación de estos en los peces y en la salud humana.
ESTUDIO TAXONÓMICO DE LA FAMILIA 'ARECACEAE' EN EL MUNICIPIO DE MACUSPANA, TABASCO, MÉXICO
Authors: Magaña Alejandro Miguel Alberto , González Hernández Alejandro
Published: August 2019

La familia Arecaceae es un grupo de angiosperma que comprende unos 200 géneros y aproximadamente 2,800 especies distribuidas en tres grandes regiones; América, Asia-Australia-Oceanía y África-Madagascar. Sin embargo, algunos autores mencionan que se distribuyen en las zonas tropicales y subtropicales del mundo. Tomando en cuenta que el municipio de Macuspana en Tabasco se encuentra dentro de esta zona y que es uno de los lugares con mayor diversidad del Estado, se realizó el estudio taxonómico de la familia Arecaceae. Se identificaron 33 especies representadas en 24 géneros, de las cuales 19 son nativas. Se analizó la distribución de las palmas en los diferentes tipos de vegetación; se encontraron nueve especies que están en el status de amenazada de acuerdo a la NOM-059-SEMARNAT-2010. Finalmente, la zona de estudio es diversa en cuanto a palmas se refiere, ya que el 60 % de las especies de palmas nativas de Tabasco están en Macuspana.

Palabras clave: Diversidad; flora regional; palmas.
Keywords: Diversity; regional flora; palms.
LOS RELEGADOS DE LA FAUNA SILVESTRE
Authors: Contreras Moreno Fernando Marcos , Segura Berttolini Elsy C.
Published: August 2019

Actualmente el valor que se le da a la fauna silvestre se encuentra influenciado por el estado de conservación en las listas nacionales e internacionales de especies en riesgo. Sin embargo, existen muchas especies que son aprovechadas constantemente en México y que no se encuentran en estas listas, por lo que por años han sido ignoradas por los grupos académicos y de conservación. La importancia de estas especies deriva de la derrama económica por actividades cinegéticas, además de funcionar como alimento para los pobladores locales. Es necesario establecer estrategias, en las que se incluya a estas especies, que permitan el acceso a recursos para realizar estudios que contribuyan a esclarecer su estatus poblacional en las diferentes regiones del sureste de México.

Palabras clave: Especie cinegética; conservación; mamíferos; cacería; poblaciones.
Keywords: Huntable species; conservation; mammals; hunting; populations.
PÓLENES ALERGÉNICOS EN EL AIRE DE DOS SITIOS DEL VALLE DE MÉXICO, MEXICO
Authors: Cid Martínez Marcela Alejandra , Fócil Monterrubio Reyna Lourdes
Published: August 2019

En el aire que respiramos se encuentran suspendidos pólenes anemófilos. Estos se rigen por factores climáticos, geográficos, entre otros. Los granos de polen pueden generar alergia, motivo por el que la aerobiología estudia su diversidad y comportamiento en la atmósfera. En este estudio se emplearon dos trampas de esporas para monitorear polen aéreo de dos sitios del Valle de México. Las muestras se analizaron bajo microscopio óptico de contraste de fases y se determinaron a nivel cualitativo y cuantitativo los grupos polínicos alergénicos. Además obtuvo un total de 62 taxa, de los cuales 24 son reportados como aeroalergénos. En relación a la comparación de los conjuntos polínicos, se observó que 22 taxa se presentaron en ambos sitios, pero únicamente Carya en el sitio “Nw” y Abies en el sitio “Sw”.

Palabras clave: Alergia; atmósfera; parámetros meteorológicos; aeroalérgenos.
Keywords: Allergy; atmosphere; meteorological parameters; aeroallergens.
Design of a pH-responsive Conductive Nanocomposite Based on MWCNTs Stabilized in Water by Amphiphilic Block Copolymers
Authors: den Hoed Frank , Pucci Andrea , Picchioni Francesco , Raffa Patrizio
Published: August 2019

