bluuebunny/crossref_metadata_2025 huggingface dataset:
Community Participation in Effort to Mitigate Caused by Mount Kelud Eruption in Ngancar District, Kediri Regency
Authors: Sejati Andri Estining , Hasan Muhammad , Hidayati Desi Nurul
Published: February 2020

Indonesia location is between four plates, there are: Eurasian, Indo-Australian, Philiphines, dan Pasicic. Subduction between plates make Indonesia disturbed a natural incident such as mountain eruption. One of disturbed mountain eruption disaster area is District Ngancar, Kediri Regency. This case because Ngancar location near Kelud slope. People participation for efforts mitigations is very important for reduced natural incident impact. The aim this paper to discuss form and level people participation in District Ngancar for efforts Kelud mountain eruption disaster mitigation. This research is survey with sample 100 from 5.340 head family. The data collected with interview and documentation, then analized by quantitative description with scoring and percentage. The research result showing that people in disaster disturbed zone I, II, and III get participation score each the amount of 1.425, 935, and 1.133. The participation action, include: elucidation disaster, organizing disaster preparedness, preparing self, making early warning system, and saving property.
THE PSYCHOLOGICAL IMPACTS OF SEXUAL ABUSE EXPERIENCED BY THE MAIN CHARACTER OF K.L RANDIS’ NOVEL SPILLED MILK
Authors: Wahyuni Sri
Published: February 2020

The title of this research is “The Psychological Impacts of Sexual Abuse Experienced by The Main Character of K.L Randis’ Novel Spilled Milk”. This study aims to determine the psychological impact of children on sexual abuse experienced by children. This research examines the phenomena of child abuse especially for sexual abuse and aim to reveal that literary work reflects social reality. The object of this research is “Spilled Milk” This novel shows that sexual abuse against children is a relationship between a child and an older person where the child is used as a satisfying object for the sexual needs of the offender. The method of this research that is used is Descriptive Qualitative. Data were obtained from words, phrases, clauses, or sentences in primary data. Data were analyzed by literary psychology approach and psychological theory. The psychological theories that are used in this thesis are the psychological impacts of sexual abuse by SECASA. The results of the psychological impact found in novel “Spilled Milk” are fear, responsibility, guilt and shame, anger and flashback or nightmare. So, hopefully this research is expected to be able to become a reference which can provide useful information child abuse and for people to prevent the act of child sexual abuse and help the victims.

Keywords: Child Sexual abuse; Psychology; The Sexual Abuse Impact
Strategi untuk Membantu Meningkatkan Perencanaan Karier Siswa di Era Revolusi Industri 4.0
Authors: Pambudi Parid Rilo , Muslihati Muslihati , Lasan Blasius Boli
Published: February 2020

Perkembangan Ilmu Pengetahuan dan Teknologi yang sangat pesat, tentunya berimbas pada tantangan dan persaingan global yang dihadapi oleh setiap negara, salah satunya Indonesia. Oleh karenanya sumber daya manusia yang berkualitas sangat diperlukan. Sumber daya manusia yang berkualitas  dibentuk melalui pendidikan Terdapat lima karakter utama yang ditingkatkan dan harus dimiliki oleh siswa dalam Penguatan Pendidikan Karakter (PPK). Karakter tersebut wajib dimiliki oleh siswa era revolusi industri 4.0 agar dapat terjun ke dunia kerja dan siap berkompetisi dengan negara lain. Setiap siswa pastinya menginginkan suatu karier yang cemerlang, dan karier tersebut diwujudkan dengan suatu usaha dan direncanakan secara matang. Segala upaya yang dilaksanakan konselor dalam membantu siswa untuk merencanakan studi lanjut maupun kariernya tidak akan berhasil tanpa adanya strategi yang tepat. Strategi untuk meningkatkan kemampuan perencanaan karier siswa di era revolusi industri 4.0 adalah Four C’s yang merupakan strategi berbasis bimbingan. Four C’s merupakan strategi untuk meningkatkan kemampuan berpikir tingkat tinggi (critical thinking, creativity, collaboration, and communication).
KEDUDUKAN KEPEMILIKAN HAK ATAS TANAH DALAM PERKAWINAN CAMPURAN TANPA ADANYA PERJANJIAN PISAH HARTA
Authors: Pratama Adhitya Dimas
Published: February 2020

Intermarriage is a phenomenon that is rife with the development of increasingly rapid technology weapons. Implementation of mixed marriages must not be separated from the constraints and risks will dihadi offender Mixed Marriage itself. One of the problems that arise are related to the occurrence of the Joint Treasure especially over land rights as legal consequences arising from the holding of intermarriage intermarriage especially if implemented without prenuptial agreement. The author of this thesis wants to study and analyze more about the law as a result of intermarriage without severance agreement treasure to land ownership and settlement of land ownership issues arising from mixed marriage without separation agreement treasure. The method used is a normative legal research, namely legal research done by researching library materials or secondary law while in locating and collecting data is done by two approaches, namely legislation and conceptual approaches.

