bluuebunny/crossref_metadata_2025 huggingface dataset:
Difficulties in the Differential Diagnosis of Tracheobronchomegaly in Children
Authors: Il’ina N. A. , Vorob’eva L. E. , Bakradze M. D. , Polyakova A. S.
Published: July 2020

Tracheobronchomegaly is a rare developmental defect in children, which is characterized by the expansion of the trachea and large bronchi, the diagnosis and treatment of which are made more often in adult practice, when the clinical diagnostic picture acquires the obvious features of Mounier-Kuhn syndrome. In this connection, the need arises for the early detection of this pathology in children and its differentiation from other diseases and malformations of the tracheobronchial tree, which mask a recurrent inflammatory process in the lung and upper respiratory tract, and primarily with those, such as cystic fibrosis and primary ciliary dyskinesia.The paper describes a case of secondary tracheobronchomegaly in a child with obvious clinical manifestations of Mounier-Kuhn syndrome in the presence of bronchiectasis, pulmonary fibrosis, and signs of systemic connective tissue disease. It discusses the possibilities of chest computed tomography in the diagnosis of this defect in children, as well as its causes. The sizes of the trachea and main bronchi in this patient are compared with those in the groups of children of the same age and sex who have cystic fibrosis or diffuse pulmonary fibrosis to identify a more significant role of hereditary connective tissue diseases in the development of secondary tracheobronchomegaly. The authors propose to separate the concepts of tracheobronchomegaly and Mounier-Kuhn syndrome in children and to recognize the threshold for tracheal expansion in these patients having +3SD or more.
O PRINCÍPIO DO MELHOR INTERESSE DA CRIANÇA: UMA ANÁLISE À LUZ DO ORDENAMENTO JURÍDICO BRASILEIRO
Authors: Freire dos Santos Bruna Aline , Alencar Bolwerk Aloísio
Published: July 2020

O texto visa a analisar a aplicação do princípio do melhor interesse da criança na legislação brasileira, por meio de um estudo do contexto histórico da situação jurídica das crianças e dos adolescentes e de uma discussão acerca das inovações legislativas nesse ramo do direito. O trabalho tem como objetivo defender a evolução legislativa como ferramenta na busca pela proteção integral da criança e do adolescente, de modo a destacar determinadas modificações legais ocorridas no Brasil. A partir do método dedutivo, foi possível apresentar a evolução do Direito da Criança e do Adolescente no ordenamento jurídico brasileiro e apontar os avanços conquistados nesse ramo, ressaltando a importância da proteção jurídica aos menores de dezoito anos.
ANÁLISE DA POSSIBILIDADE DE APLICAÇÃO DA LEI DE LAVAGEM DE DINHEIRO NO MERCADO BITCOIN
Authors: de Sousa Moura Jéssyka , Sales Queiroz de Lima Sibéria
Published: July 2020

O comércio eletrônico de moedas pode ser considerado uma nova alternativa de comércio no mercado financeiro e um meio de romper com o monopólio estatal sobre o dinheiro. Atualmente, tem chamado a atenção da sociedade a criação e desenvolvimento de criptomoedas, tendo como o mais recente exemplo a moeda Bitcoin. Essa moeda é caracterizada pela independência de qualquer autoridade regulamentadora. Com a contemporaneidade do tema e da escassez de material podem surgir algumas divergências, principalmente no âmbito jurídico, como a imprecisão nas fundamentações dos magistrados ao se depararem com ocorrências advindas, possivelmente da falta de regulamentação da moeda virtual. Além disso, todos os interessados no assunto, em algum momento podem se deparar com questionamentos relacionados à ausência da qualificação do Bitcoin em moeda ou não, e da viabilidade ou não da efetiva aplicação de normas. Por meio da pesquisa bibliográfica e documental, com abordagem qualitativa, de caráter exploratório e método descritivo analítico, buscou-se, nesta pesquisa, sanar algumas dessas obscuridades relativas ao mercado de moeda virtual e o seu tratamento jurídico, além de responder a seguinte indagação: de que forma a Lei de Lavagem de Dinheiro pode ser aplicada no mercado Bitcoin? Conclui-se que a falta de regulamentação deixa lacunas para as autoridades policiais e judiciais quando se debaterem com essa situação, sendo assim, uma solução momentânea é a aplicação do critério da adaptação, que é utilizado para empregar dispositivos do Código Penal nos crimes virtuais.
Convalescent Plasma Therapy for Covid-19: State of the Art
Authors: Focosi Daniele , Tang Julian , Anderson Arthur , Tuccori Marco
Published: July 2020

