bluuebunny/crossref_metadata_2025 huggingface dataset:
Ensayo de la aplicación de los diagnósticos enfermeros de la NANDA (NOC NIC) en los planes de cuidado de enfermería de la enfermedad de Alzheimer
Authors: Jiménez Mendoza Araceli
Published: October 2020

El presente ensayo se elaboró con fines didácticos a partir de la taxonomía diagnóstica de la NANDA, de la clasificación de intervenciones de enfermería y de la clasificación de los criterios utilizados para evaluar las intervenciones de enfermería que son aplicadas a las personas con enfermedad de Alzheimer, con el fin de identificar si este ejercicio permite orientar la práctica de enfermería en el desarrollo de planes de cuidado.
Electronic Commerce: Validity of the Digital Contract Based on Indonesia Legislation Perspective
Authors: . Sunaryo , Nuraini Hanifah
Published: October 2020

Technological developments in the economic sector, a transaction renewal known as electronic commerce. Transactions that occur in e-commerce are categorized as digital contracts. The use of digital contracts in Indonesia does not escape a number of problems, which is legal. Legal issues that appear in this digital transaction are related to the element of validity. Digital contracts as a new type of contract cannot be equated with conventional contracts, because there are different limitations. This condition resulted in the implementation of digital contracts being facilitated thoroughly by regulations. This paper will examine legal issues in the implementation of digital contracts and understand the legality of digital contracts based on legal instruments in Indonesia.
Decision Making In Higher Education to Support the Transportation and Logistics Industry in the 4.0 Era
Authors: Sari Mustika , Hidayat Raden Didiet Rachmat , Fahriza Basri , Mafrudhoh Lut
Published: October 2020

In facing the competition of skilled labor between ASEAN member countries, Indonesia needs a quality workforce that is competitive. With good quality, the country's human resources are ready to compete in the ASEAN labor market. The purpose of this research is to find the best strategy that can be carried out by tertiary institutions in facing competition with other tertiary institutions to create graduates who can be absorbed in the industry. The research method uses the analytical hierarchy process (AHP). The model uses human perceptions that are considered experts in their fields and best understand the problems faced by the company and used literature review. The results of the study, three aspects become alternative strategies to support the sustainability of tertiary institutions in supporting the transportation and logistics industry, namely aspects of cooperation in the transportation and logistics industry, aspects of cooperation with overseas universities, and aspects of licensed international training certification. Of the three aspects, international training certification is the most important aspect of the strategy of supporting the sustainability of higher education institutions
Learning Problem Posing Based on Hot Potatoes Application to Improve Concept Understanding and Problem Solving in Elementary School Mathematics on Flat-Building Materials
Authors: Anggraini Emy , Amin Siti Maghfirotun , Siswono Tatag Yuli Eko
Published: October 2020

This study aims to improve students' conceptual understanding and problem solving through the application of problem posing learning based on the hot potatoes application based on the problems of the fifth semester students of SDK Maria Fatima Bangkalan. This study uses a quantitative approach. Quantitative research is carried out by describing the data in the form of numbers, namely to determine whether there are any consequences of problem posing learning based on the hot potatoes application on concept understanding and problem solving. The subjects of this study were fifth grade students of Maria Fatima Catholic Elementary School, Bangkalan, Academic Year 2019 - 2020 with flat-building material. The results showed: (1) The effect of problem posing learning based on the hot potatoes application on students' understanding of mathematical concepts was higher with an average value of 85.83 than the control class. (2) The effect of problem posing learning based on hot potatoes application on problem solving has a higher average value than the control class, namely 88.68. (3) The effect of problem posing learning based on hot potatoes application can improve concept understanding and problem solving. Based on the results of data analysis, it can be concluded that problem posing learning based on hot potatoes application can improve the conceptual understanding and problem solving of elementary school students, but still requires adjustment to the situation and conditions at school
Molecular Docking Studies of Bioactive Compounds from Solenostemma Argel Leaf Extract as Potential Inhibitor for BCL-2 Antiapoptotic Proteins
Authors: Khamiss Mehad Mustafa Adam Khamiss; , Choudhary Prakash C.
Published: October 2020

This article deals with anticancer studies of phytochemicals identified from Solenostemma Argel leaf extract using GC-MS analysis and molecular docking studies. B cell lymphoma-2 (BCL-2) agonists are useful for regulating apoptosis which is essential for several cancers. The aim of the present study is to investigate the BCl-2 agonist property of phytochemicals from the extract of S. Argel using an Insilco approach. The docking on human BCL-2 protein was determined by GOLD 3.0.1 software. It is concluded from the studies that compound suggested by GCMS at RT 17.1 minute is 4,5,7-trihydroxy isoflavone showed best result with highest fitness index
A Digital Revolution in Pharmaceutical Industry: Mobile Health Applications
Authors: Srivastava Sanskar
Published: October 2020