The results showed that the legal consequences of intermarriage in the absence of agreement separating property to the ownership rights to the land after the enactment of Law No. 1 of 1974 About the marriage, property acquired during the marriage is community property as engaging joint property so that if it is not made an prenuptial agreement the property rights to land shall be released within a period of one (1) year or the land falls to the state. The resolution attempts to do to the problems of land ownership arising from mixed marriages without the agreement split the treasure is in the form of drafting of a treaty mate after marriage or reduction of land rights from property rights into rights of use in accordance with the provisions of that kind of tenure, which may possess by someone follow the status of their land rights subjects in accordance with the provisions of the legislation
Sanksi Bagi Notaris Yang Mempromosikan Jabatannya Pada Sosial Media
Authors: Njoto Meishell
Published: February 2020

Notary plays an important role in making authentic deed in Indonesia. Notaries are often referred to occupying honorary positions as general or state officials. As the holder of an honorary position trusted by the public to make an authentic deed, the Notary must comply with the applicable laws and the Code of Ethics. Obligations and prohibitions of Notaries have clearly been regulated in UUJN and Notary Ethics Code, but that does not mean there are no Notaries who violate these rules. In order to find out what the legal consequences of a notary who violated social media promotion, the authors conducted this research. The research method used in this study is normative legal research. Normative legal research is legal research conducted by examining materials derived from various laws and regulations and other materials from various literatures. Which means this research examines secondary data material or does a literature review. The approach used in this study is the statutory approach and the conceptual approach. The result of this research is the prohibition on promotion through social media which actually has been regulated in various rules regarding notaries along with the legal consequences if the Notary Public violates these rules.
PENGARUH PEMBELAJARAN KEWIRAUSAHAAN, PRAKTIK KERJA INDUSTRI, DAN PENGETAHUAN KEWIRAUSAHAAN TERHADAP KESIAPAN BERWIRAUSAHA
Authors: Anggriawan Lukman , Rusno Rusno , Firdaus Riril Mardiana
Published: February 2020

This  research  aimed  to  show  the  influence  of  entrepreneurship  learning,  field  work  industry  and entrepreneurship  knowledge  towards  the  readiness  of  doing  an  entreprenenur. This  research  use quantitative approach with expo-facto method. The number of population was 126 students at  SMK Budi Mulia Pakisaji. The number of sampling was 65 students which is determined by using proportional random sampling. The technique of data collection was using questionnaire. Based on analysis result, it could be concluded; there was an influence of entrepreneurship learning, field work industry and entrepreneurship knowledge towards the readiness of doing an entreprenenur, simultaneously, there was an influence of entrepreneurship learning, field work industry and entrepreneurship knowledge towards the readiness of doing an entreprenenur and R² value amount 0,779% it means that the influence of doing entrepreneurship learning, field work industry and entrepreneurship knowledge amount 77% towards the readiness of doing an entrepreneur.
PENGARUH MOTIVASI KERJA, KOMITMEN ORGANISASI DAN BUDAYA KERJA TERHADAP KINERJA GURU
Authors: Asmawati Sri , Sulistyo Sulistyo , Afian Affan
Published: February 2020

The purpose of this study was to determine: (1) the effect of work motivation, organizational commitment and work culture on teacher performance in SMK Widya Dharma Turen, (2) the effect of work motivation on teacher performance in SMK Widya Dharma Turen, (3) the effect of organizational commitment on teacher performance at SMK Widya Dharma Turen, (4) the influence of work culture on teacher performance at SMK Widya Dharma Turen. This type of research uses explanatory research using multiple linear regression. This research was conducted at Widya Dharma Turen Vocational School with a total population of 36 teachers. Sampling was conducted with a saturated sample technique that is all teachers of Widya Dharma Turen Vocational School. Data collection uses questionnaires and documentation. The data obtained were analyzed with the help of SPSS application version 22.00 for windows. Based on the calculation results, it is known that: (1) there is an influence of work motivation, organizational commitment and work culture on teacher performance in SMK Widya Dharma Turen. (2) there is an influence of work motivation on teacher performance in SMK Widya Dharma turen. (3) there is an influence of organizational commitment to teacher performance in SMK Widya Dharma turen. (4) there is an influence of work culture on teacher performance in SMK Widya Dharma Turen.
PENGARUH KOMPETENSI PEDAGOGIK GURU, PENDIDIKAN KARAKTER, DAN FASILITAS BELAJAR TERHADAP PRESTASI BELAJAR IPS DI SMP NASIONAL MALANG
Authors: Maria Mado Lipat Goreti , Andayani Endah , Naim Naim
Published: February 2020

