bluuebunny/crossref_metadata_2025 huggingface dataset:
APLIKASI E-COMMERCE DENGAN METODE THEORY OF PLANNED BEHAVIOR DALAM BISNIS PENJUALAN (STUDI KASUS TOKO-TOKO DI WONOSOBO)
Authors: Hasanah Nur
Published: December 2018

Masih banyaknya toko yang belum memanfaatkan falisitas internet, penjualan barang dagang masih bersifat konvensional, hal ini sangat berpengaruh terhadap penjualan produk hingga omzet yang didapat. Penerapan e-commerce merupakan hal yang penting dalam dunia usaha mengingat kebutuhan menyesuaikan perkembangan dunia luas sehingga mengharuskan kita agar terus berfikir secara kretif dalam mengembangkan usaha di dunia usaha Kegiatan menjual dan membeli menggunakan media internet serign dikenal sebagai e-commerce. kesuksesan penjualan pada e-commerce ini sanat tergantung akan implementasi electronic commerce technology.

Mendapatkan hasil berupa tingkat kepentingan atas implementasi e-commerce dalam bisnis penjualan dengan objek penelitian beberapa toko yang ada di Wonosobo, selain itu juga bertujuan memberikan rekomendasi kepada toko yang belum menerapkan sistem e-commerce, agar setelah penelitan dilakukan bisa memanfaatkan teknologi internet yaitu menerapkan sistem ecommerce.

Penelitian ini menerapkan Theory of Planned Behavior, dimana variabel yang mentukan intense untuk penentuan apa perilaku selanjutnya, yaitu Norma Subjektif (subjective norm) , sikap (attitude toward the behavior), dan kendali perilaku(perceivd behavior control). Variabel dependen berupa Usage Behavior dengan Intention to Use sebagai variabel independennya. Dependent Variable berikutnya yaitu niat menggunakan(Intention to Use) dengan independent variablenya adalah Subjective Norms, Sikap Atas Perilaku dan Kendali Perilaku.

Analisis data menggunakan uji regresi dengan pengecekan antara variabel independen dan variabel dependen. Akan dihasilkan model persamaan matematis dengan penggunaan uji statistik sehingga akan diketahui tingkat pengaruh independent variable atas dependent variable.
Lymphocyte active immunotherapy for unexplained recurrent spontaneous abortion
Authors: Wei Xian Jiang , Fang Xiao Qin , Tong Ling
Published: December 2018

This study is to evaluate the curative effect of lymphocyte active immune treatment for unexplained recurrent spontaneous abortion. Fourteen randomized controlled trials of 994 subjects were included. Blocking antibody positive rate of patients who experienced a new pregnancy showed significant differences between immunotherapy and placebo. Moreover, live birth rate among paternal or third-party donor lymphocytes and placebo groups had significant difference [RR= 1.63, 95% CI (1.38-1.92), p＜0.05]. Trial sequential analysis showed that the Z-curve crosses the trial sequential monitoring boundaries, confirming that the clinical benefit of active immunotherapy was significant. Subgroup analysis suggests that immunotherapy with lymphocytes might be more effective for primary recurrent spontaneous abortion than for secondary recurrent miscarriage. Taken together, women with primary recurrent spontaneous abortion who are negative for blocking antibody prior to treatment seemed most likely to obtain a potential beneficial effect of lymphocyte active immunotherapy, but not secondary recurrent spontaneous abortion.
Acroptilon repens induces apoptosis in human breast adenocarcinoma
Authors: Mosaddegh Mahmoud , Irani Mahboobeh , Hamzeloo-Moghadam Maryam
Published: December 2018

Evaluating the effect of herbal extracts has been always interesting for cancer researchers considering that these natural materials could be suitable sources for finding new anti-cancer agents. In the present study, Acroptilon repens methanol extract had been evaluated for its cytotoxic effects in two human breast cancer cell lines, MCF-7 and MDA-MB-468, using MTT assay. The apoptosis potential had also been evaluated using annexin-V/propidium iodide assay, Hoechst 33258 staining and evaluating the cell cycle with flow cytometery. The MTT results showed cytotoxicity with IC50 values of 69.2 and 32.6 μg/mL for MCF-7 and MDA-MB-468 cells, respectively. The results of the apoptosis assays confirmed the apoptosis potential of the plant extract in the breast cancer cell lines suggesting A. repens for further cancer studies.
Pseudomonas aeruginosa - Modified Hodge Test (PAE-MHT) and ChromID Carba Agar for Detection of Carbapenemase Producing Pseudomonas Aeruginosa Recovered from Clinical Specimens
Authors: Othman Hala B. , Abdel Halim Rania Mohamed , Abdul-Wahab Hoda Ezz El-arab , Atta Hossam Abol , Shaaban Omyma
Published: December 2018

AIMS: This study aims to evaluate the ability of ChromID Carba agar, and Pseudomonas aeruginosa modified Hodge test (PAE-MHT) for detection of carbapenemase-producing P. aeruginosa and to determine the associated carbapenemase gene classes by PCR.
METHODS: One hundred Carbapenem-resistant P. aeruginosa (CRPA) isolates were tested for: i) carbapenemases production by ChromID carba agar, Modified Hodge test (MHT) and (PAE-MHT) and ii) detection of some carbapenemase genes by PCR.
RESULTS: All (100%) of the isolates showed growth on ChromID Carba agar with 100% sensitivity. Using MHT, 54% of isolates were positive, 3% were indeterminate, and 43% were negative, demonstrating 58.9% sensitivity and 80% specificity. On performing PAE-MHT, 91% of the strains were positive, 3% were intermediate, and 6% were negative, demonstrating 97.9% sensitivity and 80% specificity. The most prevalent gene was blaKPC (81%), followed by blaVIM (74%); blaIMP was detected in only one isolate, and blaOXA-48 in 34% of the isolates.
CONCLUSIONS: We conclude that PAE-MHT and ChromID Carba are sensitive, specific, simple and cost-effective screening tests for detection of CRPA isolates compared to the traditional MHT.
Survival and Side Effects in Non-Small Cell Lung Cancer Patients Treated With Combination of Chemotherapy and Conformal Radiotherapy
Authors: Crvenkova Simonida
Published: December 2018

