bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing ethical considerations and research methods in children research
Authors: Abrar Mukhlash , Sidik Ezis Japar
Published: November 2020

Research involving children and young people has a particular challenge in comparison to research involving adults. Of this particular challenge is related to the issues of ethical considerations and research methods that the researchers have to commit when conducting research. These are two essential research components and integrally linked to one another because they determine the quality and integrity of the research being conducted. These issues require thorough consideration and implemented differently from the research involving adults. Therefore, this paper aimed to discuss the ethical issues and research methods in researching children and critically evaluate these issues from the research practices by taking the cases of the articles in Teaching English to Speakers of Other Languages. Three articles were selected for further analysis to identify the ways the authors address these issues in their articles. The findings indicated that the authors mainly reported common ethical principles, such as voluntary participation and anonymity, but did not explicitly outline the ethical procedures specific for their children participation in their papers. There was also no indication that they employed appropriate methods to work with children such as using child-friendly methods encouraging children’s participations and giving them space to express opinions and thoughts.
Arrangment of responsibility character module using expert validation
Authors: Astuti Budi , Mufrihah Arina
Published: November 2020

This study aims to produce responsibility character module to improve student self-regulated learning. The research method uses research and development. The research subjects involved in the need assessment were 248 students of Guidance and Counseling, School of Education, Universitas Negeri Yogyakarta which was obtained by random sampling technique. Data collection using the scale of self-regulated learning. The scale of selfregulated learning is adapted from Zimmerman's theory which consists of three aspects: cognitive, motivation and behavioral aspects. Data were analyzed using mean test. The result of the need assessment is used as a reference to develop the responsibility character module to improve student self-regulated learning. This study successfully created a module of responsibility character to improve university students’ self-regulated learning which is consisted of 12 materials that had been validated and revised; therefore it is eligible to be implemented in the self-regulated learning context.
The effectiveness of practicum-based worksheet based on salt hydrolysis material viewed from the aspect of laboratory skills and interpersonal intelligence learners
Authors: Astuti Elsa Ari , Wardani Sri , Kadarwati Sri , Kasmui Kasmui
Published: November 2020

This study aims to determine the effectiveness of a practicum worksheet (LKPPD) based on guided inquiry and the response of learners as users.  The effectiveness of LKPPD is seen from aspects of laboratory skills and students' interpersonal intelligence on hydrolysis material. This type of research is qualitative and quantitative. Data collected by interview, observation, and questionnaire. The results showed that LKPPD that has been developed is effective because 76% of students have laboratory skills with very high category and 96.5% of students have interpersonal intelligence with a minimum category high. In addition, this LKPPD received a positive response from learners as users with a percentage score of 77.9%.
Developing instruments of teacher’s perception of critical thinking in elementary school
Authors: Rahmawati Eni , Harun Harun
Published: November 2020

This study aims to develop the teacher's perceptions of critical thinking in science learning in elementary schools. The samples in this study were 50 elementary school teachers in Central Java. Selection of samples employed convenience sampling. The instruments in this study used a modified Likert Scale. The validity tests used in this research were content validity and construct validity. Content validity was measured using CVR (Content Validity Ratio) and construct validity was measured using EFA (Exploratory Factor Analysis). By using SPSS, reliability estimation was obtained with  the Cronbach Alpha formula 0.83 and it can be stated that the instruments for evaluating teacher perceptions of critical thinking in science learning are reliable.
Quality assurance mechanisms and universal basic education goal achievement in public secondary schools of Kwara State, Nigeria
Authors: Sayuti Omosidi Abdulrahman , Adetiba Atolagbe Adedapo , Tukur Muritala Abdulyaqin , Abubakar Lawal Abdulmumin
Published: November 2020

This paper examines quality assurance mechanisms as correlates of goal achievement of Universal Basic Education (UBE) in public secondary schools of Kwara State, Nigeria. A structured questionnaire was developed and issued to collect information from the study samples. The questionnaire was administered to one thousand, five hundred (1.500) respondents. Data collected were analysed using mean, standard deviation, factor analysis, correlation analysis and regression analysis. The results of the study revealed that instructional supervision, staff development practices, continuous assessment and learning environment had a significant positive relationship with goal achievement in UBE public secondary schools. From the results, it was recommended among others that ministry of education should organise workshops and seminars on quality assurance mechanisms, so that principals and teachers could gain in-depth knowledge and understanding of the identified quality assurance mechanisms.
Feasibility test application of information systems in the media as a learning in vocational school
Authors: Widodo Jumiyanto , Sutaryadi Sutaryadi , Dirgatama Chairul Huda Atma , Wirawan Arif Wahyu
Published: November 2020

