bluuebunny/crossref_metadata_2025 huggingface dataset:
ТОВАРОЗНАВЧИЙ АНАЛІЗ РИНКУ ДЕЗІНФЕКЦІЙНИХ ЗАСОБІВ
Authors: Ravliv Y. A. , Solovey Ya. V.
Published: June 2020

Під поняттям дезінфекція розуміють знищення чи видалення мікроорганізмів на різних об’єктах й у різних субстратах навколишнього середовища з метою переривання механізму передавання інфекційних збудників. Актуальним є дослідження фармацевтичного ринку щодо наявності дезінфекційних засобів для забезпечення належних санітарних та протиепідемічних заходів.

Мета дослідження – провести товарознавчий аналіз вітчизняного ринку дезінфекційних засобів.

Матеріали і методи. Встановити фірми-виробники та країни, які постачають дезінфекційні засоби на ринок України. Дослідити форми їх  випуску.

Результати. Серед країн-виробників дезінфекційних засобів лідирують вітчизняні виробники, які займають 59 % ринку. Серед країн-імпортерів лідируючу роль займають Бельгія (ТОВ «Еколаб») – 9 % ринку та Німеччина (B. Braun Melsungen AG) – 6 %, Італія, Ні­дерланди, Словаччина, Росія та Білорусь по 4 %, Швейцарія – 3 %, Китай та Франція –  2 %.

Висновки. Отримані результати дозволили встановити лідерів дезінфекційних засобів на ринку України, найбільшу частку становлять вітчизняні виробники та серед іноземних країн-постачальників лідируючу роль займає Бельгія.
РОЛЬ ВОЛЬОВОЇ САМОРЕГУЛЯЦІЇ У ФОРМУВАННІ ПРОФЕСІОНАЛІЗМУ МЕДИЧНОЇ СЕСТРИ
Authors: Koliastruk K. A.
Published: June 2020

Сьогодні медична сестра повинна виконувати лікувально-профілактичні завдання, розробляти план заходів із реалізації сестринської допомоги, проводити оцінку ефективності надання допомоги, здатна організувати заходи з надання невідкладної долікарської допомоги, профілактики захворювань. Тому медичній сестрі необхідно вміти володіти власною поведінкою у різних ситуаціях, бути здатною свідомо управляти своїми діями, станами та спонуканнями.

Мета дослідження – проаналізувати сформованості вольової саморегуляції медичних сестер відповідно до тривалості їх професійної діяльності.

Матеріали і методи. Було проанкетовано 62 медичні сестри КНП «Барська ЦРЛ» Вінницької області за допомогою тесту-опитувальника А. В. Звєрькова і Е. В. Ейдмана.

Результати. Встановлено високий бал за загальною шкалою (12 і вище) у другій і третій дослідних групах, що характеризує медичний персонал зі стажем роботи 6–20 років як емоційно зрілий, активний, самостійний. Низький бал (11 і нижче) спостерігався у медичних сестер першої і четвертої дослідних груп. Це вказує на те, що медичні сестри, які тільки почали свою професійну діяльність, і ті, що пропрацювали понад 20 років, є чуттєвими, емоційно нестійкими, невпевненими у собі. Рефлексивність у них невисока, а загальний фон активності, як правило, знижений, їм властива іпульсивність і нестійкість намірів. Також їм притаманна спонтанність й імпульсивність, низьке вміння будувати свої відносини з іншими людьми.

Висновки. Медичний персонал зі стажем роботи 6–20 років характеризується високим рівнем вольової саморегуляції із вираженою наполегливістю і самоконтролем. Медичні сестри, тривалість професійної роботи яких невеликий (до 5 років) або ж, навпаки, значний (понад 20 років), характеризуються низьким рівнем вольової саморегуляції.
Systematic review: Symptoms of parental depression and anxiety and offspring overweight
Authors: Marco Paula Lobo , Valério Inaê Dutra , Zanatti Christian Loret de Mola , Gonçalves Helen
Published: June 2020

OBJECTIVE: To evaluate the existing literature on the association between parents’ depression and anxiety and their influence on their children’s weight during childhood, identifying possible mechanisms involved in this association. METHODS: A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND (“common mental disorder” OR “mental health” OR “mental disorder” OR “depressive disorder” OR depress* OR anxiety OR “anxiety disorder”) AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR “body mass index” OR BMI). A total of 1,187 articles were found after peer selection. RESULTS: In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS: We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.
Curating as (Expanded) Art History in Southeast Asia: Recent Independent Projects in Ho Chi Minh City, Luang Prabang, and Phnom Penh
Authors: Nelson Roger
Published: June 2020

