bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of neuromuscular training and strengthening of trunk and lower limbs muscles in women with Patellofemoral Pain: A protocol of randomized controlled clinical trial, blinded
Authors: Silva Natália Camin , Silva Matheus de Castro , Guimarães Morisa Garcia , Nascimento Manoela Beatriz de Oliveira , Felicio Lilian Ramiro
Published: October 2019

Background

Patellofemoral pain (PFP) often affects young women, and the etiology is multifactorial and poorly understood. Conservative intervention has been focused on risk factors or aggravating factors and is composed of hip- and knee-strengthening exercises, as this population often has muscle weakness and poor motor control during daily and sports activities. The objective of this study was to evaluate the additional effects of neuromuscular training in a conservative treatment of trunk-, hip-, and knee-muscle strengthening on pain, function, and kinematics of the trunk, pelvis, and lower limb in women with PFP.

Methods

This is a randomised clinical trial, controlled, blinded. Ninety women who are active and engage in physical activity up to twice a week will be recruited. All participants will undergo an individual physiotherapy assessment and then will be allocated randomly into two groups. Thereafter, both groups will undergo a 12-week intervention protocol: group 1 will perform strengthening exercises for the trunk, hip, and knee muscles, while group 2 will receive the same treatment, with the inclusion of neuromuscular training exercises on the fourth week. At the end of the intervention, the volunteers will be evaluated. The primary outcomes will be pain intensity (using a Visual Analog Scale: over the last month, squat 90°, and step of 26 cm during 1 min), functional capacity (Anterior Knee Pain Scale and Activities of Daily Living Scale), and 2D kinematics of the trunk, pelvis, and lower limb during the single-leg squat. The secondary outcomes correspond to the isometric muscular strength of the lower limb and the level of satisfaction from the intervention.

Discussion

The present study was initiated on 28 January 2018 and is currently in progress, scheduled for completion in July 2019. The results of this study should contribute to the physiotherapeutic treatment of women with PFP by aggregating information on the benefits of adding neuromuscular training to strengthening of the trunk and lower-limb muscles.

Trial registration

Registro Brasileiro de Ensaios Clínicos, ID: RBR-8c7267. Registered on 2 August 2017.
Harmonisation of Outcome Parameters and Evaluation (HOPE) for actinic keratosis: protocol for the development of a core outcome set
Authors: Heppt Markus V. , Steeb Theresa , Schmitz Lutz , Garbe Claus , French Lars E. , Leiter Ulrike , Berking Carola
Published: October 2019

Background

Actinic keratoses (AK) are common skin lesions that can progress to invasive squamous cell carcinoma of the skin. A variety of lesion- or field-targeted treatment options exist and their efficacy has been demonstrated in numerous randomised controlled trials (RCTs). However, the reported endpoints are highly heterogeneous, making it difficult to assess and compare distinct treatment options and to reach an evidence-based choice of therapy.

Methods

A systematic literature search will be conducted to analyse which endpoints are reported in RCTs. The focus will be on effectiveness, tolerability, cosmesis, and patient satisfaction. The reported endpoints of these studies, as well as their frequency and data collection times, will be documented in a standardised way to generate a comprehensive list of reported endpoints. In order to complete the identified outcomes in the literature search, focus groups on affected patients and structured interviews with board-certified dermatologists will be conducted to identify both patient- and practice-relevant endpoints. After the identification phase, the evaluation of the endpoints follows. In a two-stage Delphi procedure, experts including patient representatives will evaluate the endpoints in a standardised and transparent manner. A final face-to-face consensus meeting will be conducted after the last Delphi round in which a final list of core outcomes will be consented.

Discussion

The development of a standardised endpoint set for the treatment of AK will contribute to improving the comparability of therapeutic options. Our catalogue will enhance the synthesis of evidence for the future by reducing heterogeneity in outcomes between RCTs and hence contribute to improving the quality of research, evidence-based and patient-centred treatment.

Trial registration

Core Outcome Measures for Effectiveness (COMET) database. Registered in December 2018.
Spatial and temporal disease dynamics of the parasite Hematodinium sp. in shore crabs, Carcinus maenas
Authors: Davies Charlotte E. , Batista Frederico M. , Malkin Sophie H. , Thomas Jessica E. , Bryan Charlotte C. , Crocombe Peter , Coates Christopher J. , Rowley Andrew F.
Published: October 2019

Background

The parasitic dinoflagellates of the genus Hematodinium represent the causative agent of so-called bitter or pink crab disease in a broad range of shellfish taxa. Outbreaks of Hematodinium-associated disease can devastate local fishing and aquaculture efforts. The goal of our study was to examine the potential role of the common shore (green) crab Carcinus maenas as a reservoir for Hematodinium. Carcinus maenas is native to all shores of the UK and Ireland and the North East Atlantic but has been introduced to, and subsequently invaded waters of, the USA, South Africa and Australia. This species is notable for its capacity to harbour a range of micro- and macro-parasites, and therefore may act as a vector for disease transfer.

