bluuebunny/crossref_metadata_2025 huggingface dataset:
Problem based review: The patient with hypercalcaemia
Authors:   Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, Machenahalli P , Shotliff K
Published: June 2021

Hypercalcaemia is a common problem which may present to the Acute Medical Unit. Primary hyperparathyroidism (PHPT) and malignancy are the commonest causes of hypercalcaemia, accounting for over 90% of cases. Assessment of parathyroid hormone (PTH) levels is key to determining whether hypercalcaemia is parathyroid-mediated. Initial systematic assessment and adequate rehydration are important to help make the underlying diagnosis and determine longer-term management. The medical management of primary hyperparathyroidism not requiring surgery, with Cinacalcet is highlighted.
Book Review: Acute Medicine by Declan O’Kane
Authors:   Royal Bournemouth Hospital, Wheble Micheal
Published: June 2021

This new book by Dr O’Kane is a very useful and interesting book directed towards Medical registrars but also with many positive features for anyone from Medical Student to Consultants.
The prediction of death up to 100 days after admission to hospital for acute medical illness – the comparison of two ECG interpretation methods with ECG-dispersion mapping
Authors:   Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark, Kellett John , Clifford Mary ,   Medical Assessment Unit, Nenagh Hospital
Published: June 2021

Background: the prognostic performances of different ECG interpretation methods have not been compared. Methods: the 100 day mortality of 513 patients predicted by Marquette proprietary ECG software, Tan et al’s scoring system and the myocardial micro-alternation index (MMI) were compared. Results: 33 patients (6.4%) died within 100 days of hospital admission. The c statistics for Mar Abstract quette and Tan ECG interpretation and MMI were not statistically different (i.e. 0.64, 0.68 and 0.73, respectively). Only MMI was independent from age as a predictor of mortality. The c statistic for MMI plus age of 0.81 was significantly higher than that of Marquette ECG interpretation (p 0.015). Conclusion: predictions of 100 day mortality by of all three ECG interpretation methods are equivalent.
A patient presenting with collapse and breathlessness
Authors: Raveendran Shelley , Kyprianou Katy ,   Heartlands Hospital, Bordesley Green East, Birmingham, Zenonos Kypros ,   Heartlands Hospital, Bordesley Green East, Birmingham, Saraf Sanjay ,   Consultant in Diabetes and Endocrinology, Good Hope Hospital, Rectory Road, Sutton Cold Field, West Midlands
Published: June 2021

A 57-year-old man was admitted to the Acute Medical Unit with an episode of collapse following chest pain and shortness of breath. On examination he was tachycardic, and tachypnoeic with a heart rate of 120 beats per minute and a respiratory rate of 30.
A simple intervention to improve patient safety, save time and improve staff experience in the AMU procedure room
Authors:   Hampshire Hospitals NHS Foundation Trust, Misselbrook Gary Peter , Kause Juliane ,   University Hospitals Southampton NHS Foundation Trust, Yeoh Su-Ann ,   University Hospitals Southampton NHS Foundation Trust
Published: June 2021

Over the last decade, operating theatres and Intensive Care Units (ICUs) have established systematic methods for performing procedures on patients that have been shown to reduce complications and improve patient safety. Whilst the use of procedure rooms on Acute Medicine Units (AMUs) is highly recommended by patient safety groups and Royal College publications, they are not universally available or appropriately utilised. In this article we discuss a quality improvement project that was undertaken on an AMU at a large university teaching hospital in the United Kingdom, highlighting its successes and challenges.
HIV – lessons from a late diagnosis
Authors:   Oxford University Hospitals, Chan Xin Hui S. , Onen Barbara L. ,   Oxford University Hospitals, Raza Mansoor M. ,   Milton Keynes University Hospital, Mital Dushyant ,   Milton Keynes hospital NHS Foundation Trust, Smith William R ,   Milton Keynes General Hospital
Published: June 2021

Late HIV diagnosis is the most important predictor of HIV-related morbidity and mortality in the UK and often results from missed testing opportunities during earlier contact with health services. The HPA now recommends routine HIV testing be commissioned as a priority for all general medical admissions in high prevalence areas, such as Milton Keynes. We present the case of a patient admitted to our Medical Admissions Unit (MAU) managed initially for presumed septic complications of metastatic disease who was later found to have terminal HIV disease. In keeping with UK-wide experience which we review, a local audit following this case found MAU HIV test coverage increased after routine testing but not after staff education alone, and resulted in implementation of routine HIV testing in our MAU.
Trainee Report Summer 2016
Authors:   Chelsea and Westminster Hospital, Krishnamoorthy Sanjay , Smallwood Nicholas ,   Surrey and Sussex NHS Trust
Published: June 2021

The latest SAM meeting was well attended with a number of high quality posters on display and a small but perfectly formed trainee session – thanks to those who attended. There were talks from the takeAIM fellows highlighting the important work they have been doing in improving recruitment into Acute Internal Medicine.
National Training Numbers in AIM in the UK
Authors:   Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust, Jones Matthew
Published: June 2021

It has recently become apparent that a few trainees in Acute Internal Medicine (AIM) have not been made aware of what the final outcome of their training might be. There is a need, therefore, to ensure that there are no surprises for individuals as they approach the end of training.
Evolving sepsis definitions and their impact on Acute Medical Units
Authors:   Musgrove Park Hospital, Taunton, Thompson A , Stevens M ,   Musgrove Park Hospital, Taunton, Collin I ,   Musgrove Park Hospital, Taunton, Wennike N ,   Musgrove Park Hospital, Taunton
Published: June 2021