BACKGROUND: Combined modality therapy is standard of care for patients with inoperable locally advanced non-small cell lung cancer (NSCLC), however, insufficient data exist regarding what chemoradiotherapy combination will be the gold standard.
AIM: The study aimed to compare the survival impact and side effects of concurrent versus sequential radiochemotherapy treatment in inoperable stage III non-small cell lung cancer (NSCLC).
METHODS: To evaluate the treatment results and prognostic variables, 85 NSCLC patients treated from October 2005 to November 2008 were randomly assigned to one of the two treatment arms. In the first arm (sequential arm), 45 patients received sequential chemotherapy with 4 cycles of carboplatin and etoposide followed by conformal 3-dimensional (3D) radiotherapy (RT). In the second arm (concurrent arm), 40 patients received concomitant chemotherapy with cisplatin and etoposide and conformal RT, followed by two cycles of consolidation chemotherapy with carboplatin and etoposide
RESULTS: The median survival was 13 months for the patients in the sequential arm and 19 months for those in the concurrent treatment arm (p = 0.0039). The disease-free survival (DFS) was 9 months in the sequential arm and 16 months in the concurrent treatment arm (p = 0.0023). Seven complete responses and 18 partial responses were obtained with sequential treatment. Twelve complete responses and 21 partial responses were obtained in concurrent arm. The differenced were statistically significant p = 0.03. Median survival for patients with complete response in concurrent treatment arm was 36 months versus 18 mounts for a sequential arm; partial response was 27 months versus 16 months and those with stable disease 11 months versus 9 months. Treatment-related toxicities were assessed according to the RTOG/EORTC criteria. Acute esophagitis and incidence of neutropenia were higher with the concurrent than with sequential treatment. Grade 3 esophagitis was characteristic only for concurrent treatment, and it was the reason for radiotherapy interruption, but no longer than 7 days. Secondary anaemia was more frequent in the sequential treatment arm.
CONCLUSION: The statistically significant differences in survival were suggested that the concurrent chemotherapy and conformal three-dimensional radiotherapy is the optimal strategy for patients with locally advanced NSCLC with acceptable toxicity rates.
L’enseignement, l’apprentissage, l’enseignement/apprentissage de la lecture de 1994 à 2016
Authors: Briquet-Duhazé Sophie
Published: December 2018

Pour apprendre à lire, il est nécessaire que l’enfant comprenne le principe alphabétique (caractérisant toutes les langues) consistant à faire correspondre une suite de lettres d’un mot lu en une suite de sons qui lui correspond. Plus cette procédure est automatisée, plus l’élève peut porter ses efforts sur la compréhension du texte lu. Lire c’est donc comprendre un texte lu. L’objectif de cette note de synthèse est d’établir un répertoire d’une centaine de recherches portant sur trois catégories : l’enseignement, l’apprentissage puis l’enseignement-apprentissage de la lecture, entre 1994 et 2016. Les pratiques au CP, la compréhension sont au cœur de l’enseignement de la lecture tout comme la recherche de son efficacité. L’apprentissage de la lecture s’oriente progressivement vers les difficultés en concentrant les recherches sur les prédicteurs. Les travaux reliant enseignement et apprentissage de la lecture quittent le terrain socio-économique pour se centrer sur des méta-analyses ou bien des recherches ciblées incluant l’analyse des pratiques enseignantes et la littératie.
Travail collectif et individuel des enseignants sur leurs ressources le cas d’un collectif dédié aux langues
Authors: Beauné Aurélie
Published: December 2018

La recherche présentée dans cette contribution a été conduite dans le cadre du projet ReVEA (Ressources vivantes pour l’enseignement et l’apprentissage). L’analyse porte sur une partie des données recueillies pour l’étude de l’activité d’un collectif dédié à l’enseignement des langues. Le cadre de référence mobilisé renvoie notamment à la théorie des communautés de pratiques : comment caractériser les rapports entre activités individuelles et collectives concernant les ressources éducatives ? Quels contrastes s’observent dans les activités individuelles au regard des types de participation aux activités collectives ? L’analyse menée à partir des concepts de participation « périphérique légitime » et « à part entière » a notamment permis d’attirer l’attention sur les liens entre la réification de ressources pour le collectif et le processus de sélection de ressources mis en œuvre individuellement.
L’EPS au prisme des disciplines : polysémie et pluralité de l’interdisciplinarité (1981-2015)
Authors: Le Roy Dimitri , Trohel Jean , Attali Michaël
Published: December 2018

« Interdisciplinarité, pluridisciplinarité, transdisciplinarité » : trois notions différentes, aujourd’hui à la mode dans le milieu scolaire et fréquemment usitées sans discernement par les enseignants. Si les réformes actuelles les placent au cœur des débats, l’appréhension des croisements disciplinaires est ancienne et surtout plurielle. L’Éducation physique et sportive (EPS) est régulièrement conviée à ce type de démarche pédagogique et constitue, à ce titre, un bon analyseur des rapports des enseignants à l’égard de ces concepts. Par l’intermédiaire d’une analyse de contenu (Bardin, 2003) de 1981 à 2015, de la revue professionnelle de référence –  Éducation physique et sport ( EP. S ) – nous signifions que ce périodique accorde une place croissante aux croisements disciplinaires en les associant à des enjeux éducatifs forts. Si la pluridisciplinarité est présentée comme facilitant la formation globale, l’interdisciplinarité optimiserait l’instruction et la transdisciplinarité l’éducation de l’élève.
La haine comme processus de croissance et de renaissance
Authors: Cavalli Alessandra
Published: December 2018