Convalescent blood product therapy has been introduced since early 1900s to treat emerging infectious disease based on the evidence that polyclonal neutralizing antibodies can reduce duration of viremia. Recent large outbreaks of viral diseases for whom effective antivirals or vaccines are still lacking has revamped the interest in convalescent plasma as life-saving treatments. This review summarizes historical settings of application, and surveys current technologies for collection, manufacturing, pathogen inactivation, and banking, with a focus on COVID-19.
Potential of Plant Bioactive Compounds as SARS-CoV-2 Main Protease (Mpro) and Spike (S) Glycoprotein Inhibitors: A Molecular Docking Study
Authors: Tallei Trina Ekawati , Tumilaar Sefren Geiner , Niode Nurdjannah Jane , Fatimawali Fatimawali , Kepel Billy Johnson , Idroes Rinaldi , Effendi Yunus
Published: July 2020

Since the outbreak of the COVID-19 (Coronavirus Disease 19) pandemic, researchers have been trying to investigate several active compounds found in plants that have the potential to inhibit the proliferation of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2). The present study aimed to evaluate bioactive compounds found in plants by using a molecular docking approach to inhibit the Main Protease (Mpro) and Spike (S) glycoprotein of SARS-CoV-2. The evaluation was performed on the docking scores calculated using AutoDock Vina as a docking engine. A rule of five (RO5) was calculated to determine whether a compound meets the criteria as an active drug orally in humans. The determination of the docking score was done by selecting the best conformation of the protein-ligand complex that had the highest affinity (most negative Gibbs' free energy of binding / ΔG). As a comparison, nelfinavir (an antiretroviral drug), chloroquine and hydroxychloroquine sulfate (anti-malarial drugs recommended by the FDA as emergency drugs) were used. The results showed that hesperidin, nabiximols, pectolinarin, epigallocatechin gallate, and rhoifolin had better poses than nelfinavir, chloroquine, and hydroxychloroquine sulfate as spike glycoprotein inhibitors. Hesperidin, rhoifolin, pectolinarin, and nabiximols had about the same pose as nelfinavir, but were better than chloroquine and hydroxychloroquine sulfate as Mpro inhibitors. These plant compounds have the potential to be developed as specific therapeutic agents against COVID-19. Several natural compounds of plants evaluated in this study showed better binding free energy compared to nelfinavir, chloroquine, and hydroxychloroquine sulfate which so far are recommended in the treatment of COVID-19. As judged by the RO5 and previous study by others, the compounds kaempferol, herbacetin, eugenol, and 6-shogaol have good oral bioavailability, so they are also seen as promising candidates for the development lead compounds to treat infections caused by SARS-CoV-2.
Determining Role of Air Temperature in Predicting and Controlling COVID-19 Risk Levels Anywhere Anytime Using Multiple Modelling Analyses
Authors: Chen Sifeng , Ren Yansong
Published: July 2020

COVID-19 is a pandemic with no cure. There is an urgent need for low-cost interventions. Macroclimate work through microclimate. In many situations, man-made microclimate, such as air conditioning, may override the effect of natural macroclimate in determining the pathogenicity of SARS-CoV-2. This study aimed to determine if there is a ‘safe’ temperature that is comfortable to human beings while significantly inhibitory for SARS-CoV-2 pathogenicity. Data on monthly new deaths or new cases per million population (MDPM or MCPM) and monthly cumulated days with more cases than the previous day (DI) from March 2 to June 15, 2020 were collected from all 118 countries with population over five million. Monthly average AT negatively correlated with the transmission parameters. A significant decrease in transmission was observed when AT reached above 20 ºC. Monthly average (not average high) AT of countries with MDPM <2, MCPM<10, or DI<=7 was found to be between 24.54 and 25.90 ºC (25.00 ºC on average) with average standard error of 4.97. Thus, average AT <20, 20-25, >25 ºC were considered as high, medium, and low risk AT. Furthermore, MDPM in countries with AT <20 ºC were 80.93, 50.23, 13.52, and 7.72 times of those in countries with AT >25 ºC in March, April, May, and June 1-15, respectively. MDPM high-risk rates in countries with AT >25 ºC were 0, 6.25, 14.55, and 9.84%, and the low-risk rates were 100, 83.33, 52.73, and 81.97%, respectively. In countries with AT <20 ºC, the trends were opposite. Setting indoor temperature to 25 ºC could decrease the need of social distancing for containing SARS-CoV-2 transmission. Cooling indoor temperature too low may be a reason of COVID-19 outbreak in some high AT countries. Authorities and the general population can evaluate COVID-19 risk level and manipulate microclimate to reduce the risk anywhere anytime based on local day average AT.
A Rare Case of Patella Fracture in Osteopetrosis
Authors: Khor Yuet Peng , Chee Yuhan
Published: July 2020

Case:

Fractures in patients with osteopetrosis pose unique technical challenges to the orthopaedic surgeon. We present a case of a 43-year-old man with osteopetrosis who underwent tension band wiring of a patella fracture. The intraoperative appearance of osteopetrotic bone, technical difficulties in passing wires through dense bone, and how this was overcome are presented.