Background: There are currently several different definitions for sepsis. This study looked at what proportion of acute medical admissions were identified by the different definitions, what correlation they have, and how many patients would require a review with results in 1 hour. Methods: Data on 212 admissions was collected, on time of admission and review, and number of patients with sepsis by each diagnostic criteria calculated. Results: The NICE criteria identified 69% of admissions as requiring review within one hour, compared to 6% with qSOFA and 18% with previous sepsis definitions. The mean time to review was 1hr 18min, and only 50% of patients meeting the NICE criteria were reviewed within one hour. Conclusions: The proposed NICE guidance will be challenging to implement with current resources.
Electronic Prompts Can Reduce The Number Of Unnecessary Clotting Screens Ordered For Patients
Authors:   Acute Care, Royal Liverpool University Hospital, PJ Johnson , T Dutt ,   Department of Haematology, Royal Liverpool University Hospital, BJ Renton ,   Acute Medicine, Royal Liverpool University Hospital
Published: June 2021

In an attempt to reduce the number of inappropriate clotting screens being performed in our Trust, an electronic prompt was introduced to our haematology requesting system. Over the six month period after introduction of this prompt the number of clotting screen requests reduced by 7001, representing a 21% reduction when compared to the same 6 month period one year earlier. This represented a cost saving of over £98,000 without any increase in adverse incidents being reported related to bleeding complications.
Disseminated intravascular coagulation in an under-recognised zoonotic infection
Authors:   Bolton Royal Hospital, Lawrence Sarah , Claxton Andrew ,   Intensive Care Medicine, Salford Royal Foundation Trust, Holland Mark ,   Clinical and Biomedical Sciences, Faculty of Health and Wellbeing, University of Bolton, United Kingdom, Hodd Jack ,   Acute Medicine and Intensive Care Medicine, Central Manchester Foundation Trust
Published: June 2021

A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic. Treatment is with penicillins and fluoroquinolones. Identification of risk factors for unusual organisms and recognition of DIC allowing prompt treatment is critical for the acute physician.
Third cranial nerve palsy: an unusual manifestation of Mycoplasma pneumoniae
Authors:   Barnet Hospital Education Centre, Wellhouse Lane, Barnet, Nelson Dalia , Angus-Leppan Heather ,   Clinical Neurosciences, Royal Free London NHS Foundation Trust, United Kingdom, Jacobs Phillip ,   Barnet Hospital Education Centre, Wellhouse Lane, Barnet
Published: June 2021

Mycoplasma Pneumoniae (M.pneumoniae) is a well-known cause of atypical pneumonia, however it is also associated with many extra pulmonary manifestations. This report highlights a patient with gastroenterological, haematological and neurological complications, including a third cranial nerve palsy which developed after her initial treatment and discharge from hospital.
Not just a simple sore throat
Authors:   Kingston Hospital, Jones Olivia , Salehi Aram ,   Acute Medicine, Kingston Hospital
Published: June 2021

The presentation of a ‘sore throat’ is common and often requires only symptomatic treatment. This is the case of a 20-year-old female who presented with persistent symptoms of a sore throat. On admission she had raised inflammatory markers and a subsequent blood culture demonstrated a fusobacterium necrophorum and arcanobacterium haemolyticum bacteraemia. Further investigations established an internal jugular vein thrombosis, confirming the diagnosis of Lemierre’s syndrome. This case highlights the importance of further investigation when a sore throat fails to improve, and to remember this often-forgotten syndrome.
Trainee Update, Winter 2017
Authors:   Acute Medicine Unit, University College Hospital, Euston Rd, Fitzrovia, London, NW1 2BU, Khan Tehmeena , Patel Neil ,   Society for Acute Medicine
Published: June 2021

The Specialist Advisory Committee (SAC) of June 2017 discussed the sign off of procedural competences relating to Sengstaken-Blakemore tube insertion and transvenous cardiac pacing and the application for chief registrar roles.
Relação da exodontia de terceiros molares e a ocorrência de parestesia do nervo alveolar inferior: uma revisão narrativa
Authors: Vitor Glayson Pereira , Vieira Leão Andréa Clarice
Published: June 2021

Terceiros molares inferiores podem apresentar uma estreita relação com o nervo alveolar inferior, aumentando as chances de lesão durante o ato cirúrgico. Objetivo: descrever a relação entre a exodontia de terceiros molares e a ocorrência da parestesia do nervo alveolar inferior. Revisão de literatura: cirurgia para exodontia de dentes terceiros molares é o procedimento mais frequentemente realizado entre as cirurgias bucais e, como todo tipo de cirurgia, possui riscos e acidentes e/ou complicações que podem acometer os pacientes tal como a parestesia. Esta é uma condição que altera a sensibilidade de determinada área e pode ocorrer em consequência de traumas diretos ao nervo ou pela compressão deste, devido a hematoma e edema, levando a desconforto e incômodo. Considerações finais: é importante o profissional cirurgião-dentista atentar para o planejamento correto, criterioso e fazer uso de exames complementares, a fim de precaver possíveis complicações durante o ato cirúrgico. Caso a parestesia aconteça, podem ser utilizados tratamentos medicamentosos, a laser ou cirúrgicos, com resultados em longo prazo positivos e reversão do caso.
Characterization of fish assemblages in mesophotic reefs of Cuba
Authors: Cobián-Rojas Dorka , Navarro-Martínez Zenaida M , García-Rodríguez Alain , David Andrew , Chevalier-Monteagudo Pedro , Drummond Felicia , Farrington Stephanie , Reed John K
Published: June 2021