Dans cet article, en m’appuyant sur des cas cliniques, j’ai centré ma réflexion sur la haine inconsciente, et sur le fait que son “absence” affecte l’esprit de nos patients. J’ai cherché comment amener cette haine inconsciente à la conscience dans le cadre analytique, et comment cette haine peut aider, dans son pôle constructif, le patient à se développer et à s’individuer. J’ai essayé de montrer que la haine inconsciente et la haine destructrice peuvent avoir un impact semblable sur l’esprit de nos patients comme sur celui des êtres humains en général.
La mythologie de l’Hadès et le concept de l’Ombre
Authors: Berrut Éric
Published: December 2018

Partant de la mythologie de l’Hadès et des représentations religieuses dont elle fait état, cet article suit deux lignes de réflexion qui s’entrelacent. Dans un premier temps, nous verrons comment le monde de l’Hadès s’articule au concept de l’ombre. Dans un second temps, nous questionnerons cette articulation du point de vue de ses retentissements corporels en considérant la manière avec laquelle l’ombre tend notamment à s’enfouir dans le corps pour générer différents ordres de troubles somatiques.
Le Contrat à Durée Indéterminée Intérimaire, un OVNI du droit social ?
Authors: Bourotte Nathalie , Eynaud-Chevalier Isabelle
Published: December 2018

Le CDI intérimaire est un contrat à durée indéterminée conclu entre un intérimaire et une entreprise de travail temporaire. Il permet d’alterner des missions dans les entreprises utilisatrices et des périodes sans exécution de mission, durant lesquelles le salarié reste employé et rémunéré par l’entreprise de travail temporaire. Cette innovation rassure et sécurise l’entreprise cliente, qui peut utiliser le CDII pour tester un collaborateur ou pour temporiser dans une période d’incertitude sur la possibilité de recruter. Les premières études de satisfaction menées auprès des salariés recrutés en CDII sont positives. Ce dispositif peut être interprété comme un outil supplémentaire dans la stabilisation dans l’emploi d’actifs à faible niveau de qualification.
Cosmopolitisme et politiques publiques : New York Ville Providence (1933‑1975)
Authors: Pouzoulet Catherine
Published: December 2018

Le New York du New Deal, où l’administration La Guardia engage sa ville dans la construction à l’échelle municipale d’un modèle de social-démocratie que l’on peut qualifier de ville providence, démontre l’importance de politiques publiques locales pour entretenir une tradition culturelle de cosmopolitisme. Ces choix politiques qui traitaient à égalité tous les espaces urbains n’ont pas survécu au passage après 1975 à une économie financiarisée.
Hoofstuk 3: Teksvariasie en die oorsake daarvan
Authors: Petzer J.H.
Published: December 2018

No abstract available.
Hoofstuk 5: Die gedrukte teks
Authors: Petzer J.H.
Published: December 2018

No abstract available.
Hoofstuk 6: Belangrike metodes
Authors: Petzer J.H.
Published: December 2018

No abstract available.
Hoofstuk 9: Die rekonstruksie van die teks
Authors: Petzer J.H.
Published: December 2018

No abstract available.
Hoofstuk 10: Die teks van die Nuwe Testament
Authors: Petzer J.H.
Published: December 2018

No abstract availble.
Bylae
Authors: Petzer J.H.
Published: December 2018

No abstract available.
Chapter 4: John the Baptist
Authors: Van Aarde A.G.
Published: December 2018

No abstract available.
Chapter 7: The disciples in Matthew's story
Authors: Van Aarde A.G.
Published: December 2018

No abstract available.
Chapter 1: Past and present in Matthean research: A review of the various interpretation models
Authors: Van Aarde A.G.
Published: December 2018

No abstract available.
Chapter 1: A study of the New Testament beatitude and the beatitude series in Matthew 5:3-10: A new approach to 'Gattungsforschung'
Authors: Van Aarde A.G.
Published: December 2018

No abstract available.
Hoofstuk 3: Oorsig oor die beginjare
Authors: Pont A.D.
Published: December 2018

No abstract available.
Hoofstuk 14: Die Hervormde Kerk in die agtiende eeu
Authors: Pont A.D.
Published: December 2018

No abstract available.
Hoofstuk 18: Die politieke omwenteling
Authors: Pont A.D.
Published: December 2018

No abstract available.
Joods-hellenistische opvattingen over de tempel Jerusalem. Enkele achtergronden van Hand 7:47
Authors: Faber van der Meulen H.E.
Published: December 2018

No abstract available.
Verbondsteologie – 'n Tendensstudie
Authors: Venter P.M.
Published: December 2018

No abstract available.
Verkiesing en predestinasie
Authors: Velthuysen G.C.
Published: December 2018

No abstract available.
Skrifbeskouing en die Nederlandse geloofsbelydenis
Authors: Velthuysen G.C.
Published: December 2018

No abstract available.
Die verband tuseen prediking/erediens en die lewe van die gemeente
Authors: Dreyer T.F.J.
Published: December 2018

No abstract available.
Die gesprek oor Evangelisasie
Authors: Simpson C.J.A.
Published: December 2018

No abstract available.
Studies on relationship between body length, weight and elements contents in fish Chirocentrus nudus swainson (1839) in Iran
Authors: Aberoumand Ali - , Baesi Frideh -
Published: December 2018

