bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon emissions in hydromorphic soils from an estuarine floodplain forest in the Amazon River
Authors: Lira-Guedes Ana Cláudia , Leal Géssica de Almeida , Fischer Graciela Redies , Aguiar Leonardo José Gonçalves , Melém Júnior Nagib Jorge , Baia Aldine Luiza Pereira , Guedes Marcelino Carneiro
Published: September 2021

Carbon dioxide (CO2) is produced only in biological activities. Understanding how soil tillage practices affect the dynamics of CO2 production is important, as these processes are influenced by the temperature and humidity conditions of the place. This paper aimed at quantifying CO2 flux in hydromorphic floodplain soils under different açai palm tree grove management strategies, correlating it with litter deposition, soil environment, and season of the year. Conducted in the city of Mazagão-AP, four areas of açai palm tree groves were selected with different types of management. During the evaluation period (October, November, and December 2012, and February, March, and April 2013), CO2 flux, soil moisture, and temperature were measured, and litter samples were collected. In addition, rainfall data for the region were also obtained. The CO2 fluxes obtained ranged from 0.37 to 28.55 μmol CO2 m-2 s-1, with a total average of 6.20 μmol CO2 m-2 s-1. In broad analysis, soil variables did not show significant correlations with CO2 emissions. A positive relationship between flux and litter and soil temperature, as well as a negative relationship with its moisture, were observed only in a few months and specific systems.
Examination of University Students' Nomophobia, Coping with Stress, and Anger Expression Styles
Authors: Kıvrak Ali Osman
Published: September 2021

Aim: With this study, it is aimed to examine the nomophobia, coping with stress and anger expression styles of university students. Methods: A total of 532 university students (n=201 female; n=331 male) participated in the study. While the personal information form created by the researcher was used for socio-demographic data, the nomophobia scale developed by Yıldırım and Correia (2015) and adapted into Turkish by Yıldırım et al. (2016) for smartphone addiction, Anger Expression Style Scale, developed by Spielberger et al. (1983) and adapted to Turkish by Özer (1994), was used to determine anger expression styles, and the "Stress Coping Style Scale", which was developed by Folkman and Lazarus (1980) and adapted into Turkish by Şahin and Durak (1995), was used to determine stress coping styles. The homogeneity and variances of the data were tested, Independent Samples t Test was used for pairwise comparisons, One Way Anova was used for multiple comparisons, and Tukey HSD test was used to determine the source of difference. Results: While no statistical change was observed in the dimensions of coping with anger and stress depending on the gender factor, it was determined that the mean value of males was statistically higher than that of females in all nomophobia dimensions (p<0.05). There was no statistical change in the values of anger, nomophobia and coping with stress depending on the age and accommodation factors of the students. Conclusion: Today, the fact that female and male are closer to each other in respect of social status and social roles can be seen as the reason for the similarity in the values of anger expression and coping with stress. Results related to high nomophobia of males values can be evaluated as they are more addicted to smartphones than females. Keywords: Nomophobia, University Student, Stress, Anger
Efficacy of Topical Tacrolimus 0.05% Suspension in Steroid-Resistant and Steroid-Dependent Vernal Keratoconjunctivitis
Authors: Akbari Mitra
Published: September 2021

Objective: The purpose of this study was to investigate the safety and effectiveness of topical tacrolimus 0.05% suspension in the management of prolonged steroid-dependent and -resistant vernal keratoconjunctivitis (VKC). Materials and methods: The present interventional prospective case series were conducted on the research units suffering from refractory VKC between 2017, April and 2020, December. Despite routine drug treatment, consisting of topical steroids (steroid-resistant group), all subjects exhibited active symptomatic illness or were dependent on topical steroids (steroid-dependent group). After discontinuation of all medications for at least 1 week, the patients received eye drop (topical tacrolimus 0.05%) minimally for six months. Objective and subjective signs and symptoms were examined for alterations after one week, and one and six months of treatment. Analyses were continued for probable systemic and ocular adverse effects. Results: The study included 28 eyes of 14 participants (including 4 females and 10 males), with the mean age of 22 ± 8 years (between 11 and 38 years), and the mean VKC duration of 12 ± 6 years (between 5 and 23 years), as well as follow up period of 10±2 months (between 6 and 12 months). The results showed an improvement (P<0.001) in the symptoms such as mucus discharge, foreign body sensation, photosensitivity, redness, burning and itching. The initial sign was conjunctival hyperemia, which improved one week after treatment. Other objective signs including, conjunctival and limbal papillary hypertrophy, corneal pannus and corneal punctate epithelial erosions improved at least one month after treatment. No changes were observed in corneal opacity during follow-up (p> 0.05). There were no systemic or ocular adverse effects. Conclusion: This is the first time that tacrolimus suspension drops 0.05%, are used in these cases. Topical tacrolimus 0.05% was shown to be an effectiveness and safe agent to treat the refractory VKC. This drug is recommended to be prescribed prior to the appearance of side effects such as corneal opacity, irreversible deficiency in limbal stem cell, and steroid side effects. Keywords: Vernal keratoconjunctivitis, Tacrolimus eye drop, Refractory
A IMPORTÂNCIA DO BRINCAR NA EDUCAÇÃO INFANTIL
Authors: SANTANA MARIANA
Published: September 2021