This study aims to determine the level of eligibility of the application of staffing information systems as a learning media for automation of staffing governance in the Vocational. This research method uses quantitative research methods. Data collection techniques are done using a questionnaire and analysis of needs using quantitative data analysis. Based on the results of the feasibility test on the application of the staffing information system as a learning media for automation of the governance of staffing above it was concluded that the application of the staffing information system can be categorized as very suitable for use in the learning process in the Vocational School in the Field of Automation and Office Management. Based on the results of the assessment of material experts, validation of media experts, expert practitioners and materials that show the results of the assessment of 89.2% of material experts; 95% assessment of media experts; 90% of expert practitioners, so the application is very feasible to use in the learning process.
Feasibility of electromechanical basic work e-module as a new learning media for vocational students
Authors: Hamid Mustofa Abi , Yuliawati Lely , Aribowo Didik
Published: November 2020

This study aims to develop and determine the feasibility of E-Module learning media in Electromechanical Work Basic Subjects. This research is a development research using ADDIE model. The product developed is e-module learning media on subjects in Electromechanical Basic Work. Data collection is done by means of observation, interviews and questionnaires. The data analysis technique used in this research is descriptive analysis. This research was conducted on 128 students of 10th grade Department Electrical Installation Engineering in Vocational High School in Serang, Banten. The results of the research are Media validation is very feasible with a percentage of 95.3%. Material validation is very feasible with a percentage of 97.9%. The results of the questionnaire evaluation data of small group trials get an average percentage value of 91.7% and in the very feasible category. The results of the assessment in the large group trial data questionnaire received very decent results with a percentage of 92.4%. The results of the exercises carried out an average value of 92.1 before using learning media the average value obtained by students 80.5. The results of the evaluation scores get an average value of 88.5. The e-module learning media in Electromechanical Basic Work subjects can facilitate students in the learning process and facilitate the teacher in teaching.
Translation of mathematical representation: characteristics of verbal representation unpacking
Authors: Rahmawati Dwi , Anwar Rahmad Bustanul
Published: November 2020

The translation between mathematical representations was one of the indicators in understanding mathematical concepts. Understanding the things related to the process of student representation translation was very important in learning mathematics. One of the activities that plays a role in translation was unpacking the source. This study aimed to determine the characteristics of student activity in unpacking the source when doing the process of translational verbal representation to the graph. This research was using a qualitative research. The subject of this research were twenty mathematics education students. Selection of research subjects used purposive sampling. The data were collected by test and interview. The results showed that the characteristics of student activity in unpacking the source were two that are drawing scheme of verbal situation and interpreting verbal information with its own language. In addition, there were still many students failed in translation because of difficulties in unpacking the source. The results of this study were expected to add insight into learning to minimize student difficulties in unpacking the source.
Implementation of Dakon-themed game media: Encourage curiosity 21st century in primary school
Authors: Inayah Arih Afra , Zubaidah Enny
Published: November 2020

Thematic learning, especially thematic integrative, basically requires the optimization of the use of varied learning media so that it will help students in understanding the concepts of material which are abstract. Therefore, the use of learning media is important in learning. This study aims to reveal: 1) the eligibility of Dakon-themed game media on the topic “Where I Live”, and 2) the effectiveness of Dakon-themed game media in improving the curiosity of grade IV students of elementary school. This development research was conducted in Kulonprogo Regency, Special Region of Yogyakarta, Indonesia and developed the media according to the 10 steps developed by Borg Gall. The testing subjects consisted of 9 students in the initial field trial phase, 34 students in the main field trial and 74 students in the operational field trial which were divided into experimental and control groups. The data collection was trough tests, expert rating scale and response questionnaire. The effectiveness of the media of media on the theme of topic Where I live in improving the curiosity of analytical students with N-gain, and t-test with an alpha level of 0.05.The results reveal that: (1) the developed Dakon-theme on the topic Where I Live meets the eligibility criteria based on the results of the validation with very feasible criteria; and (2) the developed game is effective in improving curiosity of the fourth grade students of elementary schools.
Overcoming self-confidence of Islamic religious education students: The influence of personal learning model
Authors: Hamzah Hamzah , Sukenti Desi , Tambak Syahraini , Ummi Tanjung Wisudatul
Published: November 2020