Homogeneous water dispersions of MWCNTs were prepared by ultrasonication in the presence of an amphiphilic polystyrene-block-poly(acrylic acid) (PS-b-PAA) copolymer. The ability of PS-b-PAA to disperse and stabilize MWCTNs was investigated by UV-vis, SEM and zeta potential. It is shown that the copolymer can disperse nanotubes directly by sonication in water. The results show that the addition of a styrene block to PAA enhances the dispersion efficiency compared to pure PAA, possibly due to the nanotube affinity with the polystyrene moiety. Notably, the dispersions show an evident pH-responsive behavior, being MWCNTs reaggregation promoted in basic environment. Furthermore, composites obtained by drop casting display electrical conductivity responsive to pH variations, showing the potential of such materials for sensing applications.
Metabolic Trajectories Following Contrasting Prudent and Western Diets from Food Provisions: Robust Biomarkers of Short-Term Changes in Habitual Diet
Authors: Wellington Nadine , Shanmuganathan Meera , de Souza Russell J. , Zulyniak Michael A. , Azab Sandi , Bloomfield Jonathon , Mell Alicia , Ly Ritchie , Desai Dipika , Anand Sonia S. , Britz-McKibbin Philip
Published: August 2019

A large body of evidence has linked unhealthy eating with an alarming increase in obesity and chronic disease worldwide. However, existing methods of assessing dietary intake rely on food frequency questionnaires or dietary records that are prone to bias and selective reporting. Herein, metabolic phenotyping was performed on 42 healthy participants from the Diet and Gene Intervention (DIGEST) pilot study, a parallel two-arm randomized clinical trial that provided complete diets to all participants. Matching urine and plasma specimens were collected at baseline and following 2 weeks of provision of either a Prudent or Western diet with a weight-maintaining menu plan designed by a dietician. Targeted and nontargeted metabolite profiling was conducted using three complementary analytical platforms, where 80 serum metabolites and 84 creatinine-normalized urinary metabolites were reliably measured (CV < 30%) in the majority of participants (> 75%) after implementing a rigorous data workflow for metabolite authentication with stringent quality control. We classified a panel of metabolites with distinctive trajectories following 2 weeks of food provisions when using complementary univariate and multivariate statistical models. Unknown metabolites associated with contrasting dietary patterns were identified with high resolution MS/MS and/or co-elution after spiking with authentic standards. Overall, 3-methylhistidine and proline betaine concentrations increased consistently when participants were assigned a Prudent diet (q < 0.05) in both plasma and urine samples with a decrease in the Western diet group. Similarly, creatinine-normalized urinary imidazole propionate, hydroxypipecolic acid, dihydroxybenzoic acid, and enterolactone glucuronide, as well as plasma ketoleucine and ketovaline increased with a Prudent diet (p < 0.05) after adjustments for age, sex and BMI. In contrast, plasma myristic acid, linoelaidic acid, linoleic acid, α-linoleic acid, pentadecanoic acid, alanine, proline, carnitine and deoxycarnitine, as well as urinary acesulfame K increased among participants following a Western diet. Most metabolites were also correlated (r > ± 0.30, p < 0.05) to changes in average intake of specific nutrients from self-reported diet records reflecting good adherence to food provisions. This study revealed robust biomarkers sensitive to short-term changes in habitual diet that can be used to reliably monitor healthy eating patterns for new advances in nutritional epidemiology, as well as the design of evidence-based public health policies for chronic disease prevention.
One-Bone Forearm Reconstruction
Authors: Devendra Agraharam , Velmurugesan Purnaganapathi Sundaram , Dheenadhayalan Jayaramaraju , Venkatramani Hari , Sabapathy Shanmuganathan Raja , Rajasekaran Shanmuganathan
Published: August 2019

Background:

Salvaging the forearm is a major challenge in cases of massive bone loss from injuries in which the extremity is severely mangled or following bone resection secondary to pathological tissue excision. The purpose of this study was to evaluate the role of one-bone forearm (OBF) reconstruction as a salvage option in these difficult situations.

