bluuebunny/crossref_metadata_2025 huggingface dataset:
Causas de descarte de vacas e novilhas dos pecuaristas da agricultura familiar de Jacaré dos Homens- AL
Authors: Silva Wesley Reniberg Timoteo , Santos Daniel Vianei dos , Silva José Crisólogo de Sales , Albuquerque Ariane Loudemila Silva de , Carvalho Cláudia Csekö Nolasco de
Published: February 2020

RESUMO:  Na agricultura familiar, ainda existe barreiras que impedem que o produtor faça um descarte pontual, podemos citar: a falta de conhecimentos zootécnicos; baixo capital disponível para reposição das fêmeas bovinas e manutenção das recrias.  Assim sendo, o objetivo deste trabalho foi estudar e levantar as principais causas de descarte de fêmeas bovinas leiteiras do rebanho da agricultura familiar do município de Jacaré dos Homens- AL. Foi realizado uma pesquisa quantitativa de caráter exploratório na zona rural do município, aplicando-se 40 questionários para caracterização do produtor de leite.  Os questionários continham informações relacionadas à índices zootécnicos, dentre os quais, a causa de descarte de vacas e novilhas leiteiras, formas de reposição, dentre outros aspectos correlacionados a atividade leiteira. As maiores causas de descarte relatadas pelos produtores foram: problemas reprodutivos, presente em 37,5% das propriedades, seca e escassez de alimentos que obteve prevalência em 27,5% dos casos, mastite e outras causas que incluem baixa na produção de leite, idade avançada e incrementação de renda, incidindo em 10% cada, respectivamente.

PALAVRAS - CHAVE: Fêmeas, bovinas, leite.
Vidas caladas: a voz feminina na obra São Bernardo de Graciliano Ramos
Authors: Cordeiro Maria Claudicélia Curvêlo da , Silva Cristiano Cezar Gomes da
Published: February 2020

RESUMO: A presente pesquisa teve como objetivo investigar a representação da figura feminina na obra São Bernardo, de Graciliano Ramos, especificamente no que se refere aos aspectos da violência e da opressão. Nesse sentido, buscou-se compreender a representação do feminino a partir do viés cultural da época de publicação da obra, enfatizando os fatores de dominação, submissão, silenciamento e exercício de poder sobre o gênero feminino. Para tanto, a escolha dessa obra como corpus da pesquisa foi motivada por representar uma personagem feminina complexa, imponente que compartilha de pensamento emancipador em meio a um período marcado pelo patriarcado. Assim, este estudo proporcionou percorrer um percurso interdisciplinar a partir das áreas dos estudos culturais, estudos literários e crítica feminista, contextualizando o período histórico representado na obra. Por outro lado, o romance também nos permitiu analisar a trajetória da mulher, situando as imposições e restrições através dos papéis preestabelecidos pela cultura e sociedade do período, além de possibilitar o estabelecimento de correlações com a mulher e o seu papel na contemporaneidade. Durante a investigação, consegue-se observar marcas do preconceito e da inferiorização enfrentados pelo gênero feminino, principalmente em relação às funções impostas no convívio social, prevalecendo uma hierarquia entre os gêneros masculino e feminino, ressaltando a dependência e a submissão feminina. A pesquisa teve como fundamentação teórico-metodológica as concepções de Beauvoir (1980); Benedict (2013); Friedan (1971); Laraia (2009); Ortner (2017) Tedeschi (2008), dentre outros. Neste trabalho, foram observados traços que representaram o caráter agressivo e dominador do homem, enquanto sujeito social e culturalmente considerado superior perante a mulher, idealizada como gênero mais frágil e auxiliar do homem. Ao longo da investigação, percebemos, em São Bernardo, a atribuição da inferiorização atribuída à mulher.

PALAVRAS-CHAVE: Graciliano Ramos. São Bernardo. Mulher.
Impact of Supplier Development and Inventory Control on Supply Chain Effectiveness in Manufacturing Companies of Pakistan
Authors: Shakeel Rida , Siddiqui Danish Ahmed
Published: February 2020

The purpose of this research is to study the impact of supplier development and inventory control on supply chain effectiveness in manufacturing companies of Pakistan. Self-administered questionnaires were used to collect data from the supply chain professionals working in different manufacturing companies of Pakistan. The study utilizes sample size of 200 and applying different statistical analysis such as Factor analysis, correlation and multiple regressions to check the hypothesis. The result indicates that supplier development and inventory control are significantly correlated with supply chain effectiveness. The result further explains that supplier development and inventory control have a significant and positive impact on supply chain effectiveness of manufacturing companies in Pakistan. Findings are helpful to supply chain practitioners and management in implementing a supply chain strategy that focuses on modern procurement procedures minimum use of inventory hence contributing in supply chain effectiveness. This will ultimately benefits the manufacturing companies in winning competitive advantage.
Impacts of Phosphorus as Soil Application on Growth, Yield and some Chemical Constitutes of Common Bean Plants Grown under Saline Soil Conditions
Authors: El-Yazal Mohamed A. Seif , El-Shewy Ahmed A. , Abdelaal Kariman E.S. , Rady Mostafa M.
Published: February 2020

