bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and content validity of the Abilitator – a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position
Authors: Wikström Miia , Anttila Heidi , Savinainen Minna , Kouvonen Anne , Joensuu Matti
Published: August 2019

Abstract

Background

The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position.
Methods
The Abilitator was developed in 2014–2017. Its construct was assessed by the members of academic expert panels (n=30), practical expert panels of service actors (n=700) and target group clients (n=28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels’ feedback. The Abilitator was also implemented among target group clients (n=3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel.
Results
The construct of the Abilitator combines the multidimensional and bio-psycho-social models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator’s 79 ICF codes covered 50% of the Generic, 73% of the Brief Vocational Rehabilitation, and 17% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 29% and 39%, respectively.
Conclusions
The Abilitator covers the relevant aspects sufficiently comprehensively to enable the assessment of the overall work ability and functioning of the population with weak position in the labour market.
Level of folic acid awareness for the prevention of neural tube defects and associated factors among pregnant women in Adama, South East Ethiopia
Authors: DESSIE MESELECH AMBAW , Berihun Ayanaw Worku
Published: August 2019

Abstract Background: Neural tube defects are congenital anomalies of the brain, spinal cord, and their surrounding structures. Folic acid intake before and during the early weeks of pregnancy could reduce neural tube and other birth defects. Folic acid usage in the protective period of pregnancy against the neural tube defects is related to high level of awareness. This study aimed at evaluating the level of folic acid awareness for the prevention of neural tube defects and associated factors among pregnant women in Adama, South East Ethiopia. Method: A descriptive cross-sectional study design was used. 398 consented pregnant women attending antenatal care in Adama were the participants of the study. The women were selected by using a systematic random sampling method. A structured pre-tested interviewer-administered questionnaire was used to collect the data. The questionnaire was concerned with participants’ demographic information, and their awareness about folic acid, roles of folic acid, and the recommended time of intake. Data were analyzed using SPSS version 20 statical software. Simple and multiple binary logistic regression analyses were conducted. 95% confidence interval and p-value were used to evaluate the association between dependent and independent variables. Results: Of the interviewed women, 20.9% reported having heard or read something about folic acid supplements. But only 1.01% and 6.03% were aware of the recommended time of intake and the role of folic acid in preventing neural tube defects and other congenital anomalies respectively. The healthcare providers were the primary source of information about folic acid, which account 78.3%. Folic acid awareness was associated with age, educational status, household monthly income, week of pregnancy at the first antenatal visit, any complication during current pregnancy, and use of folic acid during current pregnancy. Conclusions: Most of the pregnant women were not aware of folic acid, its importance and the recommended time of intake for preventing neural tube defects. Further effort is required from policymakers, healthcare providers, the media, and community to increase women's awareness about folic acid. Keywords: Folic acid, Awareness, Neural tube defects
Can we optimise doxorubicin treatment regimens for children with cancer? Pharmacokinetic simulations and a Delphi consensus procedure
Authors: Siebel Christian , Würthwein Gudrun , Lanvers-Kaminsky Claudia , André Nicolas , Berthold Frank , Castelli Ilaria , Chastagner Pascal , Doz François , English Martin , Escherich Gabriele , Frühwald Michael C. , Graf Norbert , Groll Andreas , Ruggiero Antonio , Hempel Georg , Boos Joachim
Published: August 2019

Background

Despite its cardiotoxicity doxorubicin is widely used for the treatment of paediatric malignancies. Current treatment regimens appear to be suboptimal as treatment strategies vary and do not follow a clear pharmacological rationale. Standardisation of dosing strategies in particular for infants and younger children is required but is hampered by scarcely defined exposure-response relationships. The aim is to provide a rational dosing concept allowing for a reduction of variability in systemic therapy intensity and subsequently unforeseen side effects.

Methods

Doxorubicin plasma concentrations in paediatric cancer patients were simulated for different treatment schedules using a population pharmacokinetic model which considers age-dependent differences in doxorubicin clearance. Overall drug exposure and peak concentrations were assessed. Simulation results were used to support a three round Delphi consensus procedure with the aim to clarify the pharmacological goals of doxorubicin dosing. A group of 28 experts representing paediatric trial groups and clinical centres were invited to participate in this process.

Results

Pharmacokinetic simulations illustrated the substantial differences in therapy intensity associated with current dosing strategies. The Delphi panel members recognised the clinical relevance of variability in therapy intensity and the need for optimisation of treatment regimens. Consensus among the panel members was obtained on a standardised a priori dose adaptation that individualises doxorubicin doses based on age and body surface area targeting uniform drug exposure.