Methods:

A total of 38 patients with forearm segmental bone loss (acute and chronic) treated between 1995 and 2014 were included (range of follow-up, 2 to 20 years). Sixteen of the patients, 8 with avulsion amputations and 8 with severely mangled extremities, were managed in the emergency department because they required immediate replantation and revascularization, respectively. In the chronic setting, bone loss was due to infection with nonunion in 16 patients, tumor of the radius in 2 patients, and pseudarthrosis of the forearm in 4 patients. The surgical technique included conversion to OBF by achieving union between the distal part of the radius and the proximal part of the ulna in the majority of cases, with distal radioulnar joint (DRUJ) fusion in 4 cases, and ulna to carpals in 5 cases. Direct bone contact was achieved in 16 patients, a free vascularized fibular graft was used to bridge the bone gap in 10 patients, and 12 patients required iliac crest bone-grafting.

Results:

The mean patient age was 35.5 years (range, 6 to 87 years); there were 23 male and 15 female patients. Among those who underwent OBF for acute injuries, the mean time to union was 7.3 months; 14 patients had complete union, and 2 patients had infection with nonunion requiring secondary procedures. As assessed using the criteria of Chen, 10 patients had a grade-I functional outcome, 3 patients had a grade-II outcome, and 3 patients had a grade-III outcome. In the elective group of 22 patients, the average time to union was 7.1 months. Nonunion was reported for 2 patients. On the basis of the Peterson scoring system, the outcome was excellent for 12 patients, good for 6 patients, fair for 2 patients, and poor for 2 patients.

Conclusions:

OBF reconstruction is a viable surgical treatment alternative. It is a demanding reconstruction but functions better and is cosmetically more appealing than a forearm amputation.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Bone Quality and Fracture-Healing in Type-1 and Type-2 Diabetes Mellitus
Authors: Henderson Shasta , Ibe Izuchukwu , Cahill Sean , Chung Yeon-Ho , Lee Francis Y.
Published: August 2019

➤ Patients with type-1 or type-2 diabetes have an increased risk of fracture, which is secondary to early bone loss in type-1 diabetes whereas, in type 2, the development of abnormal osseous architecture results in paradoxically increased or normal bone mineral density.

➤ Diabetic patients diagnosed with osteoporosis should receive the same standard antiresorptive therapies as non-diabetic patients in conjunction with appropriate glycemic control.

➤ Medical management of type-2 diabetes can affect bone health and fracture risk. Thiazolidinediones have been correlated with an increased facture risk, whereas metformin can be protective of the bone health of diabetic patients.

➤ Diabetes increases the likelihood of nonunion and delayed union of fractures as well as other perioperative complications such as infection.

➤ Perioperative glycemic control may decrease the risk of perioperative complications, especially surgical site infection. Methods to directly improve diabetic fracture-healing such as the use of parathyroid hormone and sclerostin antibody are in the experimental phase.

➤ Prior to proceeding with operative intervention for fractures, it is necessary to consider the additional risk posed by diabetes, which must be taken into account when planning the approach, fixation, and postoperative management in this population.
Influencia de la actividad física sobre la calidad de vida de los niños con sobrepeso u obesidad
Authors: Aguilar-Cordero María José , Rodríguez-Blanque Raquel , Menor-Rodríguez María José , Guisado-Barrilao Rafael , León-Ríos Ximena , Sánchez-López Antonio Manuel
Published: August 2019

[No disponible]
Determining ‘Curriculum Viability’ through Standards and Inhibitors of Curriculum Quality: A Scoping Review
Authors: Khan Rehan Ahmed , Spruijt Annemarie , Mahboob Usman , Merrienboer Jeroen J. G. van
Published: August 2019