Research on student confidence has been done a lot, but the focus in the field of personal learning models has not been found. This study aimed to determine the strengthening of personal learning models in developing student self-confidence. A total of 688 students were recruited as research samples using questionnaires as data collection techniques, and analyzed using simple linear regression. This research found that personal learning models can significantly develop students' self-confidence in Islamic Religious Education subjects. The personal learning model used by the teacher is quite strong in overcoming students' self-confidence in learning Islamic religious education. Predictable, if the personal learning model is maximally applied by Islamic religious education teachers in learning, to be "strong" for increase the self-confidence of students in learning Islamic religious education. This study concludes that the teacher's personal learning model can develop students' self-confidence in learning Islamic religious education. The findings of this study develop students' self-confidence theories by applying personal learning models in teacher education activities. In addition, opening a discussion room is very intense for other researchers in developing the self-confidence of students in the learning of Islamic education in schools.
Attitudes of the english language university instructors towards the use of technology in teaching and learning
Authors: Motamedi Vahid
Published: November 2020

The outburst of information technology in the later parts of the twentieth century has taken the whole world into its scope. There is an ever growing use of computers in the workplaces and universities. The purpose of this study was to measure the attitudes of the English language university instructors towards the use of computers. It was a descriptive study and data was collected by a survey. This study’s population consisted of two hundred university instructors equally divided into male and female. These instructors were randomly selected from different universities. The findings revealed that there was a significant difference between the views of the males and females instructors. Moreover, those who had no professional qualification had the highest mean score. The English language university instructors should be trained in the use of computers so that they might be able to use them more effectively in classroom settings.
Levels and degradability of crude protein in digestive metabolism and performance of dairy cows
Authors: Alves Bruna Gomes , Martins Cristian Marlon de Magalhães Rodrigues , Sousa Dannylo de Oliveira , Arcari Marcos André , Rennó Francisco Palma , Santos Marcos Veiga
Published: November 2020

Two experiments were conducted to evaluate the effect of the level and degradability of crude protein (CP) on the digestive metabolism and productive performance of dairy cows. In both experiments, 15 Holstein cows with 585 ± 40 kg of body weight were distributed in a Latin square design with five contemporary squares, three periods of 21 days and three treatments. In experiment 1, treatments consisted of three CP levels (130, 160 or 180 g CP/kg DM), while in experiment 2, the treatments consisted of three levels of rumen degradable protein (RDP; 80, 100 or 120 g RDP/kg DM) in diets with average of 163 g CP/kg DM. Variables evaluated in both experiments were dry matter intake (DMI), total apparent digestibility, milk yield (MY) and composition, ruminal fermentation and N balance. In experiment 1, the increase of CP from 130 to 180 linearly increased the organic matter, CP, neutral detergent fiber (NDF) and acid detergent fiber (ADF) intake (kg) and the apparent total digestibility coefficient of DM and CP. In addition, a linear increase of MY, fat corrected milk (FCM) and daily production of fat, protein, lactose, casein and total solids was observed. A linear increase in ruminal ammoniacal nitrogen (NH3-N) concentration and nitrogen excretion in milk, feces and urine was also observed. However, there was no observed effect on SCFA concentration. In experiment 2, the increase of the RDP from 80 to 120 increased the DMI, MY, FCM, milk protein content and digestibility coefficient of the NDF, ADF and ethereal extract. Additionally, there was an increase in NH3-N concentration and milk nitrogen excretion. The studies indicated that the increase of CP content up to 100 g RDP/kg DM increased the DMI and the productive performance of the cows, but also increased urine N. Thus, it is desirable that the increase of the CP through the increase of the RDP is carried out up to 100 g of RDP/kg DM, since there is elimination of nitrogen, decrease of milk yield and decrease of propionic acid in values above that level.
Hematological values for free-living great fruit-eating bats, Artibeus lituratus (Chiroptera: Phyllostomidae)
Authors: Kuzel Maria Alice Amaral , Tavares Jonatas Amorim , Fernandes Priscila do Amaral , Alves Bruno , Costa Neto Sócrates Fraga de , Lacorte Caroline , Borges Mylena de Souza , Bonna Isabel Cristina Fábregas , Andreazzi Cecilia Siliansky de , Moratelli Ricardo
Published: November 2020

It was provide a hematological profile of Artibeus lituratus (Phyllostomidae: Stenodermatinae). Animals were collected from October 2017 to February 2018 in an urban forest in the city of Rio de Janeiro, Southeastern Brazil. Males and females showed similar overall mean values for the parameters analyzed. Males had higher values for erythrocytes (RBC), hematocrit and basophils. Females had higher levels of eosinophils than males. The hematological values reported here will serve as reference for future research on health conditions of free-living and captive populations of Artibeus lituratus, as well as for research on pathogens associated with these bats.
Institutional Red Blood Cell Transfusion Rates Are Correlated Following Endovascular and Surgical Cardiovascular Procedures: Evidence That Local Culture Influences Transfusion Decisions
Authors: Apostolidou Eirini , Kolte Dhaval , Kennedy Kevin F. , Beale Charles E. , Abbott J. Dawn , Ehsan Afshin , Gurm Hitinder S. , Carson Jeffrey L. , Mamdani Shafiq , Aronow Herbert D.
Published: November 2020

Background

The relationship between local hospital culture and transfusion rates following endovascular and surgical cardiovascular procedures has not been well studied.