Conclusions

A Delphi consensus procedure informed by pharmacokinetic simulations was successfully applied to specify the pharmacological goals of doxorubicin dose adaptations in children with cancer and to formulate a consistent dosing concept potentially improving the safety of doxorubicin administration.
Identification of candidate genes responsible for morphological and yield-related traits via genome-wide association analysis (GWAS) in oil palm (Elaeis oleifera x Elaeis guineensis)
Authors: Osorio Jaime , Garzón Gina , Delgadillo Paola , Bastidas Silvio , Moreno Leidy , Enciso Felix , Cornejo Omar , Barrero Luz Stella
Published: August 2019

Background
The genus Elaeis has two species of economic importance for the oil palm agroindustry: Elaeis oleifera (O), native to the Americas, and Elaeis guineensis (G), native to Africa. The breeding program in Colombia relies on interspecific OxG crossing populations with tolerance to pests and diseases, high oil quality, and acceptable fruit bunch production. The identification of loci associated to morphological and yield-related traits and the dissection of their genetic architecture will provide essential insights for oil palm breeding strategies.

Results
The genotypes of 471 oil palms, including 62 E. oleifera (O), 31 E. guineensis (G) and 378 OxG samples were analyzed in this study. A total of 3,776 single nucleotide polymorphisms (SNP) were detected across the 16 oil palm chromosomes using the genotyping-by-sequencing (GBS) technique. The genetic variation and population structure analyses grouped the samples into two clades according to the parental relatedness. A genome wide association analysis (GWAS) was conducting using the OxG hybrid population, resulting in 12 SNPs significantly associated with ten different morphological and yield-related traits.

Conclusions
The work presented herein provides to our knowledge the first association mapping study in an interspecific OxG hybrid population of oil palm. We provide new insights on candidate genes involved in tissue development and plant architecture associated to traits such as: rachis length, trunk diameter, bunch number, and bunch weight. The genes identified in our analysis are putative candidates for future targeted functional analysis. They are valuable resources for the development of marker-assisted selection in oil palm breeding.

Keywords: Association mapping, Elaeis guineensis, Elaeis oleifera, genotyping-by-sequencing, plant architecture, yield.
Alterations in leaf photosynthetic electron transport in Welsh onion (Allium fistulosum L.) under different light intensity and soil water conditions
Authors: Liu Xuena , Gao Song , Liu Ying , Xu Kun
Published: August 2019

Background: Welsh onions are often affected by stressful environments, such as high light and drought, during summer cultivation, which hinders their growth. To date, few studies have focused on leaf photosynthesis of Welsh onions during summer. We used carbon dioxide assimilation and OJIP transient and MR curves to analyze the photosynthetic characteristics of Welsh onions.
Results: The results showed that strong light and drought could lead to a decrease in leaf pigment content. Simple high light stress caused a decrease in the net photosynthetic rate through stomatal limitation, while the simple drought treatment and the two stress factors combined caused a nonstomatal limitation. PSII energy distribution indicated that strong light and drought stress reduced the photochemical quantum efficiency of PSII. OJIP curve analysis showed that FO and FJ were increased, Fm was decreased, and a distinct K-phase was induced. In addition, OJIP parameters, including RC/CSO, TRO/ABS, ETO/TRO, and PIABS, were significantly reduced. MR analysis showed that strong light and drought stress blocked MR transients, leading to a gradual decrease in VPSI and VPSII-PSI.
Conclusions: In general, the photosynthesis of Welsh onion was inhibited by high light and drought, which destroyed the receptor and donor side of PSII and reduced the electron transport capacity of PSII and PSI.
Transcriptome analysis of drought-tolerant sorghum genotype SC56 in response to water stress reveals an oxidative stress defense strategy
Authors: Olden Farida , Hunt Arthur G. , Dinkins Randy
Published: August 2019

Background Drought tolerance is a crucial trait for crops to curtail the yield loss inflicted by water stress to crops, yet genetic improvement efforts are challenged by the complexity of this character. The adaptation of sorghum to abiotic stress, its genotypic variability, and relatively small genome make this species well-suited to dissect the molecular basis of drought tolerance. One efficient approach to this question is the use of differential transcriptome analysis, which provides a snapshot of the processes underlying drought response as well as genes that might be determinants of the drought tolerance trait. Results RNA sequencing was used to compare the transcriptome profiles of two sorghum lines, the drought-tolerant SC56 and the drought-sensitive Tx7000. The differential expression analysis revealed unambiguous genotypic disparities, including a massive increase of upregulated transcripts in SC56. Concomitantly, gene ontology enrichment showed that SC56 biologically outperformed Tx7000 in wet conditions, since it upregulated processes driving growth and guaranteeing homeostasis. The drought tolerance of SC56 seems to be an intrinsic trait that occurs through the overexpression of stress tolerance genes in wet conditions, notably those acting in defense against oxidative stress (SOD1, SOD2, VTC1, MDAR1, MSRB2, and ABC1K1). Under drought conditions, SC56 enhanced its transmembrane transport and maintained growth-promoting mechanisms similar to those implemented under wet conditions. SC56 also appears to preserve its biological function, in a limiting environment, by relying on reported validated stress tolerance genes that heighten the antioxidant capacity (SOD1, RCI3, VTE1, UCP1, FD1, and FD2), regulatory factors (CIPK1 and CRK7), and repressors of premature senescence (SAUL1). Of the stress tolerance genes overexpressed under both wet and drought conditions, DHAR2 might be a key determinant of drought tolerance since its role in recycling ascorbic acid was described to be directly linked to protection against reactive oxygen species-mediated damage, positive effects on photosynthetic activity, higher rate of plant growth, and delayed leaf aging. Conclusion The differential expression analysis uncovered biological processes which upregulation enables SC56 to be a better accumulator of biomass and connects the drought tolerance trait to key stress tolerance genes, making this genotype a judicious choice for isolation of tolerance genes.
OsPDR2 Mediates the Regulation on the Development Response and Maintenance of Pi Homeostasis in Rice
Authors: Cao Yue , Jain Ajay , Ai Hao , Liu Xiuli , Wang Xiaowen , Hu Zhi , Sun Yafei , Hu Siwen , Shen Xing , Lan Xiaoxia , Xu Guohua , Sun Shubin
Published: August 2019