Conclusions:

A simple transverse fracture of the patella in a patient with osteopetrosis can be fixed successfully using a standard tension band construct.
Retention of Monoblock Femoral Components Using a Dual Mobility Bearing
Authors: Kiran Manish , Peter Viju
Published: July 2020

Case:

We present the results of 3 cases followed up for a minimum period of 4.5 years of revision total hip arthroplasty using a metal acetabular shell with retention of a well-fixed monoblock femoral component by inserting a dual mobility polyethylene bearing onto the femoral head in situ.

Conclusion:

This is the first case series to use this technique to address acetabular osteolysis and avoid removing a well-fixed monoblock femoral component at the time of revision surgery.
Hemiarthroplasty for Femoral Neck Fractures in the Elderly
Authors: DeRogatis Michael J. , Piatek Allison Z. , Jacob Roshan , Kelly Sean C. , Issack Paul S.
Published: July 2020

» The incidence of displaced femoral neck fractures among elderly patients is increasing as the population ages.

» Historically, the preferred treatment for displaced femoral neck fractures in elderly patients has been hemiarthroplasty with use of cemented fixation of the implant. However, there is evidence that this technique may be associated with fat embolization and subsequent cardiopulmonary arrest in the early postoperative period. Cementing techniques are also associated with increased operative time when compared with cementless techniques.

» There is increasing evidence that, among elderly patients, the use of uncemented hemiarthroplasty has equivalent functional outcomes and overall mortality rates when compared with the use of hemiarthroplasty with cemented fixation. The main complication associated with uncemented hemiarthroplasty is intraoperative periprosthetic fracture.
Mariposas diurnas (Lepidoptera: Papilionoidea) en la Reserva Forestal El Romeral, Cordillera Central, Antioquia, Colombia
Authors: Clavijo Giraldo Alejandra , Areiza Restrepo Leidy , Álvarez Hincapie Carlos Federico , Parrales Ramirez Dumar Ariel , Borja Acosta Kevin Giancarlo , Uribe Soto Sandra Ines , Medina Uribe Claudia Alejandra
Published: July 2020

Presentamos una base de datos pública en el SIB Colombia, producto de varios estudios sobre la diversidad y complementariedad de una comunidad de mariposas (Lepidoptera: Papilionoidea) en la reserva El Romeral, un área protegida ubicada al suroeste del Valle de Aburrá, sobre la cordillera Central en el departamento de Antioquia, Colombia. Se reporta la presencia de 69 especies, 40 géneros, 12 subfamilias y 5 familias de mariposas diurnas en ecosistemas de bosque de niebla, entre los 2250 y 2878 m s.n.m, incluyendo registros únicos y especies endémicas. La información se encuentra asociada a especímenes y a secuencias de código de barras en GenBank.
Karakterisasi Morfologi Juwet (Syzygium cumini [L.] Skeels.) di Kebun Raya Purwodadi
Authors: Mudiana Deden , Ariyanti Esti Endah
Published: July 2020

Juwet merupakan nama lokal dari spesies Syzygium cumini. Keberadaan tanaman ini di masyarakat makin sulit dijumpai, karena tidak banyak yang membudidayakannya. Studi keragaman genetik dari tanaman juwet perlu dilakukan sebagai upaya untuk memperkenalkan dan mengedukasi masyarakat mengenai variasi buah juwet. Pelaksanaan penelitian dan pengumpulan data dilakukan pada bulan Juni sampai dengan September 2017, bersamaan dengan waktu musim berbuah tanaman juwet. Kegiatan penelitian dilakukan di Kebun Raya Purwodadi, Lembaga Ilmu Pengetahuan Indonesia (LIPI) yang terletak di Kecamatan Purwodadi, Kabupaten Pasuruan, Provinsi Jawa Timur. Sebanyak 53 pohon juwet berhasil diinventarisasi sebagai koleksi plasma nutfah yang dikonservasi oleh Kebun Raya Purwodadi. Dari jumlah tersebut teridentifikasi enam variasi aksesi yaitu Juwet Kerikil, Juwet Gentong, Juwet Kerikil Kecil, Juwet Putih, Juwet, dan Juwet kecil. Kunci determinasi klasifikasi telah disusun untuk membantu pengenalan keragaman jenis ini. Analisis pengelompokan berdasarkan keragaman karakter morfologi daun dan buah menghasilkan tiga kelompok, dengan kelompok paling beragam adalah kelompok II, yang terdiri atas Juwet Kerikil, Juwet Kerikil Kecil, Juwet Gentong, dan Juwet Putih.
Pengaruh Perlakuan pH dan Suhu Terhadap Sifat Fisikokimia Mocaf (Modified Cassava Flour)
Authors: Diniyah Nurud , Ganesha Pradiska Gita Vindy , Subagio Achmad
Published: July 2020