This study aims to determine whether there is influence between teacher pedagogical competence, character education and learning facilities on social studies learning achievement in VIII grade of Malang National Junior High School and to find out how much influence between teacher pedagogical competence, character education and learning facilities on social studies learning achievement together with students of class VIII of Malang National Middle School. Total population of 116 samples used 47 students proportional random sampling. Data collection was conducted using a questionnaire and documentation method. This type of research uses a quantitative research approach. The method of multiple linear regression research. Hypothesis testing using t test and F test. The results of this study indicate that there is a significant influence of teacher pedagogical competence variables on social studies learning achievement of 6.522%. The significant influence of character education on social studies learning achievement is 43.65%. The significant influence of learning facilities on social studies learning achievement is 40.21%. Based on the results of the processed data test it can be seen that the variable pedagogical competence of teachers, character education and learning facilities has a simultaneous or joint effect on social studies learning achievement of 65,3%.
PENGARUH PENGGUNAAN GADGET DAN LINGKUNGAN TEMAN SEBAYA TERHADAP MINAT BELAJAR SISWA KELAS VII PADA MATA PELAJARAN IPS
Authors: Wasa Mariana Erlin , Sulistyo Sulistyo , Afian Affan
Published: February 2020

Interest in learning is an encouragement that students have to carry out learning activities in order to achieve goals in the learning process. The purpose of this study was to determine the significant and partially simultaneous influence between the use of gadgets and the environment of peers on the learning interest of Grade VII students in Social Sciences subjects at SMP Negeri 17 Malang. this type of research uses ex post facto research using multiple linear regression. This research was conducted in SMP Negeri 17 Malang with a population of 268 students and a sample of 54 students. proportional random sampling technique. Data collection using a questionnaire. Based on the calculation results, it is known that: 1) there is an influence of the use of gadgets and peers' environment on the learning interests of Grade VII students in Social Sciences subjects at SMP Negeri 17 Malang; 17 Malang, 3) there is an influence of peers 'environment in class VII students' social studies interest in Social Sciences at SMP Negeri 17 Malang.
PENGARUH PENGETAHUAN KOPERASI, MOTIVASI BERKOPERASI DAN PELAYANAN KOPERASI TERHADAP MINAT MENJADI ANGGOTA KOPERASI MAHASISWA
Authors: Jaya Yohana , Rusno Rusno , Al Arsy Auliana Farrabanie
Published: February 2020

This study uses a population of 335 students of Universitas Kanjuruhan Malang who entered the cooperative in 2017-2018 and then the sampling technique was taken 25% of the population using proportional random sampling. The results of this study indicate that: 1) cooperative knowledge, cooperative motivation, cooperative services have a joint effect on the interests of students becoming members of student cooperatives in Universitas Kanjuruhan Malang, 2) cooperative knowledge has a positive and significant effect on the interests of students becoming members of student cooperatives, 3 ) motivation to operate positively and significantly influence the interests of students to become members of student cooperatives, 4) cooperative services have a positive and significant effect on the interests of students to become members of student cooperatives.
Artificial Intelligence in Global Health —A Framework and Strategy for Adoption and Sustainability
Authors: Hadley Trevor D. , Pettit Rowland W. , Malik Tahir , Khoei Amelia A. , Salihu Hamisu M.
Published: February 2020

Artificial Intelligence (AI) applications in medicine have grown considerably in recent years. AI in the forms of Machine Learning, Natural Language Processing, Expert Systems, Planning and Logistics methods, and Image Processing networks provide great analytical aptitude. While AI methods were first conceptualized for radiology, investigations today are established across all medical specialties. The necessity for proper infrastructure, skilled labor, and access to large, well-organized data sets has kept the majority of medical AI applications in higher-income countries. However, critical technological improvements, such as cloud computing and the near-ubiquity of smartphones, have paved the way for use of medical AI applications in resource-poor areas. Global health initiatives (GHI) have already begun to explore ways to leverage medical AI technologies to detect and mitigate public health inequities. For example, AI tools can help optimize vaccine delivery and community healthcare worker routes, thus enabling limited resources to have a maximal impact. Other promising AI tools have demonstrated an ability to: predict burn healing time from smartphone photos; track regions of socioeconomic disparity combined with environmental trends to predict communicable disease outbreaks; and accurately predict pregnancy complications such as birth asphyxia in low resource settings with limited patient clinical data. In this commentary, we discuss the current state of AI-driven GHI and explore relevant lessons from past technology-centered GHI. Additionally, we propose a conceptual framework to guide the development of sustainable strategies for AI-driven GHI, and we outline areas for future research.

Keywords: • Artificial Intelligence • AI Framework • Global Health • Implementation • Sustainability • AI Strategy

 

Copyright © 2020 Hadley et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.
Authors: Chinowaita Frank , Chaka Wendy , Nyazika Tinashe K , Maboreke Tendai C , Tizauone Emmanuel , Mapondera Prichard , Chitsike Inam , Cakana Andrew Z , Mavenyengwa Rooyen Tinago
Published: February 2020