Methods

Over a 12-month period, we interrogated 1191 crabs across two distinct locations (intertidal pier, semi-closed dock) in Swansea Bay (Wales, UK) for the presence and severity of Hematodinium in the haemolymph, gills, hepatopancreas and surrounding waters (eDNA) using PCR-based methods, haemolymph preparations and histopathology.

Results

Overall, 13.6% were Hematodinium-positive via PCR and confirmed via tissue examination. Only a small difference was observed between locations with 14.4% and 12.8% infected crabs in the Dock and Pier, respectively. Binomial logistic regression models revealed seasonality (P < 0.002) and sex (P < 0.001) to be significant factors in Hematodinium detection with peak infection recorded in spring (March to May). Male crabs overall were more likely to be infected. Phylogenetic analyses of the partial ITS and 18S rRNA gene regions of Hematodinium amplified from crabs determined the causative agent to be the host generalist Hematodinium sp., which blights several valuable crustaceans in the UK alone, including edible crabs (Cancer pagurus) and langoustines (Nephrops norvegicus).

Conclusions

Shore crabs were infected with the host generalist parasite Hematodinium sp. in each location tested, thereby enabling the parasite to persist in an environment shared with commercially important shellfish.
A human case of spotted fever caused by Rickettsia parkeri strain Atlantic rainforest and its association to the tick Amblyomma ovale
Authors: da Paixão Sevá Anaiá , Martins Thiago Fernandes , Muñoz-Leal Sebastián , Rodrigues Ana Carla , Pinter Adriano , Luz Hermes R. , Angerami Rodrigo N. , Labruna Marcelo B.
Published: October 2019

Background

Rickettsia parkeri strain Atlantic rainforest has emerged in Brazil during the last 10 years, with three laboratory-confirmed human cases. While these cases were epidemiologically associated with the tick Amblyomma ovale, in none of them the tick specimens that bit the patients could be identified.

Results

We report a clinical case of spotted fever rickettsiosis that was acquired in an Atlantic forest area in Bahia state, northeast Brazil. The case was determined to be caused by R. parkeri strain Atlantic rainforest, based on molecular analysis of the crust removed from the tick bite site (inoculation eschar) of the patients’ skin. DNA extracted from the crust yielded partial sequences of three rickettsial genes (gltA, ompA and ompB), which were 99–100% identical to R. parkeri strain Atlantic rainforest. The tick specimen that was attached to patient skin was identified as a female of A. ovale.

Conclusions

We report the fourth confirmed case of spotted fever rickettsiosis caused by R. parkeri strain Atlantic rainforest, providing to our knowledge for the first time, direct evidence of R. parkeri strain Atlantic rainforest transmission by A. ovale.
Assessment of needle stick and sharp injuries among health care workers in central zone of Tigray, northern Ethiopia
Authors: Weldesamuel Elias , Gebreyesus Hailay , Beyene Berhe , Teweldemedhin Mebrahtu , Welegebriel Zemichael , Tetemke Desalegn
Published: October 2019

Objective

Accidental occupational injuries to health care workers (HCWs) continue to have a significant problem in the healthcare system. Thus, the aim of this study was to assess prevalence of needle sticks and sharp injury and associated factors among health care workers working in Central Zone Tigray northern Ethiopia.

Result

The prevalence of needle stick and sharp injury in the past 12 months preceding the study and entire job were 25.9% and 38.5% respectively. Nearly one-third (31%) of the injuries occurred in emergency unit and 122 (71.3%) of the materials caused injury were used on patients. Practice of needle recap, ever used cigarette in last 12 months, training, work hours > 40 per week, job dissatisfaction and work experience less than 5 years were found factors significantly associated with needle stick and sharp injury for health care workers. The magnitude of Needle stick and sharp injury is high in the study area. Policy makers should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.
Accuracy of the lower third molar radiographic imaging to estimate age among Ugandan young people
Authors: Mwesigwa Catherine Lutalo , Kutesa Annet M. , Munabi Ian G. , Kabenge Catherine A. , Buwembo William
Published: October 2019

Objective

Dental development is a useful method for age estimation. Although third molar eruption is commonly used to estimate age in Uganda, it is reported to be unreliable because of external influences. The more reliable radiographic techniques have inter-ethnic differences but data from sub-Saharan Africa are limited regarding estimating age in young adults. This study, therefore, aimed at determining the accuracy of Demirjian’s classification of the lower third molar, a common dental age estimation method, in estimating key ages in a Ugandan population using Ugandan references. Dental records of 1021 Ugandans aged 10–22 years were assigned to two groups; reference and test. The reference data was retrieved from a database of a previous bigger research project.

Results

The overall sample population comprised of 514/1021 (50.3%) males. The mean age was 15.8 (3.6) years. No significant sex differences in dental age were established in the reference sample (520 records). Accuracy values (area under the curve) at the 12-, 14-, 16- and 18-year cut-offs were between 0.83 and 0.90 using the test sample (501 records). The results suggest that Demirjian’s classification of the lower third molars is a useful method for age estimation in the young urban Ugandan population in the 10–22-year age-group.
Predictive performance of the estimating equations of renal function in Sri Lankan subjects
Authors: Weerakkody Ranga Migara , Sheriff Mohammed Hussain Rezvi
Published: October 2019

Objectives

This study validates two popular predictive equations of renal function firstly, Modifications of Diet in Renal Disease and secondly, Chronic Kidney Disease Epidemiology Collaboration equations for Sri Lankan cohort. We used data of the patients referred to Renal Research lab of University of Colombo for creatinine clearance measurement.