Peningkatan sifat fungsional pati dapat dilakukan dengan mengubah struktur pati menjadi lebih banyak pada bagian amorf dengan cara perlakuan fermentasi pada umbi singkong terlebih dahulu sehingga dihasilkan Mocaf. Tujuan penelitian ini adalah untuk mengetahui perubahan karakteristik pati Mocaf dengan perlakuan panas dan pengaturan tingkat keasaman (pH) agar dapat digunaan dalam aplikasi yang lebih luas. Perlakuan dalam penelitian ini meliputi variasi suhu pemanasan (60, 70, 80, 90, dan 120 °C) dan pH (3, 4, 5, 6, dan 7) dan diulang sebanyak 3 kali dengan parameter pengukuran meliputi daya kembang, kelarutan, kekeruhan, viskositas pasta, bentuk granula pati, dan sineresis. Hasil penelitian ini menunjukkan bahwa suhu pemanasan mempengaruhi nilai daya kembang, kelarutan, viskositas, bentuk granula pati, dan sineresis Mocaf, tetapi menyebabkan penurunan tingkat kekeruhan. Sedangkan penambahan asam dapat mempengaruhi viskositas dan granula pati Mocaf.

 

Effect of pH and Temperature Treatment on Physicochemical Properties of Mocaf (Modiffied Cassava Flour) 

The changes in the starch’s structure to amorphous can increase the functional characteristics of starch using the fermentation process of cassava to be known as Mocaf. The aim of this study was to determine the physicochemical properties of Mocaf’s starch due to temperature and pH processing. Treatment in this research including various of temperature (60, 70, 80, 90, and 120 °C) dan pH (3, 4, 5, 6, dan 7) in three replications with analysis of swelling power, solubility, viscosity, starch granule, and syneresis. The results of this study indicate that the heating temperature affects the value of swelling power, solubility, viscosity, starch granule, and syneresis of Mocaf, but it causes a decrease of Mocaf’s turbidity. The addition of acid may affect the viscosity and granules of Mocaf’s starch.
Ancestral Caddo Fine Ware Vessels from Cahokian Sites in the Mid-Continent, ca. A.D. 1050-1300
Authors: Perttula
Published: July 2020

Ancestral Caddo ceramic vessels and ceramic vessel sherds have been identified from Cahokia and other sites in the U.S. Midwest in contexts dating from ca. A.D. 1050-1300. Archaeological findings from recent work in the East St. Louis Precinct by the Illinois State Archaeological Survey provides a wealth of data on the Mississippian ceramics found there as well as ceramic wares of likely ancestral Caddo manufacture. These Caddo wares comprise less than 0.3 percent of the more than 15,600 vessel batches in the East St. Louis Precinct assemblage, and almost all of them are on local pastes. It is probable, therefore, that these potters that had emigrated to Cahokia and were living there.
Report: Abstracts from the 71st Caddo Conference held at University of Central Arkansas
Authors: McKinnon
Published: July 2020

The 61st Caddo Conference was held on March 21-23, 2019 in the McCastlain Hall Ballroom on the campus of UCA. The Caddo Conference coincided with Arkansas Archeology Month. Funding was provided by UCA Foundation, the Department of Sociology, Criminology, and Anthropology (SCA) at UCA, the Caddo Conference Organization, the Arkansas Archeological Survey, and the Arkansas Archeological Society.

The conference began Friday, March 21st at 9am with several research presentations throughout the day. Twelve presentations and three research posters were presented. Additionally, several book publishers and Caddo artists displayed books and art for sale. There were 45 paid registrants attending the conference. Maximum attendance was during the Saturday afternoon public session, which is estimated around 100 people.

A special Saturday afternoon "Caddo Art and Heritage" session featured Caddo culture, art, and dance. In the session, six contemporary Caddo artists discussed their ceramic, beadwork, and stonework art.
Transborder Media Spaces. Ayuuj Videomaking between Mexico and the US de Ingrid Kummels
Authors: Tafur Arévalo Giancarlo
Published: July 2020

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Comparison of refractive outcomes after photorefractive keratectomy with different optical zones using Mel 90 excimer laser
Authors: Shin Dae Hwan , Lee Yong Woo , Song Ji Eun , Choi Chul Young
Published: July 2020

Background: A larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK. Methods: The records of 95 eyes that had undergone PRK with a 6.0 OZ ( n = 40) and a 6.5 OZ ( n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively). Results: There were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group. Conclusions: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.
Shared decision-making in advance care planning for persons with dementia in nursing homes: a cross-sectional study.
Authors: Goossens Bart , Sevenants Aline , Declercq Anja , Audenhove Chantal Van
Published: July 2020