Background: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices.
Methods: This was a descriptive cross-sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively.
Results: A total of 142 participants were enrolled; 50 (35.2%) had a positive blood culture, with 56.0% Gram positive, 42.0% Gram-negative bacteria and 2.0% yeast isolated. Common species isolated included coagulase negative Staphylococcus spp. (CoNS) (22.0%), E. coli (16.0%), K. pneumoniae (14.0%), E. faecalis (14.0%) and S. aureus (8.0%). Gram-negative isolates exhibited high resistance to gentamicin (61.9%) and ceftriaxone (71.4%) which are the empiric antimicrobial agents used in our setting. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all Gram-negative isolates, whilst vancomycin and linezolid were effective against 96.2% and 100.0% of all Gram-positive isolates respectively. We isolated 10 (66.7%) extended spectrum β-lactamase (ESBL) amongst the E. coli and K. pneumoniae isolates. Ten (66.7%) of the Staphylococcus spp. were methicillin resistant.
Conclusions: CoNS, E. coli , K. pneumoniae , E. faecalis and S. aureus were the major microbial drivers of sepsis amongst cancer patients in Zimbabwe. Most isolates were found to be resistant to commonly used empirical antibiotics, with isolates exhibiting high levels of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.
The effect of Seizure on School Attendance among Children with Epilepsy: A follow-up study at the Pediatrics Neurology Clinic, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Hassen Oumer , Beyene Ayalew moges
Published: February 2020

Backgound: Epilepsy is the most common chronic neurological disease seen in Pediatrics Neurology Units in developing countries negatively affecting school attendance and academic performance. Comorbid learning and behavioral problems may also contribute to the academic difficulties among children with epilepsy. The main aim of this study is to assess the extent and factors contributing school absenteeism among school-aged children and adolescents with epilepsy.Methods: A hospital based follow-up study was conducted among school-aged children and adolescents with epilepsy between the ages of 7-18 years attending an outpatient Pediatric Neurology Clinic. A sample of 183 children and adolescents were included in the study. The participants (children and their parents/caregivers) gave information concerning the socio-demographic characteristics of the child and the primary caregiver, information regarding the child’s presentation and whether or not they disclosed to teachers and peer. Medical charts were thoroughly reviewed on the diagnosis and prognosis. Study participants characteristics were described and logistic regression was used to determine factors associating with school absenteeism.Results: School absenteeism (≥1 days/month) over six month period among children aged 7-18 years with epilepsy was 69.4%. Factors which correlated with school absenteeism included female sex (AOR 2.19, 95% CI 1.03-4.84), children with known causes for seizures AOR 2.51, 95% CI 1.09-5.86), having seizure at school and longer epilepsy duration.Conclusion recommendation: School absenteeism was found in over two thirds of children aged 7-18 years with epilepsy attending an outpatient epilepsy clinic in Ethiopia.
Effectiveness of Steroids vs Placebo in Preventing Upper Airway Obstruction After Extubation in Critically-Ill Children: Rationale and Design of a Multicentric, Double-Blind, Randomized Study
Authors: Manrique Gema , Laiseca Laura Butragueño , González Rafael , Rey Corsino , Martínez Zuriñe , Gil Javier , Rodriguez Antonio , Martínez Cecilia , Manrique Silvia , López-Herce Jesús
Published: February 2020

Background: Post-extubation upper airway obstruction (UAO) is a frequent complication causing stridor and respiratory distress, which occasionally may require reintubation, thereby increasing morbidity and mortality rates. Contradictory results have been obtained in studies assessing the effectiveness of steroids in preventing post-extubation UAO, and the available evidence is limited. We designed a multicentric randomized, placebo-controlled study to explore the effectiveness of dexamethasone in preventing post-extubation UAO in children. Methods: A multicentric, prospective, double-blind, randomized, placebo-controlled, phase IV clinical trial has been designed. The sample will include pediatric patients between 1 month and 16 years of age who have been intubated for more than 48 hours. Patients with airway disorders or who have received steroids within the last seven days will be excluded. Patients will be randomized to receive either placebo or a therapy with dexamethasone 0.25 mg/kg every 6 hours to be started 6-to-12 hours prior to extubation, to a total of four doses. Randomization will be performed at a 1:1 ratio. Follow-up of patients will be carried out for 48 h after extubation. The main objective of this study is to access the reduction in the incidence of moderate-severe UAO symptoms following extubation. Secondary objectives include assessing the decrease in the incidence of reintubation, evaluating the use of additional therapies for upper airway obstruction, and monitoring dexamethasone potential side effects. Discussion: The results of this study will contribute to the existing evidence on prophylaxis for post-extubation airway obstruction. Trial registration: EudraCT identifier, 2009-016596-30. Registered on 11 May 2010.
Canine colostrum exosomes: characterization and influence on canine mesenchymal stem cell secretory profile and fibroblast anti-oxidative capacity
Authors: Villatoro Antonio J , Martín-Astorga María del Carmen , Alcoholado Cristina , Becerra José
Published: February 2020