Results

Predictive performances varied with the gender. Creatinine clearance and predicted renal functions were compared. Both fared unsatisfactorily with R2 ranging from 0.632 to 0.652, and overestimated renal function by 6–15%. The proportion chronic kidney disease staging 1 and 2 returned by Chronic Kidney Disease Epidemiology Collaboration equation showed significant difference, in females. Modifications of Diet in Renal Disease equation significantly under-estimated advanced chronic kidney disease in females. Chronic Kidney Disease Epidemiology Collaboration equation had better accuracy. The study sample had more females, Asian and lower body size and better renal functions than historic cohorts. Thai and Pakistani studies show both equations and their Asian adaptations fare poorly. Chronic kidney disease stages differ significantly with the equation used. Predictive equations have fared unsatisfactorily by overestimating renal functions. We recommend further studies using gold standards of measuring renal function.
Institutional design, informal practices and international conflict: The case of community-based pasture management in the Kyrgyz-Tajik border region
Authors: Kurmanalieva Gulzana , Crewett Wibke
Published: October 2019

In the Kyrgyz Region of Ferghana Valley, violent conflict flares repeatedly between the local Kyrgyz majority population and the Tajik ethnic minority. Drawing on a recent qualitative case study conducted in the borderlands of one of the two Tajik enclaves within the Kyrgyz Batken Region, this article seeks to identify the causes of pasture-related inter-ethnic conflict in the agro-pastoral Kyrgyz–Tajik border region. The paper employs an institutional perspective and explores the impact of the given institutional setup. We note that a lack of institutional arrangements for transboundary pasture use hinders Tajik herders’ legal access to the region’s sole summer pastures. The Kyrgyz “Pasture Committee” has pragmatically designed local rules on transboundary pasture use in the Kyrgyz–Tajik border region, thereby assuring Tajik herders at least semi-official access to the summer pastures. Yet while these rules limit conflict, they fail to limit overstocking. Locally designed rules also open up business opportunities to Tajik herders, which some of the Kyrgyz herders consider unfair and illegal. In order to achieve sustainable and locally accepted regional pasture management, despite the lack of legislative amendments and international agreements, we propose local-level institutional innovations. We also emphasize that pasture use regulation is paramount for maintaining regional stability and peaceful cooperation.
An analytical approach to obtain exact solutions of some space-time conformable fractional differential equations
Authors: Kadkhoda Nematollah , Jafari Hossein
Published: October 2019

In this paper, the sine-Gordon expansion method is used to obtain analytical solutions of the conformable space-time generalized reaction Duffing model and conformable space-time Eckhaus equation with the aid of symbolic computation. These equations can be reduced into ordinary differential equations (ODEs) using a suitable wave transformation with a predicted polynomial-type solution.
Levinson type inequalities for higher order convex functions via Abel–Gontscharoff interpolation
Authors: Adeel Muhammad , Khan Khuram Ali , Pečarić Ðilda , Pečarić Josip
Published: October 2019

In this paper, Levinson type inequalities are studied for the class of higher order convex functions by using Abel–Gontscharoff interpolation. Cebyšev, Grüss, and Ostrowski-type new bounds are also found for the functionals involving data points of two types.
Targeted and novel therapy in advanced gastric cancer
Authors: Selim Julie H. , Shaheen Shagufta , Sheu Wei-Chun , Hsueh Chung-Tsen
Published: October 2019

The systemic treatment options for advanced gastric cancer (GC) have evolved rapidly in recent years. We have reviewed the recent data of clinical trial incorporating targeted agents, including inhibitors of angiogenesis, human epidermal growth factor receptor 2 (HER2), mesenchymal–epithelial transition, epidermal growth factor receptor, mammalian target of rapamycin, claudin-18.2, programmed death-1 and DNA. Addition of trastuzumab to platinum-based chemotherapy has become standard of care as front-line therapy in advanced GC overexpressing HER2. In the second-line setting, ramucirumab with paclitaxel significantly improves overall survival compared to paclitaxel alone. For patients with refractory disease, apatinib, nivolumab, ramucirumab and TAS-102 have demonstrated single-agent activity with improved overall survival compared to placebo alone. Pembrolizumab has demonstrated more than 50% response rate in microsatellite instability-high tumors, 15% response rate in tumors expressing programmed death ligand 1, and non-inferior outcome in first-line treatment compared to chemotherapy. This review summarizes the current state and progress of research on targeted therapy for advanced GC.
Learning Progressions: An Empirically Grounded, Learner-Centered Framework to Guide Biology Instruction
Authors: Scott Emily E. , Wenderoth Mary Pat , Doherty Jennifer H.
Published: October 2019

