bluuebunny/crossref_metadata_2025 huggingface dataset:
Komponen Keterpaduan Objek Wisata di Kawasan City Walk Slamet Riyadi Ditinjau dari Sistem Pariwisata
Authors: Azzahra Hafiza Jasmine , Astuti Winny , Rini Erma Fitria
Published: July 2019

Tourism today is an activity that almost everyone in the world does. Each city tries to develop their tourism potential. One concept that can be carried out is city walk tourism. Surakarta city declares itself as a tourism city. In 2007, the Surakarta Municipality revitalized Slamet Riyadi city walk area, which along the road, there are some old buildings and tourist objects that can be visited. The tourism system is a complex thing that consists of several components that are interconnected. The function of the tourism system can be divided into two, from demand side and supply side, which has its own components. With the construction along Slamet Riyadi city walk, which passes several tourist objects, this momentum can be utilized to improve the tourism sector in Surakarta. In order to run optimally, it is necessary to see what the components of tourism system that required are. The method used in this research is literature review and crossing variables. These methods were used to find out what variables are important in the tourism system at Slamet Riyadi city walk. Of these two methods the output will be the integrated tourism components that influenced in tourist attraction at Slamet Riyadi city walk.
KOMPARASI PERUBAHAN ASPEK SOSIAL EKONOMI PADA PENGHUNI RUMAH SUSUN PASCA PENANGANAN SQUATTER DI KOTA SURAKARTA
Authors: Kurniawan Khizam Deby , Hardiana Ana , Putri Rufia Andisetyana
Published: July 2019

City has main attraction for livable. The public has the view that a town has a comprehensive facilities , good accessibility , a broad field of work and so on. This matter causes population growth developments in the city, because people migrating to the city livelihood for the sake of more worthy. The increasing population is not balanced with the service especially in the field of housing the city settlement that will appear squatter. So that the squatter need to be handled, in general the handling of having two pattern handling squatter approach , that is a pattern on-site and off-site. On site pattern is a problem handling squatter location without move to another region but with providing a place of decent housing. While off site pattern is handling by moving the squatter to the regions and with the status of land was legal. In fact both handling is to improve social life and economic society. One of squatter handling in Surakarta is build a low cost apartment. The limited land in Surakarta is one of the reason to build a low cost apartment in the Surakarta City for handling squatter. Based on issues, this research knowing comparisons of socio-economic change in the low cost apartment post-handling squatter. The method is applicable in weighting analysis methods in identifying the social economy at low cost apartment in Surakarta. This result oh the research re the comparisons of socioeconomic aspects of changes on residents after handling squatter in Surakarta can be seen that in Begalon I low cost apartment experienced a medium increase, while in Begalon II low cost apartment and Semanggi low cost apartment increased low. So that the change in the economic and social aspect of Begalon I low cost apartment with on site pattern has the higher than Begalon II low cost apartment and Semanggi low cost apartment with off site pattern.

 

Keywords: low cost apartment, socioeconomic aspects, squatter
KETERPADUAN KOMPONEN PENGEMBANGAN PARIWISATA KOTAGEDE SEBAGAI KAWASAN WISATA BUDAYA BERKELANJUTAN
Authors: Adhelia Nirmana , Soedwiwahjono Soedwiwahjono , Yudana Galing
Published: July 2019

Kotagede as the capital city of the former Mataram Islam kingdom has potential culture and history tourism which places in two different areas, Yogyakarta City  and Bantul region. It needs contribution between Yogyakarta government, local government and local communities to protect Kotagede. The development of tourism activities also need support from all stakeholder to make the tourism sustain. Therefore, this research was conducted to determine the level of integration of tourism development components as the area of sustainable cultural tourism in Kotagede. The method of research is deductive-quantitative, while the data analisys technique used is  descriptive analysis of quantitative, scoring and crosstab analysis. Results from this study is Kotagede judged to have met the criteria as a sustainable cultural tourism area with an integrated component of tourism development. However, when viewed from the stakeholder cooperation that occurred in the development of tourist areas, Kotagede showed a low value. Thus, although the components of tourism development Kotagede shows the alignment of sustainability, but the resulting relationship is still weak.

