bluuebunny/crossref_metadata_2025 huggingface dataset:
Response of Superovulation by Using FSH (Follicle Stimulating Hormone) and Sex Determination of Embryos Using PCR in Pesisir Cows of West Sumatra
Authors: Afriani Tinda , Sayful Fery Lismanto , Sumedi Sumedi , Putra Dino Eka , Purwati Endang
Published: October 2019

This study  was conducted to determine the response of superovulation by giving 16 ml dosage  of FSH hormone to female Pesisir cattle.  The estrus schedule of 15 Pesisir cows was set by inserting CIDR (Controlled Internal Drug Release) into the vagina for 12 days. At day 10, all cattles were injected with FSH for three consequent days but with decreasing dosage. On the 3rd day, FSH injection was accompanied by PGF2α injection and CIDR was removed. The detection of estrus was performed at  day 13. Natural mating was proceeded after the estrus signs visible. Collection of donor embryos was done on the 6th and 8th day after mating. The variables  measured were the response of superovulation, total number of corpus luteum, number of embryos and sex ratio. The results obtained were all  Pesisir cows responded to superovulation. The  average number of of corpus luteum and embryoes per cow were  5.93±3.17 and -----, respectively,  while the total of transferable embryoes were 90, with an average of 6.00 or 61.64%. The sexing of embryoes obtained in this study from 146 embryoes awere 76.03% males (111 embryoes) and 23.97% females (35 embryoes). Based on total of transferable embryoes, there were 51.37% male embryos and 11.28% of females embryos. The result of this study showed that the sex ratio of male embryos was higher than female embryos.
Administration of Various Feed Additives on Cholesterol Content of Meat and Fat Abdomen of Local Chicken (Gallus domesticus)
Authors: Ilham Ilham , Nurliana Nurliana , Al azhar Al azhar , Delima Mira , Sugito Sugito , Samadi Samadi
Published: October 2019

Cholesterol consumed more than required body will influence health problem such as arteriosklerosis and finally resulted in coronary hearth. The purpose of this study is to evaluate the concentration of cholesterol and fat abdomen local chicken administrated various levels of feed additives. Totally 200 chickens from growth study were selected for 20 chickens at the age of 90 d for further cholesterol and fat abdomen analysis. This study was designed by using completely randomized consisting of 4 treatments and 5 replications. Four treatments in this study was administration of feed additives either in the water or in the feed (A0 = control-vita chick 0.7 gram/liter; A1= 20 ml/liter probio-FM; A2= 0.08% MOS (manan-oligosakarida)/kg in feed and A3= herbal leuser KI 5 ml/liter). Variables observed in this study were the content of cholesterol and fat abdomen. All data were statistically analyzed using SPSS and differences between treatments were stated (P<0.05) by using Duncan Multiple Range Test (DMRT). The results of the study indicated that administration of various feed additives significantly effected (P<0.05) on the cholesterol content of breast meat of local chickens.  The average of breast meat cholesterol content was 52 mg/100g, 44 mg/100g, 43 mg/100g and  46 mg/100g for A0, A1, A2 and A3 respectively. Administration of administration of various feed additives significantly reduced (P<0.05) the percentage of fat abdomen of local chickens with the percentage of 0.78%, 0.36%, 0.27% and 0.42% for A0, A1, A2 and A3 respectively. This study concluded that administration various feed additives significantly reduced cholesterol content and the percentage of fat abdomen with the lowest of cholesterol content 43 mg/100g and the lowest percentage of fat abdomen 0.27% for prebiotic treatment.
Barriers to Disclose HIV Status to Family Members Among People Living with HIV
Authors: Ibrahim Kusman , Rahayuwati Laili , Herliani Yusshy Kurnia
Published: October 2019

Disclosing HIV status has inhibited HIV infected persons from getting access to sufficient prevention, care, treatment, and support, which in turn can contribute to poor HIV/AIDS control. This study aims to explore the reasons underlying the barriers to disclosing HIV status to family members among people with HIV infection. This is a qualitative exploratory study. Forty participants participated in the study which was divided into five focus group discussions. They were purposively recruited from two district hospitals in West Java. FGDs were audiotape recorded with permission from participants and were verbatim transcribed. Data were analyzed qualitatively by thematic analysis technique. Four major themes emerged from the data; 1) Negative feelings about being a HIV-infected person, 2) Feeling fear of being rejected by family members, 3) Avoiding being a burden on the family, 4) Desiring to maintain a good relationship with family members. The study suggested that nurses and health care providers need to consider family as the primary source of support and encouragement for people with HIV infection. Strengthening the self-confidence of PLWH and family coping strategies needs to be more emphasized when caring for people with HIV infection particularly in the first stage after being diagnosed as HIV positive.
Effect of Progressive Muscle Relaxation on Anxiety in Congestive Heart Failure Patients
Authors: Sulastini Sulastini , Mediani Henny Suzana , Fitria Nita , Nugraha Bambang Aditya
Published: October 2019