Vision and Change challenged biology instructors to develop evidence-based instructional approaches that were grounded in the core concepts and competencies of biology. This call for reform provides an opportunity for new educational tools to be incorporated into biology education. In this essay, we advocate for learning progressions as one such educational tool. First, we address what learning progressions are and how they leverage research from the cognitive and learning sciences to inform instructional practices. Next, we use a published learning progression about carbon cycling to illustrate how learning progressions describe the maturation of student thinking about a key topic. Then, we discuss how learning progressions can inform undergraduate biology instruction, citing three particular learning progressions that could guide instruction about a number of key topics taught in introductory biology courses. Finally, we describe some challenges associated with learning progressions in undergraduate biology and some recommendations for how to address these challenges.
Prevalence of Insomnia (Symptoms) in T2D and Association With Metabolic Parameters and Glycemic Control: Meta-Analysis
Authors: Koopman Anitra D M , Beulens Joline W , Dijkstra Tine , Pouwer Frans , Bremmer Marijke A , van Straten Annemieke , Rutters Femke
Published: October 2019

Objective

We aimed to determine the prevalence of insomnia and insomnia symptoms and its association with metabolic parameters and glycemic control in people with type 2 diabetes (T2D) in a systematic review and meta-analysis.

Data Sources

A systematic literature search was conducted in PubMed/Embase until March 2018.

Study Selection

Included studies described prevalence of insomnia or insomnia symptoms and/or its association with metabolic parameters or glycemic control in adults with T2D.

Data Extraction

Data extraction was performed independently by 2 reviewers, on a standardized, prepiloted form. An adaptation of Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included studies.

Data Synthesis

When possible, results were meta-analyzed using random-effects analysis and rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

A total of 11 329 titles/abstracts were screened and 224 were read full text in duplicate, of which 78 studies were included. The pooled prevalence of insomnia (symptoms) in people with T2D was 39% (95% confidence interval, 34–44) with I2 statistic of 100% (P < 0.00001), with a very low GRADE of evidence. Sensitivity analyses identified no clear sources of heterogeneity. Meta-analyses showed that in people with T2D, insomnia (symptoms) were associated with higher hemoglobin A1c levels (mean difference, 0.23% [0.1–0.4]) and higher fasting glucose levels (mean difference, 0.40 mmol/L [0.2–0.7]), with a low GRADE of evidence. The relative low methodological quality and high heterogeneity of the studies included in this meta-analysis complicate the interpretation of our results.

Conclusions

The prevalence of insomnia (symptoms) is 39% (95% confidence interval, 34–44) in the T2D population and may be associated with deleterious glycemic control.
Differentiating Familial Chylomicronemia Syndrome From Multifactorial Severe Hypertriglyceridemia by Clinical Profiles
Authors: O’Dea Louis St L , MacDougall James , Alexander Veronica J , Digenio Andres , Hubbard Brant , Arca Marcello , Moriarty Patrick M , Kastelein John J P , Bruckert Eric , Soran Handrean , Witztum Joseph L , Hegele Robert A , Gaudet Daniel
Published: October 2019

Context

Differentiation between familial chylomicronemia syndrome (FCS, type 1 hyperlipoproteinemia), a rare metabolic disorder, and the more common multifactorial severe hypertriglyceridemia (sHTG, type 5 hyperlipoproteinemia) is challenging because of their overlapping symptoms but important in patient management.

Objective

To assess whether readily obtainable clinical information beyond triglycerides can effectively diagnose and differentiate patients with FCS from those with sHTG, based on well-curated data from two intervention studies of these conditions.

Methods

The analysis included 154 patients from two phase 3 clinical trials of patients with sHTG, one cohort with genetically confirmed FCS (n = 49) and one with multifactorial sHTG (n = 105). Logistic regression analyses were performed to determine the ability of variables (patient demographics, medical history, and baseline lipids, individually or in sets) to differentiate the patient populations. Receiver operating characteristics were used to determine the variable sets with the highest accuracy (percentage of times actual values matched predicted) and optimal sensitivity and specificity.

Results

The primary model diagnosed 45 of 49 patients with FCS and 99 of 105 patients with sHTG correctly. Optimal sensitivity for all available parameters (n = 17) was 91.8%, optimal specificity was 94.3%, and accuracy was 93.5%. Fasting low-density lipoprotein cholesterol (LDL-C) provided the highest individual predictability. However, a three-variable set of ultracentrifugally measured LDL-C, body mass index, and pancreatitis history differentiated the diseases with a near similar accuracy of 91.0%, and adding high-density lipoprotein cholesterol and very low-density lipoprotein cholesterol for a five-variable set provided a small incremental increase in accuracy (92.2%).

Conclusions

In the absence of genetic testing, hypertriglyceridemic patients with FCS and sHTG can be differentiated with a high degree of accuracy by analyzing readily obtainable clinical information.
Impact of Second Opinions in Breast Cancer Diagnostics and Treatment: A Retrospective Analysis
Authors: Heeg E. , Civil Y. A. , Hillen M. A. , Smorenburg C. H. , Woerdeman L. A. E. , Groen E. J. , Winter-Warnars H. A. O. , Peeters M. T. F. D. Vrancken
Published: October 2019

Background

Breast cancer care is becoming increasingly complex, and patients with breast cancer are increasingly aware of the different treatment options, resulting in requests for second opinions (SOs). The current study investigates the impact of breast cancer SOs on final diagnosis and treatment in the Netherlands Cancer Institute (NCI) using a newly designed Breast Cancer Second Opinion (BCSO) classification system.