Methods and Results

Patients undergoing coronary revascularization, aortic valve replacement, lower extremity peripheral vascular intervention, or carotid artery revascularization from up to 852 US hospitals in the Nationwide Readmissions Database were identified. Crude and risk‐standardized red blood cell transfusion rates were determined for each procedure. Pearson correlation coefficients were calculated between respective procedural transfusion rates. Median odds ratios were estimated to reflect between‐hospital variability in red blood cell transfusion rates following the same procedure for a given patient. There was wide variation in red blood cell transfusion rates across different procedures, from 2% following carotid endarterectomy to 29% following surgical aortic valve replacement. For surgical and endovascular modalities, transfusion rates at the same hospital were highly correlated for aortic valve replacement (
r
=0.67;
P
<0.001), moderately correlated for coronary revascularization (
r
=0.56;
P
<0.001) and peripheral vascular intervention (
r
=0.51;
P
<0.001), and weakly correlated for carotid artery revascularization (
r
=0.19,
P
<0.001). Median odds ratios were all >2, highest for coronary artery bypass graft surgery and surgical aortic valve replacement, indicating substantial site variation in transfusion rates.

Conclusions

After adjustment for patient‐related factors, wide variation in red blood cell transfusion rates remained across surgical and endovascular procedures employed for the same cardiovascular condition. Transfusion rates following these procedures are highly correlated at individual hospitals and vary widely across hospitals. In aggregate, these findings suggest that local institutional culture significantly influences the decision to transfuse following invasive cardiovascular procedures and highlight the need for randomized data to inform such decisions.
Association Between Moderate‐to‐Vigorous Physical Activity and the Risk of Major Adverse Cardiovascular Events or Mortality in People With Various Metabolic Syndrome Status: A Nationwide Population‐Based Cohort Study Including 6 Million People
Authors: Park Sehoon , Han Kyungdo , Lee Soojin , Kim Yaerim , Lee Yeonhee , Kang Min Woo , Park Sanghyun , Kim Yong Chul , Han Seung Seok , Lee Hajeong , Lee Jung Pyo , Joo Kwon Wook , Lim Chun Soo , Kim Yon Su , Kim Dong Ki
Published: November 2020

Background

A population‐scale evidence for the association between moderate‐to‐vigorous physical activity (MV‐PA) and risks of major adverse cardiovascular event (MACE) or all‐cause mortality in people with various metabolic syndrome (MetS) status is warranted.

Methods and Results

We performed a nationwide retrospective cohort study based on the claims database of South Korea. We included people who received ≥3 national health screenings from 2009 to 2013 without a previous MACE history. We determined the MetS status of 6 108 077 people: MetS‐chronic (N=864 063), MetS‐developed (N=348 163), MetS‐recovery (N=348 313), and MetS‐free (N=4 547 538). The exposure was self‐reported MV‐PA frequencies. The outcome was incident MACEs or all‐cause mortality. The incidence rate ratios (IRR) were calculated with adjustments for clinical/demographic characteristics. During the median follow‐up of 4.28 years, 78 770 and 51 840 people experienced MACEs or died, respectively. Those who engaged in MV‐PA had a significantly lower risk of MACEs or all‐cause mortality than those not engaged in MV‐PA in every spectrum of MetS. Even among those who were free from MetS (for MACEs, IRR 0.94 [0.92–0.97], for all‐cause mortality, IRR 0.85 [0.82–0.87]) or who had already recovered from MetS (for MACEs, IRR 0.89 [0.84–0.95], for all‐cause mortality, IRR 0.74 [0.68–0.81]), 1 to 2 days per week of MV‐PA were significantly associated with lower risk of the adverse outcomes when compared with not being engaged in MV‐PA. Those who were engaged in MV‐PA more frequently also had significantly lower risks of MACEs or all‐cause mortality.