Anxiety is major psychological problem in congestive heart failure (CHF) patients. Anxiety leads to reduced quality of life. Anxiety can be treated using non phamacologic intervention. One of the interventions is progressive muscle relaxation (PMR). PMR is the most simple relaxation technique and possible to be applied in CHF patient. This study aimed to determine the effect of progressive muscle relaxation on anxiety IN CHF patients in dr. Slamet Garut hospital. This study used quasi-experimental design pretest and posttest with control group. Samples were selected using consecutive sampling technique (23 patients for each group). Hamilton Anxiety Rating Scale (HARS) was used to measured anxiety. Data were analyzed by Wilcoxon test and Mann-Whitney test. Analysis showed that there was a significant decrease in the mean anxiety score pre and post test both in the intervention and control group (p=0.000) and a significant difference in mean anxiety score reduction between groups (p=0.017) This study concluded that progressive muscle relaxation was effective to reduce anxiety levels in CHF patients. Nurses can apply progressive muscle relaxation as a complementary therapy to reduce anxiety in CHF patients
The Analysis Effect Of Commodities Crude Oil and Coal In Indonesia Stock Exchange
Authors: Hersugondo H. , Laksana Rio Dhani , Mayasari Viviana
Published: October 2019

Crude oil is a commodity and major world needs today. Since the historic collapse of Lehman Brothers helped precipitate the global economic crisis in the spring of 2008, a strong positive correlation between the price of crude oil continues to appear and the global stock markets, including the stock exchanges in Indonesia. This happens due to capital market investors assume that rising energy prices are a sign of the increasing global demand objective of this study was to determine the effect of crude oil prices and the price of coal on JCI in the Stock Exchange in the period 2012 -2017.

This study will use a time series data analysis tool Vector Autoregression approach. VAR model approach is considered more suitable for detecting a mutual relationship or a dynamic two-way causality between variables in world crude oil prices, the price of gold and the price of coal on the stock price index of the mining sector in the system of equations
AKUNTABILITAS PRAKTIK PENGELOLAAN KEUANGAN DESA GAMTALA, HALMAHERA BARAT PROVINSI MALUKU UTARA
Authors: Zainuddin Zainuddin , Ansar Resmiyati
Published: October 2019

Desa Gamtala is a social organization which has traditional characteristics, so that the accountability of its financial management process is not always supported by proper system and procedure. Although this system was carried out in simple way, this could be used to manage the asset of Desa Gamtala properly. To understand the phenomenon of the financial management in Desa Gamtala, this research was aimed to find out: 1) the participants involved in the financial management process in Desa Gamtala, 2) how the financial management process in Desa Gamtala was carried out, 3) how the participants involved understand and interpret the accountability of the financial management process. This research was conducted by using qualitative method which emphasizes on the description of every perception and habits of the human. The data analysis was conducted in three steps, such as: 1) Data Reduction, 2) Data Display, and 3) Verification. The result of this research shows that: 1) The process of financial management and its accountability in Desa Gamtala was involve all people in Desa Gamtala, 2) The accountability of the financial management is carried out consistently 3) Due to the social capital, especially belief, the participants of Desa Gamtala realize that accounting is an instrument of accountability and transparency in financial management in Desa Gamtala.
Redox Regulation and Oxidative Stress: The Particular Case of the Stallion Spermatozoa
Authors: Peña Vega Fernando Juan , O'Flaherty Cristian , Ortiz Rodríguez Jose M. , Martín Cano Francisco E. , Gaitskell-Phillips Gemma L. , Gil María C. , Ortega Ferrusola Cristina
Published: October 2019

Redox regulation and oxidative stress have become areas of major interest in spermatology. Alteration of redox homeostasis is recognized as a significant cause of male factor infertility and is behind the damage that spermatozoa experience after freezing and thawing or conservation in a liquid state. While for a long time, oxidative stress was just considered an overproduction of ROS, nowadays it is considered as a consequence of redox deregulation. Many essential aspects of spermatozoa functionality are redox regulated, with reversible oxidation of thiols in cysteine residues of key proteins acting as an “on-off” switch controlling spermatic function. However, if deregulation occurs, these residues may experience irreversible oxidation and oxidative stress leading to spermatic malfunction and ultimately death. Stallion spermatozoa are “professional producers” of ROS due to their intense mitochondrial activity, and thus sophisticated systems to control redox homeostasis are also characteristic of this species. As a result, combined with the fact that embryos can easily be collected in this species, horses are a good model for the study of redox biology in the spermatozoa and its impact on the embryo.
Randomized Controlled Trial on Effects of a Brief Clinical-Based Intervention Involving Planning Strategy on Self-Care Behaviors in Periodontal Patients in Dental Practice
Authors: Lin Jo-Hsin , Huang Yuan-Kai , Lin Kun-Der , Hsu Yuan-Jung , Huang Wei-Fu , Huang Hsiao-Ling
Published: October 2019

