bluuebunny/crossref_metadata_2025 huggingface dataset:
O OLHAR DOS/AS ACADÊMICOS/AS DO CURSO DE PEDAGOGIA SOBRE A EJA
Authors: Rabello Mariane Villain , Hanoff Mirozete Iolanda Volpato
Published: October 2019

Este artigo tem por objetivo compreender o olhar que os acadêmicos (as) do curso de Pedagogia da Unesc, futuros professores da EJA, têm sobre a Educação de Jovens e Adultos. O trabalho fundamenta-se em autores que escrevem sobre esta temática. Inicialmente foi apresentado um breve histórico sobre a Educação de Jovens e Adultos no Brasil, desde 1930 até o ano de 2003, quando governo criou o Programa Brasil Alfabetizado (PBA). Também foram identificados e brevemente exemplificados os temas: Características dos alunos da EJA, características do professor da EJA, perspectivas e desafios e as vivências acadêmicas na Educação de Jovens e Adultos. Em seguida realizou-se uma pesquisa com a aplicação do questionário com acadêmicos (as) que estão cursando da 2ª à 8ª fase do curso de Pedagogia da Unesc. Com a finalização do trabalho, conclui-se que a modalidade de ensino na EJA gera expectativa nos (as) acadêmicos (as) entrevistados desde o início do curso, mas está presente no processo de formação de uma forma ainda limitada, restringindo-se especificamente na 6ª e 7ª fases do curso.PALAVRAS-CHAVE: Educação de Jovens e Adultos. Pedagogia. Acadêmicos (as).
A TEORIA HISTÓRICO|-CRÍTICA NA PERSPECTIVA DO LIVRO DIDÁTICO DE ALFABETIZAÇÃO E LETRAMENTO DO PRIMEIRO ANO DO ENSINO FUNDAMENTAL
Authors: Mattos Sara Cabral de , Casagrande Samira
Published: October 2019

O artigo apresenta como objetivo geral problematizar o livro didático “Ápis Alfabetização e Letramento”, das autoras Ana Trinconi, Terezinha Berti e Vera Marchezi (2016), adotado pelas professoras do primeiro ano no município de Criciúma, em uma perspectiva crítica de educação. O livro didático, muitas vezes, é utilizado como único recurso de ensino, contrariando o que diz a Base Nacional Comum Curricular, que recomenda que a utilização deste seja como fonte de conhecimento para outras práticas pedagógicas. Como arcabouço teórico este artigo apresenta um estudo sobre as teorias pedagógicas no Brasil, os documentos filosóficos e metodológicos norteadores do estado e município e, por último, uma análise sobre o uso do livro didático para o processo de ensino-aprendizagem do professor/aluno. Tendo como base estes referenciais, foi realizada uma análise documental do livro didático à luz das teorias críticas, o que oportunizou refletir também sobre o planejamento do professor. Os resultados apresentaram elementos positivos, mas que ainda precisam ser aprofundados para uma prática de ensino em uma teoria crítica de educação. Assim, espera-se que o professor, apesar dos avanços metodológicos do livro didático, assuma seu papel de protagonista e o livro como coadjuvante da sua aula.PALAVRAS-CHAVE: Teoria crítica, ensino, livro didático, reflexão dos conteúdos
O potrzebie różnorodności w prawie pracy
Authors: Gładoch Monika
Published: October 2019

Panuje przekonanie, że skoro prawo pracy ma chronić pracownika, to ze swojej istoty wymaga ograniczeń. Zasada swobody umów powinna być zatem limitowana. W przeciwnym bowiem wypadku dojdzie do naruszenia systemu prawa pracy. Stąd tylko krok do stwierdzenia, że wolność w prawie pracy może stanowić zagrożenie dla realizacji podstawowej funkcji w prawie pracy. Innymi słowy, im większy uniformizm, czyli jednolitość instytucji, tym większa pewność skuteczności działania funkcji ochronnej prawa pracy. Tymczasem funkcja ochrony pracownika nie może i nie powinna stanowić bariery dla rozwoju prawa pracy. Prawo pracy XXI wieku wymaga różnorodności. Tylko dzięki nowym formom zatrudnienia i organizacji pracy oraz elastyczności można sprostać wyzwaniom rynku pracy.
Filozofia tzw. ochrony osób pracujących na zasadach cywilnoprawnych - głos w dyskusji podczas I Ogólnopolskiej Konferencji Naukowej z cyklu „Nietypowe stosunki zatrudnienia” pt. „Stosowanie umów cywilnoprawnych w świetle przepisów prawa pracy i ubezpieczeń społecznych. Łódzko-poznański początek dyskusji...”
Authors: Musiała Anna
Published: October 2019