Although mesophotic coral reef ecosystems (MCEs) are widespread and diverse, they remain largely unexplored. The Caribbean MCEs are among the most studied in the world, but detailed information regarding Cuban MCEs is limited. In this study we present the first analyses of the ichthyofauna of the Cuban MCEs based on data from a research cruise in June 2017. Forty-two sites were sampled around the Archipelago of Cuba using a Remotely Operated Vehicle at depths between 30 and 180 m. Overall, 151 species were observed, including 13 threatened species. Differences in ichthyofauna were observed between marine protected areas (MPAs) and unprotected areas, with greater abundances and species richness inside national parks. Invasive lionfish had greater abundances on the north coast, while the south coast had greater abundances and richness of threatened and commercially valuable species. A detailed analysis (Generalized Lineal Model) showed effects of depth, protection level, reef type (seamount or fringing reef), and region on abundance (as fish observed per minute), but no interaction between them. A transition was observed in the fish assemblages between the 30–60 m and 60–100 m depth ranges. Species abundance and richness decreased with increasing depth. The most represented families of commercial importance (Serranidae, Lutjanidae, and Carangidae) were well represented in the upper, middle, and lower areas of the MCEs, but dominated in deeper areas. The percentage of herbivores in the fish assemblage decreased with increasing depth, contrary to what was observed with piscivores and invertebrate feeders/piscivores. Twenty-seven functional groups were identified, with cryptic micro-invertivores and cryptic planktivores being the most abundant, while roving macro-invertivores and roving piscivores were the most functionally redundant. This research constitutes a valuable contribution to the study and management of ichthyofauna in Cuba and highlights the effectiveness of MPAs in the conservation of fish biodiversity.
Adopción de NIIF para las PYMES en empresas de Nicaragua
Authors: Laguna Laguna Odalye , Salmerón Delgado Welmer , Espinoza Torres Maria , Perez Leónidas , Sáenz Vanegas Fiorella
Published: June 2021

La apertura de las transacciones comerciales a nivel mundial trae consigo la necesidad de unificar normas contables, que faciliten la comprensión del lenguaje de la información financiera y posibiliten la participación de las empresas a nivel internacional. Este trabajo tiene como objetivo analizar la adopción de la Norma Internacional de Información financiera para las PYMES (NIIF para las PYMES) en empresas de Nicaragua; detectar los beneficios que se perciben en la adopción y la posición de las empresas que aún no adoptan la norma. El estudio se realizó con 100 empresas del municipio de León. Los resultados reflejan que una minoría de las empresas (8%) utiliza NIIF para PYMES y la mayoría (61%) aplica los Principios de Contabilidad General Aceptados (PCGA). De acuerdo al estudio entre los beneficios de la adopción de la NIIF para las PYMES destacan: una mejor competitividad en la empresa, fiabilidad y objetividad en la información financiera y transparencia de los procesos contables. Las empresas que no aplican la NIIF para las PYMES, manifestaron no hacerlo porque no perciben ningún beneficio para la empresa, por el tiempo y el costo; sin embargo, la mayoría (60%) expresó tener interés de aplicarlas en el futuro, principalmente para llevar un mejor orden y control de las operaciones económicas de la empresa.
Superoxide Dismutase (SOD) Activity in Cryopreserved Semen of Itik Pinas-Khaki (Anas platyrhynchos L.)
Authors: Ancuelo A. E. , Landicho M. M. , Dichoso G. A. , Sangel P. P.
Published: June 2021

Cryopreservation induces oxidative stress on sperm due to an increase in the number of reactive oxygen species (ROS), thereby resulting in decreased sperm quality. ROS's destructive potential is normally counteracted in sperm by their innate antioxidant system consisting of enzymes, which include superoxide dismutase (SOD). This study aimed to assess the quality of semen from Itik Pinas-Khaki (IP-Khaki) drakes that were cryopreserved with either 4.5% DMSO or 7.0% glycerol as cryoprotectant through evaluation of total sperm motility (%) and determination of SOD activity (U/mL). Here, semen samples were collected from 12 sexually mature IP-Khaki drakes, an improved egg-type breed of Philippine mallard duck, and processed using modified reported cryopreservation procedure for ducks. Results showed that post-thawing total sperm motility averages of 12.04±5.61% using 4.5% DMSO and 13.99±5.28% using 7.0% glycerol were comparable. Moreover, similar SOD activity levels of 0.39±0.18 U/mL with 4.5% DMSO and 0.33±0.21 U/mL with 7.0% glycerol in 2.00 x 108 IP-Khaki sperm cells were also observed. The observed very low intracellular SOD activity indicates severe damage to sperm cells due to cryopreservation, which resulted in a comparably low total sperm motility with either of the cryoprotectants. Thus, the cryopreservation protocol used is not the optimum for IP-Khaki semen based on the observed considerable decline in sperm motility and very low SOD activity after cryopreservation.
Divided Attention in Schizophrenia: A Dual Task Paradigm
Authors: González-Andrade Alejandro , López-Luengo Beatriz , Álvarez Manuel Miguel Ramos , Santiago-Ramajo Sandra
Published: June 2021