Determination of toxic elements in seafood was important for the health of humans and marine organisms. This study was carried out on effects of total length and weight on concentration of toxic and non-toxic elements in fish of Chirocentrus nudus of Persian Gulf, Iran. For this purpose, 20 pieces of fish in two different fish sizes were purchased from Behbahan fish market and transferred to laboratory of Khatam-al-Anbia University of Technology, Behbahan, Iran. The fish muscle after the preparation, which contains washing, biometrics and abdominal discharges, was separated. Finally, the samples elements were analyzed after extraction and digestion processes using an atomic absorption apparatus. The obtained results were compared with the World Food Standards. The concentration of elements in different amounts in fish Kharo were as follows: Fe >Zn >Pb >Cd >Ni. Results showed that with increase fish length and weight, the amount of toxic and non-toxic elements such as Ni, Pb, Fe and Zn, except Cd, were increased significantly. It can be concluded that, although the concentration of elements found in the fish in both sizes were lower than the standard levels proposed for humans, but excessive consumption fish caught from contaminated areas, can be dangerous for human health.
Do reduced VAT rates on foodstuffs in EU affect consumers?
Authors: Bánociová Anna , Ťahlová Slavomira
Published: December 2018

Value added tax represents an important fiscal policy instrument, mainly because of the stable source of tax revenues of state budgets. At the level of EU member states, the value-added tax is most harmonized, individual member states have always an option to implement more types of VAT rates on selected goods. In order to keep prices of foodstuffs and basic necessity products at the lowest possible level and with the highest availability for consumers, EU member states apply reduced VAT rates on these goods. The main objective of the paper is to research the impact on reduced VAT rates on foodstuffs in relation to consumers. The complexity of legislative adjustments on taxation of foodstuffs should be progressively simplified because reduced VAT rates on foodstuffs become ineffective and increase the burden on households compared to incomes of households. This paper is dedicated to the observation whether the application of the reduced VAT rate on foodstuffs affects the change in total expenditures of households. Based on the panel regression model with fixed effects on states, the standard VAT rate at the chosen significance level plays a significant factor, which affects total expenditures on foodstuffs of households and thus affects consumers. In the case of the reduced VAT rate on foodstuffs, this fact has not been confirmed.
Adversative Discourse Markers in Kurdish Literary Texts
Authors: Sabir Paiman Hama Salih , Jawad Hoshang Farooq
Published: December 2018

Discourse Markers are one of an uninvestigated aspect of language in old and modern Kurdish linguistics, that has not been given due attention, neither by native nor non-native researchers. On this ground, it is hoped that the present study sheds light on this almost entirely ignored aspect of the language and this study is meant to be a systematic treatment of this group of lexical items known as Discourse Markers (henceforth, DMs), more specifically one category of them; Adversative DMs.

DMs are words, phrases and even clauses that enhance discourse coherence and are found in all languages, as tapped on by researches and investigations. Numerous terminologies are utilized to refer to such group of markers by different researchers in English and other languages, such as ‘Discourse Particles, Cue Phrases, Small Words, Pragmatic Markers, Discourse Connectives… and even they are defined differently.

It is postulated that DMs are meaningless and lay outside the domain of sentence structure. Likewise, lexical expressions that have different grammatical functions such as ‘and, also, but, or, simultaneously, at the same moment …etc, can also function as DMs to connect the previous utterance with the upcoming discourse segment.

The current investigation endeavors to answer certain specific questions: first, the extents to which DMs are operated in literary texts; second, discourse functions DMs implement. Thirdly, the word categories DMs are derived from, and to which extent Halliday and Hassan (1976)’s framework is applicable to Kurdish DMs?

For achieving the aims, the researchers analyzed one of the contemporary novels of a famous novelist entitled ‘Xezlenûs w Bâxekâni Xejâł”. By applying Halliday and Hasan’s (1976) framework and also by taking insights from Fraser (2009), DMs are categorized into different classes. One of which is Adversative DMs, which are the concern of the present study.

For obtaining the frequency of each marker, the data are scrutinized manually, since there are no corpus analysis tools that can facilitate such measurements.

The study concludes that Adversative DMs are frequently used in selected Kurdish literary texts and that they are similar to those found in English in terms of derived grammatical categories, taxonomy, and they have different characteristics in terms of form, position and discourse functions. Withal, it has been arrived that Adversative DMs are of different kinds analogous to those investigated in English by Halliday and Hassan (1976).
Adölesanlarda varyant anjina: Kardiyak bilgisayarlı tomografinin kullanımı ve literatür taraması
Authors: ALP Hayrullah , KELEŞ ALP Esma , ELMACI Ahmet Midhat
Published: December 2018

Göğüs ağrısı çocuklarda ve özellikle de adölesanlarda sık

bir şikâyet olup çoğunlukla kalp dışı nedenlidir. Varyant anjina çocuklarda

nadir görülen kalp kaynaklı göğüs ağrısı nedenlerinden birisidir. Varyant

anjina erişkinlerde iyi tanımlanmış olmasına rağmen, adölesanlardaki göğüs

ağrısının nadir bir nedenidir. Bu makalede varyant anjina tanısı konulan üç adölesan

bildirilmiş olup varyant anjinanın tanısında kardiyak bilgisayarlı tomografinin

kullanımı ve tedavisi literatür eşliğinde ayrıntılı olarak tartışılmıştır.
Komplike Bir Serebral Venöz Sinüs Trombozu Vakası
Authors: BİLEK Heval , UZ Didem , AYYILDIZ Veysel
Published: December 2018