A small yet influential strain of independent contemporary curatorial practice has emerged in Southeast Asia, which is performing (expanded) art historical functions. This mode of independent curating now constitutes an important base for exciting new research—making use of diverse archives as well as other methodologies—to study the often little-known histories of the region's modern arts, including its architecture, cinema, and photography. That such research is taking place in the context of independent contemporary curatorial practice is significant because it locates modern art history largely outside of large and state-funded institutions, including museums and universities, thus enabling the development and proliferation of art historical research in areas of Southeast Asia, including its mainland sub-regions, which have comparatively little funding and official infrastructure for the arts. This article explores the emerging practice of independent curating as (expanded) art history in Southeast Asia, through comparative discussion of three case studies: the Roung Kon Project in Phnom Penh, which researches histories of cinema in Cambodia; the Buddhist Archive of Photography in Luang Prabang, which researches histories of photography in Laos; and Spirit of Friendship in Ho Chi Minh City, which researches histories of artist groups in Vietnam.
Excessive Costs and Recoverability of Costs Awards in Investment Arbitration
Authors: Bottini Gabriel , Titi Catharine , Pérez Aznar Facundo , Chaisse Julien , Jovanovic Marko , Puigdemont Sola Olga
Published: June 2020

In the era of the backlash against investor-State dispute settlement, the costs of proceedings have been a prime object of criticism. This article examines the problem of excessive costs and insufficient recoverability of costs awards. Firstly, it examines the issue of excessive costs in relation to both party costs (fees and expenses of counsel, experts, and witnesses) and tribunal costs (fees and expenses of arbitrators and arbitral institutions). Secondly, it discusses the impact of the length of proceedings on costs. Thirdly, it discusses the contribution of third-party funding to excessive costs. Finally, it analyses the issue of insufficient recoverability of costs awards and the availability of mechanisms to secure prompt payment of costs awards where there are insufficient resources or an unwillingness to pay. In examining each of these concerns, this article assesses the potential contribution of four different models for reform of investment arbitration.
Rediscovery of Aeschynanthus monetaria (Gesneriaceae) in Southeast Tibet, China after more than 100 years

Authors: HU JUN , XIONG YU-NING , LI LI , LIU QING , WEN FANG
Published: June 2020

Aeschynanthus monetaria, a beautiful epiphytic species of Gesneriaceae, was rediscovered in monsoon rain forest along the Yarlung Zangbo River in Motuo County, Southeast Tibet (Xizang), China. Its description is amended and completed with both fresh and dried specimens in this discovery. To better facilitate its identification, the color images in the field and line illustrations based on our specimens are given. A taxonomic note concerning its lectotype and the ending of specific epithet is discussed.
Verbascum seydisehirense (Scrophulariaceae), a new species from Konya, Central Turkey

Authors: ULUKUŞ DENİZ , TUGAY OSMAN , SAĞLAM COŞKUN
Published: June 2020

Verbascum seydisehirense (Scrophulariaceae), endemic to the Konya region of Central Anatolia, is described as new species based on the plant’s morphological features. The new species is morphologically similar to Verbascum phrygium, but it differs from it for basal leaf shape, calyx size, corolla size, corolla indumentum and glands, and capsule shape and size. In this study, a detailed description, illustration, distribution map, conservation status and ecology of the new species are provided. Additionally, the study looks in detail at pollen grains and seed coat ornamentation of Verbascum seydisehirense and includes SEM micrographs.
Three new species of Camillina Berland, 1919 (Araneae: Gnaphosidae) from Brazil
Authors: XAVIER CLÁUDIA , OTT RICARDO , SATURNINO REGIANE
Published: June 2020

The genus Camillina Berland, 1919 includes 75 valid species which are mainly distributed in South America. However, in Brazil, the knowledge regarding Camillina remains limited and a few contributions to the taxonomy of the genus have been made in the last two decades. Camillina belongs to Zelotinae, a group of gnaphosid spiders which diagnostic character is a preening comb on metatarsi III and IV, and the genus can be recognized by the presence of a prolaterally situated, bifid terminal apophysis and medially situated, recessed embolar base on the male palp and a median epigynal plate. Here, we describe the males and females of three new species: C. suya sp. nov. and C. kuarup sp. nov., both from Fazenda Tanguro, Querência, state of Mato Grosso, Brazil and C. bonaldoi sp. nov. from Parque Nacional de Sete Cidades, Piracuruca, state of Piauí, Brazil.
6. Sign-Communication Intervention in Adults and Children with Aphasia
Authors: Bonvillian John D. , Kissane Lee Nicole , Dooley Tracy T. , Loncke Filip T.
Published: June 2020

Chapter 6 focuses on the language and communication impairments of adults and children that may be acquired after suffering a head injury, stroke, brain infection, tumor, or other similar trauma. Such persons may have had intact language abilities before the trauma, but often present with varying degrees of severity of aphasia that may temporarily or permanently affect their receptive understanding of language and/or their production of language. Although most of the literature examines such deficits in hearing persons and the resulting impact on spoken language, deaf persons may also experience aphasic impairments to their production and understanding of sign language. An examination of apraxia, which often co-occurs with aphasia, provides another dimension that needs to be analyzed when addressing strategies for language rehabilitation. The outcomes of sign-communication interventions in persons with aphasia are presented, along with a focus on Amer-Ind, pantomime skills, and the use of signing to facilitate speech. Finally, the authors address speech and language disorders such as acquired childhood aphasia (Landau-Kleffner syndrome), developmental language disorder (formerly known as specific language impairment) in both hearing and deaf children, and childhood apraxia of speech.
How Does Principals’ Transformational Leadership Impact Students’ Modernity? A Multiple Mediating Model
Authors: Wang Shutao
Published: June 2020