Background: Canine colostrum milk (CCM) is a specific secretion of the mammary gland fundamental for the survival of the newborn. It has many described components (immunoglobulins, proteins or fat), but small vesicles named exosomes are largely unknown. Results: A characterization of the CCM exosomes has been performed. Exosome concentrations were abundant in CCM and appeared with characteristic cup-shaped morphology and well-defined round vesicles. Their size distribution was between 37−140 nm and western blot analysis showed positive expression of specific exosomal markers. Proteomic analysis revealed a total of 826 proteins in exosomes cargo. We also found that exosomes modified proliferation and secretory profiles in canine mesenchymal stem cells derived from bone marrow (cBM-MSCs) and adipose tissue (cAd-MSCs). Besides, CCM exosomes demonstrated a potent antioxidant effect on canine fibroblasts in culture. Conclusions: Our findings highlight, for the first time, the abundant presence of exosomes in CCM and their ability to interact with mesenchymal stem cells (MSCs). The addition of exosomes to the two types of MSCs in culture resulted in specific secretory profiles with functions related to angiogenesis, migration and chemotaxis of immune cells. In particular, the cAd-MSCs secretory profile showed a higher potential in adipose tissue development and neurogenesis, while cBM-MSCs production was associated with immunity, cell mobilization and hematopoiesis. Finally, exosomes also presented antioxidant capacity on fibroblasts against reactive oxygen species activity within the cell, demonstrating a fundamental role in the development and maturation of the puppy in the early stages of its life.
Genome-wide Survey of the bHLH Super Gene Family in Brassica napus
Authors: Ke Yunzhuo , Wu Yunwen , Zhou Hongjun , Chen Ping , Wang Mangmang , Liu Mingming , Li Pengfeng , Yang Jing , Li Jiana , Du Hai
Published: February 2020

Background: The basic helix-loop-helix (bHLH) gene family is one of the largest transcription factor families in plants and is functionally characterized in diverse species. However, less is known about its functions in the economically important allopolyploid oil crop, Brassica napus .
Results : We identified 602 potential bHLHs in the B. napus genome ( BnabHLHs ) and categorized them into 35 subfamilies, including seven newly separated subfamilies, based on phylogeny, protein structure, and exon-intron organization analysis. The intron insertion patterns of this gene family were analyzed and a total of eight types were identified in the bHLH regions of BnabHLHs . Chromosome distribution and synteny analyses revealed that hybridization between Brassica rapa and Brassica oleracea was the main expansion mechanism for BnabHLHs . Expression analyses showed that BnabHLHs were widely in different plant tissues and formed seven main patterns, suggesting they may participate in various aspects of B. napus development. Furthermore, when roots were treated with five different hormones (IAA, auxin; GA 3 , gibberellin; 6-BA, cytokinin; ABA, abscisic acid and ACC, ethylene), the expression profiles of BnabHLHs changed significantly, with many showing increased expression. The induction of five candidate BnabHLHs was confirmed following the five hormone treatments via qRT-PCR. Up to 246 BnabHLHs from nine subfamilies were predicted to have potential roles relating to root development through the joint analysis of their expression profiles and homolog function.
Conclusion: The 602 BnabHLHs identified from B. napus were classified into 35 subfamilies, and those members from the same subfamily generally had similar sequence motifs. Overall, we found that BnabHLHs may be widely involved in root development in B. napus . Moreover, this study provides important insights into the potential functions of the BnabHLHs super gene family and thus will be useful in future gene function research.
Keywords: Brassica napus ; bHLH transcription factor; root; gene expression
Protocol for a Randomized Control Trial of the Caregiver Support Intervention with Syrian Refugees in Lebanon
Authors: Miller Kenneth E , Arnous Maguy , Tossyeh Fadila , Chen Alexandra , Bakolis Ioannis , Koppenol-Gonzalez Gabriela V. , Nahas Nayla , Jo Mark J.D.
Published: February 2020

Background There is evidence that chronic stress negatively impacts parenting among refugees and other war-affected communities. Persistent parental stress and distress may lead to unresponsive, anxious, or overly harsh parenting and a corresponding increase in emotional and behaviour problems among children. Most parenting interventions emphasize the acquisition of knowledge and skills; however, this overlooks the deleterious effects of chronic stress on parenting. The Caregiver Support Intervention (CSI) aims to strengthen quality of parenting skills by lowering stress and improving psychosocial wellbeing among refugee caregivers of children aged 3-12, while also increasing knowledge and skills related to positive parenting. The CSI is a 9-session psychosocial group intervention delivered by non-specialist providers. It is intended for all adult primary caregivers of children in high-adversity communities, rather than specifically targeting caregivers already showing signs of elevated distress. Methods The primary objective of this study is to assess the effectiveness of the CSI through a parallel group randomized controlled study with Syrian refugee families in North Lebanon. Participants will be primary caregivers of children ages 3-12, with one index child per family. Families will be randomized to the CSI or a waitlist control group. A total of 240 families (480 caregivers) will be recruited into the study. Randomization will be at the family level, and CSI groups will be held separately for women and men. The study will be implemented in two waves. Outcomes for both arms will be assessed at baseline, post-intervention, and at a three-month follow-up. The primary outcome is quality of parenting skills. Secondary outcomes include parental warmth and sensitivity, harsh parenting, parenting knowledge, and child psychosocial wellbeing. Putative mediators of the CSI on parenting are caregiver stress, distress, psychosocial wellbeing, and stress management. Discussion This trial may establish the Caregiver Support Intervention as an effective intervention for strengthening parenting in families living in settings of high adversity, particularly refugee communities. Trial registration: The trial has been registered with the International Society for the Registration of Clinical Trials. Trial Registration: ISRCTN22321773.
The independent indicators of contrast-enhanced ultrasound for predicting renal cell carcinoma
Authors: Cao Hongli , Fang Liang , Chen Lin
Published: February 2020