Este trabalho ressalta a importância do brincar no ensino fundamental e como esta é benéfica para o desenvolvimento da criança em seus aspectos físico, psicológicos, intelectuais e sociais, assim como contribui para o aprimoramento qualidade de ensino em todo o país. A ideia é compreender o processo de aprendizagem das crianças incluindo alfabetização e seu desenvolvimento pessoal, e como estes são fundamentais para a vida em sociedade. Também não possibilitam espaços e tempos para o brincar, trocando esses espaços por uma escolarização precoce, deixando de reconhecer o lado sério da do jogo e da brincadeira. Pensar a importância do brincar é poder remeter os mais diversos aspectos, tais como o cultural, que concebe o jogo em sim como manifestação cultural que faz uma análise da contribuição do jogo no campo educacional.
A EDUCAÇÃO NO COMBATE AO PRECONCEITO
Authors: UCHOA MELISSA
Published: September 2021

Este artigo vem buscar reflexões a respeito do racismo e de como a educação pode colaborar para que ocorra uma maior igualdade entre os povos de origem Afro Descendentes. Um dos países que possuem a maior população negra, é o Brasil sendo que em pesquisas recentes é o segundo maior, embora tenhamos uma miscigenação forte da diversidade cultural brasileira o estudo da cultura africana é relegado a um segundo plano. O Brasil, por apresentar uma grande dimensão territorial, possui uma vasta diversidade cultural. Os colonizadores europeus, a população indígena e os escravos africanos foram os primeiros responsáveis pela disseminação cultural no Brasil. Em seguida, os imigrantes italianos, japoneses, alemães, árabes, entre outros, contribuíram para a diversidade cultural do Brasil. Aspectos como a culinária, danças, religião são elementos que integram a cultura de um povo.
O PROCESSO DE ALFABETIZAÇÃO E AQUISIÇÃO DA ESCRITA
Authors: SILVA SHISLAINE
Published: September 2021

O presente trabalho destina-se, por meio de revisão bibliográfica, a aprofundar conhecimentos acerca da questão da aquisição da escrita na escola, considerando todo o processo de desenvolvimento humano nas suas dimensões cognitivas, uma vez que a linguagem permeia as experiências e interações do indivíduo desde o início da vida. Objetiva-se, assim, levantar elementos referentes aos primeiros contatos do aluno com o universo da escrita, assim como analisar aspectos que influenciam de forma positiva este processo, contribuindo para seu sucesso. O papel da escrita na sociedade também é foco de discussão e levantamentos sobre sua prática ao longo do tempo são apresentados neste artigo.
ANÁLISE MICROBIOLÓGICA DE CARNE MOÍDA BOVINA COMERCIALIZADA NO MUNÍCIPIO DE JAGUARIBE - CEARÁ
Authors: Granja Paula D. D. , Costa Maria M. , Nunes Mírian R , Cruz Rafael S. , Nunes Marcos V. , Aquino Clarissa M. , Santos Luana  M. L.
Published: September 2021

A carne bovina é um alimento de amplo consumo em todo o território brasileiro, sendo comercializada em diferentes cortes, principalmente na forma de carne moída. Possui alto valor nutritivo, entretanto, apresenta elevada deterioração em virtude a proliferação de microrganismos. Tendo em vista a importância deste alimento para a população, objetivou- se neste trabalho a realização da análise microbiológica em carnes moída bovina comercializadas em frigoríficos do município de Jaguaribe, Ceará. Foram adquiridas 200g de amostras em 6 frigoríficos no comércio local e encaminhadas para o Laboratório de Química do IFCE – Campus Jaguaribe, onde realizaram-se as análises microbiológicas para detecção de Coliformes Totais, Coliformes Termotolerantes e Eschirichia coli. Os dados obtidos foram analisados utilizando-se o programa Statistic 7® para os testes de ANOVA e teste de Tukey em nível de 5% de significância. Os resultados evidenciaram que as amostras 1, 2 e 3 apresentaram resultado negativo para e Eschirichia coli. As amostras 4 e 5 apresentaram-se positivas e acima do nível permitido, enquanto a amostra a 6 apresentou- se dentro do nível de tolerância permitido, conforme a Resolução RDC no 12 da Agência Nacional de Vigilância Sanitária (ANVISA). Ressalta-se que as amostras apresentam um nível de contaminação significativo, podendo ser um risco para a saúde dos consumidores. Recomenda-se a adoção de medidas de higiene adequadas e de boas práticas de manipulação de alimentos para evitar a contaminação da carne moída, garantindo a qualidade do produto comercializado.
POTENCIAL ANTIBACTERIANO IN VITRO E TOXICOLÓGICO IN VIVO DAS FOLHAS DO JAMBO VERMELHO (Syzygium malaccensis, Myrtaceae) FRENTE A ZEBRAFISH (D. rerio) ADULTO
Authors: Cunha Fernando E. T. , Ferreira Maria I. C. , Cruz Rafael S. , Ferreira Maria J. G. , Aquino Clarissa M. , Magalhães Francisco E.  A.
Published: September 2021