Today Meteoric advancement has spread to the field of medicine also. Most importantly the smartphone technology which has played an accountable role in this direction and has made the medical provisioning via mobile a reality which one could never have thought of earlier. We have developed and evaluated mobile apps for smartphones working on different platforms (Android, iOS, Window’s) to regulate and facilitate interactions between patients and doctors where patient capable to seek advice, diagnosis and treatment from the doctor from remote places around the globe. Numerous innovations and development in mobile software applications also provide potential benefits to the public health since the mobile platforms are becoming more user-friendly, computationally powerful and affordable with each successive day. It is because of these innovative apps that have significantly contributed in clinical consultation complementing face to face interactions with doctors, healthrecord maintenance, patient management and monitoring, clinical decision- making, medical education and training and the list goes on. The GUI displays screens of the smartphones are incorporated with medical data that is required by the clinician to interpret and respond in most efficient manner possible.
Sclerozoan and fouling sabellid worms (Annelida: Sabellidae) from Mexico with the establishment of two new species
Authors: Tovar-Hernández María Ana , García-Garza María Elena , de León-González Jesús Angel
Published: October 2020

The sabellid genera Anamobaea Krøyer, 1856 and Notaulax Tauber, 1879 are two of the most attractive polychaete worms in coral reefs. Anamobaea is represented by two Caribbean species and Notaulax with 24 species from around the world, six of them previously known to tropical America. During examination of fouling biota and sclerozoans from Mexico, Anamobaea orstedii Krøyer, 1856 was found in coral reefs from the southern Gulf of Mexico and three species of Notaulax were identified to the Mexican Pacific, two of them being new species to science.

Anamobaea orstedii Krøyer, 1856 is first reported as sclerozoan of dead coral from the southern Gulf of Mexico. An amendment to the generic diagnosis of Anamobaea is provided, based on the presence of a higher number of skeletal cells than previously recorded; height, shape and exposition of the anterior peristomial ring; the non-fusion of dorsal collar margins to faecal groove; shape of collar chaetiger and abdominal chaetae and distribution and shape of radiolar ocelli. Notaulax californica (Treadwell, 1906) is reported as fouling in buoys and docks from the Gulf of California. Two new species of Notaulax are described: the former was found in hull and dock fouling from La Paz (Gulf of California) and the second one as sclerozoan of oysters from a dock fouling in Acapulco (south Mexican Pacific). In addition, reproductive features are described for the first time for A. orstedii which is a simultaneous hermaphrodite with female and males gametes found within the same segments of abdominal region. Oocytes develop synchronously and sperm morphology (spherical nucleus and rounded acrosome, four spherical mitochondria and a long free flagellum) suggest an adaptation to broadcast spawning and external fertilisation. Species of Notaulax here examined were gonochoric, with gametes distributed in abdominal segments.
An Introduction to the Minimum Information about a Digital Specimen (MIDS) Digitisation Standard
Authors: Haston Elspeth , Hardisty Alex
Published: October 2020

Digitisation is the process of converting analogue data about physical specimens to digital representation that includes electronic text, images and other forms. The term has been used diversely within the natural science collections community, and between different digitisation initiatives, the outputs can be quite different.

Digitisation of individual specimens provides explicit and precise details about each object curated in a collection. This digitisation is based on diverse aims, the needs of specific projects and the specific practices and workflows in different institutions, so the digitised output has a wide range of uses. Capturing and presenting such data from future digitisation in standard formats is essential so that data can be more easily understood, compared, analysed and communicated via the Internet. By harmonising a framework that clarifies what is meant by different levels of digitisation (MIDS level), as well as the minimum information to be captured at each level, it becomes easier to consistently measure the extent of digitisation achieved over time and to set priorities for the remaining work. Similarly, ensuring that enough data are captured, curated and published is essential so they are useful for the widest possible range of future research, teaching and learning purposes.

The Minimum Information about a Digital Specimen (MIDS) specification aims to address these problems. MIDS is a 'minimum specification', which means that the information specified as necessary at a each MIDS level is the minimum expected to be made digitally available following each major stage of digitisation. More is not precluded.

From September 2020, MIDS specification work is now the work topic of an approved TDWG Task Group.
Meeting In-Between: Moving beyond the buzz, bottlenecks, and bubble to collaboratively develop digitization tooling
Authors: Yoder Matthew
Published: October 2020