Opracowanie dotyczy ciągle powszechnego niezrozumienia fundamentalnej dla dyscypliny prawa pracy kwestii, jaką stanowi problem prawnej podstawy zatrudnienia. Chodzi mianowicie o to, co tak naprawdę determinuje wybór owej podstawy, a dokładnie, czy w przedmiotowej kwestii przesądzająca jest ostatecznie owa „wolna” wola stron. Pytania są następujące: czy rzeczywiście obrany przez ustawodawcę kierunek zrównywania prawnych podstaw zatrudnienia w sferze prawa pracy i prawa cywilnego jest błędny, a jeśli tak, to jak powinno wyglądać pewne „rozplanowanie” prawnych podstaw świadczenia pracy i co determinuje decyzję ustawodawcy o tymże planowaniu, a może to po prostu owa „wolna” wola stron w tej mierze decyduje wyłącznie? Znalezienie odwiedzi na powyższe pytania jest zupełnie kluczowe, żeby odpierać falę krytyki na propozycje zawarte w projekcie kodeksu z zakresu indywidualnego prawa pracy, opracowanego przez Komisję Kodyfikacyjną z lat 2016–2018.
Prawo do wypoczynku osób pracujących na własny rachunek – uwagi de lege ferenda
Authors: Barwaśny Mateusz
Published: October 2019

Przedmiotem niniejszego opracowania jest kwestia związana z prawem do wypoczynku osób samozatrudnionych. Obecne przepisy Konstytucji RP z 2.04.1997 r. w tej materii nie są jednoznaczne i należałoby dokonać ich rewizji. Po pierwsze, nie są zgodne z aktami prawa międzynarodowego. Po drugie, nie odzwierciedlają obecnych realiów społeczno-gospodarczych. Zdaniem autora, zakres podmiotowy prawa do wypoczynku powinien być rozszerzony na osoby samozatrudnione, które spełniają – określone w opracowaniu – kryteria.
Zbieg ubezpieczeń emerytalnego i rentowego zleceniobiorcy. Wybrane zagadnienia
Authors: Krajewski Marcin
Published: October 2019

W artykule przedstawione zostały wady i zalety podlegania ubezpieczeniu społecznemu przez zleceniobiorców, na gruncie ustawy z dnia 13 października 1998 o systemie ubezpieczeń społecznych. Publikacja ukazuje zasady zbiegu tytułów w ubezpieczeniach emerytalnym i rentowym. Analizie poddany został także obecny model kumulacji tytułów w ubezpieczeniu społecznym. W końcowej części rozważań autor przedstawia alternatywny model jednolitego obciążenia składką dochodów ubezpieczonych.
INTERPRETATION OF THE RESULTS OF IMMUNOHEMATOLOGICAL TESTS IN HEMATOLOGICAL PATIENTS
Authors: Yovdiy A. V. , Butina E. V. , Poponina E. A. , Zaitseva G. A. , Minaeva N. V.
Published: October 2019

The correct determination of the blood types of the recipient and the donor is very importante for the choice of blood components for transfusion. As a result of the study, it was established that 18.0% of patients, admitted to the hematology clinic, have difficulties in interpreting of the results of immunohematological tests. Most often, a double population of red blood cells was detected when determining antigens of the Rhesus system (10.9%), auto- (3.9%) and alloantibodies (2.8%). The proposed algorithm for the selection of donor red blood cells in difficult diagnostic cases helps to prevent the development of post-transfusion complications.
THE PROCESSES OF LIPOPEROXIDATION AND ENDOGENOUS INTOXICATION IN SALIVA IN CENTRAL AND PERIPHERAL LUNG CANCER
Authors: Bel’Skaya L. V. , Kosenok V. K. , Postnova T. V.
Published: October 2019

The aim of the study was to establish the patterns of changes in the parameters of endogenous intoxication and lipoperoxidation processes in the saliva of patients with lung cancer, depending on the form of tumor growth (central, peripheral or mediastinal cancer). Materials and methods: in the case - control study was attended by 562 volunteers, who were divided into 2 groups: main (lung cancer, n = 347) and control group (relatively healthy, n = 2015). Questioning, biochemical saliva study and histological verification of the diagnosis carried out to all participants. In peripheral lung cancer, there is a statistically significant increase in the albumin concentration (p˂0.0001), with a central MDA (p=0.0330). The content of secondary lipoperoxidation products compared with the control is increased for all groups (p˂0.0001), however, the differences are most pronounced for the mediastinal growth form. The level of medium molecular toxins is the same for both central and peripheral lung cancer, and the distribution coefficient has a stable value exceeding the corresponding value for the control group (p=0.0002). Thus, in the peripheral form of lung cancer growth under hypoxic conditions lipoperoxidation processes are less pronounced, while endotoxicosis processes are the same in both central and peripheral cancer. For the mediastinal growth, the process of lipoperoxidation is directed towards the formation of toxic Schiff bases, and the low level of medium-molecular toxins indicates a greater resistance of proteins to oxidative stress.
DETERMINING OF CYTOKINE LEVELS IN THE URINE IN CLINICAL PRACTICE
Authors: Karzakova L. M. , Kudryashov S. I. , Shestipalova M. V. , Leontyeva E. V.
Published: October 2019