Este trabalho reporta o potencial antibacteriano in vitro e toxicológico in vivo das folhas do jambo (Syzygium malaccense) frente a zebrafish (Danio rerio) adulto (ZFa). As folhas de jambo foram submetidas a desidratação (35 ± 2°C) por 24 horas, trituração e posterior extração de metabólitos por decocção, infusão e maceração com água destilada. Os extratos obtidos foram liofilizados e submetidos a análise de atividade antibacteriana in vitro frente a Gram-negativas (Escherichia coli ATCC 25922, Salmonella Enteritidis IAL 1132) e Gram-positivas (Listeria monocytogenes ATCC 19115 e Staphylococcus aureus ATCC 27664), bem como ao potencial toxicológico in vivo frente ao ZFa. O extrato obtido por infusão se mostrou mais promissor, pois apresentou concentração mínima bactericida (CMB) e concentração mínima inibitória (CMI) com maior potencial frente às gram- positivas (CMB - 6,25 e CMI - 6,25 mg/ml), bem como às gram-negativas (CMB - 25,0 e 3,125 e CMI - 3,125 mg/ml). Todos os extratos testados não se mostraram tóxicos frente ao zebrafish adulto e não alteraram o sistema locomotor dos mesmos. Desta forma, conclui-se que o extrato aquoso das folhas do jambo vermelho (Syzygium malaccense) obtido por infusão é seguro e pode ser utilizado como conservante natural com maior ação antibacteriana. Este trabalho nos conduz a novos estudos de isolamento e caracterização de princípios bioativos.
PESQUISA DE HÁBITOS DE CONSUMO DE ALIMENTOS DE ORIGEM VEGETAL PELA POPULAÇÃO DA CIDADE DE FORTALEZA – CEARÁ
Authors: Sá Kellen M. , Cruz Rafael S. , Medeiros Luana M. A. , Barros Sâmela L. , Rocha Wallacy R. P. , Aquino Clarissa M. , Silva Larissa M. R.
Published: September 2021

A maioria da população de países em desenvolvimento não tem acesso ao conhecimento sobre bons alimentos e condições de higiene, o que pode ter implicações negativas no preparo desses, como um maior risco ao desenvolvimento de doenças transmitidas por alimentos (DTA). Partindo-se da hipótese que é necessário conhecer como as pessoas de uma dada região se relacionam com o consumo e processamento dos seus alimentos, o estudo objetivou avaliar os padrões de consumo alimentar dos moradores da cidade de Fortaleza-Ceará, verificar quais são os aspectos que possuem maior influência no consumo de frutas e vegetais, como também verificar o comportamento dos consumidores com relação aos aspectos relacionados à segurança alimentar e nutricional. A pesquisa foi realizada no mês de junho de 2020, através de questionário virtual, e contou com a colaboração de 230 avaliadores voluntários, escolhidos aleatoriamente através de plataformas online. Com a avaliação dos questionários foi observado que 52,2% dos participantes compram alimentos de origem vegetal 4 ou mais vezes por mês; 51,3% dos entrevistados lavam as verduras/legumes e frutas após as compras, antes de guardar/armazenar; 93,9% fazem as compras no supermercado, enquanto 94,3% utilizam o critério da qualidade na hora da escolha dos produtos; 83,9% dos participantes descartam os vegetais quando esses apresentam evidências de deterioração. A pesquisa mostra que o consumo de vegetais entre os entrevistados é frequente, e que a maioria tem conhecimento no que diz respeito a higiene com a manipulação e o armazenamento desses alimentos, porém ainda é necessário que essas informações sejam cada vez mais difundidas entre a população.
DESENVOLVIMENTO E AVALIÇÃO CINÉTICA DE BEBIDAS ALCOÓLICAS FERMENTADAS DE GOIABA, MANGA, MELÃO E TANGERINA
Authors: Santos Edilaine A. S. , Jesus Diego S. , Carvalho Luana C. F. , Fontes Rafaela F. , Móes Raisa S. , Souza Danilo S. , Reis Maycon F. T.
Published: September 2021

O setor de bebidas alcoólicas vem ganhando cada vez mais destaque, ofertando uma variedade de produtos, fazendo uso de uma diversidade de matérias-primas. Frutas têm sido bastante empregadas para elaboração de bebidas alcoólicas fermentadas, sendo consideradas alternativas viáveis, visto que apresentam características necessárias para tal finalidade. Nesse contexto, o presente trabalho objetivou o desenvolvimento, caracterização e estudo cinético de bebidas alcoólicas fermentadas a partir de goiaba, manga, melão e tangerina. As frutas utilizadas no estudo foram adquiridas na feira livre do município de Nossa Senhora da Gloria – SE, em seguida, foram conduzidas ao laboratório para serem processadas. Realizou-se análises de Sólidos Solúveis Totais (SST), pH, Acidez Titulável Total (ATT), todos os dias durante a fermentação e no produto acabado, segundo as Normas Analíticas do Instituto Adolf Lutz (2005). Com o desenvolvimento das bebidas foi possível obter a cinética do processo fermentativo para os parâmetros avaliados. Bem como a caraterização das bebidas, encontrando os seguintes valores SST (°Brix) 8,53 ± 0,8; 7 ± 0,4 e 7,27 ± 0,0, pH 3,5 ± 0,0; 3,7 ± 0,0 e 3,9 ± 0,1, ATT (meq/L) 88,27 ± 0,7; 59,17 ± 0,0 e 69,84 ±1,2, e para o teor alcoólico (°GL) 6,47 ± 0,7; 6,43 ± 0,4 e 7,22 ± 0,0, respectivamente para os fermentados de goiaba, manga e melão com tangerina. As bebidas desenvolvidas apresentam características semelhante a de outros fermentados reportados na literatura e encontram-se dentro dos limites estabelecidos pela legislação vigente. Fortalecendo, assim a ideia de que estas frutas podem ser utilizadas para tal finalidade, obtendo-se bebidas de características comparáveis a outras bebidas.
From the bureau of forced labor to the criminal-executive inspections
Authors: Коростылёва Ольга Васильевна
Published: September 2021