Specimen digitization software and tooling is moving well past its third decade of development, yet in many ways new tools have yet to leapfrog or overcome the initial innovation realized years ago. Here I argue that a biodiversity informatics bubble has emerged, creating demands of digitization tools that are not always in line with the requirements of physical specimen curators (or others doing actual science). Pressuring tools to keep up with concepts that have emerged from this bubble, for example Life Science Identifiers (LSIDs), and its parallels in the tech industry, for example microservices, has detracted from advancements that could be made with respect to day-to-day workflows and practices of the curators themselves. These advances in turn might provide a more enjoyable, intuitive, and ultimately sustainable foundation perhaps more immune to inevitable bubble bursts, hype-based derailments, and changes in scientific goals. How then should development proceed? We can observe that existing digitization software largely fits into two sides of the spectrum: commercial monoliths like EMu and "home-grown" efforts, e.g. Specify, Arctos, and Symbiota. I argue the latter are much more in-tune with user needs, because they were first built by the users themselves. Our approach, therefore, should be to go back to the well, the curator, the digitizer, the student hourly, and the person who has to fulfill requests of those using the physical collection itself, and seek their needs, and understand their experiences. With this understanding in place, i.e., a solid user-interface/experience foundation, we can build out tooling (and standards) that developers will want to utilize in their own software. These arguments and ideas are contextualized against TaxonWorks (http://taxonworks.org) and the experiences of the five collections now using it to digitize collections to illustrate their shortcomings and potentialities.
The Health Literacy Questionnaire: Initial Validity Testing in a Norwegian Sample
Authors: Urstad Kristin Hjorthaug , Andenaes Randi , Wahl Astrid K. , Kvarme Lisbeth G. , Helseth Sølvi , Moum Torbjørn
Published: October 2020

Background:

The Health Literacy Questionnaire (HLQ) is a multidimensional generic questionnaire developed to capture a wide range of health literacy needs. There is a need for validation evidence for the Norwegian version of the HLQ (N-HLQ).

Objective:

The present study tested an initial version of the Norwegian HLQ by exploring its utility and construct validity among a group of nursing students.

Methods:

A pre-test survey was performed in participants (
N
= 18) who were asked to consider every item in the N-HLQ (44 items across nine scales). The N-HLQ was then administered to 368 respondents. Scale consistency was identified and extracted in a series of factor analyses (principal component analysis [PCA] with oblimin rotation) demanding a nine-dimension solution performed on randomly drawn 50% of the samples obtained by bootstrapping. Correlations between the nine factors obtained in the 13-factor PCA and the scale scores computed by the scale scoring syntaxes provided by the authors of the original HLQ were estimated.

Key Results:

The pre-test survey did not result in the need to rephrase items. The internal consistency of the nine HLQ scales was high, ranging from 0.81 to 0.72. The best fit for reproduction of the scales from the original HLQ was found for these dimensions: “1. feeling understood and supported by health care providers,” “2. having sufficient information to manage my health,” and “3. actively managing my health.” For the dimensions “7. navigating in the healthcare system” and “8. ability to find good health information,” a rather high degree of overlap was found, as indicated by relatively low differences between mean highest correlations and mean next-highest correlations.

Conclusions:

Despite some possible overlap between dimensions 7 and 8, the N-HLQ appeared relatively robust. Thus, this study's results contribute to the evidence validation base for the N-HLQ in Norwegian populations.

[
HLRP: Health Literacy Research and Practice
. 2020;4(4):e190–e199.]

Plain Language Summary:

This study tested the Norwegian version of the Health Literacy Questionnaire. The questionnaire (44 items across nine scales) was completed by 368 nursing students. Despite some overlap between scale 7 (“navigating in the health care system”) and scale 8 (“ability to find good health information”), the questionnaire appears to serve as a good measurement for health literacy in the Norwegian population.
Sodobni pregled slovanske filologije
Authors: Žele Andreja
Published: October 2020

Aleksandr Dmitrievič Duličenko, Osnovy slavjanskoj filologii 1: istoriko-ètnografičeskaja i ètnolingvističeskaja problematika, 2: lingvističeskaja problematika, Opole: Uniwersytet Opolski – Instytut Filologii Polskiej Opolskie Towarzystwo Przyjaciół Nauk, 2011, 526 + 640 str.
Los Indios en Tenochtitlan, la ciudad Imperial Mexica
Authors: Valero de García Lascurain Ana Rita
Published: October 2020

No disponible.
Theoretical and experimental basis for the super dielectric model of dielectric materials
Authors: Phillips Jonathan
Published: October 2020

Two theories of the fields generated by charges on parallel plate capacitors, the standard model (SM) found in virtually all text books and the recently proposed super dielectric material-theory (SDM-Theory), are described, and contrasted, in terms of theory and experimentally tested
predictions. Only the SDM-Theory model is found to be consistent with thermodynamics, basic field theory, and experimental results. According to the SM, dielectrics in the volume between the electrodes of a parallel plate capacitor store the energy in a capacitor in the form of greatly, relative
to the no dielectric case, increased electric field strength. This model is shown to be inconsistent with path independent changes in state property (e.g., voltage), and predicts, incorrectly, that dielectric material outside the volume between the electrodes will have no effect on any measurable
properties such as capacitance and energy density. In contrast, according to SDM-Theory, a theory shown to be consistent with path independent changes in state properties, as well as “conservative field theory,” the increased stored energy in the presence of dielectrics is not
associated with energy in fields, but rather it is due to the “extra” charges stored on the electrodes. The extra charge is required to create a given net field in the presence of a dielectric. Indeed, according to SDM-Theory, the effect of dielectric material, because its polarization
is opposite to the electrodes, reduces the net field at all points in space, including within the volume of the dielectric. This is the absolute opposite of the “action” of a dielectric predicated by the SM. In the SDM-Theory, at a given capacitor voltage, virtually identical net
fields exist with and without a dielectric, but the capacitance (amount of stored charge) and stored energy, a linear function of the amount of stored charge, of the latter configuration can be many orders of magnitude greater. Moreover, SDM-Theory predicts, consistent with recent observations,
that dielectric material external to the volume between electrodes should be nearly as effective at increasing capacitance, etc., as the same dielectric material between the electrodes.
Relativistic electrodynamics without Lorentz transformations
Authors: Shaffer Joseph
Published: October 2020