Methods

Patients who visited the NCI for an SO between October 2015 and September 2016 were included. Demographics, diagnostics, and treatment proposals were compared between first and SO. Discrepancy was categorized using our BCSO classification system, categorizing SOs into (1) noncomparable, (2) identical, and (3) minor or (4) major discrepancy.

Results

The majority of SOs (n = 591) were patient initiated (90.7%). A total of 121 patients underwent treatment prior to their SO, leaving 470 patients for assessment of discrepancies according to our BCSO classification system. More than 45% of these SOs resulted in at least one discrepancy, with comparable rates for physician- and patient-initiated SOs (42.5% vs. 45.6%, p = 0.708). Significantly more discrepancies were observed in patients with additional imaging (51.3% vs. 37.2%, p = 0.002) and biopsies (53.7% vs. 40.3%, p = 0.005). Almost 60% of all discrepancies were categorized as major (neoadjuvant systemic treatment instead of primary surgery, breast-conserving surgery instead of mastectomy, and proposing postmastectomy immediate breast reconstruction).

Conclusions

Our findings show substantial differences in diagnostic and treatment options in breast cancer patients visiting the Netherlands Cancer Institute for an SO, thereby emphasizing more consensus for the indications of these treatment modalities.
Lifelong Physical Activity Determines Vascular Function in Late Postmenopausal Women
Authors: GLIEMANN LASSE , RYTTER NICOLAI , TAMARIZ-ELLEMANN ANDREA , EGELUND JON , BRANDT NINA , CARTER HOWARD H. , HELLSTEN YLVA
Published: October 2019

Introduction

The study evaluated the role of lifelong physical activity for leg vascular function in postmenopausal women (61 ± 1 yr).

Method

The study design was cross-sectional with three different groups based on self-reported physical activity level with regard to intensity and volume over the past decade: inactive (n = 14), moderately active (n = 12), and very active (n = 15). Endothelial-dependent and smooth muscle-dependent leg vascular function were assessed by ultrasound Doppler measurements of the femoral artery during infusion of acetylcholine (Ach), the nitric oxide (NO) donor sodium nitroprusside and the prostacyclin analog epoprostenol. Thigh muscle biopsies, arterial and venous plasma samples were obtained for assessment of vasodilator systems.

Results

The very active group was found to have 76% greater responsiveness to Ach compared with the sedentary group accompanied by 200% higher prostacyclin synthesis during Ach infusion. Smooth muscle cell responsiveness to sodium nitroprusside and epoprostenol was not different between groups. The protein amount of endothelial NO synthase and endogenous antioxidant enzymes in muscle tissue was higher in the very active than the inactive group. The moderately active group had a similar endothelial and smooth muscle cell responsiveness as the inactive group. A secondary comparison with a smaller group (n = 5) of habitually active young (24 ± 2 yr) women indicated that smooth muscle cell responsiveness and endothelial responsiveness are affected by age per se.

Conclusions

This study shows that leg vascular function and the potential to form prostacyclin and NO in late postmenopausal women, is influenced by the extent of lifelong physical activity.
Oral l-Tyrosine Supplementation Improves Core Temperature Maintenance in Older Adults
Authors: LANG JAMES A. , KRAJEK ALEX C. , SCHWARTZ KELSEY S. , RAND JOEL E.
Published: October 2019

Introduction

During cold exposure, an increase in sympathetic nerve activity evokes vasoconstriction (VC) of cutaneous vessels to minimize heat loss. In older adults, this reflex VC response is impaired thereby increasing their susceptibility to excess heat loss and hypothermia. Becausel-tyrosine, the amino acid substrate necessary for catecholamine production, has been shown to augment reflex VC in age skin, we hypothesize that oral ingestion ofl-tyrosine will attenuate the decline in core temperature (Tc) during whole-body cooling in older adults.

Methods

In a randomized, double-blind design, nine young (25 ± 3 yr) and nine older (72 ± 8 yr) participants ingested either 150 mg·kg−1ofl-tyrosine or placebo before commencing 90 min of whole-body cooling to decrease skin temperature to approximately 29.5°C. Esophageal temperature and forearm laser Doppler flux (LDF) were measured continuously throughout the protocol to provide an index ofTcand skin blood flow, respectively. The change in esophageal temperature (ΔTES) was the difference in temperature at the end of cooling subtracted from baseline. Cutaneous vascular conductance (CVC) was calculated as CVC = LDF/mean arterial pressure and expressed as a percent change from baseline (%ΔCVCBASELINE).