Schizophrenia is known to be associated with attentional deficits. Few studies have examined whether the disorder is also associated with a deficit in the ability to divide attention, and they have given contradictory results. Some have reported that patients show greater loss of performance than healthy controls when moving from single tasks to dual tasks, and others have reported that performance loss is similar in both groups or even that patients perform the dual task better than either task on its own. To help resolve this controversy, we performed a first study in which we designed a dual task paradigm with a group of 36 healthy participants. This dual task involves 2 tasks of equivalent difficulty that make use of different sensory modalities. In the second study, we gave this dual task to 23 patients with schizophrenia and 25 healthy participants. Both groups decreased similarly their performance in dual tasks, but the patients showed lower baseline performance in the single task. Our findings suggest that patients with schizophrenia and healthy participants use similar strategies to divide their attention, but in a high-degrading stimuli condition patients perform below the controls in a single task.
Education for Sustainable Development: A Critical Analyses
Authors: Abd Elkhalek Abeer Mohamed Ali
Published: June 2021

Education has a key role in attaining sustainable development goals for both of developing and developed countries. Considering “the Decade of Education for Sustainable Development” approved by United Nations, the gap between the real and the intended contribution of education to sustainable development must be assessed. The main aim of the current study is to evaluate the contribution of education to sustainable development and explore efficient mechanisms to maximize that contribution regarding the main pillars of sustainable development. This paper goes beyond a study concentrating exclusively on the role of education in achieving sustainable development goals as it also examines the relation between education and each dimension of sustainable development to conclude related policy recommendations which are exposed to be useful in that regard.
Distinguishing the Complex Effects of Foreign Direct Investment on Environmental Pollution: Evidence from China
Authors: Chen Jianxun , Tan Hui , Ma Yingran
Published: June 2021

We attempt to investigate how and when foreign direct investment (FDI) impacts different types of environmental pollution in host countries. Using provincial data from China between 1995 and 2015, we find that FDI mitigates air pollution, yet it has insignificant effect on water and solid pollution. We further reveal that it is the combination of the technology, scale and structure effects that jointly determines the impact of FDI on environmental pollution. Among them, the technology effect takes the most dominant role, followed by the scale effect and structure effect. In addition, by considering the time effect on environmental policy change, we suggest that the pollution halo effect mainly occurs after air pollution policy revision.Our findings provide insight on the complex mechanisms and theoretical boundary of FDI on different types of environmental pollutants.
Sistema para Coleta e Tratamento Textos Brasileiros sobre Polarização Política
Authors: Costa Paulo Henrique Ribeiro , Marin Luciano Heitor Gallegos
Published: June 2021

A polarização política popular caracteriza-se quando há uma clara divisão de linhas partidárias em relação a questões políticas, políticas governamentais e figuras públicas, onde um dos lados observa o outro como ameaça. Este tipo de polarização pode ser estudado por meio de textos compartilhados em redes sociais, como no Facebook e no Twitter. Muitas vezes, pesquisadores e interessados coletam textos destas redes sociais, mas não mostram como desenvolver o processo de coleta e tratamento destes textos. Mostramos, neste artigo, o desenvolvimento de um sistema para coleta e tratamento de textos envolvendo polarização política "popular" por meio do Twitter, capaz de incluir as localizações e analisar os sentimentos existentes nestes textos.
Apuração do Capital Social Acumulado a partir de Interações Sociais em Páginas Institucionais no Facebook
Authors: Cunha Kaique Matheus Rodrigues , Gomes Alan Keller
Published: June 2021

Funcionalidades que permitem a interação entre usuários dentro das Redes Sociais Online configuram práticas de sociabilidade em rede, ou seja, ações como Publicar, Comentar, Curtir e Compartilhar têm um significado especial quando estão sob o foco da Sociologia Digital. Com o apoio da teoria de Pierre Bourdieu, neste trabalho são identificados e capturados dados relacionados às práticas de sociabilidade em rede dentro de Páginas Institucionais no Facebook. Esses dados são utilizados no aprendizado da sequência de ações. A partir da frequência de ocorrências das seqüências aprendidas, um indicador do Capital Social acumulado é apresentado. A partir desse indicador e do número de interações sociais, o volume de Capital Social é computado.
Management of Agitation in Dementia and Effects on Inpatient Length of Stay
Authors: Silverstone-Simard Isabelle , Wu Joyce , Nassim Marouane , Friedman Ruby , Segal Marilyn , Moette Johanne , Rej Soham
Published: June 2021

Background

Agitation associated with dementia impacts delivery of medical care and is a major reason for institutionalization in dementia patients. This study examines the association of medication use and other clinical factors with patients’ ‘dischargeability’ (i.e., amount of time until a patient is considered dischargeable from an inpatient unit).

Methods

This study was a retrospective chart review examining 200 patients with dementia and agitation, hospitalized at a Canadian acute care geriatric ward between November 2007 and November 2018. The main outcome measure was time until a patient was deemed dischargeable. Univariate linear regression analyses, followed by multiple linear regression analyses, were used.

Results

Risperidone and quetiapine were the most commonly prescribed medications, but were not associated with time until dischargeable. Olanzapine (40.9 vs. 16.2 days until dischargeable, β = 0.23, p = .001), regular benzodiazepine (32.7 vs. 16.5 days until dischargeable, β = 0.15, p = .027), and as-needed (‘PRN’) benzodiazepine use (31.7 vs. 15.9 days until dischargeable, β =0.19, p = .006) were independently associated with prolonging time until dischargeable.