The paper presents data on the study of the content of cytokines (IL-1β, RAIL-1β, IL-2, IL-4, IL-10, IL-17A, TNF-, IFN-γ) in the morning urine using enzyme immunoassay in healthy individuals (n = 20) and in patients with acute glomerulonephritis (n = 93). The determination of cytokine levels in patients was carried out in the debut of the disease and 12 months after the onset of the disease. The obtained indicators of cytokine content in the urine are presented as absolute values in pg/ml and creatinine-normalized values calculated by the formula: cytokine level (pg/ml) / urine creatinine (µmol/ml). The study was made of changes in the content of cytokines in the urine of patients with glomerulonephritis with respect to a group of healthy individuals, as well as the dynamics of the content of cytokines in the urine during the 12-month observation period. The results of the study showed that the absolute values of cytokines in urine can distort the true picture of the cytokine profile of urine in renal pathology. Normalized values of the predominant number of pro- and anti-inflammatory cytokines (IL-1β, IL-2, IL-8, IL-10, IL-17A and TNF-α) in patients with glomerulonephritis were significantly higher than the corresponding indicators of healthy individuals. The normalized values of cytokines were shown to be as more sensitive indicators than absolute values in the course of analyzing differences in the cytokine profile in patients with glomerulonephritis, depending on chronic and acute course of the disease. These indicators influenced the outcome of glomerulonephritis, assessed, as a rule, 12 months after the onset of the disease. Thus, the low levels of IL-1β, IL-8 and IL-17А detected in the debut of the disease in combination with the high level of RAIL-1β determined the chronization of glomerulonephritis. So, the creatinine-normalized cytokine levels in the urine expand the possibilities of using the evaluation of the cytokine profile of urine to establish changes in the cytokine content in the urine in renal pathology and predict the chronization of glomerulonephritis.
COMPARISON OF HEMOLYTIC ACTIVITY AND HEMOLYTIC TOXIN GENES OF STAPHYLOCOCCUS AUREUS CLINICAL STRAINS, ISOLATED IN RUSSIA
Authors: Abaev I. V. , Skryabin Y. P. , Korobova O. V. , Polosenko O. V. , Shepelin A. P.
Published: October 2019

Clinical strains of Staphylococcus aureus were tested for hemolytic activity on blood agar, in the PCR test and by analyzing the gene alleles of hemolytic toxins. The study analyzed the information content of the phenotypic determination of hemolytic activity to assess the pathogenic properties of S. aureus isolates.
BIOCHEMICAL MARKERS OF MYOCARDIUM DAMAGE IN CHILDREN WITH CARDIOMYOPATHY
Authors: Akhmedova D. I. , Akhmedova Nilufar Rasulovna , Aripov A. N. , Matkarimova A. A.
Published: October 2019

The article presents the results of studies of 104 patients with cardiomyopathy hospitalized in the cardiorheumatological departments of the Republican Specialized Scientific and Practical Medical Center of Pediatrics in Tashkent and the Republican Children’s Multidisciplinary Medical Center of the Republic of Karakalpakstan. An analysis of the results of the study showed that in children with cardiomyopathy there is an increase in the level of tissue (LDH, CPK) and cardiospecific (CPK-MB) enzymes, regardless of the region of residence and the form of the disease, which indicate myocardial dysfunction. Therefore, these enzymes can be regarded as highly specific biochemical markers of myocardial damage, and an increase in their activity can be used as criteria for the diagnosis of heart disease. Of the biochemical parameters, a reliable prognostic criterion for the development and outcome of cardiomyopathy is a progressive increase in the level of endothelin with increasing duration of the disease.
DIAGNOSTICS VALUE AND REGULATORY FUNCTIONS OF PROINSULIN
Authors: Poteryaeva O. N. , Usynin I. F.
Published: October 2019

Proinsulin is one of the indicators reflecting the functional activity of the pancreas. In insulin-independent diabetes mellitus the ratio proinsulin / insulin is increased. The review examined the causes of hyperproinsulinemia and the diagnostic value of proinsulin in patients with diabetes mellitus type 1 and 2. The role of proinsulin in the regulation of metabolic pathways and the preservation of the functional activity of cells under physiological conditions, during aging and during pathological processes is discussed. Studies in these areas justify the inclusion of proinsulin in the superfamily of signaling factors. The neuroprotective activity of proinsulin and its potential as a therapeutic tool for neurodegenerative diseases and retinal dystrophy are considered.
Derecho humano a la salud en el establecimiento penitenciario y carcelario de Tunja, Colombia
Authors: Rodríguez-Forero Nicolas David
Published: October 2019

Esta investigación cualitativa, pretende analizar los alcances prestacionales de protección, reconocimiento y acceso al servicio de salud en personas privadas de la libertad en el Establecimiento Penitenciario de Mediana Seguridad y Carcelario EPMSC de Tunja, durante el periodo 2005-2018. Este objetivo involucra la participación estatal, municipal, y de los organismos de control como la Personería Municipal, la Defensoría del Pueblo y la Procuraduría General de la Nación, a fin de exigir la prestación de los servicios médico-asistenciales, en el marco del Estado de Cosas Inconstitucional y de Emergencia Carcelaria. El método utilizado en este sentido fue el análisis documental de dos tipos de fuentes: a) la revisión de autores en materia de evolución del derecho a la salud en materia carcelaria, y b) el déficit y surgimiento del modelo de atención en salud penitenciaria. Los resultados muestran que el EPMSC de Tunja, es uno de los escenarios penitenciarios menos hacinados del país, el cual ha tenido un alcance y escenario de negación, débil y tenue a satisfactorio, propiciando la participación del comité en DDHH, y dependiendo principalmente del equilibrio económico del modelo de atención en salud. En consecuencia, implica que se debe requerir sostenibilidad e infraestructura en el escenario carcelario tunjano, para la garantía y exigibilidad del derecho humano a la salud.
Oral tolerance induction and food allergy prevention
Authors: Tsikhan Natallia , Belevtsev Mikhail
Published: October 2019