To explore the impact mechanism of principals’ transformational leadership on students’ modernity, this study adopted the structural equation model to test the multiple mediating effects of school climate, teacher quality, and effective teaching on the relationship between principals’ transformational leadership and students’ modernity. Results showed that there was a positive correlation between principals’ transformational leadership and students’ modernity; school climate, teacher quality, and effective teaching fully mediated the relationship between principals’ transformational leadership and students’ modernity, totally accounting for 64.37% of all the indirect effects; the mediating effects of school climate, teacher quality, and effective teaching, respectively, accounted for 30.20%, 52.29%, and 17.51%. According to these results, principal should adopt the approach of transformational leadership, promote the constructing of a fair, inclusive and innovative school climate, emphasize the improvement of teachers’ social, emotional, and innovative qualities, and encourage teachers to reflect their teaching and conduct rational practices to improve students’ modernity.
Factors influencing decision-making around pregnancy among women with severe mental illness (SMI): A qualitative study
Authors: Bagadia Ashlesha , Nanjundaswamy Madhuri H , Ganjekar Sundarnag , Thippeswamy Harish , Desai Geetha , Chandra Prabha S
Published: June 2020

Background:

Decision-making around pregnancy is challenging for women with severe mental illness (SMI), and several clinical and socio-cultural factors might influence this process.

Aim:

The main objective of this study was to determine factors that influence decision-making regarding pregnancy for women with SMI.

Methods:

Using a qualitative design, 42 women with SMI who were pregnant or planning pregnancy were assessed using a semi-structured interview by an independent researcher not involved in their clinical care. Areas of inquiry included knowledge about their illness, treatment; family and societal beliefs on mental illness and motherhood; illness management; and attitude towards medical advice.

Results:

Among the 42 women, majority of the women (88%) reported reduced autonomy in decision-making related to pregnancy. Stigma was one of the major contributory factors in decision-making. Over 80% reported not using contraception despite medical advice due to lack of control over the decisions related to the use of contraception. Over 50% of the women in the study believed that taking psychotropic medications during pregnancy would definitely harm the baby. A similar number believed that their illness would not recur if medications were to be stopped during pregnancy.

Conclusion:

Women with SMI who plan to become pregnant, especially from low-income settings in India, are disadvantaged by stigma and societal expectations, affecting their ability to make optimum decisions during this crucial period. Decision-making around pregnancy in women with SMI is complex and appears to be influenced by several socio-cultural factors and needs to be dealt with sensitively.
Deformation behavior of auxetic woven fabric made of foldable geometry in different tensile directions
Authors: Kamrul Hasan , Dong Weiguo , Zulifqar Adeel , Zhao Shuaiquan , Zhang Minglonghai , Hu Hong
Published: June 2020

Auxetic woven fabrics made with special geometrical structures have gained the interest of textile scientists in recent years. This paper reports a study on auxetic woven fabric based on a double-directional parallel in-phase zig-zag foldable geometrical structure. Such a fabric has been already produced and investigated for its negative Poisson's ratio effect in two principal directions (weft and warp directions). However, its negative Poisson's ratio effect in biased tensile directions as well as under repeated tensile loading conditions has not been studied yet. Therefore, in this paper, these two limitations are addressed. The auxetic woven fabric was firstly fabricated, and then subjected not only to tensile tests in different tensile directions, including two principle directions and three biased directions, but also to repeated tensile loading. It was found that both the negative Poisson's ratio effect and the resistance to tensile deformation are dependent upon the tensile direction, and the highest negative Poisson's ratio effect and higher resistance to tensile deformation are obtained in two principal directions.
Preparation and properties of silane-modified cardanol–benzoxazine for hydrophobic coating
Authors: Zhang Wenzheng , Jiang Ning , Zhang Tingting , Zhang Tinghao
Published: June 2020

Cardanol is a kind of green industrial raw material, refined from cashew nut shell oil by advanced technology, which has shown potential for anticorrosion coating application. A new cardanol-based benzoxazine monomer (CB) was synthesized by Mannich condensation of a cardanol, paraformaldehyde, and cardanol aldehyde amine (Carala), which was prepared based on cardanol, paraformaldehyde, and triethylenetetramine, and finally, the cardanol-based benzoxazines containing amino group were modified by silane (CBSi). Cardanol, Carala, and CB were characterized by Fourier transform infrared spectroscopy and proton nuclear magnetic resonance spectroscopy. Furthermore, the cured films have been evaluated by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA), respectively. The result of DSC of CB and CBSi showed that curing behavior of CBSi was similar to that of CB; however, the enthalpy of polymerization reaction corresponding to CB and CBSi is 84.7 J g−1 and 91.3 J g−1, respectively, and exothermic enthalpy of CBSi is slightly higher than that of CB. TGA results illuminated that the thermal stability and char yield of cardanol-based polybenzoxazine could be enhanced due to increment of silane, and residual char yield at 700°C of CBSi30 is 13%. Especially, incorporation of silane could improve the water contact angle, which can increase from 78.7° to 98.9° when the ratio of γ-(2,3-epoxypropoxy) propytrimethoxysilane to CB increases from 0% to 30%.
College Selectivity and Later-Life Memory Function: Evidence From the Wisconsin Longitudinal Study
Authors: Garcia Sarah , Moorman Sara M.
Published: June 2020