Conclusions

Olanzapine, benzodiazepine, and PRN benzodiazepine use were associated with longer time until patients with dementia and agitation were considered ready for discharge. This raises the question as to whether the risks of these medications outweigh the benefits in a hospital setting.
Collaborative Development of an Older Adult Experience Survey for Specialized Geriatric Services
Authors: Gilsenan Ronaye , Schwartz Rhonda , Gutmanis Iris A. , Day Adam M.B. , Ryan David P. , Brander Rosemary R.A. , Milne Kelly , Molnar Frank
Published: June 2021

Background

While generic, site, and disease-specific patient experience surveys exist, such surveys have limited relevance to frail, medically complex older adults attending appointment-based specialized geriatric services (SGS). The study objective was to develop and evaluate a patient experience survey specific to this population.

Methods

Using established survey research methods, this study was conducted collaboratively with older adults (patients and family members/friends) at three Ontario sites offering SGS. The study was done in three phases: Phase One—literature review, evi­dence alignment, and operationalization of core survey items; Phase Two—cognitive interviews and refinement; and Phase Three—pilot testing, survey item analysis, and refinement.

Results

Based on an evidence-informed framework, the “Older Adult Experience Survey” includes 12 core items, two global rat­ing items, two open-ended questions, and two demographic questions. The summed 12 core items demonstrated accept­able internal consistency (Cronbach’s alpha: 0.83), and the correlation between the summed score and a global question was 0.59, providing evidence of construct validity. The survey also demonstrated face and content validity.

Conclusion

This open access, collaboratively developed, psychometrically sound patient experience survey can be used to assess, then improve, the clinical experience and quality of care of older adults attending appointment-based SGS clinics/programs.
The Nature of Sacred Time
Authors: Bowler Michael ,   Philosophy Documentation Center
Published: June 2021

In his essay, I examine the nature of sacred time, focusing primarily though not exclusively on two aspects of sacred time: that it is “set aside” from use and that in this time human beings can be in union and communion with and in God. I argue that chronological, “clock” time and Heideggerian “datable” (in-order-to) time are incapable of being directly consecrated as sacred time. In order to understand sacred time, I investigate the Fall and how this results in an essentially instrumentalist understanding of the world and time, which has its ultimate motive in the drive for human self-sufficiency. Only against this backdrop can one properly understand the nature (physis) of human temporality and historicity with respect to sacred time as set apart from use and as that time we spend and thus share with Christ, thereby coming into union and communion with God.
Initial education evaluation of a Physical Education program: Perceptions of graduates from a public university in the state of Santa Catarina
Authors: Salles William das Neves , Martins Samara Escobar , Luiz Maria Eduarda Tomaz , Guimarães Adriana Coutinho de Azevedo , Marinho Alcyane
Published: June 2021

This mixed-methods study investigated the perceptions of Physical Education (PE) graduates on their education obtained at a public university in the state of Santa Catarina, Brazil. An online questionnaire was applied to collect information regarding the initial education of 94 graduates (50 bachelors and 44 teachers) trained under the new curricular proposal implemented in 2008 at the institution. Extension (8.35±1.51) and research activities (8.24±1.66) achieved the highest scores, with emphasis on the diversity of structures and options offered. The graduates’ classmates (7.45±1.73), due to the lack of dedication and commitment to the program, and the curricular structure (7.64±1.59), due to the problems in the courses’ semiannual organization, received the lowest ratings. Teachers evaluated their course higher than the bachelors, especially in the components of faculty (T = 8.55±1.02; B = 7.28±1.37), classmates (T = 7.91±1.60; B = 7.04±1.76), physical infrastructure (T = 8.30±1.69; B = 7.64±1.34), supervised internships (T = 8.61±1.45; B = 7.72±1.73), and overall program evaluation (T = 8.64±1.10; B = 7.82±1.35). Factors such as supervised internships, curricular structure, faculty, and extension activities explained 59.0% of the variance of the overall program evaluation. Considering these results, those responsible for structuring the PE program can consolidate the practices and components that have been well evaluated, as well as think of alternatives to reduce the weaknesses and negative aspects perceived by the graduates.
Avaliação da aprendizagem do teorema de Tales na Escola do Ensino Secundário do Kuito-Bié/Angola
Authors: Ecolelo Benjamim , Avelino Pedro Chimbinda
Published: June 2021

Contribuir para o desenvolvimento da atividade Matemática no decorrer da avaliação da aprendizagem do 2º teorema de Tales apoiado em recursos informáticos na unidade da Geometria é o propósito deste artigo. De forma a tornar mais claro o seu objetivo, foram elaboradas tarefas e metodologia para a aprendizagem do 2º teorema de Tales, utilizando o software GeoGebra. Tratam-se de aspectos como: avaliação de conteúdos matemáticos, o tratamento do 2.º teorema de Tales, avaliação e aprendizagem do teorema de Tales com o GeoGebra e os passos para aplicar o GeoGebra no tratamento do 2º teorema de Tales. A pesquisa enquadra-se no paradigma descritivo, seguindo uma abordagem explicativa e utilizou a metodologia de critério de expertos, com aplicação de questionários e entrevistas a 15 expertos e 300 alunos da 9ª classe de uma escola do Kuito-Bié/Angola. O resultado da pesquisa consistiu na elaboração de uma metodologia para o tratamento do 2º teorema de Tales com o uso da tecnologia, em que não se perde de vista a utilização de materiais manipuláveis, reforçados com a utilização de meios informáticos, melhorando assim o aspeto visual e desenvolvendo habilidades no trabalho com esses recursos informáticos. O emprego desta metodologia, depois da sua validação pelos expertos, levou os alunos a investigarem de forma facilitada os diferentes triângulos inscritos numa circunferência e os mesmos foram capazes não só de discriminar as características destas figuras geométricas, como também, reconhecê-las visualmente, determinando a amplitude de seus ângulos de acordo com uma classificação geométrica criada por si.Palavras-chave: avaliação, teorema de Tales; Geogebra.
Growth and Malnutrition Assessment of Neonates Admitted to a Government Hospital in Nakuru, Kenya
Authors: Thoene Melissa , Switchenko Nora , Morozov Anya , Kibaru Elizabeth , Ormer Matthew Van , Hanson Corrine , Anderson-Berry Ann
Published: June 2021