Background A curriculum is dynamic entity and hence, metaphorically, can be considered ‘alive’. Curricular diseases may impair its quality and hence its viability. The quality of a curriculum is typically assessed against certain quality standards only. This approach does not identify the inhibitors impeding the achievement of quality standards. The purpose of this study is to identify not only standards but also inhibitors of curriculum quality, allowing for a more comprehensive assessment of what we coin ‘curriculum viability’. Methods We performed a scoping review of ‘curriculum viability’, after which 13 articles were found eligible through a meticulous search and selection process. We first identified 1233 studies based on matching keywords, title and abstract; 36 of which met our inclusion criteria. After application of the Qualsyst criteria, two independent reviewers performed a thematic analysis of the 13 articles that remained. Results While all studies reported on standards of quality, only two studies described both standards and inhibitors of quality. These standards and inhibitors were related to educational content and strategy, students, faculty, assessment, educational/work environment, communication, technology and leadership. Conclusions The framework of curriculum viability thus developed will help identify inhibitors adversely affecting the curriculum viability and remaining hidden or un-noticed when curriculum evaluation is done.
The Bucket Test Differentiates Patients with MRI Confirmed Brainstem/Cerebellar Lesions from Patients Having Migraine and Dizziness Alone
Authors: Chang Tzu-Pu , Winnick Ariel A , Hsu Yung-Chu , Sung Pi-Yu , Schubert Michael C
Published: August 2019

Background: Among the most challenging diagnostic dilemmas managing patients with vestibular symptoms (i.e. vertigo, nausea, imbalance) is differentiating dangerous central vestibular disorders from benign causes. Migraine has long been recognized as one of the most common causes of vestibular symptoms, but the clinical hallmarks of vestibular migraine are notoriously inconsistent and thus the diagnosis is difficult to confirm. Here we conducted a prospective study investigating the sensitivity and specificity of combining standard vestibular and neurological examinations to determine how well central vestibular disorders (CVD) were distinguishable from vestibular migraine (VM).
Method: Twenty-seven symptomatic patients diagnosed with CVD and 36 symptomatic patients with VM underwent brain imaging and clinical assessments including; 1) SVV bucket test, 2) ABCD2, 3) headache/vertigo history, 4) presence of focal neurological signs, 5) nystagmus, and 6) clinical head impulse testing.
Results: Mean absolute SVV deviations measured by bucket testing in CVD and VM were 4.8±4.1° and 0.7±1.0°, respectively. The abnormal rate of SVV deviations (>2.3°) in CVD was significantly higher than VM (p<0.001). Using the bucket test alone to differentiate CVD from VM, sensitivity was 74.1%, specificity 91.7%, positive likelihood ratio (LR+) 8.9, and negative likelihood ratio (LR-) 0.3. However, when we combined the SVV results with the clinical exam assessing gaze stability (nystagmus) with an abnormal focal neurological exam, the sensitivity (92.6%) and specificity (88.9%) were optimized (LR+ (8.3), LR- (0.08)).
Conclusion: The SVV bucket test is a useful clinical test to distinguish CVD from VM, particularly when interpreted along with the results of a focal neurological exam and clinical exam for nystagmus.
Palliative care nurse specialists' reflections on a palliative care educational intervention in long-term care: An inductive content analysis
Authors: Frey Rosemary Ann , Balmer Deborah , Boyd Michal , Robinson Jackie , Gott Merryn
Published: August 2019

Background: Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore palliative care nurse specialists’ experiences regarding the benefits of and barriers to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities.
Methods: Reflective logs (465), recorded over the course of the yearlong SHARE intervention by the three palliative care nurse specialists from two local hospices, who were the on-site mentors, were qualitatively analyzed by two researchers utilizing inductive content analysis.
Results: Categories emerging from the logs include the importance of relationships, knowledge exchange, communication, and the challenges of providing palliative care in a long-term care setting.
Conclusion: Evidence from the logs indicated that sustained relationships between the palliative care nurse specialists and staff (registered nurses, healthcare assistants) as well as reciprocal learning were key factors supporting the implementation of this palliative care educational intervention. Challenges remain however in relation to staffing levels, which further emphasizes the importance of palliative care nurse specialist presence as a point of stability.
Novel mutations of the POLR3A gene caused POLR3-related leukodystrophy in a Chinese family: a case report
Authors: Wu Shuiyan , Bai Zhenjiang , Dong Xingqiang , Yang Daoping , Chen Hongmei , Hua Jun , Zhou Libing , Lv Haitao
Published: August 2019