Research has shown a consistent association between college completion and laterlife cognition. We extend this work by examining whether college selectivity—the achievement level required to gain admission to a college—is associated with memory functioning more than 50 years later. We analyze data from 10,317 participants in the 1957–2011 Wisconsin Longitudinal Study to examine the relationship between college selectivity and later-life memory. Models control for childhood, midlife socioeconomic status, and later-life health and adjust for selection bias. Selective college attendance was associated with small benefits in memory at age of 72 even after accounting for socioeconomic status in both childhood and midlife and later-life health. The results of this study suggest that college selectivity may be an important component of the education–cognitive functioning relationship that has modest implications for intracohort differences in later-life cognition.
Convergence of behavioral and cardiac indicators of distress in toddlerhood: A systematic review and narrative synthesis
Authors: Waxman Jordana A. , DiLorenzo Miranda G. , Pillai Riddell Rebecca R.
Published: June 2020

The objective of the current study was to systematically review the available literature on the relation between behavioral and cardiac indicators used to measure distress in toddlerhood. After ascertaining the eligibility of 2,424 articles through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PROSPERO (International Prospective Register of Systematic Reviews) guided search process, 22 articles ( N = 2,504) that investigated associations between behavioral and cardiac indicators of distress in toddlerhood were identified. The narrative synthesis described the overall relation (direction [positive, negative], strength [Cohen’s D]) between behavioral and cardiac indicators and was organized by cardiac indicator (i.e., heart rate [HR], heart period, respiratory sinus arrhythmia, pre-ejection period) and type of behavior measured (i.e., coding for expressed emotion behaviors vs. emotion regulation behaviors). Methodological characteristics (i.e., timing of measurement for behavioral and cardiac indicators [concurrent, predictive], length of measurement epochs, inclusion of covariates and moderators) were also described. HR was consistently positively ( D = .05 to .54) related to expressed emotion behaviors. No other cardiac and behavioral indicators were consistently related. Methodological differences related to behavioral and cardiac indicators utilized, timing of measurement, and length of measurement epochs may be responsible for heterogeneity in findings. The findings suggest that researchers might get divergent results depending on whether distress is measured with cardiac or behavioral indicators of distress in toddlerhood. Suggestions for future psychophysiological research with young children are offered.
Short Versus Extended Duration Vancomycin and Piperacillin/Tazobactam and the Incidence of Acute Kidney Injury in Noncritically Ill Patients
Authors: Traversa Alfredo , Hammond Drayton A. , Peksa Gary D. , DeMott Joshua M.
Published: June 2020

Background:

Vancomycin plus piperacillin-tazobactam (VPT) is a commonly used empiric combination of antimicrobials. Recently, studies have demonstrated an increase in acute kidney injury (AKI) associated with combination therapy of VPT. However, the majority of studies required patients to be on VPT for a minimum of 48 to 72 hours to be considered for inclusion and had extended treatment durations longer than most empiric, short course regimens.

Objective:

To assess the incidence of AKI in noncritically ill patients being treated with VPT for short-courses (24 to 60 hours) compared to patients receiving extended-courses (72 hours to 7 days).

Methods:

This was a retrospective cohort study comparing the incidence of AKI in noncritically ill patients receiving VPT for short and extended durations between January 2016 and August 2018. Fishers exact tests were used for differences in nominal data between groups and Mann-Whitney U tests were used for continuous data.

Results:

Of the 2567 screened, 154 patients were included in the short-course group and 106 were included in the extended-course group. The incidence of AKI for patients in the short-course group was 12% (19/154) versus 26% (28/106) in the extended-course group (odds ratio: 2.55, 95% CI: 1.33-4.87; P = .004).

Conclusion:

In noncritically ill patients, a short-course of VPT experienced less AKI compared to an extended-course. Clinicians should continue to practice strict antimicrobial stewardship for VPT therapies expected to continue beyond 72 hours.
Pro-abortion attitude with context of traditional and professional identity dilemma
Authors: Bulucu Büyüksoy Gizem Deniz , Ozdil Kamuran , Çatıker Aslıhan
Published: June 2020

Background:

Nurses are in a key position for reproduction health service delivery. Therefore, it is thought that it would be important to inspect opinions of student nurses, who will be health employees in the future, about self-induced abortion to develop women health and public health.

Objectives:

The goal of this study is to inspect opinions of nursing students with different sociocultural specialties, about self-induced abortions.

Research design:

It is qualitative type and planned with ethnographic research pattern.

Participants and research context:

The study was conducted with 20 last-term students of Kırşehir Ahi Evran University, Faculty of Health Sciences, Department of Nursing, who were chosen by maximum diversity sampling technique. Interviews were made with semi-structured interview form and voice records during the study; data were analyzed with content analyzing method.

Ethical considerations:

Permission from the organization, university ethics committee, and personal approvals were taken from participants to conduct the research.

Findings:

Based on the analysis, two major themes on self-induced abortion in Turkish nursing students were found: dilemma of traditional perspective and professional identity and occupational awareness.