Klinik tablo ve etiyolojideki heterojenite nedeniyle serebral venöz sinüs trombozunun tanısı sıklıkla atlanır ve tanı konulsa bile genellikle subklinik olarak katkıda bulunan faktörler gözden kaçırılır veya göz ardı edilir. Tüm beyin damar hastalıklarının %1’ini oluşturan bu durum, sıklıkla genç erişkinlerde görülmekle birlikte izole baş ağrısından komaya kadar değişen heterojen klinik nedeniyle klinik tanı gecikebilir. Genetik olarak artmış protrombotik risk taşıyan bireylerde, kafa travması, doğum, sistemik infeksiyon gibi tetikleyici unsurların sinüs trombozuna yol açtığı gösterilmiştir. Bu yazıda, gen mutasyonu zemininde, yıldırım çarpma öyküsü, pnömoni ve olası merkezi sinir sistemi infeksiyonunun da komplike edici etkilerinin serebral venöz sinüs trombozunun ortaya çıkmasında rol oynadığı düşünülen bir olgu sunulmuştur.
İnfertil Bir Erkekte “De La Chapelle” Sendromu: Olgu Sunumu
Authors: TEMEL Muhammed Cihan , EDİZ Caner , AKAN Serkan , YILMAZ Ömer
Published: December 2018

46 XX erkek sendromu çok nadir görülen bir hastalık olup,

ilk olarak 1964 yılında De La

Chapelle ve arkadaşları tarafından tanımlanmıştır1. Hastalar normal

genital yapıdan ambiguus genitalya kadar değişebilen bir genital görünüme sahip

olabilirler2.

Y kromozomundaki cinsiyet belirleyen SRY genini içeren bir parçanın X

kromozomuna translokasyonuyla geliştiği düşünülen bir hastalıktır. Genellikle

erkek fenotipinde gelişme olur ve Y kromozom eksikliğine bağlı testiküler

yetmezlik tablosu gelişir2. Otuz dört yaşında 10 aydır evli bir erkek hasta

infertilite nedeniyle polikliniğimize başvurdu. Fizik muayenesinde bilateral

testislerin atrofik olduğu izlendi. Hastada hipergonadotropik hipogonadizm ve

azoospermi saptandı. Hastanın karyotip analizi 46,XX olarak saptandı ve X

kromozomunda SRY sinyali mevcuttu. Moleküler analizde hastanın Y kromozomunun p

kolunun SRY ve ZFY bölgelerini içerdiği saptandı. Ayrıca AZFa, AZFb, AZFc

delesyonu bulunduğu görüldü. Bu hastalarda spermatogenez olmadığından testis

biyopsisi ve spermiogram uygun değildir8. Hastalıkta başlıca tedavi testosteron

replasmanıdır. Ayrıca profesyonel bir genetik danışmanlık için hastanın

yönlendirilmesi uygundur. De La

Chapelle sendromu, infertilite ile polikliniğe başvuran

bilateral testis atrofisinin eşlik ettiği primer hipogonadizmli hastaların

ayırıcı tanısında akılda tutulması gereken bir hastalıktır.
The efficacy of traditional cultural practices in the rehabilitation of victims of torture in Nigeria’s Niger Delta
Authors: Babatunde Abosede Omowumi
Published: December 2018

Introduction: Traditional methods of purification and healing carried out by healers and priests are of utmost importance for the mental and spiritual rehabilitation of victims of torture and perpetrators. The efficacy of traditional practices in the rehabilitation of victims of torture in Nigeria is examined. Methods: Data is derived from 60 interviews with key informants and eight Focus Group Discussions (FGDs) conducted with victims of torture, youth militias, priests, secret cults, community leaders, women leaders, youth leaders, security agencies, and others, in local communities in the Niger Delta states of Bayelsa and Ilaje, Ondo. Results: By means of reconciliation rituals, both the perpetrators and the victims are re-integrated into the community. The mental healing of victims, who were deeply traumatized by the experiences of torture during violent conflict, is an aspect of community peacebuilding that is at least as important as material reconstruction. Traditional forms of justice and reconciliation that can address the psychosocial trauma of victims of torture may be helpful in the rehabilitation process. Conclusions: This paper suggests that healing and reconciliation rituals have been an essential component of rehabilitation processes in many local communities in the Niger Delta region. International, regional and national actors and institutions must recognize the cultural importance of such rituals and their potential relevance and significance for victims of torture, but their complex dynamics need to be better understood in order to safely and effectively apply them programmatically to achieve reconciliation and rehabilitation outcomes
Addressing occupational stress among health staff in non-government controlled Northern Syria: Supporting resilience in a dangerous workplace
Authors: Othman Mahmood , Steel Zachary , Lawsin Catalina , Wells Ruth
Published: December 2018

Introduction: Syrian medical staff working in non-government controlled areas of Syria operate in situations that expose them to great personal danger, while they must often face the same challenges as the people they help. Supporting the wellbeing of these staff is crucial to the operation of health services for internally displaced Syrians given the large-scale destruction of healthcare infrastructure. Methods: Findings from a staffcare programme designed by a grassroots Syrian psychosocial organisation in Southern Turkey and implemented in a medical nongovernment organisation in Idlib in Northern Syria are presented. An iterative and collaborative process employed individual, team and organisational level consultation to identify occupational stresses within the workplace. A six-month programme involved group sessions across eight sites with 56 staff working in three primary health clinics, two mobile teams and one sexual and reproductive health clinic, serving eight internally displaced persons camps in Idlib. Results: Following the programme, staff reported significant reductions in role ambiguity, and improvements in the nature of their work, personal relationships with colleagues and superiors and physical conditions in the workplace. There were no significant differences in reported organisational structure or job satisfaction. Discussion: This evaluation of a grassroots programme, designed to address the expressed needs of displaced staff, suggests that reductions in daily living stresses can be achieved even in the context of ongoing crisis.
Gender identity and expression in focus: The report of the United Nations Independent Expert on sexual orientation and gender identity, by Victor Madrigal-Borloz.
Authors: Chiam Zhan , Ehrt Julia
Published: December 2018