Background: Strengthening adherence to self-care behaviors in patients with periodontal disease (PD) and reducing plaque index is crucial for improving PD treatment. We evaluated the effectiveness of a theory of planned behavior (TPB)-based health education intervention involving planning strategy on self-care behaviors in patients with PD. Methods: A randomized controlled trial was conducted; 158 and 139 patients comprised the experimental group (EG) and control group (CG), respectively. Both groups received a leaflet, and the EG also received a planning intervention, which was a brief one-on-one counseling session with a planning sheet. Data were collected using a self-administered questionnaire. Results: Between-group comparisons of TPB measures revealed significant differences in all domains when controlling for baseline covariates. The EG exhibited significantly higher levels of action and coping planning than the CG at 2-week follow-up (effect size (ES) = 5.54 and 5.57, respectively) and 6-week follow-up (ES = 5.66 and 5.66, respectively). Between-group differences in changes of brushing behaviors increased significantly. More frequent use of dental floss was observed in the EG than in the CG at 2-week and 6-week follow-ups (24.7% and 22.8%, respectively). Conclusions: The intervention involving planning strategy effectively promoted adherence to self-care behaviors in patients with PD.
Farmer-led Improved Storage Technique and Management of Aflatoxin in Peanut Production: Evidence from Ghana
Authors: Martey Edward , Etwire Prince Maxwell
Published: October 2019

Peanut production contributes to food security in northern Ghana due to its ability to tolerate drought and survive on marginal lands. This notwithstanding, poor handling along the value chain favors aflatoxin contamination, a threat to human and animal life. Farmer-led improved storage practice, a potential solution to aflatoxin contamination, have been promoted in northern Ghana. However, there is limited evidence on the factors influencing the use of the improved storage system that may guide dissemination efforts. Using the Cragg’s two stage model, our results show that the probability and intensity of adopting the improved storage structure is principally and significantly influenced by economic active household members, storing of peanut in other places relative to the field, and location of farmer residence. In disseminating the improved peanut storage structure, the identified factors must be incorporated in the selection criteria to ensure maximum uptake and usage. Farmer training programs that incorporate both good agronomic practices and good storage practices must be intensified to reduce postharvest losses due to aflatoxin contamination. These strategies will help mitigate the harmful effect of aflatoxin, ensure economic sustainability, and enhance food security.
Inovação na Gestão Pública como “Possibilidade Objetiva”: O Caso do Pacto pela Educação de Pernambuco sob a Ótica da Administração para o Desenvolvimento
Authors: Sousa Jessica Rani
Published: October 2019

O presente trabalho objetivou investigar como o Pacto pela Educação de Pernambuco (PPE) contribui para fomentar práticas que caracterizem inovações na gestão pela perspectiva da efetividade da política pública, adotando, como lente teórica e sensibilizante, a Teoria das Possibilidades de Guerreiro Ramos e sua abordagem sobre Administração para o Desenvolvimento. Por meio de estudo de caso qualitativo, e de análise temática de conteúdo das entrevistas realizadas nos níveis estratégico e tático de sua operacionalização, puderam ser identificadas categorias concentradas em torno de práticas especificamente advindas com o PPE: o uso de indicadores de desempenho e a publicitação de descritores escolares, pela perspectiva do SIEPE, dos painéis de gestão e pela própria mídia. Os sinalizadores de efetividade identificados para essas categorias disseram respeito a: criação de um olhar diferenciado para as escolas e alunos prioritários da rede pública; credibilidade, transparência, percepção de empoderamento e aprimoramento da consciência sobre o contexto escolar.
Análise do Controle Patrimonial de Bens Permanentes em uma Organização Pública
Authors: Fernandes Elizabeth Carvalho , Monteiro Doraliza
Published: October 2019

Este estudo objetiva analisar as atividades de controle dos bens móveis de caráter permanente em um Instituto Federal brasileiro. Especificamente, buscou-se analisar como ocorrem as etapas do fluxo das atividades básicas relativas ao controle dos bens dentro das unidades gestoras da Instituição, tais como o recebimento, a distribuição, a movimentação, os inventários e as baixas patrimoniais, e ainda apontar as dificuldades encontradas pelos servidores que executam as atividades dos setores de patrimônio. A abordagem metodológica foi qualitativa, do tipo exploratória e descritiva. As técnicas de coleta de dados foram: a pesquisa documental nos registros patrimoniais; a aplicação de questionário a todos servidores dos setores de patrimônio; e entrevistas semiestruturada realizadas com os gestores e/ou responsáveis pela área de patrimônio de unidades gestoras da Instituição. Os resultados demonstraram que o controle patrimonial ocorre parcialmente, não está sendo realizada a depreciação e a reavaliação dos ativos imobilizados A estrutura organizacional precisa aproximar e fortalecer setores envolvidos no processo e adotar sistema patrimonial realmente efetivo no controle dos bens móveis.
Dimensões estatal, gerencial e individual da Política Nacional de Prevenção e Controle do Câncer (de Mama): um modelo avaliativo
Authors: Roque Ferreira Daiane Medeiros , Lima Afonso Augusto Teixeira de Freitas de Carvalho , Ferreira Marco Aurélio Marques
Published: October 2019