Background: Phosphate (Pi), is the least accessible macronutrient in many natural and agricultural ecosystems and its low availability often limits plant growth and productivity. In Arabidopsis thaliana (Arabidopsis), Phosphate Deficiency Response2 (AtPDR2), interacts genetically with Low Phosphate Root1 (AtLPR1) in the endoplasmic reticulum (ER), play a key role in Pi deficiency-mediated inhibition of the primary root growth and remodeling of the root system architecture (RSA). However, the role of OsPDR2, the homolog of AtPDR2, either in roots response to Pi deficiency and/or in growth and development has not been elucidated as yet.
Results: Therefore, we investigated the spatiotemporal effects and the availability of Pi on the relative expression levels of OsPDR2 by employing qRT-PCR. OsPDR2 showed variable levels of relative expression pattern in vegetative and/or reproductive tissues analyzed at different stages of growth and development (5-17 weeks). Transient expression analysis revealed its subcellular localization to the ER. Further, the reverse genetics approach was employed for determining the function of OsPDR2 by RNAi-mediated suppression. Three independently generated RNAi lines (Ri2, Ri9, and Ri18) were compared with the wild-type (WT) for various vegetative and reproductive traits. The study revealed significant inhibitory effects of RNAi-mediated suppression of OsPDR2 on the root and male reproductive traits, and yield. Moreover, 32P isotope labeling and split-root experiments under different Pi regime with RNAi lines and the WT revealed the role of OsPDR2 in the maintenance of Pi homeostasis.
Conclusions: The results from this study revealed the key role of OsPDR2 in the growth and development of rice and maintenance of phosphate homeostasis.
Knowledge, attitude and practice regarding therapeutic communication among nurses in Kandy District, Sri Lanka
Authors: Dissanayake Dilrukshi , jayasinghe Rasika Manori , Abeysundara Sachith
Published: August 2019

Background

Therapeutic communication is considered as a skill required for all health care workers in order to improve understanding the patient in a better manner and encouraging the patient to express feelings & ideas. It has also been accepted as a high standard of nursing care which is to be practiced at every hospital and nursing facility. As practice of therapeutic communication improves outcome of nursing care, objective of this study was to assess the level of knowledge, attitude and practice regarding therapeutic communication among nurses in teaching hospitals in the Kandy district, Sri Lanka. Specific objectives were to determine the factors affecting practice of therapeutic communication and to evaluate the self- satisfaction of therapeutic communication among participants.

Methods

A cross sectional study design was employed to gather data by a structured self-administered questionnaire involving 200 nurses working in teaching hospitals in Kandy, Sri Lanka. Results were analyzed by MINITAB version 18.

Results

Around 63.63% nurses were strongly favorable towards the fact that active listening is the most important part in therapeutic communication between patient and the nurse. The majority of participants were with the attitude that therapeutic communication prevents medical errors which could occur when treating patients. Fifty-nine percent of nurses always applied therapeutic communication in pre-operative & post-operative care. There was a statically significant association between socio-demographic variables and knowledge, attitudes and practice of therapeutic communication among the study population. Majority agree to promote the therapeutic communication in their clinical setting. However, increased workload at the hospital was named a barrier by many participants.

Conclusions

A statistically significant association exists between educational status,position & number of years in service and knowledge, attitude & practice of therapeutic communication. Active listening is considered the most important part in therapeutic communication which prevents medical errors of patients. Majority agree to promote the practice in their clinical setting, but consider that it would increase their workload. Findings reveal the necessity of introducing awareness programs and workshops preferably by the authorities concerned highlighting advantages of applying therapeutic communication in the nursing practice.
A Qualitative Study of Physician Perspectives on Adaptation to Electronic Health Records
Authors: Sieck Cynthia Judine , Pearl Nicole , Bright Tiffani J. , Yen Po-Yin
Published: August 2019