This study aimed to assess the impact of calcium superphosphate (P; 0, 100, and 200 kg per feddan) as soil amendments, in addition to the recommended P, on the growth traits, green and dry yields characteristics, leaf photosynthetic pigments, chlorophyll fluorescence, and leaf contents of nutrients of common bean (Phaseolus vulgarisL., cv. “Bronco”) plants grown under saline soil conditions. Two field trials were conducted at the Experimental Farm of Faculty of Agriculture, Fayoum University during the 2016 and 2017 summer seasons. The obtained results showed that, Na+content was significantly declined, while the all other tested parameters such as growth characteristics (i.e., shoot length, number of leaves per plant, area of leaves per plant, and shoot fresh and dry weights), yield characteristics of green pods and dry seeds (i.e., average pod weight, number of pods per plant, pods weight per plant, dry seed weight per plant and 100-seed weight), leaf photosynthetic pigments (i.e., total chlorophylls, total carotenoids) contents and leaf chlorophyll fluorescence (i.e., Fv/Fm and PI), leaf contents of N, P, K+, and Ca2+, and the ratios of K+/Na+, Ca2+/Na+and K++Ca2+/Na+were significantly increased by the two tested P treatments compared to the controls (without more P than the recommended). The all tested treatments conferred, approximately, the same results. Therefore, results of this study recommend using P at 100 kg per feddan above the recommended dose to optimize the common bean performance in saline soils.
Dengue en recién nacidos: presentación de dos casos en Neiva (Huila, Colombia) y revisión de la literatura
Authors: Fonseca-Becerra Carlos Eduardo , Bayona-Ospina Miguel Andrés
Published: February 2020

Introducción: el dengue es una infección viral que afecta a Colombia, especialmente a niños en el departamento del Huila. Actualmente, sigue extendiéndose en países latinoamericanos con alarma reportada por diferentes organismos de salud.Objetivo: presentar los primeros casos documentados en el Huila en embarazadas y sus recién nacidos.Metodología: presentación clínica de dos casos y revisión de la literatura sobre la presencia de dengue en embarazadas, recién nacidos y casos perinatales.Resultados: la gran mayoría de los estudios son reportes de casos. Se consultaron las Guías para Dengue de 2009 de la OMS y dos revisiones sistemáticas sobre el tema. A partir de esto, se describió la forma de presentación del dengue en el embarazo y en el recién nacido, además de los problemas asociados con éste.Conclusión: se insistió en la nueva nomenclatura: en el dengue sin signos de alarma (DSSA) o con signos de alarma (DCSA) y en el dengue severo (DS). Ante lo anterior, es claro que existe una necesidad de realizar estudios comparativos para poder definir las guías específicas sobre las gestantes con dengue. Palabras clave: dengue, embarazo, recién nacido.
Sobre Sánchez: la biografía improbable de Osvaldo Baigorria
Authors: Battistoni Nieves
Published: February 2020

“¿Cómo escribir una bio después de Strafacce?”, duda Osvaldo Baigorria luego de publicada la suya sobre el escritor vagamundo Néstor Sánchez (1935 - 2003). De este modo, la pregunta habilita a reflexionar acerca de la poética y la ética biográfica (¿cómo se escribe una vida?, ¿se puede/debe escribirla?), al tiempo que convoca a la incipiente tradición biográfica local al remitirse a la biografía monumental de Ricardo Strafacce sobre Osvaldo Lamborghini (Osvaldo Lamborghini, una biografía. Mansalva, 2008) como antecesora inmediata. En el presente artículo, interesa, por un lado, hacer un contrapunto entre esa «modélica» biografía de la totalidad y la biografía fragmentaria, desviada, incluso –según juzga su autor– «fallida», que es Sobre Sánchez (Mansalva 2012a), así como también analizar sus singulares condiciones de producción, la excesiva «afectación» por la vida del Otro (vínculo biógrafo/biografiado) y la novedosa fórmula biográfica resultante de ello.
La vida (in)visible de Juan Filloy: revisando el mito del escritor oculto
Authors: De Olmos Candelaria
Published: February 2020

A lo largo de su trayectoria artística, el escritor Juan Filloy (Córdoba, 1894-2000) fue sujeto de extensas entrevistas. A ellas se deben sumar las notas críticas que aparecieron en diversos medios gráficos. Entre la biografía y la autobiografía, estos textos han construido una imagen del escritor voluntariamente escondido e injustamente olvidado. Un recorrido por este corpus permite advertir que esa construcción se asienta sobre dos datos: la residencia en un pueblo de provincia y la edición de sus libros en forma privada. Permite, asimismo, señalar constancias y transformaciones. Según mi hipótesis, estos textos urden primero la imagen del escritor de culto y solo después la del escritor oculto. Una mirada a la correspondencia del escritor invita a cuestionar ese relato y a construir otro que atienda a las opciones que este efectuó para hacerse visible.
Nuestros amigos los biógrafos Una genealogía de amores literarios
Authors: Musitano Julia
Published: February 2020