 

Keywords:cultural tourism area, integrated tourism, sustainable tourism, tourism
Bebidas endulzadas en adultos jóvenes y su asociación con adiposidad y riesgo metabólico
Authors: Cartagena Amigo Hugo , Ortega-Garrido José Alberto , Bustos-Muñoz Patricia
Published: July 2019

Objetivo. Estimar la asociación entre consumo de bebi­das endulzadas (BE) con indicadores de adiposidad y riesgo metabólico en adultos jóvenes. Material y métodos. Se analizó la frecuencia de consumo de alimentos, índice de masa corporal (IMC), circunferencia de cintura (CC), grasa corporal (PGC), glicemia y triglicéridos de 931 participantes seleccionados aleatoriamente (Región de Valparaíso, Chile), mediante modelos de regresión múltiple, controlando facto­res de confusión. Resultados. La mediana de edad fue 24.9 años; 94% (IC95% :92.3-95.3) de los participantes consumía BE, 33.1% de ellos consumía más de dos porciones (≥500 ml) diarias, que se asoció con incremento en glicemia (ambos sexos) (β=2.17; p=0.007) y con IMC (β=1.48, p=0.04), CC (β=4.50; p=0.009) y PGC (β=3.02; p<0.001) sólo en mujeres. Conclusión. La alta ingesta de BE incrementa la glicemia en adultos jóvenes y los indicadores de adiposidad en mujeres, antecedentes relevantes para formular políticas que dismi­nuyan el consumo de BE y sus consecuencias.
Impact of Rotation During Installation on the Structural Performance of Slotted Liners in Thermally Stimulated Wells
Authors: Chartier Mark A. , Yung Victor Y. , Taubner Spencer P.
Published: July 2019

Slotted liner is a sand–control technology used for completion of thermal wells. During installation, liners are subjected to tensile and compressive loads generated by string weight, wellbore drag, and bending when run through curved wellbores. Additionally, torque might be applied to “break” friction, when needed, to reduce axial drag and extend reach. These conditions lead to combined loading of liners with simultaneous axial, bending, and torsional loads.

Combined loading that exceeds the elastic capacity of the liner during installation can alter the structural capacity of the liner and reduce its ability to withstand subsequent operational loads. In particular, permanent deformation of liner struts during installation could create weak zones that trigger localization of deformations and liner failure under thermal–service loading conditions. Further, the presence of residual torque (from installation) can trigger and exacerbate the tendency of the liner struts to buckle.

Previously published works described slotted–liner installation limits and thermal operating limits separately. This paper examines the impact that rotation (during installation) can have on the subsequent thermal–service capacity and sand–control performance of a slotted liner. Specifically, the relationships between both plastic twist and residual torque from installation loads and the critical strain capacity and slot–width changes of a slotted liner under constrained thermal expansion were studied. Results demonstrated that a slotted liner can tolerate some plastic twist (during installation) without a significant impact on slot width or thermal–service performance. However, large amounts of plastic twist or residual torque from installation can bias the liner to fail in torsional buckling during thermal service. Slotted–liner tolerance, to both the plastic twist applied during installation and the residual torque remaining after installation, varies with liner configuration. Small amounts of plastic twist (0.5°/m) imposed on a high–density 60–slots–per–column (spc) liner resulted in a reduction in thermal–service capacity. In contrast, a low–density 35–spc liner with substantial imposed plastic twist (4°/m) demonstrated negligible changes in performance. Residual torque has a greater potential to impact liner performance, and its effect is less sensitive to the slotting density. Both the high–density 60–spc liner and the low–density 35–spc liner showed significant incremental slot–width changes during thermal service resulting from 5 kN·m of residual torque.

The findings of this work provided the basis for a proposed method to select appropriate engineering limits for the torque that can be applied safely to a slotted liner during running and for recommendations to reduce the potential for residual torque following installation.
Apparent Toughness Anisotropy Induced by “Roughness” of In-Situ Stress: A Mechanism That Hinders Vertical Growth of Hydraulic Fractures and Its Simplified Modeling
Authors: Fu Pengcheng , Huang Jixiang , Settgast Randolph R. , Morris Joseph P. , Ryerson Frederick J.
Published: July 2019