O objetivo desse estudo foi evidenciar a existência de três dimensões teóricas condicionantes do desempenho na Política Nacional de Prevenção e Controle do Câncer (PNPCC), a saber: a dimensão estatal, em seu aparato legal e estrutural; a dimensão gerencial, por meio da capacidade gerencial municipal; e a dimensão individual, pelo envolvimento da sociedade com comportamentos difundidos pela política.  Além disso, tem-se como proposta desenvolver um modelo para avaliar a PNPCC, o qual denominou-se de Modelo Sinérgico de Avaliação de Desempenho de Política Pública em Saúde (MoSADPPS). Para cumprir os objetivos propostos, foram adotados procedimentos metodológicos quantitativos como a Regressão Linear Logística e a Análise Fatorial. Os resultados confirmam a influência dessas três dimensões no resultado da PNPCC. Também encontrou-se que o melhor desempenho com a Política não está relacionado com melhores níveis de desenvolvimento econômico e social do município, mas possivelmente pela capacidade de gerenciar as políticas públicas de saúde.
Inovando no Desenvolvimento de Profissionais da Gestão Pública: O Caso do Programa de Desenvolvimento de Lideranças da Escola Nacional de Administração Pública – Enap
Authors: Barzelay Michael , Martins Humberto Falcão , Vilela Pedro , Marques Paulo
Published: October 2019

Este trabalho trata de uma nova abordagem, na forma e no conteúdo, de desenvolver a prática profissional de gestores públicos orientada por design, elaborada pelo prof. Michael Barzelay, objeto de seu último livro “Public management as a design-oriented professional discipline” (2019). Relata a forma como esta abordagem foi colocada em prática na Escola Nacional de Administração Pública (ENAP) do Governo Federal do Brasil entre 2016 e 2019 e os resultados positivos decorrentes para os participantes. Foi possível comparar os efeitos da abordagem nas turmas que a adoraram com os das turmas que não a adotaram. Uma avaliação econométrica e qualitativa do programa revelou efeitos positivos da abordagem relacionados à transferência de aprendizados, capacidade de estruturar problemas complexos e desenvolvimento de soluções colaborativas.
Um convite à internacionalização em prol da Gestão Pública Brasileira
Authors: Cavalcanti Bianor Scelza
Published: October 2019

Informe escrito pelo Prof. Bianor Cavalcanti para a edição especial da APGS com a SBAP.
Dimensões Intraorganizacionais e Funções Gerenciais no Setor Público
Authors: Coelho Fernando Souza , Valadares Josiel Lopes
Published: October 2019

Editorial e prefácio da edição especial APGS-SBAP.
Assessment of the Potential of Low-Salinity Water Injection Technology to Increase the Oil Recovery of the Carbonate Reservoir of the Kharyaga Field
Authors: Zoshchenko Oleg , Aleshchenko Anton , Trushin Yuri
Published: October 2019

The development of carbonate reservoirs using peripheral and pattern water flooding typically achieves oil recovery factors ranging from 0.3 to 0.5, which is due to some complicating factors, such as, oil-wet surface of the pore space or the surface with intermediate type of wetting, unfavorable ratio of oil and water viscosities, presence of extensive structure of fractures, and significant variations of permeability down the reservoir section. In a complex geological environment, wells display abrupt fluctuations of water production that is an evidence of formation water being by no means the most efficient displacement agent. In these conditions, low-salinity water flooding can improve oil recovery.

This paper reports on SCAL results of oil recovery factor determination and spontaneous imbibition using water with different composition and total solinity for Object 2 of Kharyaga oil field. Also, report contains design of on-site determination of residual oil saturation using Single Well Chemical Tracer test technology for evaluation of EOR efficiency.

Laboratory tests showed, that low-salinity Jurassic water flooding with total salinity about 5 g/l could rase recovery factor up to 4% and also give incremental recovery due to effects of spontaneous imbibition for permability lower than 100 mD, which makes the injection of Jurassic water more preferable.
Flexible Multi-Well Interference Test Design for a Deep-Water Field
Authors: Zubarev Denis , Mardanov Ruslan , Bochkarev Vitaly A. , Khmelevskij Vyacheslav
Published: October 2019

Interference testing is a common tool for addressing reservoir connectivity and compartmentalization risks. Due to the high costs of deep-water and ultra-deep-water extended well testing, this type of test is rarely performed during the appraisal phase and is usually postponed until the start of the field development. With the infrastructure in place, testing can be carried out with minimum planning and at a minimum cost. This is generally acceptable for fields with a lower subsurface complexity. However, for complex turbidite fields, this information becomes critical at the appraisal and early development planning stages to reduce the risks in depletion optimization and production infrastructure planning. To make testing practical, it has to be performed in a way that minimizes rig time and de-risks collection of required data.