Background Electronic Health Records (EHRs) have the potential to improve many aspects of care and their use has increased in the last decade. Because of this, acceptance and adoption of EHRs is less of a concern than adaptation to use. To understand this issue more deeply, we conducted a qualitative study of physician perspectives on EHR use to identify factors that facilitate adaptation.Methods We conducted semi-structured interviews with 9 physicians across a range of inpatient disciplines at a large Academic Medical Center. Interviews were conducted by phone, lasting approximately 30 minutes, and were transcribed verbatim for analysis. We utilized inductive and deductive methods in our analysis.Results We identified 4 major themes related to EHR adapation: impact of EHR changes on physicians, how physicians managed these changes, factors that facilitated adapation to using the EHR and adapting to using the EHR in the patient encounter. Within these themes, physicians felt that a positive mindset toward change, providing upgrade training that was tailored to their role, and the opportunity to learn from colleagues were important facilitators of adaption.Conclusions As EHR use moves beyond implementation, physicians continue to be required to adapt to the technology and to its frequent changes. Our study provides actionable findings that allow healthcare systems to focus on factors that facilitate the adaptation process for physicians.
The epidemiological and clinical characteristics of hand, foot and mouth disease in Hangzhou, China, 2016-2018
Authors: Wang Jie , Zhou Jun , Xie Guoliang , Zheng Shufa , Lou Bin , Chen Yu , Wu Yidong
Published: August 2019

Background Hand, foot and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV71), Coxsackievirus A16 (CV-A16) or other types of EV. Children under 5 years old are the most susceptible to HFMD. The aim of this study was to determine the epidemiological characteristics and the relationship between severe and mild HFMD. Methods We collected 4760 probable HFMD cases with skin papular or vesicular rashes on the hands, feet, mouth or buttocks in Hangzhou from 2016 to 2018. Specimens of these cases were collected and the pathogen of EV71, CV-A16, CV-A6, CV-A10, CV-A2 and CV-A5 was classified by RT-PCR. Then the pathogen distribution and clinical status of children with HFMD were described. Results From Jan. 1, 2016 to Dec. 31, 2018, the incidence and prevalence of HFMD were seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%, 3559/4760), including 426 cases of EV71 infections (8.9%, 426/4760, 249 cases of CV-A16 infections (5.2%, 249/4760) and 2884 cases of other enteroviruses infections (60.6%, 2884/4760). The percentage of EV positive HFMD cases with non-EV71 and non-CV-A16 was more than 80% (2884/3559), which increased year by year. The percentage of EV71 decreased year by year in the last three years especially in 2018. Among the 1297 cases randomly selected of other EV infections in 2017 and 2018, there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02%) cases of mixed infections and 11.0% untyped enteroviruses infections. Preschool children were still the primary population susceptible to HFMD, and the age of the children infected with other enteroviruses tended to be younger. In severe cases, EV71 infection was the main cause. Conclusions The other EV especially CV-A6 increased obviously and EV71 decreased obviously in the three years. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.
Eosinophilia and Risk of Incident End Stage Kidney Disease
Authors: Tariq Anam , Okamato Keisuke , Tariq Azka , Rosenberg Avi Z. , Soliman Karim , Ploth David W. , Atta Mohamed G. , McMahon Blaithin A.
Published: August 2019

Background
Eosinophils in kidney disease are poorly understood and are often incidental findings on kidney biopsy. Eosinophilia in blood and renal biopsy tissue is associated with a host of immune and non-immune kidney diseases. The significance of eosinophilia in renal diseases has not been well addressed. We evaluated the incidence of peripheral eosinophilia (>4% of blood leukocytes) with biopsy tissue eosinophilia and their association with end-stage-kidney-disease (ESKD).

Methods
A nested case-control of patients who underwent kidney biopsies at Johns Hopkins Hospital and Medical University of South Carolina from 2004-2018 were included in the study. From the 616 eligible patients, 178 patients were identified through the registry of kidney biopsies as 18 years or older without missing biopsy reports or hematology results. Controls had no ESKD at the time of case definition and assembled using incident density sampling, matched on age and sex. The association of peripheral eosinophilia (>4% of peripheral blood leukocytes) with the risk of progression to ESKD was evaluated using conditional logistic model after adjusting for clinical demographics.

Results
Among 178 patients, 65 (37%) had peripheral eosinophilia and 113 (63%) had no eosinophilia. Compared to patients without eosinophilia, patients with peripheral eosinophilia were notably male and had a higher serum creatinine at the time of their biopsy. Peripheral eosinophilia was significantly associated with higher risk of ESKD (OR 6.2 [1.6, 23.8]) adjusted for patient demographics including hypertension, proteinuria, race and eGFR at the time of kidney biopsy. Peripheral eosinophilia had a significant linear association with tissue eosinophilia, 22 (SD 20) per high power field (hpf) in 4-10% peripheral eosinophilia, 19 (SD 18) hpf in >10% eosinophilia and 3 (SD 7) hpf in no eosinophilia (P <0.001).