Background: POLR3-related leukodystrophy is an autosomal recessive neurodegenerative disorder characterized by onset time ranging from the neonatal period to late childhood, progressive motor decline that manifests as spasticity, ataxia, tremor, and cerebellar symptoms, as well as mild cognitive regression and hypodontia. POLR3-related leukodystrophy belongs to the family of RNA polymerase III-related leukodystrophy, which are caused by biallelic mutations in the POLR3A, POLR3B, POLRC1, or POLR3K genes.
Case presentation: In this study, we report a female child with POLR3-related leukodystrophy manifesting as cognitive decline, moderate dysarthria, motor decline, cerebellar syndrome, short stature, dysphagia, hypodontia, and mild delayed myelination by brain imaging. Interestingly, polytrichia and bronchodysplasia were first observed in a POLR3-related leukodystrophy patient. Medical exome sequencing with high coverage depth was employed to identify potential genetic variants in the patient. Novel compound heterozygous mutations of the POLR3A gene, c.1771-6C>G and c.2611del (p.M871Cfs*8), were detected. One of them is an uncommon splice site mutation, and this is the first report of this mutation in a Chinese family. The father was determined to be a heterozygous carrier of the c.2611del (p.M871Cfs*8) mutation and the mother a heterozygous carrier of the c.1771-6C>G mutation.
Conclusion: The patient’s newly emerged clinical features and mutations provide useful information for further exploration of genotype-phenotype correlations of POLR3-related leukodystrophy.
Use of patients’ unsolicited correspondence to a family doctor to describe and understand valued components of a doctor-patient relationship: A Hermeneutics approach
Authors: Yaffe Mark J. , Hovey Richard B. , Rodriguez Charo
Published: August 2019

Background

Communication and behavior within doctor - patient encounters have been examined using varied techniques; however the nature of unsolicited writings from patients to their family doctors has rarely been reported. This paper therefore aimed to explore the content of, and motivation for, such correspondence.

Methods

107 writings to one family physician about care provided during a four decade period were considered. Univariate analyses were used to identify features of patients or family members who wrote personalized notes to the doctor, when, and in what fashion. A hermeneutic approach helped look at the content of the notes, the specific words or sentiments used to describe encounters or care received, and possible motivations for writing. Iterative review of words or phrases generated themes which summarized appreciated physician or relational attributes, as well as motivations for writing.

Results

Notes were mostly handwritten, predominantly by women, and frequently coinciding with holidays and life span events. Appreciated doctor characteristics and behaviors were (1) quality care; and physician (2) competence; (3) physical presence; (4) positive personal traits; (5) provision of emotional support; and (6) spiritual impact. Motivations for writing were grouped as desire to (1) express appreciation for an established relationship; (2) acknowledge value / benefit experienced from continuity of care; (3) seek catharsis, emotional relief or closure; (4) reflect on termination of care; (5) validate care that incorporates both Hippocratic tradition and Asklepian healing ; and (6) share personal reflection, experience, or impact.

Conclusions

Unsolicited writings provide personalized links from patients to physicians, expressing thoughts perhaps difficult to share face to face. They offer potential as teaching tools about the content of doctor-patient relationships; for example, the writers studied expressed appreciation for quality continuity care that was competent, considerate, and supportive of emotional and spiritual needs.
Effects of transport stress on fecal microbiota in healthy donkeys
Authors: Jiang Guimiao , Zhang Xinhao , Gao Weiping , Feng Peixiang , Wang Tao , Feng Yulong , Li Lin , Zhou Xiangshan , Ji Chuanliang , Zhang Zhiping , Zhao Fuwei
Published: August 2019

Background: With the development of large-scale donkey farming in China, long-distance transportation has become a common practice, and the incidence of intestinal diseases after transportation has increased. Intestinal microbiota is important for health and disease, and whether transportation disturbs donkey intestinal microbiota has not been investigated. This study aims to determine the effects of transportation on the fecal microbiota of healthy donkeys using 16S rDNA sequencing.
Results: Fecal samples were collected from the rectum of 12 Dezhou donkeys before and after transportation. Results show that long-distance transportation can induce severe stress in donkeys and result in significantly lower level of bacterial richness index compared with that before transport (p=0.042) without distinct changes in diversity. This marked decrease in specific bacterial richness, such as for Eubacterium, Streptococcus, and Coriobacteriaceae, might be associated with the restricted synthesis of anti-inflammatory cytokines and metabolites, such as short chain fatty acids (SCFAs) that potentially contribute to disease development after the transport.
Conclusions: Further studies are required to understand the potential effect of these microbiota changes on the development of donkey intestinal diseases. Preventative and therapeutic measures for donkeys before and after transportation should focus on providing diverse and rich bacterial microbiota and probiotic flora.
Keywords: Transport stress, Donkeys, Fecal microbiota, 16S rDNA sequencing
Breast self-examination practice and associated factors among female healthcare workers in Western Ethiopia 2019: A cross-sectional study
Authors: Shallo seifadin Ahmed , Boru Jibril Dori
Published: August 2019