In his recent report, the United Nations Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, Victor Madrigal-Borloz, examines the “process of abandoning the classification of certain forms of gender as a pathology” – “depathologization”—and elaborates on the “full scope of the duty of the State to respect and promote respect of gender recognition as a component of identity” (p. 2). The report also discusses active measures to respect gender identity and concludes with a list of recommendations. While other United Nations special procedures and agencies have addressed and condemned violence and discrimination on the grounds of gender identity and expression, this report provides a deeper analysis on its root causes. It is the first special procedures report that exclusively addresses human rights with regard to gender identity and expression, and must be considered a mile-stone in the development and enunciation of international human rights law in this regard.
Dosimetric effects of the kV based image‐guided radiation therapy of prone breast external beam radiation: Towards the optimized imaging frequency
Authors: Xu Huijun , Lee Sung‐Woo , Guerrero Mariana , Yi Byong Yong , Chen Shifeng , Becker Stewart J. , Chung Heeteak , Cheston Sally B.
Published: December 2018

Purpose

For prone breast treatment, daily image‐guided radiation therapy (IGRT) allows couch shifting to correct breast position relative to the treatment field. This work investigates the dosimetric effect of reducing kV imaging frequencies and the feasibility of optimizing the frequency using patient anatomy or their first 3‐day shifts.

Method

Thirty‐seven prone breast patients who had been treated with skin marker alignment followed by daily kV were retrospectively analyzed. Three IGRT schemes (daily‐kV, weekly‐kV, no‐kV) were simulated, assuming that fractions with kV imaging deliver a dose distribution equivalent to that in computed tomography (CT) planning, whereas other fractions yield a dose distribution as recreated by shifting the CT plan isocenter back to its position before the couch shift was applied. Treatment dose to targets (breast and lumpectomy cavity [LPC]) and organs at risks (OAR)s (heart, ipsilateral lung) in different schemes were calculated. Patient anatomy information on CT plans and first 3‐day couch shift data were analyzed to investigate whether these factors could guide imaging scheme optimization.

Results

When kV imaging frequency was reduced, the percentage dose changes (δD) for breast and LPC objectives (average <1%) were smaller than those for heart and lung (average 28%–31% for Dmean). In general, the δD of no‐kV imaging was approximately that of weekly kV imaging × a factor of 1.2–1.4. Although most dose objectives were not affected, the potential higher heart dose may be of concern. No strong correlation was found between δD for different kV frequencies and patient anatomy size/distance or the first 3‐day couch shift data.

Conclusions

Despite resulting in lower imaging dose, time, cost, and similar target coverage, a reduction in kV imaging frequency may introduce higher heart complication risk. Daily kVs are needed more in left‐sided breast patients. A less frequent imaging schedule, if considered, cannot be individually optimized using CT anatomic features or early shift data.
New York comptroller accuses OTPs of not checking PDMP; DOH fights back
Authors: Knopf Alison
Published: December 2018

In an audit that constituted three opioid treatment programs (OTPs) and 25 patients, New York State Comptroller Thomas P. DiNapoli earlier this month criticized the state's Department of Health (DOH) for not making sure providers check I‐STOP — the state's prescription drug monitoring program (PDMP). According to the audit, OTP patients on methadone have been accessing opioid prescriptions with those prescribers not knowing that the patient is in an OTP, and the state DOH, which was the subject of the audit, has not done enough to prevent this.
Contrary to some belief, participants in syringe exchange want further help
Authors: Enos Gary
Published: December 2018

Newly published survey results bolster the argument that syringe exchange programs can serve as a critical conduit to treatment engagement, dispelling the notion that participants in these programs aren't interested in much beyond continuing to use drugs.
How to treat wealthy young adults with SUDs: Counselors comment
Authors: Carlile Elie , Czodli Megan
Published: December 2018

Editor's note: In last week's issue, we wrote about how consultants recommend working with young people with trust funds, helping ensure those young people get treatment for substance use disorders (SUDs). This week, two therapists offer their clinical advice.
Synthesis of Unsymmetrical Aromatic Azoxy Compounds by Silver‐Mediated Oxidative Coupling of Aromatic Amines with Nitrosoarenes
Authors: Ding Weijie , Xu Shengshi , Yu Xiaochun , Wang Shun
Published: December 2018

A silver(I) oxide‐mediated synthesis of unsymmetrical aromatic azoxy compounds has been successfully achieved, wherein oxidative coupling reactions between aromatic amines and nitrosoarenes take place in ethanol under air. This reaction has very high economic value because silver(I) oxide is the only oxidant required and no other additive is needed. The resulted silver particles can be easily recovered, while the only other byproduct is water. This new procedure is compatible with various functional groups and proceeds under mild reaction conditions.

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Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What Do We Know?
Authors: Moll Joel , Krieger Paul , Heron Sheryl L. , Joyce Cara , Moreno‐Walton Lisa
Published: December 2018

Background

Although lesbian, gay, bisexual, and transgender (LGBT) patients are ubiquitous in emergency medicine (EM), little education is provided to EM physicians on LGBT health care needs and disparities. There is also limited information on EM physician behavior, comfort, and attitudes toward LGBT patients. The objective of this study was to assess EM residents behavior, comfort, and attitudes in LGBT health.