This review aims to provide an overview of the issue of oral tolerance induction in early childhood and allergy manifestation. We discuss changes in epidemiology of allergic diseases that have occurred over the last decades in the context of current knowledge about environmental factors affecting prevalence of these diseases. Also this article presents current data about causes of "hygiene hypothesis" expansion to "microflora hypothesis" as well as an immunological background of this process; describes how immune factors of cord blood and breast milk, maternal and infant’s elimination diet, timing a solid food intake impact on immune system development and tolerance induction in early childhood. Current knowledge on issues of tolerance induction and allergy should induce update of allergy prevention recommendations in the nearest future.
Exponential Disruptive Technologies and the Required Skills of Industry 4.0: A Review
Authors: Bongomin Ocident , Ocen Gilbert Gilibrays , Nganyi Eric Oyondi , Musinguzi Alex , Omara Timothy
Published: October 2019

The 21st century has witnessed precipitous changes spanning from the way of life to the technologies that emerged. We have entered a nascent paradigm shift (industry 4.0) where science fictions have become science facts, and technology fusion is the main driver. Thus, ensuring that any advancement in technology reach and benefit all is the ideal opportunity for everyone. In this study, disruptive technologies of industry 4.0 was explored and quantified in terms of the number of their appearances in published literature. The study aimed at identifying industry 4.0 key technologies which have been ill-defined by previous researchers and to enumerate the required skills of industry 4.0. Comprehensive literature survey covering the field of engineering, production, and management was done from multidisciplinary databases: Google scholar, ScienceDirect, Scopus, Sage, Taylor & Francis and Emerald insight. Results of the electronic survey showed that 35 disruptive technologies were quantified and 13 key technologies: Internet of things, Big data, 3D printing, Cloud computing, Autonomous robots, Virtual and Augmented reality, Cyber physical system, Artificial intelligence, Smart sensors, Simulation, Nanotechnology, Drones and Biotechnology were identified. Both technical and personal skills to be imparted into the human workforce for industry 4.0 were reported. The study identified the need to investigate the capability and the readiness of developing countries in adapting industry 4.0 in terms of the changes in the education systems and industrial manufacturing settings. The study proposes the need to address integration of industry 4.0 concepts into the current education system.
The roles of metabolic pathways in maintaining primary dormancy of Pinus koraiensis seeds
Authors: Song Yuan , Zhu Jiaojun
Published: October 2019

Background: Korean pine seeds have primary dormancy following dispersal, leading to poor seed germination and seedling establishment. Metabolic homeostasis determines whether the seeds are dormant or non-dormant. However, the specific metabolic pathways that maintain the primary dormancy of pine seeds are poorly understood.
Results: Metabolic analysis was employed on the embryos of PDRS (seeds released from primary dormancy) and PDS (primary dormant seeds) on days 0, 5 and 11 after incubation under a germination-inductive temperature. A larger metabolic switch occurred in PDRS embryos from days 0 to 11. The contents of ninety metabolites were significantly changed from days 0 to 5, 83% of which (including most sugars, organic acids and amino acids) increased, reflecting that biosynthetic metabolism processes are initiated. The contents of ninety-two metabolites showed distinct variations from days 5 to 11, 71% of which (including most organic acids and almost all amino acids) reduced substantially. Fructose 6-phosphate, inositol-3-phosphate, 3-phosphoglyceric and D-glucose-6-phosphate contents showed the most decrease with decreasing 409-, 75-, 58- and 41-fold, indicating that the glycolysis and tricarboxylic acid (TCA) cycle strongly slowed down. The contents of the most metabolites in PDS embryos also displayed a relatively larger alteration only from days 0 to 5. Although 64% of metabolites increased from days 0 to 5, their levels were still lower compared with PDRS embryos. Furthermore, most metabolites were not further accumulated from days 5 to 11. Unlike PDRS embryos, almost all amino acids in PDS embryos did not exhibit a substantial decrease from days 5 to 11. Also, there was not a major decrease in the levels of metabolites involved mainly in glycolysis and TCA cycle, while some intermediates even increased.
Conclusions: The attenuated biosynthetic metabolism processes, the lower utilization rate of amino acids and the higher operation rate of glycolysis and TCA in embryos maintain primary dormancy.
Association of work-related and leisure-time physical activity with workplace food purchases, dietary quality, and health of hospital employees
Authors: Feig Emily , Levy Douglas E. , McCurley Jessica L. , Rimm Eric B. , Anderson Emma M. , Gelsomin Emily D. , Thorndike Anne N.
Published: October 2019

Background. While leisure-time physical activity (PA) has been associated with reduced risk of cardiometabolic disease, less is known about the relationship between work-related PA and health. Work-related PA is often not a chosen behavior and may be associated with lower socioeconomic status and less control over job-related activities. This study examined whether high work-related PA and leisure-time PA reported by hospital employees were associated with healthier dietary intake and reductions in cardiometabolic risk.