Results

Oral tyrosine ingestion augmented the cutaneous VC response to cooling in older adults (placebo, 14.4 ± 2.0; tyrosine, 32.7% ± 1.7% ΔCVCBASELINE;P< 0.05). Additionally, tyrosine improvedTcmaintenance throughout cooling in older adults (placebo, −0.29 ± 0.07; tyrosine, −0.07 ± 0.07 ΔTES;P< 0.05). Both the cutaneous VC andTcduring cooling were similar between young and older adults supplemented with tyrosine (P> 0.05).

Conclusions

These results indicate thatl-tyrosine supplementation improvesTcmaintenance in response to acute cold exposure in an older population.
Prevalence of periodontal diseases and its correlation with different risk factors among an adult Egyptian population: a cross-sectional study
Authors: Abbass Marwa M.S. , Rady Dina , Radwan Israa Ahmed , El Moshy Sara , AbuBakr Nermeen , Ramadan Mohamed , Yussif Nermin , Al Jawaldeh Ayoub
Published: October 2019

Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited.  The present study was carried out to evaluate the prevalence and the severity of periodontal disease and its correlation with different risk factors.

Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire.

Results: It was found that 58.9% of participants had calculus deposits. The prevalence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, crackers, and caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level.

Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the prevalence and the severity of periodontal diseases.
Study protocol: The INTERMAP China Prospective (ICP) study
Authors: Yan Li , Carter Ellison , Fu Yu , Guo Dongshuang , Huang Pinchun , Xie Gaoqiang , Xie Wuxiang , Zhu Yidan , Kelly Frank , Elliott Paul , Zhao Liancheng , Yang Xudong , Ezzati Majid , Wu Yangfeng , Baumgartner Jill , Chan Queenie
Published: October 2019

Background: Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood.  The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function including BP, arterial stiffness, and carotid-intima media thickness.

Methods: A total of 839 Chinese participants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls.  In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages.  Participant’s environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns.  Serum and plasma specimens were collected with 24-hour urine specimens.

Discussion:  Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision.  We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects.  The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements.  However, extensive efforts will apply to minimize those limitations (continuous observer training, repeated measurements of BP, standardized methods in data collection and measurements, and on-going quality control).
Using the Principle of Problematicity for the Development Socialization of Schoolchildren
Authors: Шевченко Н. , Shevchenko N.
Published: October 2019

The article discusses the features of the implementation of problem-based learning, as the most eff ective for the development of schoolchildren. The features of creating problem situations, tasks for them are noted. It indicates the diff erences between traditional and problem-based learning.
ESCOLA E VIOLÊNCIA: A BUSCA POR UMA AMPLIAÇÃO DO TERMO VIOLÊNCIA ESCOLAR FRENTE A REALIDADE BRASILEIRA
Authors: Marino Leonardo Freire
Published: October 2019

Este texto propõe estabelecer algumas indagações a respeito da chamada violência escolar. Nele focalizamos alguns pontos que consideramos relevantes para o entendimento do conceito de violência escolar, seus aspectos constituintes, suas manifestações cotidianas e suas motivações. Para tanto, não estabeleceremos uma análise quantitativa ou que procure uma explicação fatalista deste processo. Nossa motivação não reside em entender as razões individuais da violência escolar, mas, perceber os fatores sistêmicos e simbólicos que tem interferido no atual processo de multiplicação dos casos de violência nas escolas brasileiras.
Challenges to concordance: theories that explain variations in patient responses
Authors: Green Julie , Jester Rebecca
Published: October 2019

To meet the challenges of an increasingly ageing and multimorbid population, patients must be fully engaged to work in partnership with their health professional (HP) in the management of their condition(s). The NHS Long Term Plan (2019) outlines goals to manage the increasing demands on the health service—hospital admission avoidance, shorter length of hospital stays through enhanced recovery pathways, increased management of patients within primary care and ensuring a person-centred approach to care provision. Meeting these goals is predicated on HPs being equipped to activate patients using the skills of motivational interviewing, person-centred care and a willingness to share decision making. This article presents a range of psychological theories that could explain the everyday challenges faced in care delivery. Awareness of these theories may help HPs target their approach to care delivery more effectively, to understand patient responses and, therefore, optimise the provision of person-centred care.
Lintasan sampah mikro plastik di kawasan konservasi perairan Nasional Laut Sawu, Nusa Tenggara Timur
Authors: Purba Noir P , Pranowo Widodo S , Simanjuntak Sahat M. , Faizal Ibnu , Jasmin Haifa H. , Handyman Dannisa I.W. , Mulyani Putri G
Published: October 2019