I. Abstract Objective: Breast cancer is the leading cause of death among reproductive age women worldwide. Regular breast self-examination is one of the most cost-effective methods for early detection of breast cancer. Therefore, this study intended to assess the magnitude of breast self-examination practice and associated factors among female healthcare workers in public health facility in Western Ethiopia. Institutional based cross-sectional study was conducted among 379 female healthcare workers. The study participants were recruited by lottery method. Data were collected from March to April 2019. Data were entered into Epi data version 3.1 and analyzed using SPSS version 25. Bivariate and multiple logistic regressions analysis were done to identify factors significantly associated with the dependent variables. With 95% CI, the level of significance was decided at p-value≤ 0.05 Results: The magnitude of regular breast self-examination practice was 32.6%. After adjusting for possible confounders; educational level, being aware of the risk factors of breast cancer, knowledge towards breast self-examination were independent predictors of regular breast self-examination practice. Regular awareness creation forum on breast self-examination technique, risk factors, and related matters should be facilitated so that all female health care workers will be reminded. Keywords: breast self-examination practice, female health workers,
Nutritional status and associated factors among primary school students, in Meket Wereda, Ethiopia: comparing schools with feeding and non-feeding program
Authors: Demilew Yeshalem Mulugeta , Nigussie Azezu Asres
Published: August 2019

Background

Under-nutrition significantly affects the academic performance of students. Despite its remarkable effect, the prevalence of malnutrition was very high in Ethiopia. To reduce malnutrition and its serious consequence Ethiopian government in collaboration with the world food program implemented school feeding program in food insecure areas. However, its effect on the nutritional status of students was not assessed, yet. Therefore, this study aimed to compare the nutritional status of primary school students enrolled in schools with school feeding program and primary school students enrolled in schools without in Meket Woreda.

Methods

A school-based comparative cross-sectional study was conducted among 1091 students, from April 1-27/2015. The study participants were selected using multi-stage stratified sampling method. Structured questionnaire was used to collect data. Data entry and analysis were done by SPSS version 20 software. Descriptive statistics and logistic regression analyses were done. Anthropometric data were calculated using Anthro-plus software.

Results

the prevalence of stunting was higher among students who took meal at school than students who did not consume meal at school (58.5% Vs 48.3%) whereas the prevalence of thinness was higher among students who did not take meal at school compared with students who took meal at school (37.5% Vs27.8%). Factors associated with stunting were having uneducated mother [AOR=2.1, 95% CI: (1.4, 3.3)], drinking river water [AOR=1.5, 95% CI: (1.1, 2.1)], being a male [AOR=1.6, 95% CI: (1.3, 2.1)] and taking meal once daily [AOR=2.6, 95% CI: (1.2, 5.9)].

Whereas, students who did not take meal at school [AOR=2.6, 95% CI: (1.8, 3.8)], having uneducated mother [AOR=5.3, 95% CI: (2.2, 12.6)], being a male [AOR=1.9, 95% CI: (1.4, 2.5)], and taking meal once daily [AOR=2.7, 95% CI: (1.6, 3.9)] were positively associated with thinness.