В статье рассматривается история становления и развития учреждений и органов, исполняющих уголовные наказания и иные меры уголовно-правового характера, не связанные с изоляцией от общества. После Октябрьской революции 1917 г. был актуализирован вопрос введения мер уголовной ответственности, не связанных с изоляцией осужденных от общества. Для исполнения указанных мер в 1919 г. было создано Бюро принудительных работ, которое со временем было переименовано в инспекции исправительно-трудовых работ. В настоящее время, с 1996 г., инспекции получили свое окончательное наименование - уголовно-исполнительные инспекции. На протяжении своего существования инспекции меняли только наименование, но и ведомственную принадлежность. Уголовно-исполнительные инспекции являются учреждением, исполняющим наибольшее количество уголовных наказаний и иных мер уголовно-правового характера, установленных уголовным законодательством, а также реализуют меры процессуального учреждения, связанные с применением системы электронного мониторинга подконтрольных лиц. Проведен анализ нормативного регулирования на предмет законодательного закрепления института учреждений, исполняющих наказания, альтернативные лишению свободы, в преддверии празднования 100-летнего юбилея существования уголовно-исполнительных инспекций.

The article deals with the history of the formation and development of institutions and bodies executing criminal penalties and other criminal law measures not related to isolation from society. After the October revolution of 1917, the issue of introducing criminal liability measures not related to the isolation of convicts from society was actualized. For execution of these measures, in 1919, established the Office of forced labor, which eventually was renamed in the inspection of hard labor. At present, since 1996, the inspections have received their final name - criminal Executive inspections. Throughout its existence, the inspection changed only the name, but also departmental affiliation. Criminal-Executive inspections are the institution executing the greatest number of criminal punishments and other measures of criminal-legal character established by the criminal legislation, and also realizes the measures of procedural organization connected with application of system of electronic monitoring of under control persons. The analysis of normative regulation on the subject of legislative consolidation of the institution of institutions executing punishment alternative to imprisonment on the eve of the celebration of the 100th anniversary of the existence of criminal and Executive inspections.
KNOWLEDGE, ATTITUDE AND PERCEPTION TOWARDS THE HPV INFECTION AND IMMUNIZATION AMONG ROMANIAN MEDICAL STUDENTS
Authors: Manolescu Loredana Sabina Cornelia , Mitran Cristina Iulia , Mitran Madalina Irina , Georgescu Simona Roxana , Tampa Mircea , Suciu Ioana , Suciu George , Preda Mãdãlina , Dragomirescu Cristiana Cerasella , Popa Gabriela Loredana , Nita Irina , Popa Mircea Ioan
Published: September 2021

In Romania, cervical cancer is the second most frequent neoplasm among women of 15 to 44 years of age, mainly due to a lack of prevention efforts. The purpose of this study is to assess the current knowledge and attitude towards HPV infection and immunization among medical students. Such information is vital in order to properly assess the current shortcomings of our medical system in the struggle of lowering cancer incidence. A cross-sectional questionnaire-based study was carried out in 2016 and in 2018 on a total of 1,133 participants (median age of 21.9 years, 572 students in 2016 and 562 in 2018). No statistical differences between males and females regarding knowledge of HPV vaccine were found (chi-square 0.046, df = 1, p = 0.83). Moreover, between the 2016 and the 2018 groups, no noticeable changes in HPV awareness and information were observed (2016: chi-square: 0.003, df = 1, p = 0.955; and 2018: chi-square: 0.061, df = 1, p = 0.805). Even though the participants have noted reliable media and medical staff as their main sources of information, our study revealed poor general knowledge, no improvement in perception, and a lack of prophylactic action.
STRATEGI BAURAN PEMASARAN ( MARKETING MIX ) DALAM PERSPEKTIF SYARIAH
Authors: Rahim Endang , Mohamad Roni
Published: September 2021

Business activities are activities that require serious understanding, starting from planning what will be done, the implementation stage and the stage of monitoring a business being run. In running a business, the important task of marketers is to be able to provide what is needed by the community, both consumers and customers. In order for a business or business that is run to be successful, it would be nice to have an appropriate competitive strategy. This study aims to provide a study and analysis of the marketing mix strategy (Marketing Mix) in the sharia perspective. This type of research is a literature study, data is collected by conducting a review study of previous research journals that are relevant to this research.
Late Presentation of a Splenic Abscess after Vaginal Delivery
Authors: Holliday Nicolette P.
Published: September 2021