La autora de este artículo se interesa en pensar sobre una tradición emergente de biografías literarias en América Latina: biografías escritas por escritores actuales (1985 - 2016) que cuentan la vida de otros escritores contemporáneos (la producción biográfica de siete novelistas: Osvaldo Baigorria, Ricardo Strafacce, Fernando Vallejo, Carlos María Domínguez, Jorge Edwards, Santiago Roncagliolo y Rafael Gumucio). Específicamente, se propone analizar el proceso de construcción de una tradición, a partir de los lazos emocionales que unen a ciertos escritores con otros y que sirven de motivos para contar vidas ajenas. Entre biógrafo y biografiado (relación singular que responde a los contextos y procedimientos particulares de cada caso) se traza una línea de contigüidad fundada en la admiración literaria cuyos efectos son los de la contaminación, el contagio, la transferencia. Dos vidas se tensionan en la escritura y constituyen un espacio imaginario amoroso que pone en juego mecanismos y operaciones para apropiarse de recuerdos ajenos.
Vaksinasi dan Treatment pada Predator-Prey dengan Dua Jenis Pemangsa yang Salah Satunya Terinfeksi
Authors: Mu'tamar Khozin , Rahmalia Dinita , Sutimin Sutimin
Published: February 2020

Predator-prey adalah model matematika yang menggambarkan perilaku interaksi dua spesies, satu diantaranya merupakan pemangsa dan satu lainnya sebagai mangsa. Populasi pemangsa biasanya berada di level lebih atas dibandingkan level mangsa pada rantai makanan. Oleh karena itu, populasi pemangsa lebih sedikit dan rentan akan kepunahan baik karena penyakit ataupun kalah persaingan. Pada artikel ini, dikembangkan model predator-prey dengan dua jenis pemangsa dan salah satunya terinfeksi penyakit. Untuk mencegah penyebaran, diberikan tindakan vaksinasi dan pengobatan yang dirumuskan menggunakan Pontryagin Minimum Principle (PMP). Analisis kestabilan dilakukan secara lokal untuk menunjukkan tindakan vaksinasi dan pengobatan berpengaruh terhadap sifat kestabilan. Terakhir, simulasi dilakukan secara numerik guna melihat perilaku model dan performa vaksinasi dan treatment yang diberikan
Special Issue on Human-Robot Interaction in Close Distance
Authors: Shiomi Masahiro , Sumioka Hidenobu , Ishiguro Hiroshi
Published: February 2020

As social robot research is advancing, the interaction distance between people and robots is decreasing. Indeed, although we were once required to maintain a certain physical distance from traditional industrial robots for safety, we can now interact with social robots in such a close distance that we can touch them. The physical existence of social robots will be essential to realize natural and acceptable interactions with people in daily environments. Because social robots function in our daily environments, we must design scenarios where robots interact closely with humans by considering various viewpoints. Interactions that involve touching robots influence the changes in the behavior of a person strongly. Therefore, robotics researchers and developers need to design such scenarios carefully. Based on these considerations, this special issue focuses on close human-robot interactions.

This special issue on “Human-Robot Interaction in Close Distance” includes a review paper and 11 other interesting papers covering various topics such as social touch interactions, non-verbal behavior design for touch interactions, child-robot interactions including physical contact, conversations with physical interactions, motion copying systems, and mobile human-robot interactions. We thank all the authors and reviewers of the papers and hope this special issue will help readers better understand human-robot interaction in close distance.
PENGARUH PENGGUNAAN MEDIA SOSIAL TERHADAP PERUBAHAN SISTEM NILAI MASYARAKAT MELAYU DI KOTA PEKANBARU
Authors: Rumyeni Rumyeni , Lubis Evawani Elysa , Rimayanti Nita , Yohana Nova
Published: February 2020

Penelitian ini bertujuan untuk menganalisis pengaruh penggunaan media sosial terhadap perubahan sistem nilai masyarakat Melayu di Kota Pekanbaru. Metode penelitian yang digunakan adalah metode kuantitatif dengan pendekatan eksplanatif untuk menguji hubungan antar variabel yang dihipotesiskan. Teknik pengumpulan data menggunakan kuesioner yang diedarkan kepada 166 orang masyarakat melayu yang diambil dengan teknik unknown population. Analisis data dilakukan melalui skala Likert dengan 4 option. Hasil penelitian menunjukkan bahwa  tidak ada pengaruh secara signifikan antara penggunaan media sosial yang diukur melalui indikator frekuensi dan durasi terhadap sistem  nilai masyarakat Melayu di Kota Pekanbaru. Ada faktor lain yang tidak dilihat dalam penelitian ini yang secara signifikan memberikan andil dalam mempengaruhi sistem nilai masyarakat Melayu. Perubahan tersebut lebih kepada hal-hal yang bersifat positif dan mengarah pada penguatan penerapan sistem nilai yang telah dianut oleh masyarakat Melayu selama ini.Kata Kunci: media sosial, sistem nilai, masyarakat melayu
IbM Pengelola Paud Al Amin Untuk Peningkatan Science Instructional Quality Anak Usia Dini dan Parenting Skill Orang Tua Murid
Authors: Mujtahidin Mujtahidin
Published: February 2020