Conclusions

This nationwide study suggests that MV‐PA may be recommended to the general population regardless of recent MetS status.
Eleanor Elsner’s Discordant Discourse and Split Subjectivity in The Magic of Morocco (1928)
Authors: Aammari Lahoucine
Published: November 2020

On board the Macoris, the British woman traveller Eleanor Elsner peregrinated into French Morocco, landing in Casablanca in 1928. Elsner’s The Magic of Morocco is about the author’s search for the atavistic at a time when the European colonial power structure and the rise of tourism had transformed the exotic referent into the familiar sign of Western hegemony. Elsner could not help but experience a sense of displacement in time and space, an experience that produced either a sense of disorientation and loss, or an obsessive urge to discover the “authentic” Other. Elsner’s account is imbued with discursive ambivalences and ideological uncertainties. Her discourse is complicitous as she vociferously lauds the French colonial enterprise in the person of General Lyautey, the engineer of the “peaceful pacification.” The present paper focuses on Elsner and her account as a staunch advocate of the French colonial enterprise in Morocco and her quest for elsewhere. This paper explores Elsner’s discordant practices and discourses as a split subject/traveller in Protectorate Morocco.
An agent-based model of sign language persistence informed by real-world data
Authors: Mudd Katie , de Vos Connie , de Boer Bart
Published: November 2020

As evidence from sign languages is increasingly used to investigate the process of language emergence and evolution, it is important to understand the conditions that allow for sign languages to persist. We build on a mathematical model of sign language persistence (i.e. protection from loss) which takes into account the genetic transmission of deafness, the cultural transmission of sign language and marital patterns (Aoki & Feldman, 1991). We use agent-based modeling techniques and draw inspiration from the wealth of genetic and cultural data on the sign language Kata Kolok to move towards a less abstract model of sign language persistence. In a set of experiments we explore how sign language persistence is affected by language transmission types, the distribution of deaf alleles, population size and marital patterns. We highlight the value of using agent-based modeling for this type of research, which allows for the incorporation of real-world data into model development.
Morphological range changes in Mexican Astragalus radicans Hornem. (Fabaceae: Galegeae): review of its taxonomy and nomenclature

Authors: ESTRADA CASTILLÓN EDUARDO , VILLARREAL QUINTANILLA JOSÉ ÁNGEL , SALINAS ALFONSO-DELGADO
Published: November 2020

Continuing with the study of the Astragalus of Mexico and based on the measurement of 30 morphological characters and applying multivariate statistics, the two varieties of Astragalus radicans: A. radicans var. radicans and A. radicans var. harshbergeri were ranked at the species level and have their nomenclature updated. The results of the analysis allow the two infraspecific constitute isolated groups without overlapping between their individuals; therefore, they are raised from varieties to species, Astragalus radicans and Astragalus harshbergeri. A map with the updated distribution was included, and a dichotomous key is provided to identify the species. Both species are placed under the category of Threatened.
A new troglobitic palpigrade from Central Brazil, with notes on a new opisthosomal character (Arachnida: Palpigradi)
Authors: SOUZA MAYSA F. V. R. , MAYORAL JAIME , FERREIRA RODRIGO L.
Published: November 2020

A new species of palpigrade from the cave Gruta Cabeceira d’água in Goiás state in Central Brazil is described and illustrated based on 11 specimens: five adult males, two adult females, two immatures C and two immatures B. Eukoenenia audax sp. nov. was collected mainly in the sand banks near the main water stream, where flooding and important water fluctuations occur in the cave. The new Brazilian species shows three uncommon morphological traits: the presence of 7 + 7 setae on the propeltidium, one deuto-tritosternal seta, and 9–11 blades in the lateral organs; these characters relate Eukoenenia audax sp. nov. with only a handful of species in the world. The presence of a pair of cavities was identified in the intersegmental furrow between opisthosomal sternites III–IV, IV–V, V–VI and VI–VII. A comprehensive study of this new character was performed in other species available to the authors, and a discussion of its possible origin and function is presented.
Feasibility of Implementing Opioid Stewardship Recommendations for Sinonasal Surgery
Authors: Jordan Jaxon W. , Spankovich Christopher , Stringer Scott P.
Published: November 2020

Objective

The objective of our study was to review the current literature pertaining to perioperative opioids in sinus surgery and to determine the effects of implementing opioid stewardship recommendations in the setting of endoscopic sinonasal surgery.

Study Design

Single‐institution retrospective case‐control study.

Setting

Academic medical center outpatient area.

Methods

This retrospective review comprised 163 patients who underwent routine functional endoscopic sinus surgery, septoplasty, and/or inferior turbinate reduction before and after implementation of a standardized pain control regimen based on published opioid stewardship recommendations. The regimen consisted of an oral dose of gabapentin (400 mg) and acetaminophen (1000 mg) at least 30 minutes prior to surgery, absorbable nasal packing soaked in 0.5% tetracaine intraoperatively, and a postoperative regimen of acetaminophen and nonsteroidal anti‐inflammatory medications. Tramadol tablets (50 mg) were prescribed postoperatively for breakthrough pain. The primary outcome measure for the study was the average number of hydrocodone equivalents (5 mg) prescribed before and after the new protocol.