A 31 year old primigravid patient was induced for chronic hypertension superimposed pre-eclampsia with severe features at 34 weeks. After her uncomplicated vaginal delivery, her postpartum course was complicated by endometritis and suspected pelvic thrombophlebitis. After more than 48 hours afebrile, her antibiotics and anti-coagulation were discontinued, and she was discharged home. The patient presented back to the hospital on postpartum day 30 with a fever of 105°F, severe sepsis, and altered mental status. She was admitted to the Intensive Care Unit and was started on broad spectrum antibiotics. Blood cultures demonstrated E. coli in 1 out of 2 cultures. A 3.8 x 5.0 cm splenic cyst was noted on CT scan and abdominal ultrasound but deemed clinical irrelevant. The patient clinically improved on antibiotics. She was discharged on hospital day 5 with oral antibiotics. The patient returned the next day on postpartum day 35 for another fever, and she was admitted. An IR guided drainage of the splenic lesion revealed an E. coli positive abscess. The patient was then maintained on IV antibiotics for 45 days before being transitioned to oral antibiotics for another 28 days. Sequential imaging showed resolution of the splenic lesion, precluding her need for a splenectomy. This patient had no risk factors for development of a splenic abscess. There was a low clinical suspicion for a splenic abscess based on the characteristics of the lesion on imaging. However, since there was no obvious other source, the drainage of this lesion proved reasonable and consequently, clinically significant for diagnosis. The source of the E. coli is still unknown but suspected to be hepatobiliary or genitourinary in origin.
Evaluation of YouTube Videos as a Resource for Improving Health Literacy in Pregnant Women with Opioid Use Disorder
Authors: Kravitz Elizabeth , Close Natalie
Published: September 2021

Background: There is significant perinatal morbidity and mortality of opioid use disorder.

Objective: As YouTube becomes an increasingly prevalent source for medical education among the patient population, this project aims to evaluate the utility of YouTube as a source of education on opioid use disorder (OUD).

Study Design: The first 100 YouTube videos for each of the following search terms were evaluated based on a variety of descriptive characteristics and by a scale developed from the American College of Obstetrics and Gynecology patient education resource (Table 1): “How to quit opioids during pregnancy”, “opioid addiction treatment during pregnancy,” and “opioid detox during pregnancy.”

Results: The average views for videos targeting the general public were 20,456 views. Of these videos, the average utility score was 4.03.

Conclusion: This study not only highlights the shortcomings of current YouTube resources regarding this topic, but also emphasizes the need for further resource investment by the medical community utilizing YouTube as a resource for improving health literacy.
Making Oxalic Acid From Palm Oil Pelepah (Elaeis Guineensis) Through Nitric Acid Oxidation Reaction
Authors: Rahmadi Ihwan
Published: September 2021

Palm oil palm is one of the solid waste produced by oil palm plantations every harvest. Chemical analysis of palm oil palm oil pellets showed that there are components of cellulose, hemiscellulose, and lignin that show that palm oil pellets have the opportunity to be further processed into useful and economically valuable products. Palm waste contains cellulose by 34.89%, hemiscellulose by 27.14%, and lignin by 19.87%. The analysis conducted on raw materials includes the analysis of water content and cellulose levels of palm oil palm oil. 46.6% and cellulose levels of 29.2%. In this study quantitative analysis was conducted in the form of cellulose conversion and oxalic acid yield. The largest cellulose conversion was obtained at the use of 70% nitric acid concentration and 80 minutes reaction time of 58.56%.
Managing clinical risk retrospectively and prospectively with a risk management framework in an acute care hospital in Singapore
Authors: Bin Amat Tugiman Mahdhir , Tan Xiaohui , Chia Joanna , Lim Ghee Hian
Published: September 2021

Objective: To expound on the implementation of the clinical risk management framework in an acute care hospital to minimise clinical risks and improve patient safety on account of systemic and human risk factors and patterns.Methods: The clinical risk management framework involves a 2-pronged approach through retrospective and prospective methods. The 5 stages of the retrospective approach include data collection, data aggregation, risk assessment and prioritisation, risk mitigation, and lastly, risk monitoring. The prospective approach entails horizon scanning which aims to detect risks early and ensure controls are swiftly implemented to prevent harm from arising. When combined, the framework seeks to be responsive to reduce the possibility and severity of patient harm. The number of incidents and risk scores for top clinical risks from 2016 to 2019 were monitored and studied to assess the effectiveness of the newly implemented clinical risk management framework.Results: When the clinical risk management framework was implemented in 2017, the number of incidents as well as corresponding risk scores for many of the identified clinical incident types and root causes decreased over the years. Most notably, two top clinical risks, results not being reviewed or delayed, and staff inadequate skills and knowledge, saw major improvements in risk scores.Conclusions: The systematic workflow of the 2-pronged clinical risk management framework allows the campus to manage risks comprehensively and efficiently. While retrospective risk analysis examines and reacts to reported clinical incidents, amidst volatile circumstances and advancements of technology exposing unprecedented risks in healthcare, prospective risk analysis conducted through horizon scanning is useful in anticipating and acting before harm arises, ultimately resulting in improved patient safety.
The Medicinal Wood-Decay Species Laricifomes officinalis in the Alpe Veglia–Alpe Devero Natural Park (Italian Alps): Spatial Analysis and Growth Tests of Pure Cultures
Authors: Girometta Carolina Elena , Rovelli Laura , Bracco Francesco , Brescia Francesca , Baiguera Rebecca Michela , Chiatante Gianpasquale , Picco Anna Maria , Savino Elena
Published: September 2021

Laricifomes officinalisis a wood-decay fungus that is closely associated with old individuals ofLarix decidua. In the twentieth century,L. officinaliswas over-harvested because of its medicinal properties; consequently, it has become very rare or almost extinct in the Alps. In this study, we investigated the population ofL. officinalisin the Alpe Veglia–Alpe Devero Natural Park (Val d’Ossola, Italy) to assess a preliminary conservation strategy. Population consistency was estimated using field mapping, and spatial analysis was performed on host trees based on topographical and environmental variables. Mycelia were isolated from harvested basidiomata, and strain identity confirmed by molecular analysis of the ITS region. All isolated strains were tested for growth in Petri dishes containing different standard media to determine which strains had the highest growth rates; the fastest growing strains may be selected for future studies and applications.