Background: Shared decision-making provides an approach to discuss advance care planning in a participative and informed manner, embodying the principles of person-centered care. A number of guided approaches to achieve shared decision-making already exist, such as the three-talk model. However, it is uncertain whether daily practice methods in nursing home wards for persons with dementia comply with the underpinnings of this model. It is also uncertain whether professionals consider shared decision-making to be important in this context, and whether they perceive themselves sufficiently competent to practice this approach frequently. Methods: The study has a cross-sectional design, with 65 wards (46 Belgian nursing homes) participating in the study. We compared nursing home professionals’ and residents’ perspectives on the level of shared decision-making during advance care planning conversations with ratings from external raters. Residents and professionals rated the level of shared decision-making by means of a questionnaire, which included the topic of the conversation. External raters assessed audio recordings of the conversations. Professionals filled in an additional self-report questionnaire on the importance of shared decision-making, their competence in practicing the approach, and with what frequency.Results: At ward level, professionals and residents rated the average achieved level of shared decision-making 71.53/100 (σ=16.09) and 81.11/100 (σ=19.18) respectively. Meanwhile, raters gave average scores of 26.97/100 (σ=10.45). Only 23.8% of residents referred to advance care planning as the topic of the conversation. Professionals considered shared decision-making to be important (x̄=4.48/5, σ=0.26). This result contrasted significantly with the frequency (x̄=3.48/5, σ=0.51) and competence (x̄=3.76/5, σ=0.27) with which these skills were practiced (P<0.001).Conclusions: Residents with dementia are grateful when involved in discussing their care, but find it difficult to report what is discussed during these conversations. Receiving more information about advance care planning could provide them with the knowledge needed to prepare for such a conversation. External raters observe a discrepancy between the three-talk model and daily practice methods. Training programs should focus on providing professionals with better knowledge of and skills for shared decision-making. They should also promote team-based collaboration to increase the level of person-centered care in nursing home wards for persons with dementia.
Nomogram Model for Predicting Cause-Specific Mortality in Patients with Stage I Small-Cell Lung Cancer: A Competing Risk Analysis
Authors: Li Jianjie , Zheng Qiwen , Zhao Xinghui , Zhao Jun , An Tongtong , Wu Meina , Wang Yuyan , Zhuo Minglei , Zhong Jia , Yang Xue , Jia Bo , Chen Hanxiao , Dong Zhi , Wang Jingjing , Zhai Xiaoyu , Chi Yujia , wang ziping
Published: July 2020

Background: The five-year cumulative incidence rate in patients diagnosed with stage I small-cell lung cancer(SCLC) who were instructed to undergo surgery was from 40% to 60%.The death competition influence the accuracy of the classical survival analyses.The aim of the study is to investigate the mortality of stage I small-cell lung cancer (SCLC) patients in the presence of competing risks according to a proportional hazards model, and to establish a competing risk nomogram to predict probabilities of both cause-specific death and death resulting from other causes.Methods : The study subjects were patients diagnosed with stage I SCLC according to ICD-O-3. First, the cumulative incidence functions (CIFs) of cause-specific death, as well as of death resulting from other causes, were calculated. Then, a proportional hazards model for the sub-distribution of competing risks and a monogram were constructed to evaluate the probability of mortality in stage I SCLC patients.Results: 1811 patients were included in this study. The five-year probabilities of death due to specific causes and other causes were 61.5% and 13.6%, respectively. Tumor size, extent of tumor, surgery, and radiotherapy were identified as the predictors of death resulting from specific causes in stage I SCLC. The results showed that surgery could effectively reduce the cancer-specific death, and the one-year cumulative incidence dropped from 34.5% to 11.2%. Like surgery, chemotherapy and radiotherapy improved the one-year survival rate.Conclusions: We constructed a predictive model for stage I SCLC using the data from the SEER database. The proportional sub-distribution models of competing risks revealed the predictors of death resulting from both specific causes and other causes. The competing risk nomogram that we built to predict the prognosis showed good reliability and could provide beneficial and individualized predictive information for stage I SCLC patients.
The Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T): psychometric properties measured in the context of postgraduate nursing education
Authors: Ozga Dorota , Gutysz-Wojnicka Aleksandra , Lewandowski Bogumił , Dobrowolska Beata
Published: July 2020

Background. The Clinical Learning Environment, Supervision and Nurse Teacher Scalehttps://www.youtube.com/watch?v=4HFG5RyQPqY(CLES+T) instrument is internationally used for the evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education.Purpose. To examine the basic psychometric properties of CLES+T in the context of clinical postgraduate nursing education in Poland.Methods. Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland.Results. Cronbach’s alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach’s alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52±0.63 fornursing care on the wardto4.73±0.45 forrole of the nurse teacher.Conclusions. Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.
Genomic analysis of demographic history and ecological niche modeling in the endangered Chinese Grouse Tetrastes sewerzowi
Authors: Song Kai , Gao Bin , Halvarsson Peter , Fang Yun , Jiang Ying-Xin , Sun Yue-Hua , Höglund Jacob
Published: July 2020