Abstract. At present, marine debris is an important issue in Indonesia. Due to the complex pattern of ocean currents, research on the distribution of marine waste in Indonesia is still very lacking. This study aims to determine the movement of microplastic particles at the Savu Sea National Marine Park. The method used was to simulate the hydrodynamic model and particle trajectory. Data used were wind, tides, bathymetry, coastline, weight of garbage, and garbage fluxes. Analysis was carried out on physical data visualization, hydrodynamic models, and particle trajectory models. The hydrodynamic model simulation shows if the average current velocity ranges from 0,0002 m/s to 0.35 m/s. The particle trajectory showed that microplastic particle movements tend to move to the south, where some of them move west and east of the Savu Sea. Besides being affected by tides, microplastic particle movements in the Savu Sea National Marine Park are also influenced by various currents that pass through the Savu Sea waters, especially by Indonesia Troughflow.Keywords: ocean model, particle pathways, microdebris, Savu Seas, Indonesia Troughflow Abstrak. Saat ini, sampah laut merupakan salah satu isu kemaritiman di Indonesia. Karena pola pergerakan arus yang kompleks, penelitian mengenai distribusi sampah laut di Indonesia masih sangat kurang. Taman Laut Nasional Laut Sawu sebagai wilayah yang dilalui Arlindo juga memiliki karakteristik oseanografi yang kompleks. Penelitian ini bertujuan untuk mengetahui hasil simulasi pergerakan partikel sampah di Taman Nasional Perairan (TNP) Laut Sawu. Metode yang digunakan yaitu simulasi model hidrodinamika dan lintasan partikel. Data yang digunakan yaitu angin, pasang surut, batimetri, garis pantai, berat sampah, dan flux sampah. Analisis dilakukan terhadap visualisasi data fisik, model hidrodinamika, dan model pergerakan partikel. Simulasi model hidrodinamika menunjukkan jika rata-rata kecepatan arus berkisar antara 0,0002 m/s hingga 0,35 m/s. Hasil simulasi menunjukkan jika pergerakan partikel mikroplastik cenderung bergerak ke selatan, dimana sebagian bergerak ke arah barat dan timur Laut Sawu. Selain dipengaruhi pasang surut, pergerakan partikel mikroplastik di Taman Laut Nasional Laut Sawu juga dipengaruhi oleh berbagai arus yang melewati perairan Laut Sawu khususnya Arlindo.Kata kunci: pemodelan, lintasan partikel, sampah mikro, Laut Sawu, Arlindo.
Clays impact on bitumen-extraction processes
Authors: Hollander Elco , Omotoso Oladipo
Published: October 2019

The clay minerals present in the oil-sands ore are responsible for some of the most challenging (and intriguing) processing behavior experienced on a routine basis in oil-sands surface mining. In previous chapters, significant details have been provided on how specific clay properties can give rise to changes in slurry rheology and interface phenomena. Because the bitumen extraction process relies heavily on manipulation of interfacial effects to enhance separation, changes in clay content in the ore, not surprisingly, can have a dramatic impact on the ability to process the material. This chapter provides an overview of the extraction process, the influence of clay minerals on bitumen recovery, and the challenges in reacting to changes in the ore clay content in a typical operation. The chapters that follow focus on the larger issue of tailings treatment to create a reclaimed landscape at the end of mine life.
Reducing probes for quality of transmission estimation in optical networks with active learning
Authors: Azzimonti Dario , Rottondi Cristina , Tornatore Massimo
Published: October 2019

Estimating the quality of transmission (QoT) of a lightpath before its
establishment is a critical procedure for efficient design and
management of optical networks. Recently, supervised machine learning
(ML) techniques for QoT estimation have been proposed as an effective
alternative to well-established, yet approximated, analytic models
that often require the introduction of conservative margins to
compensate for model inaccuracies and uncertainties. Unfortunately, to
ensure high estimation accuracy, the training set (i.e., the set of
historical field data, or “samples,” required to train these
supervised ML algorithms) must be very large, while in real network
deployments, the number of monitored/monitorable lightpaths is limited
by several practical considerations. This is especially true for
lightpaths with an above-threshold bit error rate (BER) (i.e.,
malfunctioning or wrongly dimensioned lightpaths), which are
infrequently observed during network operation. Samples with
above-threshold BERs can be acquired by deploying probe lightpaths,
but at the cost of increased operational expenditures and wastage of
spectral resources. In this paper, we propose to use active learning to reduce the number of probes
needed for ML-based QoT estimation. We build an estimation model based
on Gaussian processes, which allows iterative identification of those
QoT instances that minimize estimation uncertainty. Numerical results
using synthetically generated datasets show that, by using the
proposed active learning approach, we can achieve the same performance
of standard offline supervised ML methods, but with a remarkable
reduction (at least 5% and up to 75%) in the number of training
samples.
The effect of earning information, cash flow components, and financing decision on stock returns: empirical evidence on Indonesia stock exchange
Authors: Kasmiati Mia , Santosa Perdana Wahyu
Published: October 2019

Trading, Service, and Investment sectors show an essential role in the national economy, and they have grown significantly during the past years. They have created many job opportunities in both the formal sector and the non-formal sector. This study aims to analyze the effect of net profit, operating cash flow, financing cash flow and investing cash flow and, financing decisions on stockâ€™s return of service industry listed at Indonesia Stock Exchange (IDX). The analysis was done using the data panel regression. It shows that earning information, operating cash flow, financing cash flow positively affect stock returns. However, investing cash flow and financing decisions (proxy leverage) show a negative effect on the stock's return significantly. Simultaneously, the variables above affect stock return significantly. The implication is that management should pay more attention to financial factors, especially net profit, cash flow, and leverage to increase stock return and the companyâ€™s value.
Causes et états de la recherche en LOCI
Authors: Stillemans Jean
Published: October 2019