Results

The average number of opioid medications prescribed, measured as hydrocodone equivalents (5 mg), decreased from 24.59 preprotocol to 18.08 after the initiation of the new perioperative regimen (P <. 001). There was no significant difference between the periods (P >. 05) in number of postoperative phone calls regarding pain or in patient satisfaction scores.

Conclusion

Opioid stewardship recommendations can be instituted for sinonasal surgery, including multimodal perioperative pain management and substitution of tramadol for breakthrough pain, as a method to decrease the volume of opioids prescribed, without increasing patient phone calls or affecting the likelihood of physician recommendation Press Ganey scores.
Paradoxes of populism during the pandemic
Authors: Brubaker Rogers
Published: November 2020

Populist protests against Coronavirus-related restrictions in the US appear paradoxical in three respects. Populism is generally hostile to expertise, yet it has flourished at a moment when expertise has seemed more indispensable than ever. Populism thrives on crisis and indeed often depends on fabricating a sense of crisis, yet it has accused mainstream politicians and media of overblowing and even inventing the Corona crisis. Populism, finally, is ordinarily protectionist, yet it has turned anti-protectionist during the pandemic and challenged the allegedly overprotective restrictions of the nanny-state. I address each apparent paradox in turn before speculating in conclusion about how populist distrust of expertise, antipathy to government regulation, and skepticism toward elite overprotectiveness may come together – in the context of intersecting medical, economic, political, and epistemic crises – in a potent and potentially dangerous mix.
Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis
Authors: Mathew Asha , Doorenbos Ardith Z. , Li Hongjin , Jang Min Kyeong , Park Chang Gi , Bronas Ulf G.
Published: November 2020

Background:

Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population.

Purpose:

To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer.

Methods:

Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality.

Results:

Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality.

Conclusion:

This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis
Authors: Jain Anuj , Rai Anshul
Published: November 2020

Study Design:

Systematic review and meta-analysis.

Objective:

Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma.

Methodology:

An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF.

Results:

A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable.

Conclusion:

The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.
Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States
Authors: Cascino Thomas M. , Ashur Carmel , Richardson Caroline R. , Jackson Elizabeth A. , McLaughlin Vallerie V.
Published: November 2020

Exercise rehabilitation is underutilized in patients with pulmonary arterial hypertension despite improving exercise capacity and quality of life. We sought to understand the association between (1) patient characteristics and (2) patient‐perceived barriers and referral to exercise rehabilitation. We performed a cross‐sectional survey of patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension attending an International PAH meeting. Predictors of referral considered included gender, body mass index, subjective socioeconomic status, insurance type, age, and World Health Organization functional class and perceived barriers assessed using the Cardiac Rehabilitation Barriers Scale. Among 65 participants, those in the lowest subjective socioeconomic status tertile had reduced odds of referral compared to the highest tertile participants (odds ratio 0.22, 95% confidence interval: 0.05–0.98, p = 0.047). Several patient‐perceived barriers were associated with reduced odds of referral. For every 1‐unit increase in a reported barrier on a five‐point Likert scale, odds of referral were reduced by 85% for my doctor did not feel it was necessary; 85% for prefer to take care of my health alone, not in a group; 78% many people with heart and lung problems don’t go, and they are fine; and 78% for I didn’t know about exercise therapy. The lack of perceived need subscale and overall barriers score were associated with a 92% and 77% reduced odds of referral, respectively. These data suggest the need to explore interventions to promote referral among low socioeconomic status patients and address perceived need for the therapy.
Identity Development During Student Exchange: A Qualitative Study of Students’ Perspectives on the Processes of Change
Authors: McKay Samuel , Lannegrand Lyda , Skues Jason , Wise Lisa
Published: November 2020

Student exchange is associated with many positive outcomes, however, little is known about the experiences that drive such changes. The aim of the current qualitative study was to explore how exchange students conceptualize the processes of change and development during exchange within an identity framework. Twenty interviews were conducted with Australian and French exchange alumni aged 19–23 years. Thematic analysis identified two major themes of change with specific associated driving experiences titled “ I did it, so I can do it” and “ I know who I am, I know what I want.” The second theme included two subthemes addressing an increased valuing of diversity and interest in international experiences. Three themes of influencing factors showed that students’ attitudes, previous experience, and family environments could impact exchange outcomes. The findings suggest that identity development is central to development during exchange, with the findings aligning with pre-existing models from the identity literature.
Automated Stat Testing Laboratory
Authors: Farnsworth Ralph E.
Published: November 2020