The object of this exercise is to show that the force between moving charges can be obtained in a very different way than is usual without recourse to the Lorentz transformations. We suppose the spinning electron creates two massless strings which connect to another electron either
stationary or moving. Each string carries a wave, one the de Broglie wave and the other a wave that moves at c that mediates the force between charges in addition to guiding the electron’s motion.
KidNet
Authors: S. Umamaheswari , D. Sangeetha , Mouliganth C. , M. Vignesh E.
Published: October 2020

Kidney cancer is one of the 10 most common cancers in both men and women. The lifetime risk for one developing kidney cancer is about 1.6%. The rate of kidney cancer diagnosis has been rising since the 1990s due to the use of newer imaging tests such as CT scans. The kidneys are deep inside the body and hence small kidney tumours cannot be seen or felt during a physical examination. Existing work on kidney tumour diagnosis uses traditional machine learning and image processing techniques to find and classify the images. Deep learning systems do not require this domain-specific knowledge. The kidney tumour diagnosis system uses deep learning and convolutional neural networks to classify CT images. A deep learning neural network model named KidNet has been implemented. It has been trained using labelled kidney CT images. To achieve acceleration during the training phase, GPUs have been used. The network when trained with abdominal CT images achieved 86.1% accuracy, and the one trained with cropped portion of kidney images achieved 89.6% accuracy.
Deep Learning With Conceptual View in Meta Data for Content Categorization
Authors: R. Asokan , P. Preethi
Published: October 2020

Data gathered from various devices have to be observed by human operators manually for extended durations which is not viable and may lead to imprecise results. Data are analyzed only when any unwanted event occurs. Machine-learning technology powers many aspects of modern society, from web searches to content filtering on social networks to recommendations on e-commerce websites, and it is increasingly present in consumer products. Machine-learning systems are used to identify objects in different forms of data. For decades, constructing a pattern-recognition, machine-learning system required careful engineering and domain expertise to design a feature extractor that transformed the raw data into a suitable internal representation, which the learning subsystem could detect patterns in the input by making use of and integrating ideas such as backpropagation, regularization, the softmax function, etc. This chapter will cover the importance of representations and metadata appendage and feature vector construction for the training deep models optimization.
Analysis of Heart Disorder by Using Machine Learning Methods and Data Mining Techniques
Authors: Kodati Sarangam , Selvaraj Jeeva
Published: October 2020

Data mining is the most famous knowledge extraction approach for knowledge discovery from data (KDD). Machine learning is used to enable a program to analyze data, recognize correlations, and make usage on insights to solve issues and/or enrich data and because of prediction. The chapter highlights the need for more research within the usage of robust data mining methods in imitation of help healthcare specialists between the diagnosis regarding heart diseases and other debilitating disease conditions. Heart disease is the primary reason of death of people in the world. Nearly 47% of death is caused by heart disease. The authors use algorithms including random forest, naïve Bayes, support vector machine to analyze heart disease. Accuracy on the prediction stage is high when using a greater number of attributes. The goal is to function predictive evaluation using data mining, using data mining to analyze heart disease, and show which methods are effective and efficient.
Biometric National Identification
Authors: Eilu Emmanuel
Published: October 2020

Fifty-five percent of the people living in sub-Saharan Africa lack any official identification documentation and this has created a hug identity gap. African countries are using biometric technology to pilot multimillion-dollar national identification projects aimed at narrowing the identity gaps. However, there has been little evidence published on the extent this technology has led to economic development and to narrowing the identity gap in sub-Saharan Africa. Using a narrative review, this chapter explores the role of the emerging biometric national identification technology in narrowing the identity gap and contributing to economic development in sub-Saharan Africa. This chapter is of significance in that it informs governments in developing and transitional countries especially in Africa on lessons learned from the pilot projects and suggests better ways of narrowing the identity gap using the emerging biometric national identification technology.
IT Governance Within Corporate Governance
Authors: Ako-Nai Sonny Anyetei
Published: October 2020