The height growth of a hydraulic fracture is known to be affected by many factors that are related to the layered structure of sedimentary rocks. Although these factors are often used to qualitatively explain why hydraulic fractures usually have well–bounded height growth, most of them cannot be directly and quantitatively characterized for a given reservoir to enable a priori prediction of fracture–height growth. In this work, we study the role of the “roughness” of in–situ–stress profiles, in particular alternating low and high stress among rock layers, in determining the tendency of a hydraulic fracture to propagate horizontally vs. vertically. We found that a hydraulic fracture propagates horizontally in low–stress layers ahead of neighboring high–stress layers. Under such a configuration, a fracture–mechanics principle dictates that the net pressure required for horizontal growth of high–stress layers within the current fracture height is significantly lower than that required for additional vertical growth across rock layers. Without explicit consideration of the stress–roughness profile, the system behaves as if the rock is tougher against vertical propagation than it is against horizontal fracture propagation. We developed a simple relationship between the apparent differential rock toughness and characteristics of the stress roughness that induce equivalent overall fracture shapes. This relationship enables existing hydraulic–fracture models to represent the effects of rough in–situ stress on fracture growth without directly representing the fine–resolution rough–stress profiles.
The effect of vitamin D supplementation on the glycemic control of pre-diabetic Qatari patients in a randomized control trial.
Authors: Thani Mohammed Al , Sadoun Eman , Sofroniou Angeliki , Jayyousi Amin , Baagar Khaled Ahmed Mohamed , Hammaq Abdulla Al , Vinodson Benjamin , Akram Hammad , Bhatti Zaid Shakoor , Nasser Heba Samir , Leventakou Vasiliki
Published: July 2019

Background: Vitamin D deficiency is associated with indicators of pre-diabetes including, insulin resistance, β-cell dysfunction and elevated plasma glucose with controversial findings from current trials. This study aims to investigate the long-term effect of vitamin D on glucose metabolism and insulin sensitivity in pre-diabetic and highly vitamin-deficient subjects. Methods: 132 participants were randomized to 30,000 IU vitamin D weekly for 6 months. Participants underwent oral glucose tolerance test (OGTT) at 3-month intervals to determine the change in plasma glucose concentration at 2h after 75g OGTT (2hPCG). Secondary measurements included glycated hemoglobin, fasting plasma glucose and insulin, post-prandial insulin, indices of insulin sensitivity (HOMA-IR, Matsuda Index), β-cell function (HOMA-β, glucose and insulin area under the curve (AUC), disposition and insulinogenic indices), and lipid profile. Results: A total of 57 (vitamin D) and 75 (placebo) subjects completed the study. Mean baseline serum 25(OH) D levels were 17.0 ng/ml and 14.9 ng/ml for placebo and vitamin D group, respectively. No significant differences were observed for 2hPC glucose or insulin sensitivity indices between groups. HOMA-β significantly decreased in the vitamin D group, while area under curve for glucose and insulin showed a significant reduction in β-cell function in both groups. Additionally, HOMA-β was found to be significantly different between control and treatment group and significance persisted after adjusting for confounding factors. Conclusion: Vitamin D supplementation in a pre-diabetic and severely vitamin-deficient population had no effect on glucose tolerance or insulin sensitivity. The observed reduction in β-cell function in both placebo and vitamin D groups could be attributed to factors other than supplementation. Trial registration: The trial was registered at www.clinicaltrials.gov with number: NCT02098980.
Gadolinium oxide nanoparticles enhance the cytotoxicity of chemotherapeutic drugs by blocking autophagic flux in cancer cells
Authors: Zhang Tianyu , Zhong Cheng , Xie Zhixiong
Published: July 2019

During chemotherapy, drugs can damage cancer cells’ DNA and cytomembrane structure, and then induce cell death. However, autophagy can increase the chemotherapy resistance of cancer cells, reducing the effect of chemotherapy. We found that gadolinium oxide nanoparticles (Gd2O3 NPs), which have great potential for use as a contrast agent in magnetic resonance imaging, could block the late stage of autophagic flux in a dose-dependent manner and then cause autophagosome accumulation in HeLa cells. When co-treated with 8 μg/mL Gd2O3 NPs and 5 μg/mL cisplatin, the number of dead cancer cells increased by about 20% compared with cisplatin alone. We observed the same phenomenon in cisplatin-resistant COC1/DDP cells. Thus, Gd2O3 NPs have significant potential for use in both cancer diagnosis and therapy.
Maternal satisfaction on delivery care services and associated factors among mothers who gave birth in the University of Gondar teaching and referral hospital, northwest Ethiopia
Authors: Firdie Andualem , Maru Alemnew , Deriye Abdulahi , Assefa Amare , Bedassa Abdi , Bekele Anteneh , Alemayehu Amanuel , Abebe Zegeye , Gizaw Zemichael
Published: July 2019

Introduction

Maternal satisfaction on delivery services is an important indicator for assessment of the quality of care. Quality of delivery care increases the likelihood of timely and appropriate treatment and good outcomes. The use of delivery services and outcomes are the result not only of the provision of care but also of women’s experience of that care. Therefore, investigating women’s experience or satisfaction on delivery care is of paramount importance to enhance the services utilization.