Tujuan program IbM ini adalah mensinergikan antara pola pendidikan di sekolah yang dilakukan guru dan pola asuh orang tua dalam pendidikan di dalam keluarga untuk anak usia dini. IbM ini dilakukan untuk guru-guru dan orang tua murid di PAUD Al Amin, Kabupaten Pamekasan-Madura. Oleh karena itu, program IbM ini memberikan bekal bagi guru dan orang tua dalam menjalankan proses pengasuhan dan pendidikan anak dengan mudah dan tepat. Program IbM ini berisi paket pelatihan penyusunan rencana pelaksanaan pembelajaran harian (RPPH) untuk meningkatkan science instructional quality, pengembangan media pembelajaran sains untuk guru, dan pelatihan parenting skill untuk orang tua murid. Capaian hasil kegiatan IbM dapat dilihat dari perubahan mindset guru dan orang tua sedikit demi sedikit dalam pola asuh anak. Guru menjadi terampil dalam mengembangkan RPPH untuk pembelajaran anak usia dini, guru terampil dalam mengembangkan media yang sesuai dengan tahapan perkembangan anak. Guru dan orang tua memperoleh pengetahuan tentang persiapan ruang mental dalam memfasilitasi perkembangan mental positif anak, prinsip-prinsip dasar dalam membentuk sikap dan perilaku anak, melatih secara sehat dan efektif dalam menjalani pengasuhan anak, motivasi gairah belajar orang tua, serta membantu orang tua dalam membina hubungan lebih berkualitas dengan anak untuk mendukung terciptanya keluarga berkualitas yang menyenangkan dan tentram.
Ocho casos de violencia contra la mujer en el discurso periodístico peruano
Authors: Portilla Durand Luisa
Published: February 2020

Se presenta una muestra del análisis del discurso periodístico peruano que trata acerca de la violencia contrala mujer, en particular en el caso de feminicidio o intento de feminicidio. Del corpus, recopilado de los diarios de circulación nacional en el Perú, se presenta en esta oportunidad una selección de casos de violencia contra la mujer ocurridos en agosto de 2015, ocho casos en los que se explicitó el nombre de víctimas y victimarios. A partir de la selección, se identifican y analizan las estructuras discursivas con las que algunos medios de comunicación peruanos visibilizan o, por el contrario, justificanla violencia contra la mujer
Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI
Authors: Xie Dayang , Zhou Jianhui , Cao Xueying , Zhang Qingtao , Sun Yanli , Tang Li , Huang Jing , Zheng Juanli , Lin Li , Li Zhenzhen , Cai Guangyan , Chen Xiangmei
Published: February 2020

Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.
Ropivacaine 75mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair - The ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trial.
Authors: CARDAILLAC Claire , Ploteau Stéphane , Thuaut Aurélie Le , Dochez Vincent , Winer Norbert , Ducarme Guillaume
Published: February 2020

Background Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have already showed-investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy, but have only focused on the immediate postpartum period (at 24 and 48 hours after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and quality of life at mid- and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (mid-term), defined by the numerical scale of pain (ENS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (ENS), the impact of pain on daily behavior, on the quality of life (36-Item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale) and on sexuality (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show a approximately 30% relative risk reduction in the incidence of perineal pain at day 7 from 70.0% to 50.0%. Discussion Ropivacaine was is a promising candidate drug, inexpensive, easy to administer, and easy to add on and would be suitable to include in the routine management of deliveries in labor ward. This study will investigate if perineal ropivacaine infiltration just after birth can reduce mid- and long-term postpartum pain and increase quality of life in women with mediolateral episiotomy.
Methanandamide diminish the Porphyromonas gingivalis lipopolysaccharide induced response in human periodontal ligament cells
Authors: Zhang Fengqiu , Özdemir Burcu , Nguyen Phuong Quynh , Andrukhov Oleh , Rausch-Fan Xiaohui
Published: February 2020