The need for oversight has prompted the incorporation of IT governance into corporate governance codes and practices. However, since its incorporation, the understanding and implementation of IT governance codes have been challenging for the board. Boards find these codes extending beyond their governance oversight responsibilities. Whilst existing literature have divergent approaches and focus, most agree and call for more explicit studies on how corporate governance board are affecting IT governance oversight. This chapter reviews IT governance frameworks, corporate governance codes, and practices to identify key aspects of IT governance relevant and applicable at the board level. The chapter derived a conceptual framework of an effective IT governance implementation that consists of four key components that directly influence IT governance implementation: governance capabilities, key features of implemented IT governance frameworks, and change management. The framework postulates that boards that focus and address these components would improve the IT governance effectiveness.
Predicting Student Intention to Use Cloud Services for Educational Purposes Based on Perceived Security and Privacy
Authors: Padayachee Nikhil , Civilcharran Surika
Published: October 2020

Cloud services in its entirety has drastically changed the perception of how industry experts and academics alike foresee the information technology sector. The reach of cloud services stretches into many sectors of society. Such sectors include the use of cloud technologies in education, which is of growing interest to academics and higher education institutions. However, many institutions adopt these services into their workflow without properly identifying the potential impacts on their students, since it is the student who engages with the new technology to enhance their knowledge base. This chapter investigates how student's perceptions of security and privacy, influences their adoption of cloud services for use in an educational setting. This study proposes that student intention to use a cloud service (e.g., DropBox) for academic purposes can be predicted upon their perception of security and privacy when using a specific cloud service.
Opportunistic Edge Computing Architecture for Smart Healthcare Systems
Authors: Nivethitha V.  , Aghila G.
Published: October 2020

Some of the largest global industries that is driving smart city environments are anywhere and anytime health monitoring applications. Smart healthcare systems need to be more preventive and responsive as they deal with sensitive data. Even though cloud computing provides solutions to the smart healthcare applications, the major challenge imposed on cloud computing is how could the centralized traditional cloud computing handle voluminous data. The existing models may encounter problems related to network resource utilization, overheads in network response time, and communication latency. As a solution to these problems, edge-oriented computing has emerged as a new computing paradigm through localized computing. Edge computing expands the compute, storage, and networking capabilities to the edge of the network which will respond to the above-mentioned issues. Based on cloud computing and edge computing, in this chapter an opportunistic edge computing architecture is introduced for smart provisioning of healthcare data.
Risk Analysis of Diabetic Patient Using Map-Reduce and Machine Learning Algorithm
Authors: Dharwadkar Nagaraj V. , Poojara Shivananda R. , Kannur Anil K.
Published: October 2020

Diabetes is one of the four non-communicable diseases causing maximum deaths all over the world. The numbers of diabetes patients are increasing day by day. Machine learning techniques can help in early diagnosis of diabetes to overcome the influence of it. In this chapter, the authors proposed the system that imputes missing values present in diabetes dataset and parallel process diabetes data for the pattern discovery using Hadoop-MapReduce-based C4.5 machine learning algorithm. The system uses these patterns to classify the patient into diabetes and non-diabetes class and to predict risk levels associated with the patient. The two datasets, namely Pima Indian Diabetes Dataset (PIDD) and Local Diabetes Dataset (LDD), are used for the experimentation. The experimental results show that C4.5 classifier gives accuracy of 73.91% and 79.33% when applied on (PIDD) (LDD) respectively. The proposed system will provide an effective solution for early diagnosis of diabetes patients and their associated risk level so that the patients can take precaution and treatment at early stages of the disease.
Descriptive Data Analytics on Dinesafe Data for Food Assessment and Evaluation Using R Programming Language
Authors: Kunjir Ajinkya , Shah Jugal , Trikha Vikas
Published: October 2020

In the digital era of the 21st century, data analytics (DA) can be highlighted as 'finding conclusions based on observations' or unique knowledge discovery from data (KDD) in form of patterns and visualizations for ease of understanding. The city of Toronto consists of thousands of food chains, restaurants, bars based all over the streets of the city. Dinesafe is an agency-based inspection system monitored by the provincial and municipal regulations and ran by the Ministry of Health, Ontario. This chapter proposes an efficient descriptive data analytics on the Dinesafe data provided by the Health Ministry of Toronto, Ontario using an open-source data programming framework like R. The data is publicly available for all the researchers and motivates the practitioners for conveying the results to the ministry for betterment of the people of Toronto. The chapter will also shed light on the methodology, visualization, types and share the results from the work executed on R.
An exploratory study of pre-extrusion flavouring: investigation with vitamins, amino acids, essential oils, natural aromas and seasonings
Authors: Milk Leonardo Heleno , Milani Talita Maira Goss , Conti-Silva Ana Carolina
Published: October 2020