Background and Aims: Inadequate nutrient provision causes neonatal growth failure and malnutrition. Therefore, this study aimed to 1) quantify infant growth velocity from birth to hospital discharge, 2) determine the incidence of neonatal malnutrition at the time of discharge from a government hospital newborn unit in Nakuru, Kenya.
Methods: After ethical approval, data was collected for infants (n=104) hospitalized >14 days (June 2016 - December 2018) including: birth gestational age (GA), birth and discharge weight (grams, g) with z-scores (2013 Fenton Preterm or 2006 World Health Organization 0-2 Year growth chart), hospital length of stay (LOS) days. Growth during hospitalization was calculated in g/day [(discharge weight – birth weight)/LOS] and g/kilogram(kg)/day [1000xln(birth weight/discharge weight)/LOS). Malnutrition was diagnosed by birth to discharge weight z-score change (decline): mild = 0.8-1.2 standard deviations (SD), moderate = >1.2-2.0 SD, severe = >2.0 SD. P-value <0.05 was significant.
Results: 94/104 (90.4%) infants were preterm with median birth GA 32 weeks, weight 1500 g (z-score -0.33), LOS 21 days and discharge weight 1735 g (z-score -1.95). Median weight gain was 8.2 g/day or 5.2 g/kg/day with weight z-score change -1.34 SD. Linear regression predicted each hospital day decreased z-score by -0.031 (p<0.001). At discharge, 81.7% of infants met malnutrition criteria—27.1% mild, 49.4% moderate, 23.5% severe.
Conclusions: Infants with LOS >14 days in a government hospital newborn unit in Nakuru, Kenya, experience growth rates below recommended velocities by the World Health Organization (23-34 grams/day from 0-4 months). Nutrition intervention is necessary to support appropriate growth.
The Subjective Comfort Test of Autism Hug Machine Portable Seat
Authors: Maula Mohamad Izzur , Aji Akhmad Lutfiyan , Aliyafi M. Bahtiar , Afif Ilham Yustar , Ammarullah Muhammad Imam , Winarni Tri Indah , Jamari J.
Published: June 2021

This preliminary study proposes to investigate (i) the mean comfortable deep pressure of Autism Hug Machine Portable Seat (AHMPS) manual pull and inflatable wrap models; and (ii) the effect of using AHMPS in reducing anxiety in children with autism spectrum disorder (ASD). The first phase was done to determine the comfort test. Fifteen healthy adolescents (13 men and 2 women; aged 19-25 years) individuals volunteered to participate in the comfort test in determining the pressure of AHMPS, both manual pull, and inflatable wrap. The second phase was completed in children with ASD, in which the comforting pressure from the first phase was then applied to five children with ASD (4 boys and 1 girl; aged 8-15 years) from the Putra Mandiri Public Special School Semarang. All children were administered both the AHMPS inflatable wrap and manual pull as a deep pressure apparatus while traveling by bus. A pulse oximeter was used to measure heart rate variability (physiological arousal). The mean comfort pressure was obtained from 15 healthy subjects, which was 0.81 psi on the chest and 0.80 psi on the thigh for the manual pull; and 0.65 psi on the chest and 0.45 psi on the thigh for the inflatable wrap. In the second phase, the AHMPS manual pull did not significantly decrease heart rate with p=0.114, but the AHMPS inflatable wrap significantly decreased heart rate with a significance value of p=0.037. We conclude, therefore, the AHMPS inflatable wrap decreases physiological arousal in children with ASD.
A new model for learning-based forecasting procedure by combining k-means clustering and time series forecasting algorithms
Authors: Hartomo Kristoko Dwi , Nataliani Yessica
Published: June 2021

This paper aims to propose a new model for time series forecasting that combines forecasting with clustering algorithm. It introduces a new scheme to improve the forecasting results by grouping the time series data using k-means clustering algorithm. It utilizes the clustering result to get the forecasting data. There are usually some user-defined parameters affecting the forecasting results, therefore, a learning-based procedure is proposed to estimate the parameters that will be used for forecasting. This parameter value is computed in the algorithm simultaneously. The result of the experiment compared to other forecasting algorithms demonstrates good results for the proposed model. It has the smallest mean squared error of 13,007.91 and the average improvement rate of 19.83%.
Expression and gene regulation network of TYMS and BCL2L1 in colorectal cancer based on data mining
Authors: Jie Yanghua , Yang Xiaobei , Chen Weidong
Published: June 2021

Background

The purpose of this study was to study the role of thymidylate synthetase (TYMS) and B-cell lymphoma-2 like 1 (BCL2L1) in the occurrence and development of colorectal cancer and its potential regulatory mechanism.