Background:The endocannabinoid system is involved in the regulation of periodontal tissue homeostasis. Synthetic cannabinoid methanandamide (Meth-AEA) has improved stability and affinity to cannabinoid receptors compared to its endogenous analog anandamide. In the present study, we investigated the effect of methanandamide on the production of pro-inflammatory mediators in primary human periodontal ligament cells (hPdLCs).Methods:hPdLCs were treated with Meth-AEA for 24 h, and the resulting production of interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1 was measured in the absence or the presence ofPorphyromonas gingivalislipopolysaccharide (LPS). Additionally, the effect of Meth-AEA on the proliferation/viability of hPdLCs was measured by MTT method.Results:Methanandamide at a concentration of 10 µM significantly inhibitedP. gingivalisLPS induced production of IL-6, IL-8, and MCP-1. Basal production of IL-6 and IL-8 was slightly enhanced by 10 µM Meth-AEA. No effect of Meth-AEA on the basal production of MCP-1 was observed. Meth-AEA in concentrations up to 10 µM did not affect the proliferation of hPdLCs, but significantly inhibited it at a concentration of 30 µM.Conclusion:Our study suggests that the inflammatory response in periodontal ligament cells could be influenced by the activation of the cannabinoid system, which might be potentially involved in the progression of periodontal disease.
Transcriptome Profiling Provides Insights into Molecular Mechanism in Peanut Semi-dwarf Mutant
Authors: Guo Fengdan , Ma Junjie , Hou Lei , Shi Suhua , Sun Jinbo , Li Guanghui , Zhao Chuanzhi , Xia Han , Zhao Shuzhen , Wang Xingjun , Zhao Yanxiu
Published: February 2020

Background: Plant height, mainly decided by main stem height, is the major agronomic trait and closely correlated to crop yield. A number of studies had been conducted on model plants and crops to understand the molecular and genetic basis of plant height. However, little is known on the molecular mechanisms of peanut main stem height. Results: In this study, a semi-dwarf peanut mutant was identified from 60 Co γ-ray induced mutant population and designated as semi-dwarf mutant 2 ( sdm2 ). The height of sdm2 was only 59.3% of its wild line Fenghua 1 (FH1) at the mature stage. The sdm2 has less internode number and short internode length to compare with FH1. Gene expression profiles of stem and leaf from both sdm2 and FH1 were analyzed using high throughput RNA sequencing. The differentially expressed genes (DEGs) were involved in hormone biosynthesis and signaling pathways, cell wall synthetic and metabolic pathways. BR, GA and IAA biosynthesis and signal transduction pathways were significantly enriched. The expression of several genes in BR biosynthesis and signaling were found to be significantly down-regulated in sdm2 as compared to FH1. Many transcription factors encoding genes were identified as DEGs. Conclusions: A large number of genes were found differentially expressed between sdm2 and FH1. These results provide useful information for uncovering the molecular mechanism regulating peanut stem height. It could facilitate identification of causal genes for breeding peanut varieties with semi-dwarf phenotype.
Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency
Authors: Song Min , Liu Yijie , Lu Zhiwen , Luo Hong , Peng Hong , Chen Ping
Published: February 2020

Background: Risk factors affecting the prognosis of acute respiratory distress syndrome (ARDS) in adults were investigated. The aim was to identify new predictors for ARDS patient prognosis, including those with clinical, pathophysiological, and atypical immunodeficiency.
Methods: ARDS patients were retrospectively included. The patients were grouped and analysed according to different oxygenation index grades and prognosis, and factors influencing prognosis and survival were examined. Adolescent patients, patients with typical immunodeficiency and patients who died within 24 hours after being diagnosed with ARDS were excluded. The predictive value for mortality was determined by Cox proportional hazard analysis.
Results: In total, 201 patients who fulfilled the Berlin definition of ARDS were included. The severity of critical illness on the day of enrolment, as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score (P=0.016), Sequential Organ Failure Assessment (SOFA) score (P=0.027), and PaO2/FiO2 (P=0.000), worsened from mild to severe ARDS cases. Compared with survivors, non-survivors were significantly older and had higher APACHE II and SOFA scores. Moreover, significantly lower lymphocyte/neutrophil ratios and leukocyte counts were found among non-survivors than survivors (P=0.008, P=0.012). A moderate positive correlation between the lymphocyte/neutrophil and PaO2/FiO2 ratios (P=0.023) was observed. In predicting 100-day survival in patients with ARDS, the area under the curve (AUC) for the lymphocyte/neutrophil ratio was significantly higher than those for the PaO2/FiO2 ratio alone, body mass index (BMI) alone, and the lymphocyte count alone (P=0.0062, 0.0001, and 0.0154). Age (per log10 years), BMI<24, SOFA score, leukocyte count, and the lymphocyte/neutrophil ratio were independent predictors of 28-day mortality in ARDS patients. Additionally, ARDS patients with a lymphocyte/neutrophil ratio <0.0537 had increased 28-day mortality rates (P=0.0283). Old age affected both 28-day and 100-day mortality rates (P=0.0064,0.0057).
Conclusions: Age (per log10 years), BMI<24, SOFA score, lymphocytes, and the lymphocyte/neutrophil ratio were independent predictors of 100-day mortality in patients with ARDS. The lymphocyte/neutrophil ratio may represent a potential molecular marker to evaluate atypical immunosuppression or impairment in patients with ARDS.
Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK
Authors: PIAO JUNJIE , Whang Woong-Joo , Joo Choun-Ki
Published: February 2020