Expanded corn snacks are obtained through thermoplastic extrusion and then a lipid vehicle (oil or hydrogenated vegetable fat) is sprinkled on the product, giving the desired flavour. However, this second step called post-extrusion flavouring increases the lipid content and the caloric value of the snack, reasons why these products are highly criticized. Thus, the study of pre-extrusion flavourings is an interesting way of finding corn snacks with better nutritive value. Therefore, we aimed to explore pre-extrusion flavouring using different substances, investigating the odour and flavour on the extrudates and the impact of such substances on their expansion ratio, density, and colour. To do this, vitamins, amino acids, essential oils, natural aromas and seasonings were added to corn grits and extruded. The addition of different substances, especially the essential oils, natural aromas and seasonings, produced odour and flavour in the extrudates, as well as having little negative impact on their physical properties of the extrudates, no impact or even a small positive impact. Therefore, this study provides a range of possibilities to be explored, using pre-extrusion flavouring as a way of reducing the use of lipids and improving the nutritive value of expanded snacks.
Disclosure of human immunodeficiency virus status to children: Pattern followed by parents and caregivers
Authors: Dlamini Cebsile P. , Matlakala Mokgadi C.
Published: October 2020

Background: Disclosure of human immunodeficiency virus (HIV) status may be perceived as simply the process of revealing a person’s HIV status, whether positive or negative. Despite the emerging evidence of the benefits of disclosure, who, when and what to disclose to a HIV-infected child remains a challenge.Aim: This article reports on the patterns of HIV status disclosure to the infected children by their parents and caregivers.Setting: The study was conducted in the outpatient clinic of one referral hospital offering comprehensive HIV care in the Lubombo region, eSwatini.Methods: A qualitative descriptive design was followed. Data were collected through semi-structured individual interviews with a purposive sample of 13 parents and caregivers whose children were on antiretroviral treatment and collecting treatment from the specific outpatient clinic. Audio recorded data were transcribed verbatim, thematic content analysis was done and used to organise and present the findings.Results: Four themes that emerged in relation to the topic of patterns of disclosure were disclosure of HIV status as a process rather than an event, a proposed person to disclose the HIV status to the child, the appropriate age to disclose HIV status to a child and type and amount of information to give in relation to the HIV status. The proposed person to disclose the HIV status to the infected child was the parent or caregiver involved as the primary carer of the child. There was no agreeable appropriate age to disclose HIV status to an infected child and the type and amount of information to disclose varied with the individuals depending on what prompted disclosure.Conclusion: Human immunodeficiency virus disclosure to children demands parents’ and caregivers’ participation and their knowledge of child development.
Addressing Firearm Safety Counseling: Integration of a Multidisciplinary Workshop in a Pediatric Residency Program
Authors: McKay Sandra , Bagg Michael , Patnaik Anish , Topolski Natasha , Ibraheim Marina K. , Zhao Ning , Aitken Mary E.
Published: October 2020

Background

Firearm-related injuries are the second leading cause of death among US children. Given this, firearm injury prevention should be a key aspect of pediatric anticipatory guidance.

Objective

We assessed the impact of a firearm safety counseling workshop on pediatric resident knowledge, self-efficacy, and self-reported practice patterns.

Methods

Sixty of 80 residents (75%) participated in a 2-hour multimodal workshop, including video, didactics with experts, and role-play scenarios. Participants were invited to complete pre-workshop, immediate post-workshop, and 3- and 6-month post-workshop self-reported questionnaires evaluating knowledge, comfort, perceived barriers, and reported practice patterns. Data comparing pre- and 6-month post-workshop practice patterns were analyzed via Fischer's exact test. Remaining statistical analysis utilized a one-sided, unpaired Mann–Whitney U test. A binomial exact proportions test was used for open-ended responses.

Results

After the workshop, the percentage of participants with perceived concern regarding parental barriers decreased significantly (24% to 7%, P = .001). Participants 6 months post-workshop were 5.14 times more likely to counsel their patients on firearms during more than 75% of their well visits than prior to the intervention (P = .010). Participants reported greater comfort asking patients about firearms, with mean Likert scores increasing from 3.81 pre to 4.33 post (P = .022), which was similar to 3-month (4.39, P = .06) and 6-month evaluations (4.54, P = .003).

Conclusions

Education on firearm safety counseling improved pediatric resident comfort level in discussing the topic. This impact persisted 6 months after the workshop, implying a sustained change in attitudes and behaviors.
Evaluation of clinical, diagnostic and treatment aspects in hydatid disease: analysis of an 8-year experience
Authors: Sen Pinar , Demirdal Tuna , Nemli Salih Atakan
Published: October 2020