Discussion and conclusion:

It is seen that there is a dilemma between traditional point of view and professional identities about self-induced abortion for nursing students, but they had occupational awareness. It should be recommended to give information about national and international licit legislations for reproductive health, self-induced abortion, and setting up ethical discussion environments for nursing students.
Resonance behavior in coupled Van der Pol harmonic oscillators with controllers and delayed feedback
Authors: EL-Sayed Ashraf T
Published: June 2020

It has been revealed in the proposed work that a pair of delay positive position feedback control can lessen the vibration response of double Van der Pol oscillators with external forces. We also studied the effects of both the control and the delayed feedback signal gains to illustrate the low vibration amplitudes. The averaging perturbation process has been used to consider the frequency-response equations of amplitudes and modulation phases at the primary resonance and one-to-one internal resonances. According to the perturbation solutions for the four-degrees-of-freedom system, we presented the frequency response curves that were periodic in the time delays. The stability analysis presented in this study has shown optimum stable ranges. If the time delays increase, the steady-state amplitudes of the oscillator’s system will periodically result in few stable regions and more unstable ones. The numerical simulation has been introduced to check the analytical approximation. It was also found to be almost identical after presenting the comparison of the results.
Speculative Inquiry: Thinking With Whitehead
Authors: Mazzei Lisa A.
Published: June 2020

This article explores what Whitehead’s process philosophy opens up for “new” approaches to philosophically informed inquiry. The article begins with a brief discussion of Whitehead’s process philosophy, an explanatory section that develops key concepts necessary for understanding his ontological principle, followed by a discussion of how Whitehead offers a recalibration of experience and the subject in his process philosophy. The article ends with a discussion of how this system of thought is different from the epistemological system of thought that grounds conventional social science inquiry and what is opened up in terms of inquiry in the new.
A weighted multi-objective optimisation approach to improve based facade aperture sizes in terms of energy, thermal comfort and daylight usage
Authors: Yılmaz Yiğit , Yılmaz Burcu Çiğdem
Published: June 2020

In building design, the decision-makers should not focus only on energy efficiency as a single objective but indoor environmental quality indicators, such as thermal comfort, daylight usage and so on, should also be considered as a part of building performance. The building performance can be ensured by determining the proper performance indicators and the variables during the design. In this context, a weighted (among the objectives) multi-objective cost function was proposed, for the optimisation of energy, thermal comfort and daylight usage of a case study archetype design, through the selected design variables, considering the base architectural design principles as well. A typical social housing archetype design was determined as the case study to apply the proposed approach. The window sizes are optimised for each orientation simultaneously, for a temperate-humid climatic region. The results were evaluated in terms of improvement potentials of energy, thermal comfort and daylight performances, and the dominant values for the window sizes for each facade. According to the results, the optimised scenario achieved an 11.42% reduction in primary energy use equivalent to 181.24 kWh/m2a, a 4.52% reduction in a predicted percentage of dissatisfied with 9.12%, and a reduction in lighting energy of 4.94% equivalent to 21.17 kWh/m2a. These reductions verify the possibility to achieve higher performances on each criterion.
Silencing Nrf2 attenuates chronic suppurative otitis media by inhibiting pro-inflammatory cytokine secretion through up-regulating TLR4
Authors: Tuoheti Abulajiang , Gu Xingzhi , Cheng Xiuqin , Zhang Hua
Published: June 2020

Compromised TLR-mediated chronic inflammation contributes to bacterial infection-caused chronic suppurative otitis media, but the mechanisms are unclear. The present study examined the expression status of nuclear erythroid 2-related factor 2 (Nrf2) and TLRs in human middle-ear mucosae tissues collected from patients with chronic suppurative otitis media, chronic otitis media and non-otitis media, and found that Nrf2 was high-expressed, whereas TLR4, instead of other TLRs, was low expressed in chronic suppurative otitis media compared to chronic otitis media and non-chronic otitis media groups. Consistently, inflammatory cytokines were significantly up-regulated in the chronic suppurative otitis media group, instead of the chronic otitis media and non-chronic otitis media groups. Next, LPS-induced acute otitis media and chronic suppurative otitis media models in mice were established, and high levels of inflammatory cytokines were sustained in the mucosae tissues of chronic suppurative otitis media mice compared to the non-otitis media and acute otitis media groups. Interestingly, continuous low-dose LPS stimulation promoted Nrf2 expression, but decreased TLR4 levels in chronic suppurative otitis media mice mucosae. In addition, knock-down of Nrf2 increased TLR4 expression levels in chronic suppurative otitis media mice, and both Nrf2 ablation and TLR4 overexpression inhibited the pro-inflammatory cytokine expression in chronic suppurative otitis media. Finally, we found that both Nrf2 overexpression and TLR4 deficiency promoted chronic inflammation in LPS-induced acute otitis media mice models. Taken together, knock-down of Nrf2 reversed chronic inflammation to attenuate chronic suppurative otitis media by up-regulating TLR4.
Shock-wave lithotripsy, ureterorenoscopy and percutaneous nephrolithotomy for 1–2 cm renal stones: A randomised pilot study
Authors: McCahy Philip J , Hong Matthew , Paul Eldho , Berman Ivor , Shahbaz Shekib
Published: June 2020

Objectives:

This study aimed to assess which of extracorporeal shock-wave lithotripsy (SWL), ureterorenoscopy (URS) or percutaneous nephrolithotomy (PCNL) offers the best stone-free rate (SFR) for 1–2 cm renal stones.