Background This prospective cohort study clinically evaluated the visual outcomes after refractive surgery for myopia using femtosecond laser-assisted in situ keratomileusis (femto-LASIK) and epipolis LASIK (flap-off). Methods Forty eyes of 27 patients were divided into 2 groups in this prospective cohort study. Femto-LASIK flaps were created using a femtosecond laser; epipolis LASIK flaps (flap-off) were made using and Epi-K TM epikeratome. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), corneal asphericity (Q-value), and corneal higher-order aberrations (HOAs) were assessed pre- and postoperatively. Results The improvement in LogMAR UDVA after refractive surgery was statistically significant for both groups ( P < 0.001 for all groups); it was significantly improved for femto-LASIK at 1 day and 1 week postoperatively ( P < 0.001, P = 0.019, respectively). In analysis of the front and total corneal HOAs, there were significant differences in spherical aberrations (Z 4,0 ) between the femto-LASIK and flap-off epipolis LASIK groups ( P = 0.016 and P = 0.017, respectively). In analysis of the back corneal HOAs, there were significant differences in vertical coma (Z 3,-1 ) aberration 0.027 ± 0.027 μm (femto-LASIK) and 0.001 ± 0.034 μm (flap-off epipolis LASIK); horizontal secondary astigmatism (Z 4,2 ) aberration -0.008 ± 0.012 μm (femto-LASIK) and 0.007 ± 0.018 μm (flap-off epipolis LASIK); oblique tetrafoil (Z 4,-4 ) aberration -0.008 ± 0.029 μm (femto-LASIK) and 0.015 ± 0.026 μm (flap-off epipolis LASIK), respectively ( P = 0.018, P = 0.007, and P = 0.022, respectively). However, the back corneal HOA changes did not have a significant effect on the total corneal HOA changes. Conclusion Femto-LASIK yielded better early visual outcomes than that by flap-off epipolis LASIK, but there was no significant difference between the outcomes of the 2 procedures 1 week postoperatively.
Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice
Authors: Presley Carolyn , Krok-Schoen Jessica , Wall Sarah , Noonan Anne , Jones Desiree , Folefac Edmund , Williams Nicole , Overcash Janine , Rosko Ashley
Published: February 2020

Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes of older adults. However, there are still gaps between knowledge and practice for older adults with cancer.Methods: Here we provide a detailed methodology of geriatric oncology care delivery within a single institution. The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). The multidisciplinary team assesses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic consultative model is a novel approach integrating cancer subspecialties with geriatric oncology healthcare delivery.Conclusions: Older adults with cancer have a unique needs that independent of routine oncology care. The CARE clinic model provides specific assessments and interventions to improve outcomes among older adults with cancer.
Role of verbal and non-verbal communication of health care providers in general satisfaction with birth care: A cross-sectional study in government health settings of Erbil City, Iraq
Authors: Ahmed Hamdia Mirkhan
Published: February 2020

Background: Effective communication by maternity care staff can help a woman during labor and birth have a positive birth experience. Due to limited knowledge regarding this topic in Iraqi Kurdistan, therefore, this study assessed: 1) The level of women’s satisfaction regarding verbal and non-verbal communication of midwives and physicians in the delivery room and 2) the association between this satisfaction level and socio-demographic and obstetric characteristics of the women and their general satisfaction with care during labor and delivery. Methods: A cross-sectional study was conducted on a convenient sample of 1196 women recruited between January and March 2019 from Erbil city, Iraq, who gave birth in the year before that. Data were collected from women through direct interview. A questionnaire which included sociodemographic, obstetrical information and 28 items related to verbal and non-verbal communication of physicians and midwives in the delivery room was used. Chi-square tests were used to find the association between dependent and independent variables. Results: Although 58.4% of the women were generally satisfied with communication of midwives and physicians in the delivery room, a large percentage (41.6%) were not satisfied. Only 14.6% and 27.3% of the women were completely satisfied with verbal and non-verbal communication of health care providers, respectively. There was a statistically significant association between women’s satisfaction with care during labor and their satisfaction with health care providers’ communication; 70.4% of women who were satisfied with care during birth were also satisfied with the communication of delivery room staff. There were statistically significant associations between the satisfaction of women with the communication of midwives and physicians and their level of education, parity, having stillbirth or neonatal death, and the setting of the last delivery. Conclusions: Women’s satisfaction with verbal and nonverbal communication of health care providers in the delivery room is associated with their satisfaction with birth care. Improving communication skills of health care providers can be a considerable part of improving care in delivery room.
Tongue fissure visualization by using deep learning – an example of the application of artificial intelligence in traditional medicine
Authors: Chang Wen-Hsien , Wu Han-Kuei , Lo Lun-chien , Hsiao William W. L. , Chu Hsueh-Ting , Chang Hen-Hong
Published: February 2020