To optimize the interference test design for the West Africa deep-water field appraisal phase, a simulation study was carried out to assess the impact of major uncertainties. A fine-scale 3D simulation model was used due to high heterogeneity and complex connectivity between individual channels and channel complexes. Impact of the drawdown rate, flow duration, tidal effect amplitude, OWC, faults transmissibility, absolute permeability, reservoir pore volume, and zones connectivity on interference time for different selections of test and observation wells were assessed through the sensitivity runs. Results were analyzed to get a better understanding of reservoir dynamic response such as pressure travel time and potential interference between zones.

Based on this study a flexible interference test plan was defined that ensures optimal rig use and minimal risk of sub-optimal dataset collection. This plan embeds both pre-test decisions and real-time decisions that depend on early time observations. An optimal test and observation wells setup that provides a balance between the rig time and value of information will depend on the planned appraisal well results and is one of the decisions to be finalized before the test. However, decisions on flow duration adjustment and consequent data monitoring in the observation wells will be made based on a set of early time events identified from the sensitivity of pressure interference response between different zones and wells.

The proposed uncertainty driven approach provides an obvious advantage over the common test design based on the "best technical estimate" model. It also provides a better basis for test feasibility decision and cost-effective implementation.
Application of Hybrid DPDP-DFN Modeling of Fractured Carbonate Reservoirs
Authors: Shevko Nikolay , Shaislamov Vil , Savelev Oleg
Published: October 2019

Predicting naturally fractured carbonate reservoir behavior is associated with fluid flow modeling of two and more mediums. Presence of highly conductive faults and fractures complicates the process. These complications are generally addressed by common approaches using DPDP models and modern techniques of explicit discrete fracture networks (DFN) modeling.

Dual porosity-dual permeability (DPDP) models do not provide proper results without significant modifications and improvements. Flow simulation of the whole fracture set in discrete format on full-scale models is computationally intensive and time-consuming task thus not applicable for practical purposes.

Alternative hybrid modeling approach based on combination of individual DFN objects (faults and long fractures) with traditional DPDP modeling was created based on detailed geological static model. Full scope of available geological, geophysical and production data was used to provide background for flow simulations.

Numeric algorithms were optimized for three mediums including single porosity medium (SPM), fracture medium (DFN) and discrete objects representing irregular fault and long fracture systems.

Generalized workflows for creating static model, defining fractured zones and explicit discrete objects, followed by DPDP-DFN hybrid modeling are described in this paper.

The proposed approach was utilized to perform full-scale model history matching, optimize well locations, estimate risks and uncertainties of gas injection efficiency.
Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.
Authors: Tarekegn Daniel , Birhanie Meseret , Lemma Wossenseged
Published: October 2019

Abstract
Background: In Ethiopia Stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town.
Methods: Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully-automated haematological analyzers were used to determine haematological and biochemical parametrs.
Results: Atotal of 384 school children were recruited in this study. The overall prevalence of helminth infections was 45.8% (178/384) with the leading Ascaris lumbericoides infection (20.6%) compared to the second leading Schistosoma mansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thinnes, 17.2% (66) sever thinness, 38.3% (147) thinness, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-glycemia, hypo-proteinaemia and anemia compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infection.
Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.
Key Words: school children; malnutrition; intestinal helminth infections; nutritional indices; Gondar town.
Short-term and long-term outcomes of robotic, laparoscopic and open radical gastrectomy in gastric cancer: A single-center retrospective study
Authors: Zhang Weifan , Zhao Xinhui , Liu Zhao , Dang Hui , Meng Lei , Xia Peng
Published: October 2019

Background: Few studies on the comparison among robotic, laparoscopic, and open gastrectomy had been reported in gastric cancer . The goal of this study was to evaluate the advantages of robotic-assisted gastrectomy (RAG) by comparing with laparoscopic-assisted gastrectomy(LAG) and open gastrectomy (OG). Methods: 147 gastric cancer patients who underwent gastrectomy were enrolled and retrospectively analyzed between January 2017 and July 2019. Short-term outcomes such as operation time, intraoperative estimated blood loss(EBL),number of retrieved lymph nodes, postoperative recovery, learning curve, and long-term outcome such as overall survival(OS) was compared among RAG, LAG and OG groups. Results: RAG group included 47 patients, 44 in the LAG, and 61 in the OG. Basic information such as gender, age, BMI, ASA degree were similar among three groups, and there were no statistically significances in pathological TNM staging, tumor resection extent, resection margin, methods of reconstruction( P ＞0.05). The cumulative sum(CUSUM) method showed that learning curve of RAG reached stability after 17 cases . For short-term outcomes, the RAG group had the shortest EBL( P =0.033), the shortest time to first flatus( P ＜0.001), shortest time to first intake liquid diet ( P =0.004),shortest postoperative hospital stay ( P =0.023)and the largest number of retrieved lymph nodes( P =0.044),the longest operation time( P ＜0.001), the most expensive treatment cost( P ＜0.001),however, there were no significant differences in postoperative drainage, postoperative white blood cell(WBC)count and early complications among three group( P ＞0.05). In addition to long-term outcome, similar OS was observed in three groups. Conclusion: Compared with LAG and OG, RAG has certain advantages in short-term outcomes and is a safe and reliable surgical method. But still need further prospective, multi-center research to confirm this.
Determinants of Hospital Efficiency: insights from the literature
Authors: Asbu Eyob Zere , Masri Maysoun Dimachkie
Published: October 2019