Background: The value of contrast-enhanced ultrasound (CEUS) in differentiating between renal cell carcinoma (RCC) and angiomyolipoma (AML) was analyzed. The purpose of this study was to identify the independent indicators of CEUS for predicting RCC.
Methods: A total of 172 renal tumors (150 RCCs, 22 AMLs) in 165 patients underwent conventional ultrasound (CUS) and CEUS examinations before radical or partial nephrectomy, and the features on CUS and CEUS were analyzed.
Results: There were significant differences in echogenicity, blood flow signals in color Doppler flow imaging (CDFI), peak intensity, homogeneity of enhancement, wash in, wash out, and perilesional rim-like enhancement between RCC and AML ( P <0.05 for all). Multivariate analysis indicated that perilesional rim-like enhancement ( P =0.035, odds ratio [OR]=9.907, 95% confidence interval [CI]: 1.169-83.971) and fast wash out ( P =0.001, OR =9.755, 95%[CI]: 2.497-38.115) were independent indicators for predicting RCC. The area under the receiver operating characteristic (ROC) curve (AUC) for perilesional rim-like enhancement was 0.838 (95% CI:0.774-0.890) with 76.7% sensitivity and 90.9% specificity, while the AUC of fast wash out was 0.833 (95% CI:0.768-0.885) with 74.7% sensitivity and 81.8% specificity.
Conclounsions: This study indicated that CEUS has value in differentiating RCC and AML. Present perilesional rim-like enhancement and fast wash out may be important indicators for predicting RCC.
Key words: Renal cell carcinoma; angiomyolipoma; contrast-enhanced ultrasound; ultrasonography
Effects of a single interprofessional simulation session on medical and nursing students’ attitudes toward interprofessional learning and professional identity: A questionnaire study
Authors: Burford Bryan , Greig Paul , Kelleher Michael , Merriman Clair , Platt Alan , Richards Elize , Davidson Neil , Vance Gill
Published: February 2020

Background

Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK.
Method

Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured.
Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures.
Results

A total of 194 medical and 266 nursing students completed questionnaires.
A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site.
Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students.
Conclusions

Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace.

Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect
Factors influencing cognitive reactivity among young adults at high risk for depression in China: a cross-sectional study
Authors: huang fei fei , Wen Zhi Peng , li qi , chen bin , Weng Wen Jie
Published: February 2020

Background: Understanding the factors influencing cognitive reactivity (CR) may help identify individuals at risk for first episode depression and relapse and facilitate routine access to preventative treatments. However, few studies have examined the relationship between CR and depression in Asian countries. This study was performed to assess the current status of CR among Chinese young adults and explore influencing factors.
Methods: A national cross-sectional online study using convenience sampling was conducted among 1597 healthy young adults in China (93.94%) with a mean age of 24.34 (SD=5.76) years.
Results: The mean CR score was 51.36±18.97 (range 0-130). Binary logistic regression showed that a low level of CR was associated with the following factors: high self-compassion, high social support, high resilience, high monthly household income, and living in a rural area, with odds ratios (ORs) ranging from 0.14 to 0.70. Young adults in full-time employment, experiencing poor sleep, with high neuroticism, who reported frequent sad mood, and who had a high intensity of negative life events had increased CR to depression, with ORs ranging from 1.18 to 6.66. The prediction probability of these factors was 75.40%. Causal relationships among the influencing factors and CR could not be established.
Conclusions: The self-reported CR levels among Chinese young adults were moderate. Enhancing self-compassion, resilience, and social support for young adults and reducing negative life events, neuroticism, and poor sleep may help decrease CR. These findings may help healthcare providers or researchers determine how to cultivate and improve the CR of young adults by establishing documented policies and/or improving intervention efficacies.
Polychlorinated Biphenyls in the Drinking Water Source of the Yangtze River: Characteristics and Risk Assessment
Authors: Cui Xiaoai , Dong Jing , Huang Zhifeng , Liu Chengyou , Qiao Xiaocui , Wang Xing , Zhao Xingru , Zheng Binghui , Shen Jinshan
Published: February 2020