Background & Objective: Echinococcosis is still a common health problem. The aim of this study was to discuss our 8-year data in terms of diagnosis, treatment and follow-up of cystic Echinococcosis.Methods: A total of 178 patients who had hydatid cyst were analyzed retrospectively from the hospital records. The diagnosis of hydatid cyst was based on clinical-serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings.Results: A total of 178 medical records were evaluated; the male:female ratio was 0.73 and mean age 44.6±16.9 years. The most common symptom was abdominal pain (94, 52.8%). The mean cyst size was 9.5±3.9 cm. Eosinophilia was significantly higher in patients with complicated cyst (35.3%) (p=0.002). The average duration of hospitalization in surgical patients was shorter than non-surgical patients (p=0.026). There was no significant correlation between the preference of scolicidal agent (hypertonic saline, H2O2, povidone iodine) and recurrence in patients who underwent surgery (p>0.05). There was no significant difference between the patients who underwent radical and conservative surgery in terms of complication and recurrence (p=0.077, p=0.557). No significant difference was found between percutaneous and surgical treatment in terms of complication and recurrence (p=0.264, p=0.276).Conclusion: Even though considerable progress has been made, uncertainties remain in the diagnosis and treatment of Echinococcosis. Hence, standardized diagnostic and treatment procedures should be established with well-designed studies.Keywords: Echinococcosis, hydatid cyst, diagnosis, treatment.
Prevalence and determinant factors of hookworm infection among school age children in Jawe district, NorthWest Ethiopia
Authors: Hailu Tadesse , Mulu Wondemagegn , Abera Bayeh
Published: October 2020

Background: Hookworm infection is a common parasitic infection in sub-Saharan Africa. The prevalence of hookworm infection is influenced by different determinant factors. This study aimed to determine the prevalence of hookworm infection and determinant factors among school age children in North West Ethiopia. Methods: A cross-sectional study was conducted from April 2016 to August 2016. Children were selected by systematic random sampling and Formoleether concentration technique was used to identify hookworm infection. We conducted descriptive and logistic regression analysis for categorical variables. The adjusted odds ratio was calculated at 95% confidence interval. Results: Among 333 children, 49 (14.7%) were infected with hookworm parasites. Eating raw vegetables, not wearing shoes, absence of regular wearing of shoes and hand washing habit, absence of proper utilization of latrines, absence of deworming were significantly associated (p<0.05) with hookworm infection. Conclusion: The prevalence of hookworm infection was high among school age children. Walking with bare foot, hand washing habit, and absence of proper latrine utilization are the major determinant factors for the high prevalence of hookworm infection. Therefore, community mobilization and health education should be done to decrease hookworm infection among school age children in Jawe district.
Comparative effects of glibenclamide, metformin and insulin on fetal pancreatic histology and maternal blood glucose in pregnant streptozotocin-induced diabetic rats
Authors: Lawal Sodiq Kolawole , Adeniji Adeoluwa Akeem , Sulaiman Sheu Oluwadare , Akajewole Mustapha Mas’ud , Buhari Muhammad Olanrewaju , Osinubi Abraham Adewale
Published: October 2020

Background: Oral hypoglycemic agents use during pregnancy was assumed to cause fetal macrosomia and skeletal deformities, and maternal complications due to significant transfer across placenta or ineffective control of blood glucose.Objective: This study investigated effects of insulin, metformin and glibenclamide on maternal blood glucose; and fetal crown-rump length, gross malformation and pancreatic histology in pregnant streptozotocin-induced diabetic rats.Methods: Twenty-five pregnant rats of groups 1 to 5 as normal and diabetic controls; and diabetic treated with insulin, metformin and glibenclamide were used. Experimental GDM was induced using 45 and 35mg/Kgbw of intraperitoneal streptozotocin.Results: Metformin, Insulin and Glibenclamide significantly reduced maternal glucose by 140.6mg/dL, 103.2mg/dL and 98.54mg/dl; respectively and showed islets with regular interlobular ducts, islets with some irregular interlobular ducts, and islets with many irregular interlobular ducts in histological fetal pancreatic photomicrographs respectively. This depicts metformin having highest ameliorative effect. There were no significant differences in maternal and fetal body weights, maternal blood glucose between diabetic groups, and fetal gross examination.Conclusion: At the doses used in this research, metformin and glibenclamide showed no adverse effects on maternal and fetal features in the treatment of GDM. Thus, they can be used as safe and inexpensive alternatives to insulin.Keywords: Gestational diabetes mellitus, oral hypoglycemic agents, blood glucose, fetal malformation and fetal pancreatic histology.
Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa
Authors: Masumbuko Claude Kasereka , Mutheke Edward Gakuya , Mbindyo Benjamin , Hawkes Michael T
Published: October 2020

Background: Supracondylar humeral fractures (SHFs) in children are associated with morbidity due to elbow stiffness. Timely operative management and/or physiotherapy are thought to reduce this complication, but pose challenges in settings with limited resources for health.Methods: This prospective cohort study included 45 pediatric patients with isolated SHF at a large tertiary hospital in Nairobi, Kenya. Patients were managed non-operatively or operatively with varying wait times to surgery, with or without physiotherapy. The measurement of elbow ROM was done up to 12 weeks after removal of Kirshner wires and/or backslab.Results: Elbow ROM increased in the follow-up period, yet residual restricted mobility in the flexion-extension plane was common. Delayed surgical management ≥7days was associated with reduced elbow ROM in the flexion-extension plane at 12 weeks median IQR 105° 92°-118° vs 120° 108°-124°, p=0.029. Physiotherapy was associated with reduced ROM at 12 weeks p=0.003, possibly due to the use of prolonged immobilization.Conclusion: In this study of pediatric SHFs at a resource-limited hospital, elbow flexion was restricted at 12 weeks follow-up and was associated with major delays in operative management. Quality of orthopedic surgical care and physiotherapy services in low-resource settings deserves further attention.Keywords: Delayed surgery, reduced elbow range, supracondylar humeral fractures, sub-Saharan Africa.
The role of elastography in the assessment of chronic liver disease in children
Authors: Sönmez Süleyman , Boşat Merve , Yurtseven Nihal , Yurtseven Eray
Published: October 2020