Conclusion

School meal program is important to prevent thinness. Thus, school meal program should be implemented in schools have no the program. Education should be given to improve the source of drinking water, frequency and diversity of food at home by giving emphasis to uneducated and housewife mothers.
A five year retrospective analysis of common intestinal parasites at Poly Health Center, Gondar, Northwest Ethiopia
Authors: Ayelgn Meseret , Worku Ligabaw , Ferede Getachew , Wondimeneh Yitayih
Published: August 2019

Objective: Intestinal parasites are present throughout the world in varying degrees of prevalence due to many factors. The aim of this study was to determine the five year trend prevalence of intestinal prevalence among patients who had been suspected for intestinal parasite infections. A retrospective study was conducted from 2009 to 2013 at Poly Health Center Gondar, Northwest Ethiopia. Samples were examined using direct saline wet mount methods. Statistical analysis was done using SPSS version 20 software and P-value of < 0.05 was considered statistically significant. The results were presented in tables and graphs.
Results: during the study period, a total of 13,329 stool samples were requested for intestinal parasite diagnose and 41.3% laboratory confirmed cases were reported with a fluctuating trend. Ten different parasites were reported in each year with Entamoeba histolytica/dispar (16.8%) being the predominant parasite followed by Giardia lamblia (11.4%) and Ascaris lumbricoides (6.7%). Both males (49%) and females (51%) were equally affected. Intestinal parasite was reported in all age groups in the area but the age group of 10–19 years (44.7%) was more affected.
Key words: Intestinal parasite, Trend prevalence, Gondar, Ethiopia
Feasibility of a Twitter campaign to promote HPV vaccine uptake among racially/ethnically diverse young adult women living in public housing
Authors: Allen Jennifer , Hollander Justin , Gualtieri Lisa , Falconi Tania M. Alarcon , Savir Stephanie , Agénor Madina
Published: August 2019

Objectives

This study assessed the feasibility of implementing a one-month Twitter campaign to promote knowledge about the human papillomavirus (HPV) vaccine among low-income women living in public housing.

Methods

We recruited a convenience sample (n=35) of women ages 18-26 years who resided in public housing in Massachusetts. We assessed the feasibility and acceptability of the campaign. Online assessed changes in HPV knowledge, attitudes, and vaccine intentions before and after the campaign.

Results

Most believed that Twitter was an acceptable educational strategy and remained engaged with the campaign throughout the intervention. There were no changes in HPV knowledge, perceived benefits of or barriers to vaccination, decision self-efficacy, or vaccine intentions. Perceived risk for cervical cancer decreased after the campaign.

Conclusions

The one-month educational campaign was feasible and acceptable but did not result in measurable changes perhaps due to high vaccine awareness and uptake before the intervention.

Practice Implications

Twitter may be a feasible and acceptable method for promoting knowledge about the HPV vaccine, but more research is needed to understand how best to reach low-income women with low levels of vaccine uptake.
Complementray medicine seeking behaviour among Sudanese infertile women
Authors: Babikir Suhad Abdelhamid , Alhassan Gamal Osman , Hamad-Alneil Alnazeir Ibrahim , Alfadl Abubakr Abdelraouf
Published: August 2019

Background

This study was conducted in Sudan, which is a sub-Saharan Africa country with similar problems regarding infertility, to explore the perspectives of currently married infertile Sudanese women on complementray medicine seeking behaviour with more emphasis on traditional self-management strategies.

Methods

A cross-sectional survey involving 203 infertile women in Khartoum, Sudan, using a convenient sampling method at the women’s visits of infertility treatment clinics. A validated questionnaire was used for data collection.

Results

Findings of the study revealed that 43.3% of participated women had rich experience with infertility self-management strategies, and 65.0% of them used these strategies to treat infertility. Also 59.1% of the participants mentioned unaffordability of modern treatment as a main factor for trying self-management strategies. 45.3% of the participating women believe that the best strategy for self-management of infertility is Qura’an and Sunna treatment provided by Shaikh. Only 42.9% of the participants agreed with the statement that their ‘cognitive knowledge about self-management of infertility does not encourage its use’.