Conclusions
Peripheral eosinophilia is an independent predictor of tissue eosinophilia and subsequent progression to ESKD. Peripheral eosinophilia may be an early biomarker for underlying inflammation and disease, but further studies to investigate this clinical association are warranted.
Error in the Automatic Bolus Tracking System in Dynamic Computed Tomography: Preliminary Case Results
Authors: Kim Myeong Seong , Choi Jiwon , Kweon Dae Cheol
Published: August 2019

Background: Multidetector computed tomography (CT) images of the liver can be obtained rapidly, and parenchymal lesions can be detected using an iodine-containing contrast medium. In such imaging, the time to peak enhancement is important for optimal lesion detection. When using the bolus tracking system (BTS), the CT commences after a threshold Hounsfield unit value is reached. Methods: In current BTS, contrast medium is injected into blood vessels at a high speed using an automated injector; however, it may cause movement in the vessel in which the region of interest (ROI) is set, so that the timing of the scan is affected, leading to indeterminate artery and portal phase in angiography or liver dynamic examination. We therefore aimed to identify the cause of failure of CT due to an error in BTS and to suggest an appropriate preventive method. Results: Subjects underwent BTS-CT angiography and abdominal examinations in two university hospitals using a 64-detector CT scanner. An automatic BTS was used to time the start of the scanning when the injected contrast medium reached the threshold level in the ROI. Errors in bolus tracking were divided into patient-related and machine-related errors. Among 2,000 patients who underwent BTS-CT, error was observed in 15 cases, in which the bolus tracking timing was shifted as a result of movement of the patient or respiratory changes due to the rapid injection of contrast medium, which led to CT failure. Conclusions: To reduce CT-BTS failures, the patient's position and the change in the position of the blood vessels due to the patient's breathing pattern should be carefully considered, and the ROI should be set to a sufficiently small area in the blood vessel.
Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review
Authors: Lyutakov Ivan Aleksandrov , Ursini Francesco , Penchev Plamen Ivanov , Caio Giacomo , Carroccio Antonio , Volta Umberto , De Giorgio Roberto
Published: August 2019

BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.ObjectiveTo perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with bile acid malabsorption.DesignA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one tests was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.
An Observational Review and Analysis of Qualitative Data to Explore the Benefits of Equine Assisted Learning in Improving the Engagement of Adolescents with Complex Learning Needs, within the Educational Setting
Authors: Madders Gabrielle , Orrell-Stokes Ruth M
Published: August 2019

The study determined whether Equine Assisted Learning (EAL) acted as a positive influence to improve the engagement of adolescents with complex learning needs, within their educational setting. The past two years has seen a continuous increase in the number of pupils with complex learning needs in the UK, from 1,244,255 in January 2017 to 1,276,215 in January 2018, an increase from 14.4% to 14.6%. These increasing figures provide a clear rationale for the requirement for a greater utilisation of various learning intervention tools, to begin to meet the dynamic needs of these learners. Seven participants engaged in six EAL sessions over six weeks and were involved in an array of unmounted EAL activities. Questionnaires were formulated with reference to the “Student Engagement (SE) Survey” and were presented to both staff and parents at three points throughout the study, along with Carpenters approved engagement scale for staff to complete weekly, within the lesson following the EAL session. Furthermore, observational research was conducted by the researcher to generate a supportive discussion for the obtained results. Through the quantitative data formulated no significant difference was shown, however a moderate positive correlation between the before and after results of staff and parent questionnaires was presented (Staff Questionnaire p =.119366. Parent Questionnaire p = .145547). Further trends also began to emerge, with correlations forming between improved engagement and specific EAL activities, providing a direction for future research.
Analysis of cash dividend policy in Indonesia stock exchange
Authors: Sri Utami Elok , Ary Gumanti Tatang
Published: August 2019

Dividend policy has been puzzling for researchers for decades. The level of dividend varies not only across industries, but also across countries. This research analyzes the dividend policy of Indonesian public companies, in particular it examines the partial effect of cash ratio, debt ratio, company size, profitability, and asset growth on cash dividend policy in Indonesia Stock Exchange from 2008 to 2015. A total of 102 companies was used as a sample. The samples are divided into four groups: (1) a group of companies paying changeable dividends (Change group), (2) a group of companies paying continuous dividends, but then stop paying dividend (Omission group), (3) a group of companies that initially do not pay the dividends, but then continuously paying dividend (Initiation group); and (4) a group of companies paying constant dividends (Constant group). Results of hypotheses testing using multiple regression analysis show that profitability and asset growth affect dividend policy in all company groups. Company size affects dividend policy in the Change, Initiation, and Constant groups. Debt ratio influences dividend policy only in the Change group.
As doenças relacionadas ao trabalho e a Saúde dos Trabalhadores
Authors: Workers The work-related diseases and Health
Published: August 2019

Editorial
Tornando-se um cuidador de um familiar com Alzheimer: o rito de passagem
Authors: Da Silva Maria Betania Maciel , Medeiros Soraya Maria de , Costa Raphael Raniere de Oliveira , Bosco Filho João
Published: August 2019