Background As the longest river in Asia, the Yangtze River flows through the most industrialized cities in China and provides critical ecological services for agriculture, industry, and transportation. Polychlorinated biphenyls (PCBs) have been banned for many years, but trace amounts of PCBs still exist as persistent organic pollutant in drinking water and are an ecotoxicological problem. In this work, we collected water, sediment, and suspended particulate matter (SPM) samples along the Yangtze River, to study the distribution and transport of PCBs for the risk assessment of the Yangtze River as a drinking water source. Results The ΣPCBs concentrations in water, sediment, and SPM ranged in 0.044–10.98 ng/L, 0.33–69.43 ng/g, and 0.72–152.66 ng/L, respectively. The main pollutants were PCB17, 18, 28, 47 and 118 in the Yangtze River. The ff SW value of PCB18 and PCB28 all exceeded 0.5, whereas the ff SW value of PCB47 and PCB118 (except for PCB118 at Y-4) were less than 0.5. The toxic equivalent quantity (TEQ) range of PCBs in water and in sediment was 0–5.55 pg-TEQ/L and 0–2.51 pg-TEQ/g, respectively. Conclusions In both water and sediment, lower chlorinated PCBs are dominant in the middle reaches and higher chlorinated PCBs are dominant at downstream. In contrast, SPM is dominated by tetra-CBs. The ff SW values reveal a net redissolution of lower PCBs from sediments to water but a net sorption of higher PCBs from water to sediment. The PCBs in water and sediment at downstream pose potential ecological risk, but the drinking water does not have a non-carcinogenic risk for humans.
Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population
Authors: Zhang Heng , Li Zhijuan , Wei Yarong , Fu Jinyan , Feng Yaling , Chen Daozhen , Xu De-xiang
Published: February 2020

Background：Vitamin D insufficiency and deficiency in childhood are common, which is closely related to bone development. However, the status and influential factors of vitamin D during different ages are not clear. This study aimed to survey vitamin D status in children aged 0 to 6 years and explore its influential factors.
Materials and methods: A total of 6953 children were recruited in Wuxi City of East China from January to December in 2016. Enzyme-linked immunosorbent assay was used to determine the serum concentrations of 25-hydroxyvitamin D [25(OH)D].
Results: The median vitamin D level in the infant group (0-1 years of age) was 69.40 nmol/L, which was higher than that in both the toddlerhood group (1-3 years of age; 62.30 nmol/L) and the preschool group (3-6 years of age; 50.85 nmol/L) (P < 0.001). In addition, the median vitamin D level was 71.70 nmol/L in summer, which was higher than that in spring (64.25 nmol/L), autumn (62.95 nmol/L) and winter (64.10 nmol/L; P < 0.001). However, no difference was observed between genders (P = 0.974). Furthermore, the prevalence of vitamin D deficiency (<50 nmol/L) was 48.1% in the preschool group (3-6 years of age), which was higher than the 21.2% vitamin D deficiency in the toddlerhood group (1-3 years of age) and the 17.9% vitamin D deficiency in the infant group (0-1 years of age). Interestingly, a nonlinear association between 25(OH)D and air temperature was observed.
Conclusions: A high prevalence of vitamin D deficiency was common in a Chinese population of children 0-6 years old, especially in the preschool-aged children. Season and air temperature were related to vitamin D status. Therefore, we suggest that the recommendation for vitamin D supplementation in the Chinese pediatric population should be revised to include preschoolers and adolescents.

Keywords: Vitamin D; deficiency; preschool; season; air temperature.
Do Caregiving Hours Impact on Female Caregivers’ Receipt of Mammogram?: A Comparison with Non-Caregivers
Authors: Kim Soo Young , Guo Yuqi , Won Chorong , Lee Hee Yun
Published: February 2020

Background

caregiving responsibilities significantly impact females’ decisions on adhering to preventive mammography. The purpose of this study is to examine (1) the levels of Mammogram receipt, (2) the role of caregiving factors on the receipt of mammogram in caregiving group, and (3) the role of cancer beliefs on Mammogram screening in caregivers and non-caregivers.

Methods

the 2017 Health Information National Trends Survey (HINTS) provides samples of 1228 women aged 40 to 75 years old for this secondary analysis. By using Andersen’s Behavioral Model of Health Services Use, a binomial logistic regression model was used to analyze associations between mammography and socioeconomic factors, caregiving factors, and cancer belief factors.

Results

caregivers who provided more hours of caregiving per week (OR=0.749, 95% CI=0.564-0.94) and caregivers who had the belief of rather not know the likelihood of getting cancer (OR=0.673, 95% CI=0.496-0.914) were less likely to use mammogram. However, caregivers who believed cancer is more common than heart disease (OR=1.490, 95% CI=1.302- 2.151) were more likely to use mammogram. Non-caregivers who worried about getting cancer (OR=1.158, 95% CI=0.793-1.691) were more likely to use mammogram, but non-caregivers who had the belief of rather not know the likelihood of getting cancer (OR=0.825, 95% CI=0.713-0.955) were less likely to use mammogram.

Conclusions

to support caregivers’ breast cancer prevention, caregiving-related policies based on caregiving hours should be developed. Particularly, effort to promote breast cancer screening education and care support among older primary caregivers will likely increase their adherence to preventive mammography uptake. Development of targeted cancer prevention interventions on specific cancer beliefs held by both groups are also urgently needed to promote mammography.
A multi-scale flow model for blood regulation in a realistic vascular system
Authors: Qohar Ulin Nuha Abdul , Munthe-Kaas Antonella Zanna , Nordbotten Jan Martin , Hanson Erik Andreas
Published: February 2020