Patients and methods:

A total of 31 patients with renal stones between 1 and 2 cm were randomised to SWL, URS or PCNL. Repeat treatments or alternatives were performed until the patient was stone free or clinically in no further need of treatment. All patients were assessed with computed tomography scanning independently reviewed by a radiologist blinded to the treatment.

Results:

Overall, 10 well-matched patients were randomised to SWL, 11 to URS and 10 to PCNL. SFRs were 60% for SWL, 55% for URS and 80% for PCNL (no significant difference). The mean number of procedures required were 2.6 (range 1–7) for SWL, 2.5 (range 1–4) for URS and 1.3 (range 1–3) for PCNL ( p=0.072). There were no major complications, but 50% of SWL had minor complications compared with 9% for URS and 20% for PCNL.

Conclusion:

The results for SWL were disappointing for SFR, number of procedures and complications. In common with other recent studies, the SFR following URS was also poor. PCNL had the best results for SFR with the fewest procedures. We calculate that an adequately powered study will require 42 patients per arm.

Level of evidence

Level 2b
Strategic Use of Technology for Inclusive Education in Hong Kong: A Content-Level Perspective
Authors: Chiu Thomas K. F. , Lim Cher Ping
Published: June 2020

Purpose:

A growing body of research has focused on the topic of inclusive education for ethnic minorities in Hong Kong. At the same time, few scholars have explored the role technology can play in enhancing inclusivity within the context of quality education. This study examines how the differentiated use of technology that takes into account disparities in prior knowledge can benefit students of different learning backgrounds.

Design/Approach/Methods:

This study adopted an experimental design to investigate how content-specific and content-neutral technologies can be strategically used to support the classroom discussions of Chinese and ethnic minority students’ learning Chinese language and mathematics. One hundred and twenty-one secondary school students participated in the study. Each student was randomly assigned to a condition, in a 2 (ethnicity: Chinese vs. ethnic minority) × 2 (content: content-specific first vs. content-neutral first) design.

Findings:

The study found that (a) for Chinese language lessons, ethnic minority students preferred to learn with content-neutral and content-specific technologies in prediscussion and postdiscussion activities, respectively; whereas the Chinese students’ preferences were the opposite and (b) for mathematics lessons, both groups of students performed better when content-specific and content-neutral technologies were used in prediscussion and postdiscussion activities, respectively.

Originality/Value:

The study presents five practical suggestions for the strategic use of technology in inclusive classrooms in Hong Kong.
“Our Lives Are Affected by Government Agencies”: Citizens’ Perception Survey as a Measure of Public Service Efficiency in Ghana
Authors: Gumah Bernard , Aziabah Maxwell A.
Published: June 2020

Efficiency in public service delivery is critical in enhancing and improving the quality of citizens’ lives. Conversely, inefficient public service delivery has profound adverse effects on the quality of citizens’ lives. In the theory of public services efficiency, direct citizens’ surveys are a useful tool for measuring efficiency in public services. Our core consideration is the impact on human life, which is viewed as a function of the efficiency of public services delivered. We rely on the Ghana Living Standards Survey data to show that analytic leverage can be gained in gauging public perceptions of public services delivery using a perception index through the application of a comparative analytic design. Our results show that differences exist in the perceptions of efficiency and inefficiency among essential and auxiliary services, and such differences have also been found to mirror the spatio-economic attributes of citizens. We argue that public services can positively affect lives through a combination of policy measures spanning increased fight against corruption, improved funding, enhanced monitoring, and increased institutional capacity for improved expansion in physical presence, quality, and the visibility of public services.
Preparing Instructional Supervisors for Educational Change: Empirical Evidence From the Sultanate of Oman
Authors: Al-Kiyumi Amal , Hammad Waheed
Published: June 2020

This article reports on findings from a larger research project examining instructional supervision in the Sultanate of Oman. It sought to explore how teacher supervisors perceived their preparation for the current education reforms. To realize this objective, the study adopted a qualitative research design. Data were collected using semistructured interviews with a sample of teacher supervisors in the Muscat Educational Supervision Directorate. The findings indicate that the supervisors considered their preparation to be inappropriate, reasoning that most of the training programs provided were short theoretical conferences or lectures with no or a few opportunities for practice. The supervisors expressed their need for more adequate and sufficient training to enable them to undertake their new supervisory roles.
Identification of Ankle Injury Risk Factors in Professional Soccer Players Through a Preseason Functional Assessment
Authors: Manoel Lucas Sartori , Xixirry Marcela Godoy , Soeira Thabata Pasquini , Saad Marcelo Camargo , Riberto Marcelo
Published: June 2020

Background:

Etiologically, the risk of an ankle injury depends on extrinsic and intrinsic factors, such as muscle strength asymmetry, decreased flexibility, and decreased proprioception, as well as patient age and history of injuries.