Methods

An anonymous survey link was sent to EM programs via the Council of Residency Director listserv. The primary outcome of the 24‐item descriptive survey was the self‐reported comfort levels and self‐reported practice in LGBT health care. Secondary outcomes included individual comfort toward LGBT colleagues and patients who are LGBT, and the frequency of colleagues making discriminatory statements toward LGBT patients and staff in the emergency department setting. Associations between personal and program demographics and survey responses were also examined.

Results

There were 319 responses The majority of respondents were male (63.4%), Caucasian (69.1%), and heterosexual (92.4%). A sizeable minority of respondents felt histories and physical examinations were more challenging for lesbian, gay, or bisexual patients (24.6%) and more so for transgender patients (42.6%). Most residents do not ask patients to identify sexual orientation when presenting with abdominal or genital complaints (63%). Discriminatory LGBT comments were reported from both fellow residents (16.6%) and faculty (10%). A total of 2.5% of respondents were uncomfortable with other LGBT physicians, and 6% did not agree that LGBT patients deserve the same quality care as others.

Conclusion

A number of residents find caring for LGBT patients more challenging than heterosexual patients. Even with professed comfort with LGBT health care, most residents report taking incomplete sexual histories that may affect patient care. Attitudes toward LGBT patients are mainly, but not completely, positive in this cohort.
Strategic offers in day‐ahead market co‐optimizing energy and reserve under high penetration of wind power production: An MPEC approach
Authors: Tsimopoulos Evangelos G. , Georgiadis Michael C.
Published: December 2018

This work based on Stackelberg hypothesis, which considers a conventional power producer exercising their dominant position in an electricity pool with high penetration of wind power production. A bi‐level optimization model is used to describe the delivery of a single settled hourly auction process. The upper‐level problem illustrates the expected profit optimization of the strategic producer whereas the lower‐level problem represents the energy‐only market clearing process through a two‐stage stochastic program. The bi‐level problem is recast into mathematical programming with equilibrium constraints (MPEC), which is then reformulated into an MILP. These transformations occur using the Karush‐Kuhn‐Tucker optimality conditions and the strong duality theory. Energy dispatch and reserve deployment are co‐optimized under various scenarios of wind production uncertainty realization. The suggested model provides optimal strategic offers and local marginal prices under different levels of wind penetration and network line transmission capacities. © 2018 American Institute of Chemical Engineers AIChE J, 65: e16495 2019
Comparative Risk of Venous Thromboembolism in Rheumatoid Arthritis Patients Receiving Tofacitinib Versus Those Receiving Tumor Necrosis Factor Inhibitors: An Observational Cohort Study
Authors: Desai Rishi J. , Pawar Ajinkya , Weinblatt Michael E. , Kim Seoyoung C.
Published: December 2018

Objective

To evaluate the risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA) patients receiving tofacitinib versus those receiving tumor necrosis factor (TNF) inhibitors.

Methods

RA patients who were initiating treatment with tofacitinib or a TNF inhibitor and had not previously received any biologic agent or tofacitinib were identified from the Truven MarketScan database (2012–2016) or Medicare claims (parts A, B, and D) database (2012–2015). Patients were followed up until treatment discontinuation, treatment switch, insurance disenrollment, or administrative censoring. The outcome of VTE was identified using inpatient claims for pulmonary embolism or deep vein thrombosis. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were determined using a Cox proportional hazards model after accounting for confounding through propensity score–based fine‐stratification weighting. HRs were pooled across databases using the inverse variance meta‐analytic method.

Results

A total of 34,074 RA patients (mean age 50 years; 5.6% tofacitinib initiators) and 17,086 RA patients (mean age 71 years; 5.8% tofacitinib initiators) were identified from the Truven and Medicare databases, respectively. The crude incidence rates of VTE per 100 person‐years were 0.60 (95% CI 0.26–1.19) and 0.34 (95% CI 0.27–0.41) in Truven and 1.12 (95% CI 0.45–2.31) and 0.92 (95% CI 0.76–1.11) in Medicare for patients receiving tofacitinib and patients receiving TNF inhibitors, respectively. Propensity score–adjusted HRs showed no significant differences in the risk of VTE between tofacitinib‐treated and TNF inhibitor–treated patients in either database, with a pooled HR of 1.33 (95% CI 0.78–2.24).

Conclusion

Occurrence of VTE in a total of 50,865 RA patients initiating treatment with tofacitinib or a TNF inhibitor was infrequent (<1 per 100 person‐years). We observed a numerically higher, but statistically nonsignificant, risk of VTE in RA patients receiving tofacitinib versus those receiving TNF inhibitors.
Biosensor‐assisted engineering of a high‐yield Pichia pastoris cell‐free protein synthesis platform
Authors: Aw Rochelle , Polizzi Karen M.
Published: December 2018

Cell‐free protein synthesis (CFPS) has recently undergone a resurgence partly due to the proliferation of synthetic biology. The variety of hosts used for cell‐free extract production has increased, which harnesses the diversity of cellular biosynthetic, protein folding, and posttranslational modification capabilities available. Here we describe a CFPS platform derived from Pichia pastoris, a popular recombinant protein expression host both in academia and the biopharmaceutical industry. A novel ribosome biosensor was developed to optimize the cell extract harvest time. Using this biosensor, we identified a potential bottleneck in ribosome content. Therefore, we undertook strain engineering to overexpress global regulators of ribosome biogenesis to increase in vitro protein production. CFPS extracts from the strain overexpressing
FHL1 had a three‐fold increase in recombinant protein yield compared with those from the wild‐type X33 strain. Furthermore, our novel CFPS platform can produce complex therapeutic proteins, as exemplified by the production of human serum albumin to a final yield of 48.1 μg ml
−1. Therefore, this study not only adds to the growing number of CFPS systems from diverse organisms but also provides a blueprint for rapidly engineering new strains with increased productivity in vitro that could be applied to other organisms.
Photoautotrophic synthesis of butyrate by metabolically engineered cyanobacteria
Authors: Lai Martin J. , Lan Ethan I.
Published: December 2018