Doença de Alzheimer; Cuidadores; Relações familiares.
Morbidade por acidentes e violências nos Hospitais Regionais de Saúde de Mato Grosso e nos Prontos- Socorros da Grande Cuiabá
Authors: Ferreira Junior Paulo Antonio , De Oliveira Elaine Cristina , Ribeiro Manoel Carlos S. de A.
Published: August 2019

Morbidade; Causas externas; Violência; Serviços médicos deemergência.
Instrumentos para avaliação da habilidade técnica e do conhecimento sobre higienização das mãos
Authors: Melo Gabriela de Sousa Martins , Tibúrcio Manuela Pinto , Freitas Camylla Cavalcante Soares de , Liberato Samilly Márjore Dantas , Mendes Cristina Katya Torres Texeira , Torres Gilson de Vasconcelos
Published: August 2019

Desinfecção das mãos; Conhecimento; Questionários; Avaliação em saúde.
Avaliação do processo de gestão em uma secretaria municipal de saúde do estado da Bahia
Authors: Gomes dos Santos Alexandro Gesner , Bárbara da Silva Silvone Santa
Published: August 2019

Evaluating the management process of a municipal Health department in Bahia state, Brazil
Mortalidade por infarto agudo do miocárdio no estado do Espírito Santo de 1999 a 2012: uma análise de tendência
Authors: Santana dos Santos Marina de , Moreira Lopes Rita Simone , Luna Filho Braulio , Fiorin Bruno Henrique
Published: August 2019

Mortality rates due to acute myocardial infarction recorded in Espírito Santo state, from 1999 to 2012: a trend analysis
Elementos históricos da Zika no Brasil
Authors: Fátima de Aquino Danielle , Sampaio Buffon Poliane Barbosa
Published: August 2019

Historical elements of Zika in Brazil
Determinantes sociais do consumo de bebidas alcoólicas por adolescentes
Authors: Garcia Gabira Fernanda , Oliveira Gabriela , Araújo de Oliveira Elizabete Regina
Published: August 2019

Social determinants of alcohol consumption by adolescents
Cisplatin-resistant MDA-MB-231 Cell-derived Exosomes Increase the Resistance of Recipient Cells in an Exosomal miR-423-5p-dependent Manner
Authors: Wang Bing , Zhang Yuzhu , Ye Meina , Wu Jingjing , Ma Lina , Chen Hongfeng
Published: August 2019

Background:

Chemoresistance blunts the therapeutic effect of cisplatin (DDP) on Triple-Negative Breast
Cancer (TNBC). Researchers have not determined to date whether exosomes confer DDP resistance to other breast
cancer cells or whether exosomal transfer of miRNAs derived from DDP-resistant TNBC cells confer DDP resistance.

Objective:

The aim of this study was to investigate the role of exosomes in chemoresistance in breast cancer.

Methods:

MDA-MB-231 cells resistant to DDP (231/DDP) were established. Exosomes were isolated from 231/DDP
cells (DDP/EXO) and characterized by measuring the levels of protein markers, nanoparticle tracking analysis and
transmission electron microscopy. MDA-MB-231, MCF-7 and SKBR-3 cell lines were treated with the isolated
DDP/EXOs and cell proliferation and cytotoxicity to DDP were evaluated using MTT assays and apoptosis analyses.
Western blotting was used to examine P-glycoprotein (P-gp) expression. Additionally, a microarray was used to
analyse microRNA (miRNA) expression profiles in MDA-MB-231 and 231/DDP exosomes. The effects on miRNAs
were determined using RT-PCR. Exosomal miR-423-5p was extracted, and differential expression was verified. The
MTT cell viability assay, flow cytometry, and Transwell and immunofluorescence assays were performed to determine
if differential expression of miR-423-5p sensitized cells to DDP in vitro.

Results:

Under a transmission electron microscope, the isolated exosomes exhibited a round or oval shape with a
diameter ranging between 40 and 100 nm. DDP/EXOs labelled with PKH67 were taken up by MDA-MB-231 cells.
After an incubation with DDP/EXOs, the cell lines exhibited a higher IC50 value for cisplatin, P-gp expression, migration
and invasion capabilities and a lower apoptosis rate. Furthermore, 60 miRNAs from exosomes derived from
231/DDP cells were significantly up-regulated compared to exosomes from MDA-MB-231 cells. Notably, compared
to the corresponding sensitive exosomes, miR-370-3p, miR-423-5p and miR-373 were the most differentially expressed
miRNAs in DDP-resistant exosomes. We chose miR-423-5p, and up-regulation and down-regulation of
exosomal miR-423-5p expression significantly affected DDP resistance.