Background: The Quaternary is characterized by marked climatic oscillations between glacial and interglacial periods that had worldwide consequences in forming the contemporary diversity of many populations, species and communities. The origin and evolution of biodiversity in mountainous areas are highly dependent on historical orogenesis and associated climatic changes. The Chinese grouse Tetrastes sewerzowi is a forest-dwelling species endemic to the mountains to the east of the Qinghai–Tibet Plateau, which has been listed as Near Threatened with a decreasing trend by the IUCN because of ongoing deforestation and fragmentation of coniferous forests. Understanding demographic history is important in placing current population status into a broader ecological and evolutionary context. Results: Analyses of the Chinese Grouse genome revealed fluctuations in effective population size throughout the Pleistocene. Populations decreased during early to middle Pleistocene but showed an expansion during late Pleistocene which was then followed by a sharp decline during the last glacial maximum (LGM). Ecological niche modeling indicated that a suitable habitat shift between high altitude regions to low altitude regions was due to a changing climate. This result parallels patterns of population size change in Chinese Grouse estimated from PSMC modelling, which suggested an expansion in population size from the last interglacial period (LIG) and then a peak and a bottleneck occurring at the last glacial maximum (LGM). Furthermore, the present-day distribution of Chinese Grouse is greatly reduced and fragmented. It will likely become even more fragmented in the future since coniferous forest cover is threatened in the region of their distribution and the availability of such habitat restricts their ecological niche. Conclusions: The Chinese Grouse have experienced substantial population size changes from the beginning to the LIG and reached a peak before the LGM. A sharp decrease and bottleneck occurred during the LGM, when the coniferous forests were subjected to extensive loss. The results inferred from the whole genome sequencing and species distribution models both support historical population fluctuations. The distribution of the Chinese Grouse is strongly dependent on the coniferous forest cover. To protect the fragmented coniferous forests is an essential action to protect the Chinese Grouse.
Magnitude of Turnover Intention and Associated Factors Among Nurses Working in Emergency Departments of Governmental Hospitals in Addis Ababa, Ethiopia: A cross sectional institutional based study.
Authors: Aniley Andualem Wubetie , Taye Biniyam , Girma Biruk
Published: July 2020

Background: Turnover intention is a probability of an employee to leave the current institution within a certain period due to various factors. It is the strongest predictor of actual turnover expected to increase as the intention increases. Emergency Department (ED) nurses are especially vulnerable to turnover because of their increased potential for developing burnout and compassion fatigue with the work environment has a great role. The aim of this study was to assess nurses’ intention to leave their current health institution and associated factors in emergency departments of selected governmental hospitals in Addis Ababa, Ethiopia.Methods: Institutional based cross-sectional study was conducted on 102 nurses in three selected governmental hospitals, Addis Ababa from February 19 to March 31, 2018, using a structured pre-tested self-administered questionnaire. Logistic regression model was used and adjusted odds ratio with a 95% confidence interval was calculated to identify associated factors.Result: A total of 102 respondents were involved with a response rate of 91.1%. Among them, 79 (77.5%) respondents had the intention to leave the current working unit of the emergency department or hospital. Significant predictive factors of nurses' intention to leave their jobs are educational status (adjusted odds ratio (OR) =4.700, 95% confidence interval (CI)=1.033- 50.772; p<0.048), monthly income of Less than 3145 Birr (adjusted OR=6.05, 95% CI=1.056-34.641; p<0.043) and professional autonomy (adjusted OR=0.191, 95% CI=0.040- 0.908; p<0.037).Conclusion: more than 77% of the respondents has intention to leave their current working place of emergency unit. Educational status; monthly income and autonomy were significantly associated with emergency nurses’ turnover intention in three governmental hospitals. Emergency leaders and hospital managers should have made efforts to enhance nurses' decision making for patient care activities and shared decision overwork or unit related activities.
A high fat diet with a high C18:0/C16:0 ratio induced worse metabolic and transcriptomic profiles in C57BL/6 mice
Authors: Wang Liqiang , Xu Fei , Song Zhenfeng , Han Dan , Zhang jingyi , Chen Linjun , Na Lixin
Published: July 2020