Laboratory testing is a labor intensive and hazardous activity, and yet it is critical for patient care. In these days of rising healthcare costs, automation of the testing process is becoming a necessity.
Clinical Laboratory Engineering in a Multidisciplinary Platform: A Perspective from France
Authors: Truchaud A. , Le Neel T. , Perrier S. , Brochard H. , Malvaux S. , Cazaubiel M.
Published: November 2020

The clinical laboratory is moving from an activity focused on the analysis to an in vitro diagnostic service network. Laboratory analysis is a disassembly process, very different from manufacturing processes which are assembly processes. Specific quality goals must be discussed before adopting robots. As an example, in order to achieve the ultimate quality goals in our laboratory, it was necessary to use automation for sample handling. We developed automation in a new multidisciplinary model at the Institute of Biology of Nantes. Our multidisciplinary laboratory included clinical laboratories, research laboratories, and start-up companies in an open space of 10,000 m2 shared between two floors. Sample transportation is automated from clinical wards to laboratory workstations.
Lung Adenocarcinoma Presenting as Multiple Thromboembolic Events: A Case Report and Review of the Literature
Authors: Galarza Fortuna Gliceida M. , Singh Anita , Jacobs Adam , Ugalde Israel
Published: November 2020

Patients with malignancy may present with significant thromboembolic complications including deep vein thrombosis (DVT), pulmonary embolism, arterial thrombosis, nonbacterial thrombotic endocarditis, and stroke due to abnormal coagulation cascades. Although these events are typically recognized later in the disease process, complications of a hypercoagulable state can rarely present as the first manifestation of an occult malignancy. We report a case of a young male who was ultimately found to have an aggressive form of lung adenocarcinoma after the initial presentation of multiple thromboembolic events. DVT and stroke as an initial presentation of an active lung adenocarcinoma in a young patient is extremely rare as patients presenting in a hypercoagulable state usually are older. Though testing for a hypercoagulable state is not recommended for the first unprovoked DVT, clinicians should be prompted to screen for malignancy in the setting of cryptogenic strokes, especially in younger patients with no prior risk factors.
Reflection on career choices in clinical neurosciences
Authors: Restellini A , Piguet C
Published: November 2020

Medical faculties are responsible for high-level training, not only on clinical skills but also on scientific research and medical advances. There is an evident need to promote academic careers to ensure the continuity and improvement of top-notch health care. Even if Switzerland is one of the countries with the highest medical density per inhabitant, the lack of interest for academic careers has increased, resulting in difficulties to form clinician-scientists and ensure succession. In this article, we reflect on the challenges and the potential solutions in the training of an academic career.
MicroRNA-296-5p inhibits cell metastasis and invasion in nasopharyngeal carcinoma by reversing transforming growth factor-β-induced epithelial–mesenchymal transition
Authors: Chen Meihui , Chen Chen , Luo Haiqing , Ren Jing , Dai Qiuqin , Hu Wenjia , Zhou Keyuan , Tang Xudong , Li Xiangyong
Published: November 2020

Aim

To explore the effect of miR-296-5p on the metastasis of nasopharyngeal carcinoma (NPC) cells and investigate the underlying mechanism.

Methods

The expressions of miR-296-5p in NPC tissues and cells were determined using GSE32920 database analysis and real-time PCR and miRNA microarray assays. An miR-296-5p mimic and inhibitor were transfected into NPC cells. Then, immunofluorescence imaging, scratch wound-healing, transwell migration and invasion assays were used to observe the effects of miR-296-5p on cell metastasis and invasion. Real-time PCR and western blotting were carried out to detect the expressions of genes and proteins related to epithelial–mesenchymal transition (EMT). A dual luciferase reporter assay was used to identify whether TGF-β is the target gene of miR-296-5p. Finally, TGF-β expression plasmids were transfected into NPC cells to verify the role of TGF-β in the miR-296-5p-mediated inhibition of nasopharyngeal carcinoma cell metastasis.

Results

Our results show that miR-296-5p inhibits the migratory and invasive capacities of NPC cells by targeting TGF-β, which suppresses EMT. Importantly, the miR-296-5p level was significantly lower in human NPC tissues than in adjacent normal tissues. It also negatively correlated with TGF-β and was significantly associated with the lymph node metastasis of patients with NPC.