Conclusions:

Exosomes from DDP-resistant TNBC cells (231/DDP) altered the sensitivity of other breast cancer
cells to DDP in an exosomal miR-423-5p dependent manner. Our research helps to elucidate the mechanism of DDP
resistance in breast cancer.
Ethnobotany and Pharmacology of Pinus Species Growing Naturally in Indian Himalayas: A Plant Review
Authors: Singh Lav , Dixit Pooja , Srivastava Ravi P. , Pandey Shivaraman , Verma Praveen C. , Saxena Gauri
Published: August 2019

Pinus species are amongst the most commonly used medicinal plants in Indian Northwestern Himalayas. Nearly all parts of the plant especially needles are believed to possess medicinal and clinical values in traditional systems of medicine such as Ayurvedic, Unani or Homeopathic. They are used to heal numerous diseases, including afflictions of the skin, eyes, throats and ears. Various parts of the plant including needles are rich in biologically active compounds, such as thunbergol, 3-carene, cembrene, α-pinene, quercetin, xanthone, etc. The scientific data available for the biological potential of this plant and its constituents have been found to be scanty and also does not satisfy the basis of their age-old folklore and local uses. This review focuses on a detailed analysis of ethnopharmacognosical studies on the needles of different Pinus species growing naturally in northwestern region of Indian Himalayas including investigations and findings that have come up with a concrete view of the abilities of plant components for example phenolics, flavonoids, tannins and other constituents to treat oxidative, inflammatory and microbial responses. Careful evaluation of the data presented may be helpful for the researchers to discover and evaluate the specific chemical entities responsible for the traditional medicinal uses of P. roxburghii, P.wallichiana, P. merkusii, P.kesiya and P.thunbergii.
Market Analysis of Medicinal Plants in India
Authors: Ravi Sanskriti , Bharadvaja Navneeta
Published: August 2019

There has been significant growth in the herbal drugs market around the world, over the last few decades due to growing awareness among people about the rising cost as well as side effects related to the use of synthetic drugs. Herbal medicine has been used in traditional medicinal systems around the world, especially India where the oldest systems of medicine namely Ayurveda, Siddha, and Unani make use of more than 90% plant-based formulations. India is rich in medicinal and herbal plants resources that provide for both the health care needs of rural India as well as the source of raw material for therapeutic agents required in the production of traditional and modern medicine. This review article presents an overview of the knowledge of Indian herbal plants based medicine in the national and international market and the trends in its production, sustainability, and promotion.
AMPK: Potential Therapeutic Target for Alzheimer's Disease
Authors: Yang Luping , Jiang Yijing , Shi Lihong , Zhong Dongling , Li Yuxi , Li Juan , Jin Rongjiang
Published: August 2019

Alzheimer's disease (AD) is the most common neurodegenerative disorder. The pathogenesis of AD is very complicated. For decades, the amyloid hypothesis has influenced and guided research in the field of AD. Meanwhile, researchers gradually realized that AD is caused by multiple concomitant factors, such as autophagy, mitochondrial quality control, insulin resistance and oxidative stress. In current clinical trials, the improvement strategies of AD, such as Aβ antibody immunotherapy and gamma secretase inhibitors, are limited. There is mounting evidence of neurodegenerative disorders indicated that activation of AMP-activated protein kinase (AMPK) may have broad neuroprotective effects. We reviewed the researches on AMPK for AD, the results demonstrated that activation of AMPK is controversial in Aβ deposition and tau phosphorylation, but is positive to promote autophagy, maintain mitochondrial quality control, reduce insulin resistance and relieve oxidative stress. It is concluded that AMPK might be a new target for AD by aggressively treating the risk factors in the future.
Decrease in Serum Levels of Adiponectin and Increase in 8-OHdG: a Culprit for Cognitive Impairment in the Elderly Patients with Type 2 Diabetes
Authors: Huang Ting-Fu , Tang Zhi-Pei , Wang Shan , Hu Ming-Wei , Zhan Lu , Yi Yi , He Yong-Li , Cai Zhi-You
Published: August 2019

Background:

Adiponectin and 8-Hydroxy-2′-deoxyguanosine (8-OHdG) are
identified as important biomarkers in the pathogenesis process of type 2 diabetes
mellitus (T2DM). Whether adiponectin and 8-OHdG have a relation to cognitive decline
in the elderly T2DM patients has been poorly understood. The aim of this study was to
evaluate the effects of adiponectin and 8-OHdG in the elderly patients with T2DM and to
determine the role of adiponectin and 8-OHdG in the cognitive impairment of the elderly
patients with T2DM.

Methods::

57 individuals were recruited and analyzed , with 26 cases of T2DM without
cognitive impairment and 31 cases of T2DM with cognitive impairment. All of them
underwent an examination of diabetes scales and blood glucose at different times. A
primary diagnosis of diabetes was in line with the diagnosis criteria set by the American
Diabetes Association (ADA). Statistical significance was defined as a P-value of less
than 0.05.

Results::

The variables of sex, age, body mass index (BMI), hypertension, diabetes,
metabolic syndrome, lacunar cerebral infarction, smoking and drinking in T2DM patients
without cognitive impairment and with cognitive impairment showed no difference
according to the univariate analysis exploring each variable separately (p>0.05). A
significant difference was observed in the serum levels of adiponectin and 8-OHdG and
the scales of MMSE and MoCA (p<0.05).
Therefore,
it
was
inferred
that
there is no
correlation between glucose metabolic value and cognitive outcome of T2DM patients.
Serum levels of adiponectin and 8-OHdG could act as biomarkers of cognitive
impairment degree in the elderly T2DM patients.