Background: Differential effects of individual saturated fatty acids (SFAs), particularly stearic acid (C18:0), relative to the shorter-chain SFAs have drawn interest for more accurate nutritional guidelines. However, specific biologic and pathologic functions that can be assigned to particular SFAs are very limited. The present study was designed to compare changes in metabolic and transcriptomic profiles in mice caused by a high C18:0 diet and high palmitic acid (C16:0) diet.Methods: Male C57BL/6 mice were assigned to a normal fat diet (NFD), a high fat diet with high C18:0/C16:0 ratio (HSF) or an isocaloric high fat diet with a low C18:0/C16:0 ratio (LSF) for 10 weeks. An oral glucose tolerance test, 72-h energy expenditure measurement and CT scan of body fat were done before sacrifice. Fasting glucose and lipids were determined by an autobiochemical analyzer. Blood insulin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured by enzyme-linked immunosorbent assay methods. Free fatty acids (FFAs) profiles in blood and liver were determined by using gas chromatography-mass spectrometry. Microarray analysis was applied to investigate changes in transcriptomic profiles in the liver. Pathway analysis and Gene Ontology analysis were applied to describe the roles of differentially expressed mRNAs. Results: Compared with the NFD group, body weight, body fat ratio, fasting blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, IL-6, serum and liver FFAs including total FFAs, C16:0 and C18:0 were increased in both high fat diet groups and were much higher in the HSF group than in the LSF group. Both HSF and LSF mice exhibited distinguishable lncRNA, microRNA and mRNA expression profiles when compared with those of NFD mice. Additionally, more differentially expressed lncRNAs and mRNAs were observed in the HSF group than in the LSF group. Some biological functions and pathways, other than energy metabolism regulation, were identified as differentially expressed mRNAs between the HSF group and LSF group. Conclusion: The high fat diet with a high C18:0/C16:0 ratio induced more severe glucose and lipid metabolic disorders and inflammation and affected expression of more lncRNAs and mRNAs than an isocaloric low C18:0/C16:0 ratio diet in mice. These results provide new insights into the differences in biological functions and related mechanisms, other than glucose and lipid metabolism, between C16:0 and C18:0.
Bacterial infections in a pediatric cohort of primary and acquired complement deficiencies.
Authors: Al-Shaikhly Taha , Hayward Kristen , Basiaga Matthew L , Allenspach Eric J
Published: July 2020

Background: Acquired complement deficiency can occur in the setting of autoimmune syndromes, such as systemic lupus erythematosus (SLE), with very low or, occasionally, undetectable C3 levels. Based on inherited complement defects, patients with transiently low complement may be at similar risk for serious bacterial infection, but the degree of risk related to C3 level and temporal association is unknown. Methods: We performed a retrospective study including pediatric patients with undetectable total complement activity or absent individual complement components measured at our institution from 2002 to 2018. We assessed annual rate of serious bacterial infection (SBI) defined as requiring hospitalization and/or parenteral antibiotics by manual chart review. Among included SLE patients, we assessed the 30-day probability of SBI for given C3 measurements using a logistic regression model to determine risk. Primary complement deficiency was analyzed for SBI rate as comparison. Covariates included age, level of immune suppression and history of lupus nephritis.Results: Acquired complement deficiency secondary to SLE-related disease [n=44] was the most common underlying diagnosis associated with depressed complement levels and were compared to a cohort of primary complement deficient patients [n=18]. SBI per 100 person-years and cohort demographics were described in parallel. Our logistic regression analysis of pediatric patients with SLE showed low C3 level was temporally associated with having an SBI event. Given equivalent immunosuppression, patients with an SBI had lower C3 levels at the beginning of the observation period relative to patients without SBI. Conclusion: Pediatric patients with the diagnosis of SLE can develop very low C3 levels that associate with risk of serious bacterial infection comparable to that of patients with primary complement deficiency. Patients prone to severe complement consumption may particularly be at risk.
Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa
Authors: MAKHADO LUFUNO , Davhana-Maselesele Mashudu , Lebese Rachel Tsakani , Maputle Sonto Maria
Published: July 2020

Background: Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The purpose of this study was to determine factors facilitating trained nurse-initiated management of antiretroviral therapy (NIMART) adherence to TB/HIV treatment guidelines in KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa.Design: The study was qualitative, exploratory-descriptive in nature. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and data analysis was through ATLAS T.I. software program (version 7.0). This followed the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured.Results: The singular theme of factors facilitating trained NIMART nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Conclusion: Continuous training, support supervision and improved relationships with colleagues need to be enhanced to enable NIMART nurses to adhere to treatment guidelines.
The relationship between parents’ dietary care and food diversity among preschool children in Japan
Authors: Ishikawa Midori , Haraikawa Mayu , Eto Kumi , Yoshiike Nobuo , Yokoyama Tetsuji
Published: July 2020

Background

Increasing food diversity in early childhood diets is important; however, few studies on parental care emphasize the necessity of ensuring greater food diversity for children. The aim of this study was to identify the relationship between preschool children’s dietary diversity and parents’ care behaviors related to their diet including contents of foods and snacks, mealtime practice, and parent–child communication.

Methods

Data were extracted from the National Nutrition Survey on Preschool Children conducted among households with toddlers and preschoolers in 2015 by Japan’s Ministry of Health, Labor and Welfare. Based on 2143 responses from households with children aged 2–6 years, a food diversity score (8 food groups: max of 8 points) was calculated and the distribution was confirmed. The participants were divided into higher (≥4 points, n = 1151) and lower (≤3 points; n = 992) food diversity groups. A comparison between the two groups examined parents’ socioeconomic status, children’s health and living conditions, and parental care concerning children’s diets (13 items, including nutritional balance of foods, snack content, and regularity of mealtimes). Based on the results, a multiple regression analysis was performed relating food diversity scores to the factors of parental socioeconomic status and child health, and a logistic regression analysis was conducted to identify factors of parental care related to the higher food diversity group.