Background Achieving Universal Health Coverage and other health and health-related targets of the sustainable development goals entails curbing waste in health spending due to inefficiency. Inefficiency is a pervasive problem in health systems. The World Health Organization estimates that on average, 20-40% of the global total health expenditure is wasted. The proportion of total health expenditure attributed to hospitals is high, which implies that improving the efficiency of hospitals will lead to more efficient health systems. This study aims to synthetize the major determinants of hospital inefficiency and to develop a framework to identify causes of inefficiency and develop multi-factor interventions to address inefficiencies.Methods The study is based on survey of the literature on hospital efficiency and its determinants. The studies include those that employ ratio methods of efficiency analysis, data envelopment analysis and stochastic frontier models and econometric models such as the tobit regression to assess determinants of technical efficiency. Data was extracted in a table format categorized as those that are within the hospital, outside the hospital but within the health system and those that are outside the hospital and health system in the broader macroeconomic system and analyzed.Results Hospital efficiency is influenced by factors that may be internal to the hospital or external and thus could be wholly or partially out of the control of the hospital. Hospital-level characteristics that influence efficiency include ownership, size, specialization/scope economies, teaching status, membership of multihospital system and other factors such as case-mix and ratio of outpatients to inpatients. However, the effects of these variables are not definitive and consistent; all depends on the context. Factors out of the direct control of the hospital include geographic location, competition and reimbursement systems. The findings further elucidate that no single factor is effective in addressing hospital inefficiencies in isolation from others.Conclusion There is no one single magic formula or intervention that can be adopted by different hospitals and can be effective in improving hospital efficiencies. Multiple factors influence the efficiency of hospitals and to address hospital inefficiency multi-intervention packages focusing on the hospital and its environment should be developed.
Getting Around Regional Inequalities: Solidary Cooperation of the Health Professionals Relationship Network
Authors: Lama Daniela Del , Farina Milton Carlos , Oliva Eduardo de Camargo , Carvalho Antonio Aparecido de , Neto Alvaro Francisco Fernandes , Campão Andre Ciro de Lima
Published: October 2019

Context The Brazilian Health Care Program is formed by a complex network of public and private services that often complement each other, especially in the area of qualified Human Resources for Health (HRH). Due to social inequalities, the shortage of qualified HRH in remote regions is a reality in Brazil. The workforce imbalance associated with the socioeconomic inequality of the population in these regions reduces the access to these health maintenance services. Given this reality, this research aimed to explore and analyze the cooperation network of health professionals, a strategy used to alleviate the problems of care through social inequality, in a district of the Amazon region far from the great centers.Method A questionnaire was answered by doctors, dentists, physiotherapists and occupational therapists in the district of Rondon do Pará (Brazil). The collected data were dichotomized and analyzed using the Social Network Analysis technique using the Ucinet software.Results By means of the figures of the network of related players, it was found that cooperation between health professionals occurs in the exercise of the profession, with many strong and essential relationships for the existence of the network as well as the essential and centralized participation of medical professionals, as it reveals strong cooperative relationships with all network professionals, even if some are not reciprocal or are weak, such as relationships between physiotherapists, occupational therapists and dentists, even playing important relationship roles.Conclusions The results indicate that there is a network of health professionals cooperating in solidarity in the district of Rondon do Pará, Brazilian Amazon region. In face of difficulties in working in the profession and social inequalities, the research participants follow the principle of solidarity, cooperating with information among professional colleagues to serve the population of the district. Besides the existence of the cooperation network, being the doctors the key professionals for its execution, the collected data indicated the main difficulties faced as the lack of: opportunity for professional improvement, infrastructure to perform the work, technical support in equipment maintenance, supplies and support for people with special needs.
Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.
Authors: Nyachwo Evelyne Baelvina , Naigino Rose , Apolot Rebecca Rachael , Wanyenze Rhoda K. , Kiguli Juliet , Bukenya Justine
Published: October 2019