Compared to the control strains from Val Malenco and Parco Nazionale del Gran Paradiso, all strains from Alpe Veglia–Alpe Devero Natural Park had lower growth rates. There was no significant difference between the growth rates of strains from Alpe Veglia and those from Alpe Devero.

The results suggest that the population consistency ofL. officinalisin the Alpe Veglia–Alpe Devero Natural Park is related to two main factors: habitat preservation and harvesting prohibition. These results confirm the need to protectL. officinalisboth inside and outside natural reserves, despite the apparent increase in local populations.
Evolutionary Strategies of Highly Functional Catalases for Adaptation to High H2O2 Environments
Authors: Yumoto Isao , Hanaoka Yoshiko , Hara Isao
Published: September 2021

Enzymatic evolutionary strategies for adaptation to a high H2O2 environment have been evaluated using catalases with high catalytic efficiency isolated from two H2O2-tolerant bacteria, Exiguobacterium oxidotolerans and Psychrobacter piscatori. The entrance size of the narrow main channel in catalase has been estimated by determining the formation rate of the intermediate state of peracetic acid (b), which is a larger substrate than H2O2 versus that of catalase activity with H2O2 (a) (calculated as b/a). The ratio of b/a in E. oxidotolerans catalase (EKTA) is much higher than that of P. piscatori catalase (PKTA). To elucidate the structural differences between the catalases, the amino acids present in the main channel have been compared between the two catalases and other catalases in the database. The combination of amino acid residues, which contribute high catalytic efficiency in the narrow main channel of EKTA were different from those in PKTA. In this review, we discuss strategic differences in the elimination of high concentration of H2O2 owing to differences in the phylogenetic positions of catalases. In addition, we describe the relationships between the environmental distributions of genera involved in H2O2-resistant bacteria and their catalase functions based on the main channel structure of catalase.
Morphological Keys for the Identification of Tunisian Culicoides Biting Midges (Diptera: Ceratopogonidae)
Authors: Slama Darine , Chaker Emna , Babba Hamouda
Published: September 2021

Culicoides biting midges are tiny blood-feeding insects of several diseases with veterinary and public health significance, including Bluetongue in ruminants, African horse sickness in equids and filarial diseases like Onchocercosis and Mansonellosis affecting various species such as humans. Their identification depends basically on the microscope examination of key morphological characters. Consequently, identification keys are important to any non experiment working with these biting midges. The Tunisian fauna of Culicoides biting midges consists of 35 species, whose morphological delineation may be troublesome for non-taxonomists. In response to this situation, and for the first time a key to the adult Culicoides species in Tunisia was prepared.
Clinical Scholars: Effective Approaches to Leadership Development
Authors: S.P. Fernandez Claudia , Corbie-Smith Giselle , Green Melissa , Brandert Kathleen , Noble Cheryl , Dave Gaurav
Published: September 2021

The Clinical Scholars (CS) National Leadership Institute (CSNLI) equips interprofessional teams of health care professionals through equity-centered leadership training, preparing them to be change leaders working to advance health equity in communities across the US and its territories. At the time of this writing, four cohorts consisting of 131 Fellows from 14 different disciplines, participating in 36 different teams of two to five members are working on “Wicked Problem Impact Projects”, an implementation science-based approach to action learning projects. This chapter reports on the design of the 3-year CS experience, the onsite and distance-based training support, and the subsequent learning responses of 98 participants, 30 of whom had completed the 3-year training (Cohort 1), 34 of whom had completed 2-years of the training (Cohort 2), and 34 who had completed 1-year of the training (Cohort 3). The training program is guided by 25 competencies that weave leadership and equity throughout, which are divided into four families: Personal, Interpersonal, Organizational, and Community & Systems. Learning outcomes indicated that Fellows are highly satisfied, with all participants rating their experience at 6.10-6.77 on a 7-point scale across all sessions, all years. Retrospective pre-and post-tests assessed learning gains on the competencies, indicating statistically significant changes from baseline to midpoint in participant knowledge, attitude, use, and self-efficacy in each of the 25 competencies and large and significant gains by competency family. The Clinical Scholars Program presents an in-depth, longitudinal, state-of-the-art approach to promoting the cultivation and development of a large and sophisticated set of skills that intentionally integrate leadership competencies with a focus on health equity. Taken together, these outcomes show how a logical and structured process, using widely available tools, can contribute to both learning and implementation of skills that lead to real world impacts in communities. Given the results reported at the close of their Clinical Scholars experience, the data suggest that investing in robust, intensive leadership development of interprofessional teams is a smart decision for impacting the culture of health in communities nationwide.
Culture of Health Leaders: Building a Diverse Network to Advance Health Equity
Authors: S. Burke Natalie , C. Christopher Gail , S. Hacker Tara , Moy Jeffrey , Williams Andrea
Published: September 2021

The Culture of Health Leaders Program takes a holistic approach to leadership development, having participants work through a three-year process centered around four Areas of Mastery (self, relationships, environment, and change). Applying an equity lens to their leadership style and systems-level change work, a focus on the inner world, and network activation are some of the unique approaches the program uses that have resulted in advancing equitable leadership and a culture of health around the country. Use of rapid cycle learning and participant-led activities has allowed program staff to build upon lessons learned and adapt to participant needs in order to evolve the programming and participant experience since its inception in 2016.
From Margins to Mainstream: Creating a Rural-Based Center of Excellence in Transgender Health for Upstate, New York
Authors: Wolf-Gould Carolyn
Published: September 2021