Background: Traditional Chinese medicine (TCM) describes physiological and pathological changes inside and outside the human body by the application of four methods of diagnosis. One of the four methods, tongue diagnosis, is widely used by TCM physicians, since it allows direct observations that prevent discrepancies in the patient’s history and, as such, provides clinically important, objective evidence. The clinical significance of tongue features has been explored in both TCM and modern medicine. However, TCM physicians may have different interpretations of the features displayed by the same tongue, and therefore intra- and inter-observer agreements are relatively low. If an automated interpretation system could be developed, more consistent results could be obtained, and learning could also be more efficient. This study will apply a recently developed deep learning method to the classification of tongue features, and indicate the regions where the features are located.Methods: A large number of tongue photographs with labeled fissures were used. Transfer learning was conducted using the ImageNet-pretrained ResNet50 model to determine whether tongue fissures were identified on a tongue photograph. Often, the neural network model lacks interpretability, and users cannot understand how the model determines the presence of tongue fissures. Therefore, Gradient-weighted Class Activation Mapping (Grad-CAM) was also applied to directly mark the tongue features on the tongue image. Results: Only 6 epochs were trained in this study and no graphics processing units (GPUs) were used. It took less than 4 minutes for each epoch to be trained. The correct rate for the test set was approximately 70%. After the model training was completed, Grad-CAM was applied to localize tongue fissures in each image. The neural network model not only determined whether tongue fissures existed, but also allowed users to learn about the tongue fissure regions.Conclusions: This study demonstrated how to apply transfer learning using the ImageNet-pretrained ResNet50 model for the identification and localization of tongue fissures and regions. The neural network model built in this study provided interpretability and intuitiveness, (often lacking in general neural network models), and improved the feasibility for clinical application.
Overproduction of the Flv3B flavodiiron, enhances the photobiological hydrogen production by the nitrogen-fixing cyanobacterium Nostoc PCC 7120
Authors: Roumezi Baptiste , Avilan Luisana , Risoul Véronique , Brugna Myriam , Rabouille Sophie , Latifi Amel
Published: February 2020

Background: The ability of some photosynthetic microorganisms, particularly cyanobacteria and microalgae, to produce hydrogen (H2) is a promising alternative for renewable, clean-energy production. However, the most recent, related studies point out that much improvement is needed for sustainable cyanobacterial-based H2 production to become economically viable. In this study, we investigated the impact of induced O2-consumption on H2 photoproduction yields in the heterocyte-forming, N2-fixing cyanobacterium Nostoc PCC7120. Results: The flv3B gene, encoding a flavodiiron protein naturally expressed in Nostoc heterocytes, was overexpressed. Under aerobic and phototrophic growth conditions, the recombinant strain displayed a significantly higher H2 production than the wild type. Nitrogenase activity assays indicated that flv3B overexpression did not enhance the nitrogen fixation rates. Interestingly, the transcription of the hox genes, encoding the NiFe Hox hydrogenase, was significantly elevated, as shown by the quantitative RT-PCR analyses. Conclusion: We conclude that the overproduced Flv3B protein might have enhanced O2-consumption, thus creating conditions inducing hox genes and facilitating H2 production. The present study clearly demonstrates the potential to use metabolic engineered cyanobacteria for photosynthesis driven H2 production.
Korean medicine students' entrance factors and satisfaction with their college experience: a quantitative nationwide study
Authors: Kim Hyun-Seok , Lee Joohyun , Kim Hwimun , Yang Unho , Kim Hyunho
Published: February 2020

Background Korean medicine (KM) has equal legal rights with conventional Western medicine in South Korea and is taught at KM colleges. To date, no research has been conducted on the entrance factors and satisfaction of KM college students. Thus, this study attempts to fill this gap in the literature. Methods Content validity tests and face validity tests were conducted during the development of the questionnaires used in this study. The scores of each item and the correlation between items and sub-items were analyzed and factors were correlated with students’ satisfaction and willingness to re-enter KM colleges. Results A total of 420 students responded to the survey. The mean of the item considering stable incumbency and examination scores was the highest. The highest correlation between an item and sub-item concerned interaction with people. The questionnaire items or sub-questionnaire items that showed moderate high correlation with the questionnaire items asked whether participants were willing to re-enter the KM college and were both about independent choices. Conclusions Identifying college entrance factors can contribute to increasing current students’ academic satisfaction and decreasing drop-out rates. College entrance factors that are closely related to students’ motivation to become KM doctors may increase the current academic satisfaction of KM students and decrease drop-out rates. This study highlights factors that can be applied in college curriculum or subject teaching, such as interest in research on KM.
A survey exploring ophthalmologists’ attitudes and beliefs in performing Immediately Sequential Bilateral Cataract Surgery in the United Kingdom.
Authors: Lee Eunkyung , Balasingam Bagishan , Mills Emily , Zarei-Ghanavati Mehran , Liu Christopher
Published: February 2020

Purpose

To examine the attitudes and beliefs of UK ophthalmologists towards Immediately Sequential Bilateral Cataract Surgery (ISBCS); explore their reasons to either practise or not practise ISBCS; identify barriers hindering its implementation in the UK.

Setting

Consultant members of The Royal College of Ophthalmologists (RCOphth, UK)

Design

Survey-based, questionnaire

Methods

Distributed to members and collected electronically. An initial screening question in regards to prior experience with ISBCS directed the rest of the survey; participants were asked to rate the importance of several factors with regards to performing ISBCS. Free text options were also available. Descriptive analysis was subsequently performed.