Methods

An institution-based cross-sectional study design was used. Data were collected using structured and pretested questionnaire from 403 mothers who were recruited by simple random sampling technique. Multivariable binary logistic regression analysis was used to identify variables associated with maternal satisfaction on delivery services on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value less than 0.05.

Results

The current study found that the overall satisfaction of mothers on delivery services was found to be 65.5%. Specifically, 78.2%, 65.5%, 64.3%, 49.9% and 44.7% of the mothers who gave birth at the University of Gondar teaching and referral hospital were satisfied on physicians’ communication, healthcare services, physicians’ attitude, privacy and sanitation condition of the health institution respectively. Maternal satisfaction was statistically associated with maternal education (diploma and above education) [AOR = 0.29, 95% CI = (0.13, 0.66)], maternal education (secondary and/or primary education) [AOR = 0.42, 95% CI = (0.20, 0.90)], antenatal care (ANC) follow-up in the current pregnancy [AOR = 4.47, 95% CI = (1.77, 11.27)] and short waiting time [AOR =1.85, 95% CI = (1.19, 2.88)].

Conclusion

This study revealed that the overall satisfaction of mothers on delivery service was found to be suboptimal. Physicians’ communication, healthcare services and physicians’ attitude were areas where the highest proportion of mothers satisfied. On the other hand, the highest proportion of mothers was dissatisfied on sanitation condition. Educational status, ANC follow-up and waiting time were found to be statistically associated with maternal satisfaction on delivery services.
Microscopic features of small bowel mucosa of patients with Crohn’s disease
Authors: cui yun , Lu Shi-yuan , Xu Jie , Peng Yan-shen , Miao Qi , wang xiao-qing , Chen Xiao-yu , Ran Zhi-hua
Published: July 2019

Background Double-balloon enteroscopy enables performing numerous small bowel biopsies for pathologic analysis. However, most histopathological characteristics of Crohn’s disease are non-specific characteristics. We aimed to explore the small bowel mucosal histopathologic characters of Crohn’s disease and identify some disease-specific changes.
Methods We included 253 patients without tumors and grouped them into Crohn’s disease, suspected Crohn’s disease, and non-Crohn’s disease groups. These patients underwent double-balloon endoscopy examination and small bowel biopsy at Renji Hospital, Shanghai. All histopathological sections were reviewed, and >20 histopathological parameters were assessed. Immunohistochemistry was conducted when necessary.
Results There were different forms of granulomatous lymphangitis on the small bowel mucosa in Crohn’s disease. They showed as various macrophages or epithelioid cells in the lumina of lymphatics or in the center of the villi with or without evident obstruction. These features were only observed in Crohn’s disease patients. Furthermore, they were correlated with granuloma and lymphangiectasia. Additionally, 15 other features showed significant differences among the three groups, and Crohn’s disease patients showed an average of almost seven histopathological characteristics.
Conclusions We described the detailed morphologies of granulomatous lymphangitis on the small bowel mucosa and recommend it as a useful histopathological feature for the diagnosis of Crohn’s disease. In terms of specificity and sensitivity, it was superior to non-caseating epithelioid granuloma.
Low risk patients with acute atrial fibrillation and elevated high-sensitivity troponin do not have increased incidence of pathological stress test: a prospective cohort study
Authors: Thelin Johan , Gerward Sofia , Melander Olle
Published: July 2019

Background

Many patients with atrial fibrillation (AF) or atrial flutter (AFL) and rapid ventricular response (RVR) have elevated high-sensitivity troponin T (hsTnT) values. Elevated hsTnT is an independent risk marker for cardiovascular events and mortality. The aim was to examine if AF/AFL patients with RVR and elevated hsTnT have an increased incidence of pathological cardiac stress tests, indicating need of further evaluation for coronary artery disease (CAD).