Methods. This was a cross-sectional analysis of baseline data collected from 602 hospital employees who used workplace cafeterias and enrolled in a health promotion study between 2016-2018. Participants completed the International Physical Activity Questionnaire and two 24-hour dietary recalls used to calculate Healthy Eating Index (HEI) scores. A Healthy Purchasing Score was calculated based on healthfulness of workplace food/beverage purchases. Weight, blood pressure, HbA1c, and lipids were measured. Regression analyses examined Healthy Purchasing Score, HEI, and obesity, hypertension, hyperlipidemia, and diabetes/prediabetes by quartile of work-related PA, leisure-time PA, and sedentary time.

Results. The mean age of participants was 43.6 years (SD = 12.2), 79.4% were female, and 81.1% were white. In total, 30.3% had obesity, 20.6% had hypertension, 26.6% had prediabetes/diabetes, and 32.1% had hyperlipidemia. Median leisure-time PA was 12.0 (IQR: 3.3, 28.0) and median work-related PA was 14.0 (IQR: 0.0, 51.1) MET-hours/week. Higher leisure-time PA was associated with higher workplace Healthy Purchasing Score and HEI (p’s < 0.01) and lower prevalence of obesity, diabetes/prediabetes, and hyperlipidemia (p’s < 0.05). Work-related PA was not associated with Healthy Purchasing Score, HEI, or cardiometabolic risk factors. Increased sedentary time was associated with lower HEI (p = 0.02) but was not associated with the workplace Healthy Purchasing Score.

Conclusions. Employees with high work-related PA did not have associated reductions in cardiometabolic risk or have healthier dietary intake as did employees reporting high leisure-time PA. Workplace wellness programs should promote leisure-time PA and healthy food choices for all employees, but programs may need to be customized and made more accessible to meet the unique needs of employees who are physically active at work.
Catastrophic Health Expenditure Incidence and Its Equity in China: A Study on the Initial Implementation of the Medical Insurance Integration System
Authors: liu huan , zhu hong , wang jiahui , qi xinye , zhao miaomiao , shan linghan , gao lijun , kang zheng , jiao mingli , pan lin , chen ruohui , liu baohua , Wu Qunhong , ning ning
Published: October 2019

Introduction: By 2013, several regions in China had introduced health insurance integration policies. However, few studies addressed the impact of medical insurance integration in China. This study investigates the catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated and non-integrated areas in China in 2013.
Methods: The primary data are drawn from the fifth China National Health Services Survey in 2013. The final sample comprises 19,788 households (38.4%) from integrated areas and 31,797 households (61.6%) from non-integrated areas. A probit model is employed to decompose inequality in the incidence of catastrophic health expenditure in line with the methodology used for decomposing the concentration index.
Results: The incidence of catastrophic health expenditure in integrated areas is higher than in non-integrated areas (13.87% vs. 13.68%, respectively). The concentration index in integrated areas and non-integrated areas is -0.071 and -0.073, respectively. Average household out-of-pocket health expenditure and average capacity to pay in integrated areas are higher than those in non-integrated areas. However, households in integrated areas have lower share of out-of-pocket expenditures in the capacity to pay than households in non-integrated areas. The majority of the observed inequalities in catastrophic health expenditure can be explained by differences in the health insurance and householders’ educational attainment both in integrated areas and non-integrated areas.
Conclusions: The medical insurance integration system in China is still at the exploratory stage; hence, its effects are of limited significance, even though the positive impact of this system on low-income residents is confirmed. Moreover, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and use of health services significantly affect the equity of catastrophic health expenditure incidence and are key issues in the implementation of future insurance integration policies.
Keywords: Catastrophic health expenditure, Medical insurance integration system, Equity, Influencing factors
The Prevalence of Shiga toxin-1 in Shigella spp. Isolates Collected from Diarrhea Patients, Ahvaz, Iran
Authors: Mahdian Nahid , Gheysarzadeh Ali , Valadbeigi Hassan , Ghafourian Sobhan , Maleki Abbas , Sadeghifard Norkhoda
Published: October 2019

Objective Shigellosis is one of the substantial causative agents of microbial dysentery and still has a remarkable prevalence particularly in areas with poor hygienic infrastructures. The probable existence of the deadly Shiga toxin-1(Stx1) protein in some Shigella strains would manifest life-threatening clinical symptoms of the infection. The aim of this study was to determine the presence of Stx1 in isolated from patients with diarrhea. Results Totally, 227 Shigella species including 60 S. flexneri, 157 S. sonnei, and 10 S. boydii were collected from diarrheal patients in tropical infectious diseases research center of Ahvaz, Iran, from 2013 till 2015. The isolates were collected mostly from the intensive care unit, infectious disease, and surgery settings. The isolates were identified and the polymerase chain reaction (PCR) was performed to detect the stx gene. The results indicated that none of them encode the stx gene. In conclusion isolates of this study were not capable of stx1 encoding.
Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district, Uganda.
Authors: Iramiot Jacob Stanley , Rwego Innocent B. , Kansiime Catherine , Asiimwe Benon B
Published: October 2019