Background: Health facility delivery improves maternal and child health outcomes but has not been fully achieved in countries with the poorest maternal health indicators. We identified and examined the roles of key influencers (significant others) of mother’s perceptions towards health facility delivery in Northern Uganda. Methods: This was an exploratory study conducted using in-depth interviews with eleven significant others in a mother’s life; who were purposively selected from four sub-counties of; Ogur, Agweng, Amach and Agali, as part of a larger study in Lira district, Northern Uganda. We also conducted seven key informant interviews with health workers involved in maternal and child health care. Data analysis using Atlas ti version.7.0 was conducted deductively following a thematic framework approach to analyse themes adapted from the health belief model. Results: The study identified husbands, biological mothers, mothers-in-law, fathers-in-law, brothers and co-wives as influencers of mother’s perceptions on uptake of health facility delivery. Other significant others included traditional birth attendants who were believed to have the ability to determine when the condition of a mother required the intervention of a medical expert. Community members such as local village leaders, village health extension workers and neighbours were also cited . Whereas husbands were regarded as ke y significant others of women, health workers emphasized that, husbands were not always available to support the mothers during pregnancy and child birth. The roles of significant others of women included: planning for birth, providing financial support, making decisions on where a mother will deliver from, continued counselling and psychosocial support. Conclusion: Programs aimed at increasing male involvement to improve maternal and child health outcomes should also target other influencers of women’s perceptions on health facility delivery including family and community members, to provide back-up support to mothers in the absence of their husbands.
Linkage disequilibrium score regression distinguishes associations between lean body mass and blood plasma proteome
Authors: Zhang Lu , Zhao Yan , Wen Yan , Ma Mei , Cheng Shiqiang , Cheng Bolun , Liu Li , Li Ping , Qi Xin , Liang Chujun , Zhang Feng
Published: October 2019

Background: Lean body mass (LBM) is an essential component of body composition. Recent studies observed associations between altered plasma proteins and LBM. This study aims to explore the potential genetic relationships between LBM and plasma proteome. Methods: The genome-wide association study (GWAS) summary data of LBM were driven from ~85,000 individuals of European descent. The GWAS summary data of 3,622 plasma proteins were obtained from 3,301 healthy participants. Linkage disequilibrium score regression (LDSC) analysis were conducted to evaluate the potential genetic correlation between each plasma protein and LBM using the GWAS summary statistics. Results: LDSC scan identified multiple plasma proteins for LBM, such as stabilin-1(coefficient=-0.4583, P value=0.0253) and inter-alpha-trypsin inhibitor heavy chain H1 (coefficient=-0.1716, P value=0.0314) for append LBM, and glyceraldehyde-3-phosphate dehydrogenase (coefficient=0.5997, P value=0.0315) and immunoglobulin lambda-like polypeptide 1(coefficient=0.35, P value=0.0334) for whole LBM. We also detected two common plasma proteins shared by append and whole LBM, including stabilin-1 and glyceraldehyde-3-phosphate dehydrogenase. Conclusions: This study provided an atlas of genetic correlations between LBM and plasma proteome, which are helpful for understanding the biological mechanism of LBM.
The miR-15a affected the development of sepsis and septic shock by suppression BCL-2
Authors: Wu Yunzhen , Xie Yuanli , Jiao Fangfang , Liu Xinlei
Published: October 2019

Background: This study aimed to investigate the mechanism of microRNA-15a (miR-15a) in the development of sepsis and septic shock. Methods: Sepsis and septic shock rat models were constructed by intraperitoneal injection of E.coli endotoxin (LPS). The real-time polymerase chain reaction (RT-PCR), Enzyme-Linked ImmunoSorbent Assay (ELISA), ematoxylin-eosin (HE) and Masson staining, TdT-mediated dUTP Nick-End Labeling (TUNEL), as well as Western blot analysis were performed to reveal the expression of microRNA-15a and changes in sepsis/septic shock myocardial cells or tissue. The rat sepsis model (sepsis group and septic shock group) was successfully established. Results: The results of HE and Mason staining showed that myocardial tissue damage gradually deepened with the progression of sepsis. Moreover, the serum levels of creatinine kinase-mb (CK-MB) and cardiac troponin I (cTnI) in model groups were significantly increased than those in control group. In addition, the RT-PCR analysis showed that miR-15a was up-regulated in model groups. Furthermore, luciferase reporter gene assay showed that 3'-UTR was the binding site of BCL-2 to miR-15a. Finally, the TUNEL and Western blot showed the cardiomyocyte apoptosis in model group. Conclusions: The overexpression of miR-15a might take part in the progression of LPS-induced sepsis and septic shock via suppressing Bcl-2 expression. Furthermore, myocardial markers such as CK-MB and cTnI might be biomarkers for sepsis progression.
Awareness of Young Japanese Women on HPV Self-Sampling Trial using Opt-in Method
Authors: Tada Sayako , Ito Yumi , Nagai Natumi , Nakamura Kanako , Nohara Kiriko , Sagawa Tadashi
Published: October 2019