In the last decade, numerical models have been an increasingly important tool in medical science both for the fundamental understanding of the physiology of the human body as well as for diagnostics and personalized medicine. In this paper, a multi-scale model is developed for blood flow and regulation in a full vascular structure of an organ. We couple a 1D vascular graph model to represent blood flow in larger vessels and a porous media model to describe flow in smaller vessels and capillary bed. The vascular model is based on Poiseuille’s law, with pressure correction by elasticity and pressure drop estimation at vessels junctions. The porous capillary bed is modeled as a two compartments domain (arterial and venal) and Darcy’s law. The fluid exchange between the arterial and venal capillary bed compartments is defined as blood perfusion.
The numerical experiments show that the proposed model for blood circulation: 1) is closely dependent on the structure and parameters of both the vascular vessels and of the capillary bed, and 2) it provides a realistic blood circulation in the organ. The advantage of the proposed model is that it is complex enough to capture the underlying physiology reliably, yet highly flexible as it offers the possibility of incorporating various local effects. Furthermore, the numerical implementation of the model is straightforward and allows for simulations on a regular desktop computer.
Prognoses, outcomes and clinicopathological characteristics of very elderly patients with hepatocellular carcinoma who underwent hepatectomy
Authors: Shimada Shingo , Kamiyama Toshiya , Orimo Tatsuya , Nagatsu Akihisa , Asahi Yoh , Sakamoto Yuzuru , Kamachi Hirofumi , Taketomi Akinobu
Published: February 2020

Background

The aim was to evaluate the prognostic factors, clinicopathological characteristics and surgical outcomes after hepatectomy in very elderly patients with hepatocellular carcinoma (HCC).

Methods

We analyzed 796 patients with HCC from 2000 to 2017. Patients aged 80 years or older were classified into the very elderly group (group VE; n=49), patients younger than 80 years old and aged 65 years or older were classified into the elderly group (group E; n=363), and patients younger than 65 years old were classified into the young group (group Y; n=384). We investigated the prognoses, clinicopathological characteristics and surgical outcomes after hepatectomy.

Results

The number of surgical procedures and outcomes, including morbidities, were not significantly different. Groups VE, E and Y showed similar prognoses in terms of both survival and recurrence. In group VE, PT < 80% and PIVKA-II ≥ 400 mAU/ml were unfavorable factors for survival, and PIVKA-II ≥ 400 mAU/ml and the presence of portal venous invasion (PVI), hepatic venous invasion, and fibrosis were unfavorable factors for recurrence. In group E, ChE < 180 IU/l, AFP ≥ 20 ng/ml, tumor size ≥ 10 cm, and the presence of multiple tumors, PVI, and hepatic venous invasion (HVI) were unfavorable factors for survival, and ChE < 180 IU/l, tumor size ≥ 10 cm, and the presence of multiple tumors, PVI, and HVI were unfavorable factors for recurrence. In group Y, AFP ≥ 20 ng/ml, the presence of multiple tumors, poor differentiation, PVI, HVI, and blood loss ≥ 400 ml were unfavorable factors for survival, and PT < 80%, albumin < 3.5 g/dl, AFP ≥ 20 ng/ml, tumor size ≥ 10 cm, and the presence of multiple tumors, poor differentiation, and PVI were unfavorable factors for recurrence.

Conclusions

Tumor factors might have limited influence on the prognosis of very elderly patients, and liver function reserve might be important for the long-term survival of very elderly patients. Hepatectomy can be performed safely, even in very elderly patients. Hepatectomy should not be avoided in very elderly patients with HCC if the patients have a good general status because these patients have the same prognoses as nonelderly people.
Spread through air spaces is a poor prognostic indicator in patients undergoing lobectomy for lung cancer: A systematic review and meta-analysis
Authors: Wen Yaokai , Liang Hengrui , Qiu Guanping , Li Shuben , Liu Jun , Ying Weiqiang , He Jianxing , Liang Wenhua
Published: February 2020

Background: Previous studies have confirmed the poor prognostic value of spread through air spaces (STAS) in patients undergoing limited resection for lung cancer. Nevertheless, its prognostic value remains controversial in patients undergoing lobectomy. Consequently, we aim to systematically and comprehensively evaluate the prognosis of patients with STAS undergoing lobectomy for lung cancer. Methods: An extensive search of literature databases was conducted. Recurrence-free survival (RFS) and overall survival (OS) were compared between patients with or without STAS undergoing lobectomy. In addition, results of the limited resection were also evaluated and presented. Results: 5 studies with 1531 patients reported the outcomes of lobectomy and 4 studies including 505 patients evaluated the survival of limited resection. In patients undergoing lobectomy, STAS was associated with significantly worse survival than non-STAS, including both RFS (HR=1.700; 95% CI: 1.265–2.283; P＜0.001; P for heterogeneity=0.637; I2=0.0%) and OS (HR=2.620; 95% CI: 1.138–6.031; P=0.024; P for heterogeneity=0.128; I2=51.4%). STAS was also correlated with shorter RFS (HR=3.434, 95%CI 2.173 to 5.428; P＜0.001; P for heterogeneity=0.828, I2=0.0%) and OS (HR=3.494, 95%CI 2.128 to 5.736; P＜0.001; P for heterogeneity=0.501, I2=0.0%) in limited resection. Conclusions: STAS is a poor prognostic indicator in patients undergoing lobectomy for lung cancer.