Conclusions

Our findings show that miR-296-5p represses the EMT-related metastasis of NPC by targeting TGF-β. This provides new insight into the role of miR-296-5p in regulating NPC metastasis and invasiveness.
Correction to: Gender differences in nerve regeneration after sciatic nerve injury and repair in healthy and in type 2 diabetic Goto-Kakizaki rats
Authors: Stenberg Lena , Dahlin Lars B.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature
Authors: Zahedi Maryam , Hizomi Arani Reyhane , Tohidi Maryam , Haghighi Shirin , Mehrpour Masoud , Hadaegh Farzad
Published: November 2020

Background

Primary nasopharyngeal lymphoma (NPL) is a very rare tumor of Waldeyer ring (WR) lymphoid tissue. It is challenging to differentiate lymphoma infiltration of pituitary from a pituitary adenoma, meningioma infiltration, and other sellar lesions to plan a suitable treatment strategy. We presented for the first time a unique case of NPL with an unusual presentation of oculomotor nerve palsy associated with pan-pituitary involvement in a diabetic patient.

Case presentation

A 64-year old diabetic woman with no previous history of malignancy presented with intermittent diplopia for about the last nine months. Severe headache, left eye ptosis and hypoglycemic episodes were added to her symptoms after a while. Further complaints include generalized weakness, loss of appetite, generalized musculoskeletal pain, and 6–7 kg weight loss within six months. Her family history was unremarkable. Physical examinations of eyes indicated left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric, and the pupillary reflexes were normal on both eyes. No lymphadenopathy, organomegaly and other abnormalities were found. Magnetic resonance imaging (MRI) showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without bone erosion. Also, both cavernous sinuses were infiltrated and both internal carotid arteries were encased by the neoplastic lesion. It suggested an infiltrative neoplastic lesion which compressed the cranial nerves. Pituitary hormone levels assessment indicated a pan-hypopituitarism. Following nasopharyngeal mucosal biopsy, the immunohistochemistry (IHC) findings revealed a low-grade non-Hodgkin’s B-cell lymphoma. Systemic workup, including cerebrospinal fluid (CSF) studies, bone marrow aspiration, chest and abdominopelvic high-resolution computed tomography (HRCT) indicated no other involvement by the lymphoma. After chemotherapy courses, central adrenal insufficiency, partial central diabetes incipidious (CDI) and central hypothyroidism have been resolved. To our best knowledge, we found 17 cases of NPL with cranial nerve palsy, 1 case of NPL with pan-hypopituitarism and no NPL case with both cranial nerve palsy and pituitary dysfunction.

Conclusions

The incidence of cranial neuropathy in patients with diabetes should not merely be attributed to diabetic neuropathy without further evaluation.
Does the type of health insurance enrollment affect provider choice, utilization and health care expenditures?
Authors: Atake Esso-Hanam
Published: November 2020

Background

Two of the objectives of Universal Health Coverage are equity in access to health services and protection from financial risks. This paper seeks to examine whether the type of health insurance enrollment affects the utilization of health services, choice of provider and financial protection of households in Togo.

Methods

Data were obtained from a cross-sectional, representative household survey involving 1180 insured households that had reported either illness in the household in the 4 weeks preceding the survey or hospitalization in the 12 months preceding the survey. A nested logit model was used to account for the utilization of health services and provider choice, and methods of assessing catastrophic health care expenditures were used to analyze the level of household financial protection.

Results

Policyholders of private health insurance use private health care facilities more than policyholders of public health insurance. The main reasons for not using health centers among households with public insurance were out-of-pocket payments (49.19%), waiting time (36.80%), and distance to the nearest health center (36.76%). Furthermore, on average, households with public insurance spent a higher proportion of their total monthly nonfood expenditures on health care than those with private insurance. We find that the type of insurance, share of expenditures allocated to food, distance to the nearest health center, and waiting time significantly impact the choice of provider. Regardless of the type of health insurance, elderly individuals avoid using private health centers and referral hospitals due to the high cost.

Conclusion

We found that a multiple health insurance system results in a multilevel health system that is not equitable for everyone. The capacity of the health insurance system to provide equitable health care services and protect its members from catastrophic health care expenditures should be at the core of health care reform. This study recommends raising awareness of the criteria for the reimbursement of medical procedures within the framework of public insurance and promoting specific health insurance mechanisms for elderly individuals. Careful attention should be paid to ensuring universal education and literacy as a means of improving access to and the use of health care.
Correction to: MicroRNA-138-5p targets the NFIB-Snail1 axis to inhibit colorectal cancer cell migration and chemoresistance
Authors: Xu Weifeng , Chen Beibei , Ke Dianshan , Chen Xiaobing
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.