L’article reprend les mots d’introduction à une journée facultaire consacrée à la recherche en architecture (2011). Il y est développé, entre autres, que cette recherche suppose comme conditions de déploiement : la suspension de l’urgence, la retenue éthique et la concentration spéculative.
Confrontation du standard Maison Passive à la notion d'architecture soutenable
Authors: Van Moeseke Geoffrey
Published: October 2019

Le Standard Maison Passive a été défini il y a 20 ans et s'est rapidement répandu en Europe suite au projet Cepheus. L'article pointe le caractère essentiellement performantiel du standard Maison Passive, et pose la question de la cohérence de ce standard avec une définition plus large de l'architecture soutenable, englobant de multiples dimensions environnementales, sociales et culturelles.

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Pierre Van Assche
Authors: Vandernoot Cécile
Published: October 2019

Pierre Van Assche, architecte urbaniste, conçoit des projets de différentes envergures, privés comme publics. Ses idéaux ont contribué dans les années septante à sensibiliser les autorités bruxelloises à la préservation du patrimoine. Familier des contrats de quartier, attentif aux zones plus fragilisées, il décrit ses projets comme de modestes maillons dans le processus de redéveloppement urbain.
Arrêts sur images
Authors: Dath Fabienne , Houdé Joëlle
Published: October 2019

A partir de la vision de films sur des œuvres architecturales du XXè s en Inde, quelques séances de recherche graphique ont permis aux étudiants de donner une interprétation d’objets d’artisanat et d’architecture en suites associées de compositions abstraites où la couleur donne à voir le jeu des dispositions spatiales sous la lumière.
Concevoir un projet d'architecture. Calmer les certitudes, gérer l'incertitude
Authors: Claeys Damien
Published: October 2019

Le processus de conception d'un projet d'architecture n'est pas linéaire, il est plutôt circulaire, itératif, réflexif et il passe alternativement par des phases de convergence et de divergence avant d'aboutir à une solution sous-optimale. Alors que le concepteur est affecté d'incomplétude, d'autoréférence et d'indétermination, l'usage du pseudo hasard et la pratique de l'abduction peuvent susciter la sérendipité créative en architecture.
ATENÇÃO FARMACÊUTICA A PACIENTES DO SISTEMA ÚNICO DE SAÚDE COM ACNE GRAVE: UM SERVIÇO DE SAÚDE NO AMBIENTE ACADÊMICO
Authors: Rodrigues Marília de Carvalho , Bezerra Walkiria Brenda de Sousa , Benvindo Trajano Leticia Paula , Barbosa Ferreira Pablo Ricardo , Ferreira de Araújo Éverton José
Published: October 2019

Acne é uma doença cutânea, genética-hormonal que provoca a formação de comedões, pápulas e pústulas na região da face e do tórax. A presente pesquisa avaliou o impacto da Atenção Farmacêutica a pacientes do Sistema Único de Saúde (SUS) que recebem isotretinoína sistêmica gratuitamente para o tratamento de acne grave em um serviço de saúde desenvolvido em uma farmácia universitária pública inserida no Componente Especializado da Assistência Farmacêutica. Trata-se de um estudo descritivo, retrospectivo e quantitativo baseado na análise das fichas de acompanhamento farmacoterapêutico, intervenções farmacêuticas e exames laboratoriais documentados em registros internos de pacientes assistidos pela Farmácia Escola da Universidade Federal do Piauí no período de novembro de 2015 a julho de 2017. Foram analisados os registros de 23 pacientes nos quais foram constatados 34 tipos de reações adversas ao medicamento, além de 4 intervenções farmacêuticas, predominantemente relacionadas ao risco de interações medicamentosas. A pesquisa ressalta a notoriedade da iniciativa da implantação desse tipo de serviço em locus acadêmico para a formação de novos profissionais da saúde, além dos benefícios do acompanhamento farmacêutico aos pacientes com acne grave.
The Image of the Little Child and its Upbringing as Reflected in Yconomica by Conrad of Megenburg. A Contribution to the History of Education in the Late Middle Ages
Authors: Brzeziński Witold
Published: October 2019

The paper is concerned with the views of the fourteenth-century German thinker and writer Conrad of Megenburg on the nature of a little child (until the age of seven) and his or her  upbringing as reflected in his Yconomica. This work belonged to the oeconomica genre – books of instructions about the prudent management of the household, including recommendations on the proper upbringing of offspring. Conrad perceives the child primarily as lacking an ability to reason. Consequently, in his opinion what the child speaks or does is only a mindless imitation – a kind of aping – of what he or she hears or sees in others. Therefore, recommendations given by Conrad to parents on how they should take care of their children are mostly concerned with their health and proper physical development. To a lesser degree the first years of living is a time for the child to learn some good manners, e.g. while eating and to gain basic religious knowledge. This kind of learning, however, does not require any understanding, it consists in developing appropriate habits in children. Only when they reach the age of seven did their proper education begin. In his view of the little child and his or her upbringing Conrad of Megenburg follows the Aristotelian tradition.