Purpose/Hypothesis:

The purpose of this study was to identify risk factors present in the preseason assessment that may predispose professional soccer players to ankle injuries. We hypothesized that analysis of these parameters could relate the incidence of injuries to the deficits found during the preseason period, enabling the identification of risk factors to predict the occurrence of injuries.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 89 professional soccer athletes were evaluated in the preseason period; the evaluation included athlete history and anthropometric data collection, an isokinetic ankle evaluation, and functional tests: the Dorsiflexion Lunge Test and Y-Balance Test (YBT). The athletes were monitored during the competitive period, and the incidence of injuries was surveyed. The association of quantitative variables and injury outcomes was analyzed using the Student t test for independent samples, with P < .05. For the association of categorical variables and injury outcomes, the chi-square test was performed, with P < .05.

Results:

A higher incidence of ankle injuries was associated with lower YBT scores in the dominant ( P = .04) and nondominant ( P = .01) limbs. A higher body mass index was also associated with a higher injury occurrence ( P = .01).

Conclusion:

Functional tests, such as the YBT, are indicated tools for assessing the physical capacities and possible risks of ankle sprains, as they can evaluate the ankle functional capacity in a complex way, identifying athletes more prone to ankle injuries. Athletes’ body mass index should also be taken into account to prevent such injuries.
A prospective safety and feasibility study of metered cryospray for patients with chronic bronchitis in COPD
Authors: Garner Justin L. , Shaipanich Tawimas , Hartman Jorine E. , Orton Christopher M. , Caneja Cielito , Klooster Karin , Thornton John , Sin Don D. , Slebos Dirk-Jan , Shah Pallav L.
Published: June 2020

Background

No currently approved intervention counteracts airway metaplasia and mucus hypersecretion of chronic bronchitis in COPD. However, metered cryospray (MCS) delivering liquid nitrogen to the tracheobronchial airways ablates abnormal epithelium and facilitates healthy mucosal regeneration. The objective of this study was to evaluate the feasibility, efficacy and safety of MCS in chronic bronchitis.

Methods

Patients with a forced expiratory volume in 1 s of 30–80% predicted who were taking optimal medication were recruited. Primary outcomes were feasibility (completion of treatments), efficacy (3-month change in St George's Respiratory Questionnaire (SGRQ)) and safety (incidence of adverse events). Secondary outcomes were lung function, exercise capacity and additional patient-reported outcomes.

Results

35 patients, 19 male/16 female, aged 47–76 years, Global Initiative for Chronic Obstructive Lung Disease grade I (n=3), II (n=10) and III (n=22), underwent staggered liquid nitrogen treatments to the tracheobronchial tree. 34 patients completed three treatments, each lasting 34.3±12.1 min, separated by 4–6 weeks; one withdrew after the first treatment. ∼1800 doses of MCS were delivered. Clinically meaningful improvements in patient-reported outcomes were observed at 3 months: change in SGRQ −6.4 (95% CI −11.4 to −1.3; p=0.01), COPD Assessment Test (CAT) −3.8 (95% CI −6.4 to −1.3; p<0.01) and Leicester Cough Questionnaire (LCQ) 21.6 (95% CI 7.3 to 35.9; p<0.01). Changes in CAT were durable to 6 months (−3.4, 95% CI −5.9 to −0.9; p=0.01); changes in SGRQ and LCQ were durable to 9 months (−6.9, 95% CI −13.0 to −0.9; p=0.03 and 13.4, 95% CI 2.1 to 24.6; p=0.02, respectively. At 12 months, 14 serious adverse events were recorded in 11 (31.4%) subjects; six (43%) moderate and eight (57%) severe. Nine were respiratory-related: six exacerbations of COPD, two pneumonias and one case of increased coughing; all recovered without sequelae. None were serious device- or procedure-related adverse events.

Conclusion

MCS is safe, feasible and associated with clinically meaningful improvements in multidimensional patient-reported outcomes.
Epidemic and pandemic viral infections: impact on tuberculosis and the lung
Authors: Ong Catherine Wei Min , Migliori Giovanni Battista , Raviglione Mario , MacGregor-Skinner Gavin , Sotgiu Giovanni , Alffenaar Jan-Willem , Tiberi Simon , Adlhoch Cornelia , Alonzi Tonino , Archuleta Sophia , Brusin Sergio , Cambau Emmanuelle , Capobianchi Maria Rosaria , Castilletti Concetta , Centis Rosella , Cirillo Daniela M. , D'Ambrosio Lia , Delogu Giovanni , Esposito Susanna M.R. , Figueroa Jose , Friedland Jon S. , Ho Benjamin Choon Heng , Ippolito Giuseppe , Jankovic Mateja , Kim Hannah Yejin , Rosales Klintz Senia , Ködmön Csaba , Lalle Eleonora , Leo Yee Sin , Leung Chi-Chiu , Märtson Anne-Grete , Melazzini Mario Giovanni , Najafi Fard Saeid , Penttinen Pasi , Petrone Linda , Petruccioli Elisa , Pontali Emanuele , Saderi Laura , Santin Miguel , Spanevello Antonio , van Crevel Reinout , van der Werf Marieke J. , Visca Dina , Viveiros Miguel , Zellweger Jean-Pierre , Zumla Alimuddin , Goletti Delia
Published: June 2020