Background: Uganda is among the 51 countries where cholera outbreaks are common. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda.
Methods: A descriptive cross-sectional study was carried out between 2017 and 2018 to describe the epidemiology of the cholera epidemic of in Kasese district, Uganda. Rectal swabs from 69 suspected case-persons were cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Questionnaires were administered to a total of 75 participants who were either the cases or relatives to the case. GPS points of the homes of the cases and pictures of potential source infection were also taken and cases were mapped.
Results: A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Culture isolated 69 V. cholerae 01 serotype Inaba from the total of 71 samples. Salmonella typhi was Isolated from the other two samples which were negative for V. cholerae. Antibiotic susceptibility testing showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/Sulfamethoxazole whereas gentamicin showed 100% susceptibility. Environmental assessment revealed rampant cases of open defecation.
Conclusion: Though we did not culture water to confirm contamination with Vibrio cholerae, we hypothesize that the cholera epidemic in Kasese 2017 was sparked off by consumption of contaminated water following the heavy floods that washed away latrines into water sources in Bwera, Isango and Nakiyumbu sub-counties. V. cholerae was also highly resistant to the commonly used antibiotics.
Key words: Cholera, antibiotic resistance, epidemiology, environment.
Transcriptome profiling analysis of sex-based differentially expressed mRNAs and lncRNAs in the brains of mature zebrafish (Danio rerio)
Authors: Yuan Wenliang , Jiang Shouwen , Sun Dan , Wu Zhichao , Wei Cai , Dai Chaoxu , Jiang Linhua , PENG SIHUA
Published: October 2019

Background: Similar to humans, the zebrafish brain plays a central role in regulating sexual reproduction, maturation and sexual behavior. However, systematic studies of the dimorphic patterns of gene expression in the brain of male and female zebrafish are lacking. Results: In this study, the mRNA and lncRNAs expression profiles were obtained from the brain tissue samples of the three male and three female zebrafish by high-throughput transcriptome sequencing. We identified a total of 108 mRNAs and 50 lncRNAs with sex-based differential expression. We randomly selected four differentially expressed genes for RT-qPCR verification and the results certified that the expression pattern showed a similar trend between RNA-seq and RT-qPCR results. Protein-protein interaction network analysis, Gene Ontology (GO) analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to obtain the biological significance of differentially expressed mRNA in the brain dimorphism of zebrafish. Finally, a Pearson correlation analysis was performed to construct the co-expression network of the mRNAs and lncRNAs. Conclusions: We found that 12 new lncRNAs not only have significant gender specificity in the brain of zebrafish, and this finding may provide a clue to further study of the functional difference between male and female zebrafish brain.
Multicentre, Double Blind, Randomised Sham-Controlled Trial of 10kHz High-Frequency Spinal Cord Stimulation for Chronic Neuropathic Low Back Pain (MODULATE-LBP): A Trial Protocol
Authors: Al-Kaisy Adnan , Royds Jonathan , Palmisani Stefano , Pang David , Wesley Samuel , Taylor Rod S , Cook Andrew , Eldabe Sam , McCracken Lance , Duarte Rui , Fairbank Jeremy
Published: October 2019

Introduction Chronic neuropathic low back pain (CNLBP) is a debilitating condition in which established medical treatments seldom alleviate symptoms. There is evidence demonstrating high frequency 10kHz spinal cord stimulation (SCS) reduces pain and improves health-related quality of life in patients with Failed Back Surgery Syndrome (FBSS) but there is limited evidence in CNLBP without prior surgery. The aim of this multicentre randomised trial is to assess the clinical and cost-effectiveness of 10kHz SCS for this population. Methods This is a multicentre double-blind randomised sham-controlled trial with a parallel economic evaluation. A total of 96 patients with CNLBP who have not had spinal surgery will be implanted with an epidural lead and a sham lead outside the epidural space without a screening trial. Patients will be randomised 1:1 to 10kHz SCS plus usual care (intervention group) or sham 10kHz SCS plus usual care (control group) after full implant. The SCS devices will be programmed identically using a cathodal cascade. Participants will use their handheld programmer to alter the intensity of the stimulation as per routine practice. Primary outcome will be a 7 day daily pain diary. Secondary outcomes include the Oswestry Disability Index, complications, EQ-5D-5L, and health and social care costs. Outcomes will be assessed at baseline (pre-randomisation) and at 1 month, 3 months and 6 months after device activation. The primary analyses will compare primary and secondary outcomes between groups at 6-months adjusting for baseline outcome scores. Incremental cost per quality adjusted life year (QALY) will be calculated at 6-months and over the patient lifetime. Discussion The outcomes of this trial will inform clinical practice and healthcare policy on the role of high frequency 10kHz SCS for patients with CNLBP without prior surgery.
Self-Care for Head and Neck Cancer Survivors with Lymphedema and Fibrosis: Study Protocol for a Randomized Controlled Trial
Authors: Deng Jie , Dietrich Mary S. , Murphy Barbara
Published: October 2019

Abstract

Background : Head and neck cancer (HNC) patients are at high risk for developing lymphedema and fibrosis (LEF) following cancer treatment. Once HNC patients develop LEF, they need to conduct life-long self-care to slow LEF progression and reduce associated symptom burden and functional deficits. Data demonstrate that inadequate LEF self-care may be a potentially remediable issue. The objective of this study is to explore the feasibility and preliminary efficacy of an Information-Motivation-Behavioral (IMB) Skills model driven self-care program (SCP) to improve LEF management and reduce LEF-related symptom burden and functional impairments.