Results

Among the higher food diversity group, mothers were older, subjective economic status was higher, parents’ skipped breakfast skipping less, and children had fewer caries and engaged in less than two hours of screen time per day. Parental care concerning children’s diets was the factor most strongly associated with children’s food diversity scores. Among such habits, those factors most strongly associated with higher food diversity were nutritional balance of foods (OR: 1.76; 95% CI: 1.44–2.16; p < .0001), snack contents (OR: 1.41; CI: 1.07–1.86; p = 0.014), and regular mealtimes (OR: 1.30; CI: 1.08–1.55; p = 0.005).

Conclusion

The findings indicate the importance of parents paying attention to the contents of children’s foods and snacks, ensuring that children eat regularly, and increasing the diversity of their diets.
The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.
Authors: GENCER MUZAFFER , Göçmen Ayşe Yeşim
Published: July 2020

Background: In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group) (n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results: Demographic data and peri-operative variables was similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/Ml (max:489.92±22.36 pg/mL, min: 94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room, (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group p <0.05.Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration:This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).
Cannabis against chronic muskuloskeletal pain: A scoping review on users and their perceptions
Authors: Furrer Daniela , Kröger Edeltraut , Marcotte Martine , Jauvin Nathalie , Bélanger Richard , Ware Mark , Foldes-Busque Guillaume , Aubin Michèle , Pluye Pierre , Dionne Clermont E.
Published: July 2020

Background Chronic musculoskeletal pain (CMP) may lead to reduced physical function and is the most common cause of chronic non cancer pain. Currently, the pharmacotherapeutic options against CMP are limited and mainly consist of pain management with gabapentinoids or opioids, which carry major adverse effects. Although the effectiveness of medical cannabis (MC) for CMP still lacks solid evidence, several patients suffering from it are exploring this therapeutic option.Objectives Little is known about MC users suffering from CMP. We aimed to increase this knowledge, useful for health care professionals and policy makers considering this treatment, as well as for researchers planning rigorous randomized clinical trials on the effectiveness of MC.Methods We conducted a scoping literature review, according to the methods developed by Arksey and O’Malley, to describe the views and perceptions of patients who had consumed MC to relieve chronic CMP and other non-cancer pain, as well as their demographic characteristics, patterns of MC use, and perceived positive and negative effects.Conclusion Our review shows that MC users are frequently young or middle-aged men, and that the preferred form of use was smoking. Participants of the included studies reported that MC use was helpful in reducing CMP and other chronic non-cancer pain with only minor adverse effects; in addition, they reported improved psychological well-being. Discussion The information from the included studies has several methodological limitations and is exploratory. MC use might, from the perspective of persistent users suffering from CMP and other chronic non-cancer pain, produce more benefits than harms. However, specific results for CMP are very scarce.
Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors
Authors: Mitsui Kiyomi , Endo Motoki , Imai Yuya , Ueda Yuito , Ogawa Hiroko , Muto Go , Yan Yan , Deshpande Gautam A. , Terao Yasuhisa , Takeda Satoru , Tanigawa Takeshi , Nishimura Katsuji , Hayashi Kazuhiko , Saito Mitsue , Kokaze Akatsuki
Published: July 2020

Background The number of breast cancer patients of working age is increasing in Japan . Consequently, there is a need for support for working individuals concomitantly undergoing breast cancer treatment. The present study aimed to clarify the risk factors for resignation and taking sick leave among breast cancer survivors in continued employment at the time of diagnosis. Methods As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2018. The investigators analyzed the risk factors for post-breast cancer diagnosis resignation and sick leave using a logistic regression model, including age at diagnosis, educational level, cancer stage, surgery, pharmacotherapy, radiotherapy, employment status, and occupational type. Results 40 of 269 breast cancer survivors (14.9%) quit their job after cancer diagnosis. Predictors of resignation included lower education level (odds ratio [OR]: 3.802; 95%CI: 1.233-11.729), taking sick leave (OR: 2.514; 95%CI: 1.202-5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221-0.998). Of 229 patients who continued working, sick leave was taken by 72 (31.4%); having surgery was a predictor for taking sick leave (OR: 8.311; 95%CI: 1.007-68.621). Conclusions 14.9% of Japanese employees quit their jobs after being diagnosed with breast cancer. Being younger at breast cancer diagnosis, having lower educational attainment level, and utilizing sick leave were identified as predictors of post-cancer diagnosis resignation. Surgery was associated with the highest risk of taking sick leave. Breast cancer survivors exhibit higher risks for resignation, and may require more carefully follow-up after diagnosis by healthcare providers and employers to protect work sustainability.