Background: Conventional ultrasonography is a method preferred for the investigation of chronic liver diseases in pediatric groups, as it is non-invasive, cheap, feasible and available. The purpose of this study is to present the role of Share-wave Elastography (SWE) in terms of diagnostic value in children diagnosed with “chronic liver disease.”Methods: We studied patients who had been diagnosed with chronic liver disease between March 2012-September 2015, and who had undergone liver biopsy and had their pathology results, compared with 26 healthy subjects. Statistical analysis was performed with IBM SPSS Statistics for Windows, Version 20.0. “Pearson Correlation Analysis” was performed in order to measure the relationship between elastography values and Brunt level.Results: This study had 107 subjects in total, consisting of 81 patients between 0-204 months of age Pearson correlation coefficient level was determined as r = 0.644. Since the correlation coefficient is positive, there is a same-directional relationship between Elastography level and Brunt degree. This means that while one of the variables is increasing, the other one will also increase.Conclusion: Since it is known that development of hepatic fibrosis is a dynamic process, and that many hepatic fibrosis etiologies are known to continue throughout the course of life, the application of Real time SWE method instead of repeated liver biopsies on patients is a much simpler and smart method. Increasing the clinical use of Real Time SWE method with future studies might provide an opportunity for preventing unnecessary liver biopsies since the patients are evaluated in a shorter time and in a cost-effective manner.Keywords: Shear-Wave Elastography, Brunt degree, chronic liver disease, liver biopsy.
Herpes zoster complicated by phrenic nerve palsy and respiratory compromise
Authors: Apiyo Paska , Hajek Jan
Published: October 2020

Background: Herpes zoster can be associated with severe neurological complications.Case presentation: In this article, we describe the case of a 54-year-old man with herpes zoster affecting his right upper chest and neck region complicated by phrenic nerve palsy and respiratory compromise. The diagnosis of herpes zoster was made based on the classic appearance of the rash and associated neuropathic-type pain. The diagnosis of phrenic nerve palsy was made by chest x-ray and ultrasound.Conclusion: Clinicians should be aware of the possibility of phrenic nerve palsy occurring in patients who have herpes zoster affecting the region of C3,4,5 dermatomes. Although symptoms of unilateral diaphragmatic paresis are usually mild, in patients with obesity or comorbid lung disease, new onset phrenic nerve palsy can lead to significant respiratory compromise.Keywords: Herpes zoster, neurologic complication, phrenic nerve palsy, case report.
Ghrelin, resistin and insulin in obese diabetic women in Wad-Madani, Sudan
Authors: Aliya  Elamin Mohammed , Mohammed Youseif Sukkar , Azhari Mohammed Hamid
Published: October 2020

Background: Obesity in the Sudan is increasing at alarming rate with the tendency of reaching an epidemic proportion in women. It is commonly associated with type 2 diabetes (T2D). Some adipokine hormones such as resistin are associated with obesity.

Objectives:. To study how the levels of resistin, ghrelin and insulin are associated with obesity,fat distribution and (T2D) and to ascertain any interrelationships between them.

Subjects and methods: 150 women, age ≥18 years old, resident in Wad-Madani town, Sudan were participated in the study. They were divided into 3 groups according to body mass index ( BMI) value: I (normal weight), II (overweight) and III (obese diabetic). Fasting serum resistin and ghrelin concentrations were measured using ELISA method. Insulin levels were determined by radioimmunoassay(RIA).

Results: The mean±SD levels of resistin 5.80±4.91ng/mL,Ghrelin107.60±26.67pg/M and Insulin 11.92±8.54mLU/ml in obese diabetic were found to be greater than in normal or overweight women.In normal weight values were 3.07±2.15 ng/ mL 83.30±13.38pg/mL, and 6.62±6.77mLU/ml for resistini, ghrelin and Insulin, respectively. Values for overweight women 3.64±2.63 pg/mL 90±17.35 pg/mL and 8.13±7.54 mLU/ml for resistin, ghrelin and insulin respectively.

Conclusions and recommendations: Increased BMI, waist circumference (WC) and hormones (ghrelin and resistin) were associated with insulin resistance.Further studies are needed to accept or refute these findings.

Keywords: Obesity; BMI; WC; T2D; ghrelin; resistin; insulin resistence (IR).