Methods/Design : This is a three-arm, prospective, randomized controlled clinical trial to compare: Group 1-Usual Care, Group 2-Usual Care Plus LEF-SCP, and Group 3 - Usual Care Plus LEF-SCP Plus Follow-Up. Participants will be HNC survivors aged > 18 years of age, who meet predefined inclusion and exclusion criteria. A sample size of 75 participants is targeted. Interventions will be provided by trained staff. The study assessments for all groups will take place at five points: study entry then 3-, 6-, 9-, and 12-month post-enrollment. Outcome measures include: 1) feasibility (barriers to implementation, safety, and satisfaction) of the proposed intervention; 2) self-efficacy and adherence to self-care; and 3) preliminary efficacy (LEF progression, symptom burden, and functional status) of the proposed intervention.

Discussion : This will be the first study to evaluate the feasibility of a LEF-SCP in the HNC population and its impact on self-efficacy and adherence. Furthermore, it will evaluate the potential benefit of routine follow-up on adherence and fidelity to the self-care protocol. We expect that the trial will provide evidence supporting the feasibility of a LEF self-care program. In addition, we anticipate that preliminary data will support improved outcomes including increased adherence and fidelity, and decreased LEF associated symptoms.

Trial registration : This study was registered on January 22, 2017 at Clinical Trial.gov, a service of the US National Institute of Health (NCT 03030859). The URL of the trail registry record: https://clinicaltrials.gov/ct2/show/NCT03030859?term=lymphedema+and+fibrosis&cond=Head+and+Neck+Cancer&cntry=US&rank=1

Keywords : Head and neck cancer, lymphedema, fibrosis, self-care, self-management, survivorship
Enhancement of de novo sequencing, assembly and annotation of the Mongolian gerbil genome with transcriptome sequencing and assembly from several different tissues
Authors: Cheng Shifeng , Fu Yuan , Zhang Yaolei , Xian Wenfei , Wang Hongli , Grothe Benedikt , Lu Xin , Xu Xun , Klug Achim , McCullagh Elizabeth
Published: October 2019

BACKGROUND: The Mongolian gerbil ( Meriones unguiculatus ) has historically been used as a model organism for the auditory and visual systems, stroke/ischemia, epilepsy and aging related research since 1935 when laboratory gerbils were separated from their wild counterparts. In this study we report genome sequencing, assembly, and annotation further supported by transcriptome sequencing and assembly from 27 different tissues samples.
RESULTS: The genome was sequenced using Illumina HiSeq 2000 and after assembly resulted in a final genome size of 2.54 Gbp with contig and scaffold N50 values of 31.4 Kbp and 500.0 Kbp, respectively. Based on the k-mer estimated genome size of 2.48 Gbp, the assembly appears to be complete. The genome annotation was supported by transcriptome data that identified 31 769 (>2000bp) predicted protein-coding genes across 27 tissue samples. A BUSCO search of 3023 mammalian groups resulted in 86% of curated single copy orthologs present among predicted genes, indicating a high level of completeness of the genome.
CONCLUSIONS: We report the first de novo assembly of the Mongolian gerbil genome enhanced by assembly of transcriptome data from several tissues. Sequencing of this genome and transcriptome increases the utility of the gerbil as a model organism, opening the availability of now widely used genetic tools.
Promoting Independence in Dementia (PRIDE): Protocol for a Feasibility Randomised Controlled Trial
Authors: Shafayat Aisha , Csipke Emese , Bradshaw Lucy , Charlesworth Georgina , Day Florence , Leung Phuong , Moniz-Cook Esme , Montgomery Alan , Morris Steve , Mountain Gail , Ogollah Reuben , Sprange Kirsty , Yates Lauren , Orrell Martin
Published: October 2019

Background Memory services often see people with early stage dementia who are largely independent and able to participate in community activities but who run the risk of reducing activities and social networks. PRIDE is a self-management intervention designed to promote living well and enhance independence for people with mild dementia. This study aims to examine the feasibility of conducting a definitive randomised trial comparing the clinical and cost-effectiveness of the PRIDE intervention offered in addition to usual care or with usual care alone. Methods/Design PRIDE is a parallel, two-arm, multicentre, feasibility, randomised controlled trial (RCT). Eligible participants aged 18 or over who have mild dementia (defined as a score of 0.5 or 1 on the Clinical Dementia Rating Scale) who can participate in the intervention and provide informed consent will be randomised (1:1) to treatment with the PRIDE intervention delivered in addition to usual care, or usual care only. Participants will be followed-up at three and six month’s post-randomisation. There will be an option for a supporter to join each participant. Each supporter will be provided with questionnaires at baseline and follow-ups at three to six months. Embedded qualitative research with both participants and supporters will explore their perspectives on the intervention investigating a range of themes including acceptability and barriers and facilitators to delivery and participation. The feasibility of conducting a full RCT associated with participant recruitment and follow-up of both conditions, intervention delivery including the recruitment, training, retention of PRIDE trained facilitators, clinical outcomes, intervention and resource use costs and the acceptability of the intervention and study related procedures will be examined. Discussion This study will assess whether a definitive randomised trial comparing the clinical and cost-effectiveness of whether the PRIDE intervention offered in addition to usual care is feasible in comparison to usual care alone, and if so will provide data to inform the design and conduct of a future trial. Trial Registration and protocol version ISRCTN, ISRCTN11288961, registered on 23 October 2019, http://www.isrctn.com/ISRCTN12345678 Protocol V2.1 dated 19 June 2019 Keywords Dementia, self-management, feasibility trial
Enterococcal periprosthetic joint infection: clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej
Published: October 2019