Direct conversion of carbon dioxide into chemicals using engineered autotrophic microorganisms offers a potential solution for both sustainability and carbon mitigation. Butyrate is an important chemical used in various industries, including fragrance, food, and plastics. A model cyanobacterium Synechococcus elongatus PCC 7942 was engineered for the direct photosynthetic conversion of CO
2 to butyrate. An engineered
Clostridium Coenzyme A (CoA)‐dependent pathway leading to the synthesis of butyryl‐CoA, the precursor to butyrate, was introduced into
S. elongatus PCC 7942. Two CoA removal strategies were then individually coupled to the modified CoA‐dependent pathway to yield butyrate production. Similar results were observed between the two CoA removal strategies. The best butyrate producing strain of
S. elongatus resulted in an observed butyrate titer of 750 mg/L and a cumulative titer of 1.1 g/L. These results demonstrated the feasibility of photosynthetic butyrate production and expanded the chemical repertoire accessible for production by photoautotrophs.
Thioamide‐Bridged Nucleic Acid (thioAmNA) Containing Thymine or 2‐Thiothymine: Duplex‐Forming Ability, Base Discrimination, and Enzymatic Stability
Authors: Habuchi Takaki , Yamaguchi Takao , Obika Satoshi
Published: December 2018

Oligonucleotides containing bridged nucleic acids (BNAs) show high duplex‐forming ability towards target single‐stranded RNA, so many BNAs have been developed for antisense applications. Amide‐bridged nucleic acids (AmNAs), which are BNA analogues bearing an amide bond at the bridge, exhibit high duplex‐forming ability, enzymatic stability, and antisense activity; thus, the AmNA motif represents a promising BNA scaffold. The high enzymatic stability of the AmNA motif is presumably attributable to the bulky amide structure, because it inhibits the access of nucleases to the phosphodiester linkage. Here, to improve enzymatic stability further, we designed thioAmNAs: thioamide‐bridged nucleotides that have a bulkier bridge structure than AmNA. The synthesis of thioAmNAs bearing either thymine (thioAmNA‐T) or 2‐thiothymine (thioAmNA‐S2T) bases was successful, and the obtained monomers were introduced into designed oligonucleotides without noticeable by‐product generation. The thioAmNA‐T‐ and thioAmNA‐S2T‐modified oligonucleotides showed strong binding affinity toward complementary single‐stranded RNA, with the thioAmNA‐S2T‐modified oligonucleotide displaying excellent base‐discrimination capability. Moreover, both thioAmNA‐T and thioAmNA‐S2T endowed oligonucleotides with higher resistance to enzymatic degradation than AmNA‐T. These results indicate that thioAmNAs are potentially useful chemical modifications for oligonucleotide‐based therapeutics.
Chirality Dependence of Amyloid β Cellular Uptake and a New Mechanistic Perspective
Authors: Dutta Subrata , Finn Thomas S. , Kuhn Ariel J. , Abrams Benjamin , Raskatov Jevgenij A.
Published: December 2018

Amyloid β is an inherently disordered peptide that can form diverse neurotoxic aggregates, and its 42‐amino‐acid isoform is believed to be the agent responsible for Alzheimer's disease (AD). Cellular uptake of the peptide is a pivotal step for it to be able to exert many of its toxic actions. The cellular uptake process is complex, and numerous competing internalization pathways have been proposed. To date, it remains unclear which of the uptake mechanisms are particularly important for the overall process, and improvement of this understanding is needed, so that better molecular AD therapeutics can be designed. Chirality can be used as a unique tool to study this process, because some of the proposed mechanisms are expected to proceed in stereoselective fashion, whereas others are not. To shed light on this important issue, we synthesized fluorescently labeled enantiomers of amyloid β and quantified their cellular uptake, finding that uptake occurs in stereoselective fashion, with a typical preference for the l stereoisomer of ≈5:1. This suggests that the process is predominantly receptor‐mediated, with likely minor contributions of non‐stereoselective mechanisms.
TiS2 Monolayer as an Emerging Ultrathin Bifunctional Catalyst: Influence of Defects and Functionalization
Authors: Das Tisita , Chakraborty Sudip , Ahuja Rajeev , Das Gour P.
Published: December 2018

We have envisaged the hydrogen evolution and oxygen evolution reactions (HER and OER) on a two‐dimensional (2D) noble‐metal‐free titanium disulfide (TiS2) monolayer, which belongs to the exciting family of transition metal dichalcogenides (TMDCs). Our theoretical investigation to probe the HER and OER on both the H and T phases of 2D TiS2 is based on electronic‐structure calculations witihin the framework of density functional theory (DFT). Since TiS2 is the lightest compound among the group‐IV TMDCs, it is worth exploring the catalytic activity of a TiS2 monolayer through the functionalization at the anion (S) site, substituting with P, N, and C dopants as well as by incorporating single sulfur vacancy defects. We have investigated the effect of functionalization and vacancy defects on the structural, electronic, and optical response of a TiS2 monolayer by determining the density of states, work‐function, and optical absorption spectra. We have determined the HER and OER activities for the functionalized and defective TiS2 monolayers based on the reaction coordinate, which can be constructed from the adsorption free energies of the intermediates (H*, O*, OH* and OOH*, where * denotes the adosrbed state) in the HER and OER mechanisms. Finally, we have shown that TiS2 monolayers are emerging as a promising material for the HER and OER mechanisms under the influence of functionalization and defects.