Conclusion

The study revealed women’s rich experience and wide use of different types of self-management strategies together with formal infertility health care services either simultaneously or subsequently. Also, unaffordability of formal treatment services was reported as one of the most encouraging factors towards seeking traditional treatment options. Therefore, most important literature gap this study hoped to fill is its focus on traditional treatment strategies of infertility, and thereby, can help policy makers and public health activists tailor more efficient plans to handle this complicated problem.
Potential for non-combustible nicotine products to reduce socioeconomic inequalities in smoking: a systematic review and synthesis of best available evidence
Authors: Lucherini Mark , Smith Katherine , Hill Sarah
Published: August 2019

Background

While some experts have emphasised the potential for e-cigarettes to facilitate cessation among smokers with low socioeconomic status (SES), there is limited evidence of their likely equity impact. We assessed the potential for electronic cigarettes and other non-combustible nicotine-containing products (NCNPs) to reduce inequalities in smoking by systematically reviewing evidence on their use by SES in countries at stage IV of the cigarette epidemic.

Methods

Ten electronic databases were searched in February 2017 using terms relating to e-cigarettes, smokeless tobacco and nicotine replacement therapy (NRT); and socioeconomic status. We included studies published since 1980 that were available in English and examined product use by SES indicators such as income and education. Data synthesis was based on those studies judged to be of medium- to high-quality using guidelines adapted from the Critical Appraisal Skills Programme.

Results

We identified 54 studies describing NCNP use by SES across 12 countries, of which 27 were judged of sufficient quality to include in data synthesis. We found mixed patterns of e-cigarette current use by SES, with evidence of higher use among low-income adults but unclear or mixed findings by education and occupation. In contrast, smokeless tobacco current use was consistently higher use among low SES adults. There was very limited evidence on the SES distribution of NRT in adults and of all NCNPs in young people.

Conclusions

The only NCNP for which there are clear patterns of use by SES is smokeless tobacco, where prevalence is higher among low SES groups. While this suggests a potentially positive impact on inequalities in smoking (if NCNP use displaces smoked tobacco use), this has not been seen in practice. These findings do not support the suggestion that e-cigarettes have the potential to reduce social inequalities in smoking, since i) current evidence does not show a clear trend of higher e-cigarette use in population groups with higher tobacco consumption, and ii) the experience of smokeless tobacco suggests that – even where NCNP use is higher among low SES groups – this does not necessarily replace smoked tobacco use in these groups.
DEVELOPMENT OF A HIGH NUMBER, HIGH COVERAGE DOG RABIES VACCINATION PROGRAMME IN SRI LANKA
Authors: Soriano Carlos Sánchez , Gibson Andrew D. , Gamble Luke , Bailey Jordana L. Burdon , Green Samantha , Green Mark , Bronsvoort Barend M. deC. , Handel Ian G. , Mellanby Richard J. , Mazeri Stella
Published: August 2019

Background: Rabies is estimated to cause 59,000 deaths and economic losses of 8.6 billion USD every year. Despite several years of rabies surveillance and awareness programmes, increased availability of post-exposure prophylaxis vaccinations and dog population control, the disease still remains prevalent in Sri Lanka. This study reports the development and roll-out of a high number, high coverage canine rabies vaccination campaign in Sri Lanka, providing estimates for the vaccination coverage achieved, analysing the local dog demographics, and identifying barriers of attendance to static vaccination clinics. Methods: A mass dog vaccination campaign was undertaken in Negombo, Sri Lanka. The campaign was composed of static point and door-to-door vaccination stages, with a final survey of vaccination coverage. A large volume of data on the distribution, health, and signalment of vaccinated dogs was collected through a mobile phone application. A logistic regression model was developed to investigate which socio-spatial and dog-related factors influenced attendance of owners to static vaccination points. Results: The campaign vaccinated over 7,800 dogs achieving a vaccination coverage of 75.8%. A dog:human ratio of 1:17 was estimated. Most dogs were owned, and the dog population was mostly male, adult, and non-sterilized. Unawareness, unavailability and handling problems were the most common reasons given by owners to explain failure to attend a static vaccination point. The regression analysis showed that increasing distance to a static point, in addition to young age and poor health of the dog, were associated with a decrease in the likelihood of attendance to a static vaccination points. Conclusion: This study demonstrates the feasibility of high number, high coverage vaccination campaigns in Sri Lanka. The information on dog ecology and barriers of attendance to a static point vaccination clinic will facilitate development of future vaccination campaigns.