Results

Of the 1357 recipients, 130 (9.6%) ophthalmologists completed the survey. Of those, 13.9% were currently performing ISBCS, 83.1% had never performed, and 3.1% had previously done so but since stopped. The main factors that acted as barriers were lack of: (1) College approval (20.5%); (2) medico-legal approval (20.2%); (3) evidence to support the use of ISBCS (16.0%); and (4) hospital approval (13.3%). Additionally, the perceived risk of complications for patients played an important role when considering ISBCS, with the risk of endophthalmitis being most feared.

Conclusions

This survey demonstrates some of the barriers that prevent ophthalmologist’s performing ISBCS in the UK. There is a need for further exploration in this field to evaluate the effect of addressing any of these concerns on the implementation of ISBCS.
Energy-dense nutrient-poor snacks and risk of non-alcoholic fattyliver disease: a case-control study in Iran
Authors: yari zahra , Cheraghpour Makan , Aghamohammadi Vahideh , Alipour Meysam , Ghanei Nila , Hekmatdoost Azita
Published: February 2020

Objective: The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire.Results: The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (p=0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR:1.94; 95% CIs: 1.16-3.26; P for trend=0.015) and adjusted (OR:2.27; 95%CIs: 1.19-4.31; P for trend=0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend=0.037) and soft drinks (OR: 1.64, P for trend=0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.
Degradation of Emerald Green: Scientific Studies on Multi-polychrome Vairocana Statue in Dazu Rock Carvings, Chongqing, China
Authors: Li Zhimin , Wang Lele , Chen Huili , Ma Qinglin
Published: February 2020

The spontaneous degradation of pigments in painting may occur depending on environment, especially the surrounding condition of high humidity and soluble salts. Even some of these are well studied, more investigations are still in need for heritage science. Paint cross sections from Vairocana Statue in Dazu Rock Carvings, one of World Cultural Heritage, Chongqing, China are studied by optical microscopy (OM), Raman spectroscopy (Raman) and mapping, and scanning electron microscopy coupled with energy dispersive X-ray analysis (SEM–EDS). Ultramarine blue, emerald green, synthetic atacamite, vermilion, red lead, gold foil, orpiment, cerussite, gypsum and barite are identified as pigments. Moreover, lavendulan (NaCaCu5(AsO4)4Cl·5H2O) and mimetite (Pb5(AsO4)3Cl) are degradation products of emerald green (Cu(C2H3O2)2·3Cu(AsO2)2) and cerussite(PbCO3) originally used as green pigment with mixture. These secondary products is formed via multistep progresses as degradation of emerald green and cerussite, oxidation of arsenite ((AsO2)-), migration of arsenate ((AsO4)3-) and precipitation reaction of these ions with other necessary ions from environmental conditions. Based on the pigment and paint layer stratigraphy analysis, the paintings of the statue have been executed at least four times and the most recent may be after 1850s. The formation of lavendulan give rise to a highlight for identification of green copper-arsenic containing pigments and characterization of degradation in complex conditions.
The expression of BAFF in the muscles correlate with refractory autoimmune necrotizing myopathy with anti-signal recognition particle antibodies
Authors: Zhao Yawen , Zhang Wei , Liu Yilin , Wang Zhaoxia , Yuan Yun
Published: February 2020

BackgroundAutoimmune necrotizing myopathy with anti-signal recognition particle antibodies (ANM-SRP) is considered as a refractory myositis; some patients respond poorly to conventional immunosuppression，required the treatment of B lymphocyte clearance. We aimed to identify the factors related to refractory ANM-SRP.Results48 patients with ANM-SRP were included to identify the factors related to refractory ANM-SRP. We monitored the clinical symptoms and image changes over 12 months. Refractory ANM-SRP appeared in 32.5% patients, who showed no or minimal improvement after 12 months with steroid therapy. The clinical risk factors for refractory patients were male (19.57, 1.49-256.53), severe muscle weakness (7.51, 41.03-54.88) and concurrent interstitial lung disease (39.70, 3.04-518.38). The fatty infiltration rate of thigh muscles over 3 months was more severe (P=0.022) in refractory patients. Muscles of all patients underwent routine histology, enzyme histochemistry and immunohistochemistry staining. The first antibodies used for immunohistochemistry include anti-B cell activating factor (BAFF) and BAFF receptor (BAFF-R) antibodies. Immunohistochemical staining and western bolt showed that the expression of BAFF and BAFF-R in muscles of the patients were higher than that of the normal controls. The positive BAFF-R cells (P=0.036) and CD19 positive lymphocytes (P=0.002) in refractory patients were higher than in patients with good clinical response to therapy.ConclusionThe expression of BAFF and BAFF-R in muscles of ANM-SRP were upregulated. Male, severe muscle weakness, concurrent interstitial lung disease, quick development of muscle fatty infiltration and more BAFF-R and B-lymphocytes infiltration in muscle indicate a poor response to immunosuppressive therapy.