Conclusion::

Serum levels of adiponectin and 8-OHdG could act as specific and
sensitive biomarkers for the early diagnosis and treatment of cognitive impairment in
elderly T2DM patients. Serum levels of adiponectin and 8-OHdG have a close relation to
the neurological cognitive outcome of
the elderly T2DM patients.
Recent Progress in the Development of HIV-1 Entry Inhibitors: From Small Molecules to Potent Anti-HIV Agents
Authors: Suttisintong Khomson , Kaewchangwat Narongpol , Thanayupong Eknarin , Nerungsi Chakkrapan , Srikun Onsiri , Pungpo Pornpan
Published: August 2019

Viral entry, the first process in the reproduction of viruses, primarily involves attachment of the viral envelope proteins to membranes of the host cell. The crucial components that play an important role in viral entry include viral surface glycoprotein gp120, viral transmembrane glycoprotein gp41, host cell glycoprotein (CD4), and host cell chemokine receptors (CCR5 and CXCR4). Inhibition of the multiple molecular interactions of these components can restrain viruses, such as HIV-1, from fusion with the host cell, blocking them from reproducing. This review article specifically focuses on the recent progress in the development of small-molecule HIV-1 entry inhibitors and incorporates important aspects of their structural modification that lead to the discovery of new molecular scaffolds with more potency.
Exploring Antimicrobials from the Flora and Fauna of Marine: Opportunities and Limitations
Authors: Venkateskumar Krishnamoorthy , Parasuraman Subramani , Chuen Leow Y. , Ravichandran Veerasamy , Balamurgan Subramani
Published: August 2019

About 95% of earth living space lies deep below the ocean’s surface and it harbors extraordinary
diversity of marine organisms. Marine biodiversity is an exceptional reservoir of natural
products, bioactive compounds, nutraceuticals and other potential compounds of commercial
value. Timeline for the development of the drug from a plant, synthetic and other alternative
sources is too lengthy. Exploration of the marine environment for potential bioactive compounds
has gained focus and huge opportunity lies ahead for the exploration of such vast resources in the
ocean. Further, the evolution of superbugs with increasing resistance to the currently available
drugs is alarming and it needs coordinated efforts to resolve them. World Health Organization recommends
the need and necessity to develop effective bioactive compounds to combat problems
associated with antimicrobial resistance. Based on these factors, it is imperative to shift the focus
towards the marine environment for potential bioactive compounds that could be utilized to tackle
antimicrobial resistance. Current research trends also indicate the huge strides in research involving
marine environment for drug discovery. The objective of this review article is to provide an
overview of marine resources, recently reported research from marine resources, challenges, future
research prospects in the marine environment.
Fast and Efficient One-Pot Three-Component Synthesis of Some 1,2,3,4- Tetrahydro-6-methyl-N-phenyl-5-pyrimidinecarboxamide Derivatives via Biginelli Condensation Reaction
Authors: Gülten Şirin , Gezer Ufuk , Gündoğan Elmas Aksanli
Published: August 2019

Tetrahydropyrimidine (THPM) synthesis has an enormous importance in organic chemistry
and especially in pharmaceutical applications. Pyrimidines are the most active class of N-containing
heterocyclic compounds and have different biological properties. The heterocyclic ring system with a
thio group occupy a unique position in medicinal chemistry. This type of compounds play an important
role in synthetic drugs and in biological processes. Dihydropyrimidinethione derivatives occur widely
in nature. Several modifications of THPM-5-carboxamides have attracted considerable interest of medicinal
chemists due to their pharmacological and therapeutic properties. A series of 1,2,3,4-tetrahydro-
2-pyrimidinone/thione derivatives bearing a phenylcarbamoyl group at C-5 position were synthesized
by one-pot three-component Biginelli condensation reaction. The reaction of acetoacetanilide as the
1,3-dicarbonyl component with various aromatic aldehydes and urea/thiourea in the presence of a catalytic
amount of p-toluenesulfonic acid monohydrate (PTSA·H2O) or concentrated HCl as an efficient
catalyst leads to Biginelli compounds. We have prepared eight THPM 5-carboxamide derivatives, four
of them are new compounds. Their structures were confirmed by spectroscopic techniques and elemental
analysis. These compounds have potential applications in organic synthesis and medicinal
chemistry. We have synthesized a series of THPM-5-carboxamides by simple and efficient threecomponent
Biginelli condensation reaction. Significant benefits of the present procedure include: a)
application of inexpensive, non-toxic, environmentally friendly and easily available catalysts, b) the
reactions are easy to carry out without high temperature and the workup is very simple, c) the required
reaction times are relatively short (30-80 min with HCl and 8-24 h with PTSA·H2O), d) compatibility
with various functional groups, e) the products are isolated in good to excellent yields (50-95%).