Transgender people face many barriers to healthcare, especially in rural America. The work to decrease barriers to care and address health care disparities for this population meets criteria for a wicked problem, each of which is unique and has no clear solution. The barriers are related to the individual and society and are both formal and informal. The definition for a Center of Excellence in healthcare is loose, but these organizations aspire to serve as specialized programs that offer comprehensive, interdisciplinary expertise and resources within a medical field to improve patient outcomes. With funding and leadership training from the Robert Wood Johnson Clinical Scholars program, a group of medical and mental health clinicians worked for three years with the goal of creating a Rural-Based Center of Excellence in Transgender Health embedded within a family practice to approach the wicked problem of transgender healthcare in their region. The goals of the center were six pronged: the provision of competent and affirming medical, surgical and mental health services, training for healthcare professional students, medical-legal advocacy and patient-centered research. The team created a strategic plan, with five strategic directions, including 1) developing infrastructure and organizational capacity, 2) expanding awareness, knowledge and skills, 3) fulfilling staffing needs, 4) ensuring gender-affirming care, and 5) advancing evidence-based care. I describe our work to bring transgender health from the margins to the mainstream for our region through implementation of this strategic plan.
underdog DREAMS: Improving Long-Term Quality of Life Outcomes for Florida’s Foster Youth and Families
Authors: Bell Annette , Bourdeau Slyving , Davis Asha , Stanec Amanda , Stephens Derrick
Published: September 2021

Children and youth in the foster care system face significant and continuing barriers to both physical and mental health, including lack of a medical home, disruptions in primary care providers, frequent moves to new homes, excessive caseloads for oversight providers, and at times continuing exposure to the risk factors that are considered Adverse Childhood Experiences (ACEs). The underdog DREAMS project sought to alter the course of the foster youth experience via a tri-part model that focused on clinical, research, and advocacy interventions for foster youth and the development of the workforce that supports them through training on the impacts of trauma and poverty.
Creating a Culture of Mental Health in Filipino Immigrant Communities through Community Partnerships
Authors: Sepulveda Aviril , M. Coffey Dean , David Jed , Lopez Horacio , Bantol Kamil , R. Javier Joyce
Published: September 2021

One out of five children in the United States has a mental, emotional, or behavioral health diagnosis. Behavioral health issues cost America $247 billion per year and those with mental health disorders have poorer health and shorter lives. Evidence-based parenting interventions provided in childhood have proven to be effective in helping parents to prevent disruptive, oppositional and defiant behaviors, anxiety and depressive symptoms, tobacco, alcohol, and drug misuse, aggression, delinquency, and violence. Yet, few parents participate in such programs, especially hard-to-reach, underserved minority and immigrant populations. The Robert Wood Johnson Foundation has identified a culture of health action framework that mobilizes individuals, communities, and organizations in order to examine ways to improve systems of prevention, invest in building the evidence base for such systems, and provide evidence-based information to decision makers. The overarching goal of this effort was to create a culture of mental health among Filipinos, a large, yet understudied immigrant community that is affected by alarming mental health disparities, including high rates of adolescent suicide ideation and attempts. Our impact project focused on increasing the reach of the Incredible Years® because maximizing the participation of high-risk, hard-to-engage populations may be one of the most important ways to increase the population-level impact of evidence-based parenting programs. If the approach succeeded with Filipinos, comparable strategies could be used to effectively reach other underserved populations in the U.S., many of whom are reluctant to seek behavioral health services. In this chapter we discuss 1) the state of the literature on the topic of Filipino adolescent mental health disparities; 2) our wicked problem and the impact project aimed at ameliorating this issue; 3) how our team formed and implemented our impact project; 4) outcomes and results of our efforts; 5) challenges we faced and how they were overcome; 6) the leadership and health equity skills that were most helpful in addressing our problem; and 7) a toolkit that could assist other communities addressing youth mental health and prevention of suicide and depression.
Somewhere to Go: Implementing Medication-Based Treatment for Opioid Use Disorders in Rural Maryland and beyond
Authors: Himelhoch Seth , Currens Marion , Benford Jewell , Weintraub Eric
Published: September 2021

Treatment for opioid use disorders is highly effective yet unavailable in many rural areas. “Somewhere to Go: Ensuring Access to Medication-Assisted Treatment in Rural Maryland” is a Robert Wood Johnson Funded Clinical Scholars project intended to expand the use of tele-health medication-based treatment for opioid use disorders services directly to rural areas in need. We demonstrated that a University-based substance use treatment team can successfully collaborate with a geographically distant rural substance use treatment clinic to provide medication-based treatment for opioid use disorders using a HIPPA compliant telehealth strategy. We provide an overview of the implementation strategies our team used to expand overall access in different locales throughout the State of Maryland and beyond. We describe implementation results of a tele-health medication-based treatment program for opioid use disorders that focuses on implementation successes and how to identify and overcome implementation challenges and barriers. Implementation of a telemedicine approach can be challenging, but careful consideration and forethought can map a successful path to program development, operation and sustainability.
Heavy Metal Removal by Alginate Based Agriculture and Industrial Waste Nanocomposites
Authors: Omer Shivangi
Published: September 2021