Major epidemics, including some that qualify as pandemics, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), HIV, influenza A (H1N1)pdm/09 and most recently COVID-19, affect the lung. Tuberculosis (TB) remains the top infectious disease killer, but apart from syndemic TB/HIV little is known regarding the interaction of viral epidemics and pandemics with TB. The aim of this consensus-based document is to describe the effects of viral infections resulting in epidemics and pandemics that affect the lung (MERS, SARS, HIV, influenza A (H1N1)pdm/09 and COVID-19) and their interactions with TB. A search of the scientific literature was performed. A writing committee of international experts including the European Centre for Disease Prevention and Control Public Health Emergency (ECDC PHE) team, the World Association for Infectious Diseases and Immunological Disorders (WAidid), the Global Tuberculosis Network (GTN), and members of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycobacterial Infections (ESGMYC) was established. Consensus was achieved after multiple rounds of revisions between the writing committee and a larger expert group. A Delphi process involving the core group of authors (excluding the ECDC PHE team) identified the areas requiring review/consensus, followed by a second round to refine the definitive consensus elements. The epidemiology and immunology of these viral infections and their interactions with TB are discussed with implications for diagnosis, treatment and prevention of airborne infections (infection control, viral containment and workplace safety). This consensus document represents a rapid and comprehensive summary on what is known on the topic.
An exploration of the complex biogeographical history of the Neotropical banner-wing damselflies (Odonata: Polythoridae)
Authors: Sánchez-Herrera Melissa , Beatty Christopher D. , Nunes Renato , Salazar Camilo , Ware Jessica L.
Published: June 2020

Background

The New World Tropics has experienced a dynamic landscape across evolutionary history and harbors a high diversity of flora and fauna. While there are some studies addressing diversification in Neotropical vertebrates and plants, there is still a lack of knowledge in arthropods. Here we examine temporal and spatial diversification patterns in the damselfly family Polythoridae, which comprises seven genera with a total of 58 species distributed across much of Central and South America.

Results

Our time-calibrated phylogeny for 48 species suggests that this family radiated during the late Eocene (~ 33 Ma), diversifying during the Miocene. As with other neotropical groups, the Most Recent Common Ancestor (MRCA) of most of the Polythoridae genera has a primary origin in the Northern Andes though the MRCA of at least one genus may have appeared in the Amazon Basin. Our molecular clock suggests correlations with some major geographical events, and our biogeographical modeling (with BioGeoBEARS and RASP) found a significant influence of the formation of the Pebas and Acre systems on the early diversification of these damselflies, though evidence for the influence of the rise of the different Andean ranges was mixed. Diversification rates have been uniform in all genera except one—Polythore—where a significant increase in the late Pliocene (~ 3 mya) may have been influenced by recent Andean uplift.

Conclusion

The biogeographical models implemented here suggest that the Pebas and Acre Systems were significant geological events associated with the diversification of this damselfly family; while diversification in the tree shows some correlation with mountain building events, it is possible that other abiotic and biotic changes during our study period have influenced diversification as well. The high diversification rate observed in Polythore could be explained by the late uplift of the Northern Andes. However, it is possible that other intrinsic factors like sexual and natural selection acting on color patterns could be involved in the diversification of this genus.
P-values – a chronic conundrum
Authors: Gao Jian
Published: June 2020

Background

In medical research and practice, the p-value is arguably the most often used statistic and yet it is widely misconstrued as the probability of the type I error, which comes with serious consequences. This misunderstanding can greatly affect the reproducibility in research, treatment selection in medical practice, and model specification in empirical analyses. By using plain language and concrete examples, this paper is intended to elucidate the p-value confusion from its root, to explicate the difference between significance and hypothesis testing, to illuminate the consequences of the confusion, and to present a viable alternative to the conventional p-value.

Main text

The confusion with p-values has plagued the research community and medical practitioners for decades. However, efforts to clarify it have been largely futile, in part, because intuitive yet mathematically rigorous educational materials are scarce. Additionally, the lack of a practical alternative to the p-value for guarding against randomness also plays a role. The p-value confusion is rooted in the misconception of significance and hypothesis testing. Most, including many statisticians, are unaware that p-values and significance testing formed by Fisher are incomparable to the hypothesis testing paradigm created by Neyman and Pearson. And most otherwise great statistics textbooks tend to cobble the two paradigms together and make no effort to elucidate the subtle but fundamental differences between them. The p-value is a practical tool gauging the “strength of evidence” against the null hypothesis. It informs investigators that a p-value of 0.001, for example, is stronger than 0.05. However, p-values produced in significance testing are not the probabilities of type I errors as commonly misconceived. For a p-value of 0.05, the chance a treatment does not work is not 5%; rather, it is at least 28.9%.

Conclusions

A long-overdue effort to understand p-values correctly is much needed. However, in medical research and practice, just banning significance testing and accepting uncertainty are not enough. Researchers, clinicians, and patients alike need to know the probability a treatment will or will not work. Thus, the calibrated p-values (the probability that a treatment does not work) should be reported in research papers.