Methods

The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) were analyzed to examine the expression and prognostic value of TYMS and BCL2L1 in colorectal cancer. C-BioPortal analysis was used to detect the TYMS and BCL2L1 alterations. Through The Human Protein Atlas (THPA), the TYMS and BCL2L1 protein levels were also assessed. The protein protein interaction (PPI) network was built using GeneMANIA analysis, while co-expression genes correlated with TYMS and BCL2L1 were identified using LinkedOmics analysis. Finally, we collected clinical samples to verify the expressions of TYMS and BCL2L1 in colorectal cancer.

Results

TYMS and BCL2L1 were up-regulated, and TYMS and BCL2L1 genomic alterations were not associated with the occurrence of colorectal cancer. TYMS and BCL2L1 were significantly connected with the prognosis of colorectal cancer patients. The genes interacted with TYMS and BCL2L1 were linked to functional networks involving pathway of apoptosis, apoptosis-multiple species, colorectal cancer, platinum drug resistance and p53 signaling pathway. qRT-PCR verification results of TYMS were consistent with the result of TCGA and GEO analysis.

Conclusions

This study display that data mining can efficiently provide information on expression of TYMS and BCL2L1, correlated genes of TYMS and BCL2L1, core pathways and potential functional networks in colorectal cancer, suggesting that TYMS and BCL2L1 may become new prognostic and therapeutic targets for colorectal cancer.
Parques Nacionais, turismo e governança
Authors: Brumatti Paula Normandia Moreira , Rozendo Cimone
Published: June 2021

A concessão dos serviços turísticos em Parques Nacionais, baseada em parcerias público-privadas, constitui o principal mecanismo da gestão do uso público desta categoria de unidade de conservação no Brasil. A opção pelo modelo é justificada por seu potencial de sustentabilidade, capaz de fazer convergir interesses conservacionistas e econômicos. Essa habilidade tem sido questionada, principalmente, no que tange às possibilidades de participação de comunidades locais na gestão, aspecto basilar da proposta, que pretende ser referência de governança. Nesse artigo, procurou-se através de revisão bibliográfica, refletir sobre como se configuram os processos participativos no âmbito da implementação e gestão dessas concessões. As análises identificam a prevalência da racionalidade econômica na tomada de decisão e grandes dificuldades em considerar os valores socioculturais na gestão, inclusive na resolução de conflitos fundiários e sociais ocorridos com a implementação dos próprios parques. A participação social é concebida em termos retóricos ou de forma subordinada. Os padrões históricos de exclusão perpetuam-se sob qualificativos de eco ou sustentável sob forte apelo ao ecoturismo, mas sem conexões reais com a proposta. Nesse quadro, é importante atentar para adoção de políticas públicas orientadas efetivamente por uma acepção de ecoturismo capaz de promover a integração do turismo à diversidade sociocultural, à conservação da natureza e de oportunidades para o desenvolvimento da governança local.
Análisis de la localización de la oferta restaurantera del destino turístico Varadero, Cuba
Authors: García Pulido Yadrián Arnaldo , Rodríguez Bello Ismaray , Frías Jiménez Roberto Argelio
Published: June 2021

Entre los principales destinos de sol y playa de Cuba, se encuentra Varadero donde una adecuada planificación de los servicios que se ofertan, resulta vital para su gestión. La creciente variedad de ofertas gastronómicas en sus 22 km de extensión, no está cumpliendo con las expectativas de los clientes por razones como la deficiente localización no solo en el plano, sino también de acuerdo al tipo de oferta que brindan. La presente investigación tuvo como objetivo analizar la localización de los servicios gastronómicos del destino turístico Varadero. Para el desarrollo del trabajo se realizó una amplia revisión documental, entrevistas a los administrativos de los restaurantes y el empleo de sistemas de información geográfica y análisis clúster. El análisis de los 43 restaurantes en operación en el Varadero histórico evidenció una concentración de 10 establecimientos por kilómetro cuadrado. Se detectaron 11 centroides donde los restaurantes se encuentran a menos de 100 metros, siendo el rango de distancia mayoritario de 30 a 200 metros. Se evidenció un significativo desbalance tanto en la localización como en la oferta de las instalaciones en el área, con una clara incidencia en la percepción de variedad del destino , and impact, followed by Spain.
Occurrence of Aflatoxins in Retail Kola Nuts in Ibadan Metropolis
Authors: Akande O. O. , Kolawole O. O. , Afolabi A. A. , Okewole S. A. , Oyekunle L. O.
Published: June 2021

Aim: This study was designed to determine Aflatoxins present in kola nuts sold in Ibadan metropolis.

Study design: Kola nuts were randomly purchased from different markets in Ibadan, Oyo State.

Methodology: Thin layer chromatography (TLC) and spectrophotometric method were used for the determination of aflatoxins in the kola nuts samples.

Results: All the samples collected were contaminated with aflatoxins. Aflatoxin B1 and B2 were present in the kola nuts samples ranging from 9.73 - 25.43 μg/kg and 10.90 - 29.67 μg/kg respectively.