Background: Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI.
Methods: Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test. Treatment success was defined by absence of relapse or persistence of PJI due to enterococci or death related to enterococcal PJI. Clinical success was defined by the infection-free status, no subsequent surgical intervention for persistent or perioperative infection after re-implantation and no PJI-related death within 3 months.
Results: Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 2 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The outcome data was available for 66 patients (88%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery.
Conclusion: About half of enterococcal PJI were polymicrobial infections. The treatment success was high (84%). All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
Trial registration: The study was retrospectively registered with the public clinical trial identification NCT0253022 at https://www.clinicaltrials.gov.
The effectiveness of schistosomiasis health education session in primary and secondary schools in Pemba Island, Zanzibar
Authors: Xu Da Cheng , Li Wei , Juma Saleh , He Ming Zhen , Kabole Fatma , Wang Xin Yao , Yang Kun
Published: October 2019

Background: Schistosomiasis seriously endangers the health of African people, hinders local economic and social development, and becomes a serious local public health problem. However, in addition to preventive chemotherapy, other social, environmental and health promotion measures are progressing slowly, lack of sanitation, treated water, and systematic health education, the people are still at risk of infection. In 2011, a survey of 24 school in Zanzibar showed that the average infection rate of Schistosoma haematobium was 8% (0-38%) in Unguja, and was 15% (1-43%) in Pemba.
Methods: According to the shape of the island, the island is divided into three regions: the south, the middle, and the north. A Shehia in the southern, central and northern parts of Pemba Island was randomly selected respectively, the schistosomiasis health education session was conducted in primary and secondary schools of the selected Shehias. The students were randomly selected for schistosomiasis cognitive level test by designed questionnaire including 8 knowledge questions and 4 behavior questions before and after health education, through a chi-square test of the awareness rate and the correct behavior rate of schistosomiasis before and after the health education, the effect of health education session was evaluated.
Result: A total 712 students were sampled before and after the health education in 8 schools. Before the health education session, the awareness rates of schistosomiasis were 64.62% and 68.75% among primary and secondary school respectively. After the session, the awareness rates increased to 79.74% and 84.70% respectively, and the difference was statistically significant (χ2=179.3, P<0.0001). Before the sessions, the correct behavior rates were 63.96% and 54.79% among boys and girls. After the sessions, the correct behavior rates increased to 82.83% and 76.58%, and the difference was also statistically significant (χ2=143.8, P<0.0001).
Conclusion: The awareness rate and correct behavior rate of schistosomiasis were low in Pemba Island, Zanzibar, hence the schistosomiasis health education needs to be strengthened. The schistosomiasis health education session has an obvious effect on the improvement of cognitive level of schistosomiasis among local students. This method can be promoted and implemented in local schools with the effort of local health and education departments.
Short or Long Antibiotic Regimes in Orthopaedics (SOLARIO): a Randomised Controlled Open-Label Non-Inferiority Trial of Duration of Systemic Antibiotics in Adults with Orthopaedic Infection Treated Operatively with Local Antibiotic Therapy
Authors: Dudareva Maria , Kümin Michelle , Vach Werner , Kaier Klaus , Ferguson Jamie , McNally Martin , Scarborough Matthew
Published: October 2019

Background Orthopaedic infections such as osteomyelitis, diabetic foot infection and prosthetic joint infection, are most commonly treated by a combination of surgical debridement and a prolonged course of systemic antibiotics, usually for at least 4 -6 weeks. Use of local antibiotics, implanted directly into the site of infection at the time of surgery, may improve antibiotic delivery and allow us to shorten the duration of systemic antibiotic therapy, thereby limiting the frequency of side effects, cost and selection pressure for antimicrobial resistance. Methods SOLARIO is a multi-centre open label randomised controlled non-inferiority trial comparing short and long systemic antibiotic therapy alongside local antibiotic therapy. Adult patients with orthopaedic infection, who have given informed consent, will be eligible to participate in the study provided that no micro-organisms identified from deep tissue samples are resistant to locally-implanted antibiotics. Participants will be randomised in a 1:1 ratio to receive either a short course (≤ 7 days) or currently recommended long course (≥ 4 weeks) of systemic antibiotics. The primary outcome will be treatment failure by 12 months following surgery, as ascertained by an independent Endpoint Committee blinded to treatment allocation. An absolute non-inferiority margin of 10% will be used for both per-protocol and intention-to-treat populations. Secondary outcomes will include probable and definite treatment failure, serious adverse events, treatment side-effects, quality of life scores and cost analysis. Discussion This study aims to assess a treatment strategy that may enable the reduction of systemic antibiotic use for patients with orthopaedic infection. If effective, this will be to the advantage of patients and contribute to antimicrobial stewardship.