BackgroundThe rate of young Japanese women attending Cervical Cancer screenings is still low. There is a lack of studies that discussed awareness, preference, and anxiety of women to HPV self-sampling. The aim was to clarify the awareness of young women who want and do not want HPV self-sampling toward improvement the rate of attending Cervical Cancer screenings.Methods We carried out the observation study by self-administered questionnaires about the awareness of HPV self-sampling with the trial in a city, in Hokkaido, Japan. The subjects were selected at random to 25-29 years old women (837 persons) residing in a city. We compared their awareness between want and do not want self-sampling. For data analysis, statistical analysis software SPSS for Windows Ver.21 was used setting the significance level at below 5%.ResultsYoung women in this study who firstly responded wanting practice of self-sampling were 9.8%, and not wanting in were 90.2%. The reasons of young women that want self-sampling were “Free self-sampling supported from the city”, “I can do it in my own time”, and “I have experience of sexual intercourse”. In contrast, the reasons of do not want self-sampling were “I have no symptom”, and “I am anxious about doing the test by myself”. The awareness of HPV self-sampling was low with all subjects, and they have few the general knowledge of Cervical Cancer. ConclusionThere is a possibility to increase the number of young women who want self-sampling by using an HPV self-sampling trial of the opt-in method that also considers the emotions of the women. Young Japanese women who do not want self-sampling, tend to have a fear and anxiety toward self-sampling, in contrast, many of the women who conducted self-sampling prefer it. This study suggests the need of new practical education for self-sampling, including HPV infection, and Cervical Cancer prevention performed by clinicians, nurses and midwives.
Perspectives of older adults with a chronic condition on functioning, social participation and health: a qualitative study
Authors: De Coninck Leen , Declercq Anja , Bouckaert Leen , Vermandere Mieke , Graff Maud J.L. , Aertgeerts Bert
Published: October 2019

BackgroundProblems with mobility, functioning and social participation makes living independently difficult for frail older adults. Treatment adherence is a prerequisite for successfully continuing to live independently. The cause of non-compliance among older adults are multiple and complex. Insight into older adults’ perspectives regarding their functioning is essential and an important factor for treatment adherence.Objectives This study investigates the perspectives of older adults on their functioning, social participation and health, and the factors influencing these components.Method We conducted a qualitative study about the older adult’s perceived functioning, social participation and health. Fourteen home dwelling older adults suffering from chronic health issues were purposively selected. Semi-structured interviews were conducted with open-ended questions. Data were analysed following the Basic Logical Model of Abduction and the coding method of Creswell.ResultsAssistive devices, their dwelling and living environment, professional and informal support, and medication are perceived as important determinants. Attitude, social influence and personal effectiveness were found to be of influence whether or not a person will perform an activity, or choose to participate. A person’s attitude is related to the significance the activity has to that person, the importance of the activity, personal wellbeing, their values and the desire for autonomy. Peers and children have a social influence on the level of activity of the older person. Traditions and in particular, religious activities, along with personal effectiveness are motivating factors for whether or not to perform an activity or to participate. Personal effectiveness is linked to the belief in their personal competencies and to the relationship between effort and result.Finally, it appears that the type of coping strategy the older adult adopts, has an influence on his or her behavior. The older adults often used remarkable problem-focused strategies, which had a positive effect on their level of autonomy.ConclusionOlder adults have identified barriers and facilitators that influence their level of functioning and social participation. These findings help to create a framework for maintaining and increasing treatment adherence. This conceptual framework may be helpful in facilitating occupational therapists and other healthcare professionals to detect determinants of treatment adherence.
Enablers And Barriers To Utilisation Of Available Formal Support By Institutionalised Individuals With Alzheimer’s Disease And Related Dementias In Rural South Western Uganda: A Qualitative Descriptive Study
Authors: NIYONZIMA VALLENCE , Maling Samuel , Chemali Zeina
Published: October 2019

Background: The world’s population is ageing resulting in a larger number of people living with dementia. Prevalence of dementia for persons aged above 60 years is expected to increase . There is paucity of information regarding formal support available for institutionalised individuals with AD/ADRD, enablers and barriers to its utilisation particularly South Western Uganda. Therefore this study, filling this knowledge gap, sought to assess formal support available for individuals with AD/ADRD, enablers and barriers to its utilisation in rural communities in South Western Uganda Methods: This study was conducted in two nongovernmental community based facilities for the elderly in South Western Uganda employing a qualitative cross sectional study design. Purposive sampling was used to recruit caretakers of individuals with Alzheimer’s disease and related dementias. A total of 28 in depth interviews and 6 key informant interviews were conducted. Results: Three arching themes emerged: 1) Formal support services available, 2) Enablers and 3) Barriers to the utilisation of the formal support services in institutionalised patients with AD/ADRD in rural communities in South Western Uganda. Conclusions: These findings highlight the importance of formal care in the long-term care of individuals with AD/ADRD. There is a dire need to equip caretakers involved in the care of patients with AD/ADRD with the required skill set and include formal support services in the mainstream primary health care to make the services accessible.