Conclusion: The levels of aflatoxins in the sampled kola nuts were mostly above recommended tolerable limits. It is imperative to enlighten stakeholders on possible ways of handling kola nuts towards reducing the aflatoxin incidences to the barest minimum in order to safeguard the health of the populace.
The effect of Dichlorvous (Sniper) Inhalation on the Histology of the Lungs of Adult Male Wistar Rats
Authors: Anyabolu A. E. , Ezejindu D. N. , Obinwa B. N.
Published: June 2021

The organophosphate, dichlorvous (Otapia-pia) formulated in varying concentrations as insecticides is utilized by several individuals in most remote places of Nigeria due to its affordable value and accessibility. However, this present study is conducted to investigate the adverse effect of the exposure of this substance on the respiratory system (lungs) of male albino wistar rats. Twenty (20) albino wistar rats comprising of all males weighing between 150-230g were divided into four groups (A-D) of five animals each. Group A received only water, feed, and served as the control. Group B was exposed to dichlorvous inhalation 3hrs daily for a period of two weeks; Group C was exposed to dichlorvous inhalation 6hrs daily for a period of two weeks; while Group D was exposed to dichlorvous inhalation 10hrs daily for a period of two weeks. Twenty four hours after the last exposure, the animals were sacrificed by cervical dislocation and dissected. The lungs were weighed and fixed in 10% formal saline for histological studies. The body weight of the experimental groups decreased insignificantly when compared with the control group. The lungs weight increased significantly when compared to the control groups. Histological observation revealed a moderate to severe effects on the lungs with severe consolidated inflammatory exudates (discharge of fluids from pores), a moderate intra-alveoli hemorrhage, and a severe dilation of alveolar septa which is evident as emphysematous changes. This result revealed that the exposure to dichlorvous causes distortion of the normal histological architecture of the lungs. Thus, showing that dichlorvous inhalation influences the normal physiologic mechanisms of the lungs.
Adsorption of Crude Oil Spill from Aqueous Solution using Agro-Wastes as Adsorbents
Authors: Oluwatoyin Akinsete O. , Olalekan Araoye A.
Published: June 2021

Ever increasing and growing awareness of oil-spillage to water environment has led to the search for cost-effective unconventional remediating techniques. This study was carried out using agro-wastes (Rice Husks, Banana Peels and Groundnut Husks) adsorbents. They were activated with H3PO4 for crude oil spill removal from aqueous solution; results were analysed using atomic absorption spectroscopy. The raw agro-wastes and their activated forms were characterized by SEM. The sorption study for maximum adsorption capacity were carried out at different adsorbent concentrations, adsorbent dosage, contact time, pH and rotational speed. The experimental results were analysed using Langmuir, Freundlich, Temkin, Dubinin-Radushkevich isotherm models. The maximum average adsorption capacity (qe) for raw and activated carbon adsorbents were observed in rice husks with 0.2750 and 0.3698 mg/g respectively. The Langmuir isotherm was found to well represent the measured sorption data for the raw and activated banana peel while the remaining raw and activated adsorbents followed the Temkin isotherm. The batch adsorption data on the effect of contact time were fitted into the pseudo-first-order and pseudo-second order models. The banana peel data and its activated form were best described by the pseudo-second-order model indicating chemisorption process while the remaining adsorbents followed the pseudo-first-order model indicating physisorption process. The average removal efficiency of oil by the various adsorbents used increase in the order: (Raw: Banana Peels (50.4 %) < Groundnut Husks (56.8 %) < Rice Husks (74.4 %); Activated Carbon: Banana Peels (61.4 %) < Groundnut Husks (65.6 %) < Rice Husks (82.8 %)). Results of this study (high values of R2 and least values AARE and RMSE) revealed and confirmed that activated carbon adsorbents have better adsorption capacity than the raw forms to clean-up oil spills in aqueous solution.
Influence of Gas Pressure and Blowing Agent Content on the Formation of Aluminum Alloy Foam
Authors: García-Moreno Francisco , Banhart John
Published: June 2021

Apart from density and alloy composition, the structure of solid metallic foams determines their mechanical performance. Herein, the effect of ambient pressure on the foaming behavior of AlSi6Cu4 precursors is studied. In situ X‐ray radioscopy is applied while foaming in a furnace chamber pressurized up to 40 bar. The content of the blowing agent (TiH2) is varied for each of the pressures chosen. The foam density and morphology are analyzed quantitatively using time‐resolved X‐ray radioscopy sequences and postsolidification X‐ray tomography data. The optimal content of blowing agent as well as the pore sizes and distributions is found to depend strongly on the ambient pressure. At high pressures very small, round, and uniformly distributed pores are formed and crack formation is avoided during the gas nucleation stage, which helps to prevent structural defects. Adjusting the ambient pressure allows for better control of the foam structure and density, which is relevant for commercial production and application.
In Situ Surface Film Formed by Solid‐State Anodic Oxidation for Stable Lithium Metal Anodes
Authors: He Yitao , Zhang Yaohui , Wang Zhihong , Li Xifei , Lü Zhe , Huang Xiqiang , Liu Zhiguo
Published: June 2021

Surface protection has drawn increasing attention in lithium (Li) metal batteries by simultaneously taking advantage of the uniform potential distribution and high conductivity, whereas tuning the composition of the protective film and improving the resistance at the interface of protective film/Li metal remain the challenges. Herein, a solid‐state anodic oxidation strategy for preparing an in situ protective film for enhanced cycle life of Li metal anode is illustrated. The solid‐state anodic oxidation of lithium metal is realized for the first time, and the method can be further modified for tuning the composition of the protective film for highly ionic conductive fluorine‐rich interface. Surface electrodeposition simulations indicate the important role of the conductive protective film in increasing the uniform potential distribution on the Li surface. The as‐prepared in situ fluorinated protective film efficiently suppresses the dendrite growth and promotes the cycling performance of the Li metal full cell in commercial ester electrolyte without any additive. This work opens up a new avenue for fabricating unique in situ protective films with controlled composition on Li surface for energy storage applications.