The use of biopolymers and nonliving organisms as sorbents is one of the most promising techniques because they contain several functional groups which show different affinities towards various metal ions. Alginate is naturally occurring anionic biopolymer extracted from brown algae. It also contains numerous applications in biomedical science and engineering due to its favorable properties and ease of gelatin. This chapter represents a overview based on alginate based agriculture and industrial waste nanocomposites and found that limited studies are reported for combination of alginate with industrial/agriculture waste in nanoscalic material so far, but this review study enlightening the several studies based on nanocomposite combinations of alginates and biopolymers and these biopolymers can also be derived from various agro/industrial waste by simple chemical and mechanical methods. So, we should work on the formulation of alginates agro/industrial waste nanocomposites. Preparation of alginate nanomaterials with agriculture/industrial waste constituents confirms its effectiveness in water purification. In the environment, we can control its reutilization by desorption studies. Another advantage is that it can be transform from nanoparticles to nano polymeric films and support to batch adsorption process to fixed bed column in form of large-scale application.
Deficiency of Vitamin B-Complex and Its Relation with Body Disorders
Authors: Farhan Sarwar Muhammad , Haroon Sarwar Muhammad , Sarwar Muhammad
Published: September 2021

Vitamins B denote to some diverse kinds of vitamins which collectively, are recognized as B-complex vitamin. At hand are eight types of vitamins in vitamin B complex; thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate (B9) also known as folic acid and cobalamin (B12). B vitamins have a direct impact on body energy levels, brain function and cell metabolism. There is a roundup of four top causes of vitamin B deficiency; a non-balanced diet, excessive alcohol consumption, various medications and gut malabsorption conditions. Deficiencies in these B vitamins can lead to a number of different symptoms like paresthesias, peripheral neuropathy, psychosis and heart attack and stroke over time if the deficiency is not reversed. Vitamins are found in highest abundance in meat, eggs and dairy or milk products such as butter, yogurt and cheese produced from milk of mammals usually buffaloes, cattle, goats, sheep and camels. Most people can get many nutrients they need, including B vitamins, by eating a varied diet of lean meats, grains, fruits and vegetables. This chapter provides an affluent of the most common types of vitamins B, including why body needs these, their deficiency symptoms and which foods contain them.
Cervical Cancer Prevention and Control
Authors: Laelago Ersado Tariku
Published: September 2021

Cervical cancer is caused by HPV (human papilloma virus). It is the second most common cancer in women living low developed countries. The components of cervical cancer prevention and control comprises primary prevention, secondary prevention and tertiary prevention. Primary prevention of cervical cancer encompasses prevention of infection with HPV. Giving HPV vaccine for girls aged 9–14 years before they initiate sexual activity is one of the interventions of primary prevention of cervical cancer. Screening and treatment is needed in secondary prevention of cervical cancer. Screening of cervical cancer encompasses testing a target group (women) who are at risk for a cervical pre-cancer. Tertiary prevention of cervical cancer comprises treatment of cervical cancer and palliative care. The components of tertiary care comprise surgery, radiotherapy, chemotherapy and palliative care. Community mobilization, health education and counseling on cervical cancer prevention and control is vital to make ownership on cervical prevention. Monitoring and evaluation of cervical cancer prevention and control on key program indicators should be done regularly.
Facing Adversity during Graduate Medical Training: The Concept of ‘Coping Intelligence’
Authors: Taylor Nicholas , Clare Kelley Katie , S. Firstenberg Michael , Tracy Davido H. , J. Papadimos Thomas , E. McCallister Dianne , Ali Asim , Erickson-Parsons Laurel , P. Stawicki Stanislaw
Published: September 2021

Effective coping strategies are of great importance for trainees actively navigating the challenges and stresses of graduate medical education (GME). Although there is increasing emphasis on the concept of emotional intelligence (EI) in medical curricula, the range of behavioral skills learned in typical EI training may not be sufficient when dealing with extreme stress – something that healthcare students in general, and GME trainees as a subset, continue to struggle with. Under the conditions of extreme stress, multiple competing priorities and high cognitive load, even those with excellent command of EI skills may not be able to universally maintain sufficient emotional control. This, in turn, exposes a significant opportunity for further understanding and development in this dynamically evolving area of investigation. Increasing amount of research suggests that a unique skill set exists, known as ‘coping intelligence’ (CI), that may help fill the gap under the conditions of extreme stress and significantly elevated cognitive load. This chapter will discuss CI as a unique and novel concept, further exploring the possibility of introducing this new construct into the realm of GME.
Importance of Resistance Training in the Management of Cardiovascular Disease Risk
Authors: S. Shaw Brandon , A. Brown Gregory , Shaw Ina
Published: September 2021

Contrary to the longstanding taboo of resistance training (RT) as a therapeutic treatment, RT has been gaining importance as a safe therapeutic option in the management of numerous diseases. Although exercise has well-documented health benefits on cardiovascular disease (CVD), the benefit of RT on CVD risk factors is not yet as widely prescribed as other modes of exercise. Due to its efficacy in the management of CVD, RT should be regarded as a complementary therapeutic treatment rather than a substitute to other modes of exercise therapy. While it is clear that RT can result in an attenuation of CVD risk, the various RT design options related to intensity and volume and how they impact on CVD risk, especially in different populations (i.e. children, elderly, women) is not yet well documented. This chapter will discuss the physiological phenomenon and benefits of RT as a therapeutic intervention aiming to manage CVD risk.