Methods

We prospectively included 90 AF/AFL patients without known heart failure and CAD presenting with AF/AFL and RVR. Half of the patients had elevated hsTnT (cases) and half had levels below the 99th percentile (controls). All patients were discharged in sinus rhythm. After approximately one week in sinus rhythm a new hsTnT was analysed and the patients performed a bicycle exercise stress test within the 30 day follow-up. The primary endpoint was a pathological stress test confirmed by a pathological SPECT myocardial perfusion imaging or a coronary angiography.

Results

None of the controls reached the primary endpoint. Two patients (4%) out of the 45 cases reached the primary endpoint (p= 0.49 vs controls), but only one was found to have significant CAD at subsequent coronary angiography.

Conclusions

Patients with paroxysmal AF/AFL, without history of CAD and heart failure, who present with a RVR and minor hsTnT elevations do not have an increased incidence of pathological stress test compared to patients with hsTnT values below the 99th percentile. Our results do not support the need of performing stress tests in this population.
Matching actual treatment with patient administration-route-preference improves analgesic response among acute-low-back-pain patients
Authors: Shani Adi , Granot Michal , Mochalov Gleb , Raviv Bennidor , Rahamimov Nimrod
Published: July 2019

Background

Accommodating a patient's treatment preference has been reported to promote greater responsiveness and better clinical outcomes. The effect of administration-route-preference (ARP) on the individual analgesic response has not been extensively examined to date. This study aimed to explore whether ARP-matched treatment i.e. individualized intramuscular (IM) or oral (PO) analgesic administration according to patient choice, would increase the analgesic effect.

Methods

38 patients with acute-low-back-pain (aLBP) presenting at the emergency room, reported their ARP for analgesics, and, regardless of their initial desire, were randomly assigned to receive either PO or IM diclofenac. Pain intensity was self-reported using the numeric pain score (NPS) before and during the first hour after drug administration.

Results

Both groups receiving PO or IM administration reported similar initial pain, (NPS 8.63±1.5 and 8.74±1.6 respectively (and magnitude of pain reduction. However, patients who received the drug in their desired route (oral or injection) had a significantly greater reduction in pain levels (4.05±2.8) as compared with patients who received the undesired route (2.08±1.8) p<0.05.

Conclusions

These findings support the hypothesis that individualized ARP-matching treatment in aLBP improves therapeutic outcomes, potentially by triggering an additive analgesic placebo reaction above the direct pharmacological effect alone.
Perceptions and vocational tendency of undergraduate clinical medical students in China to general practice：A cross-sectional study
Authors: Ren wen , Qiu Yan , Liu Ying , Fang Xiangming , Wu Yan , Yan qinqin , jiang zhengzhi , ren Jingjing , Wang Yongchen
Published: July 2019

Background Undergraduate education determines the overall quality of general practitioners in the future, however, there were lack of standard objectives and teaching content of general practice in the academic sessions in China. This paper explore on the perception of general practice and vocational tendency of undergraduate clinical medical students.
Methods A questionnaire was sent to clinical medical students from those 5 universities at the first semester by Wenjuanxing software. 30 valid questionnaires in each grade of each university were selected. Main outcome included the general information, cognizance of general medicine and attitude to be general practitioners.
Results Among the 750 medical students, 87.9% thought it was necessary to developing this course and 54.5% thought it should be a required subject in the undergraduate years. Multimode teaching (74.1%) was the favorite teaching mode. The percentage of clinical medical students willing to be general practitioners was only 34.9%, the most important reason for medical students willing or unwilling to be general practitioners was both career prospect. In those who eager to be general practitioners 63.2% were unwilling to work in the community health service center. In logistic regression analysis, the grade (Odds Ratio [OR] = 1.55, 95% Confidence Interval [CI]: 1.20-2.0), the place of birth (OR = 0.82; 95% CI: 0.72-0.94), and the universities (OR = 1.24, 95% CI: 1.10-1.41) were significantly associated with the willingness of becoming general practitioners (P<0.05). The students who thought it was worth to developing general practice course were more prefer to be general practitioner, and students from schools who had made it a compulsory course.
Conclusions
In order to improve the perceptibility about general practice and attract more medical students to be general practitioners, the government should establish a perfect educational system, explore new teaching patterns and offer a bright career future.
Relationship between KCNQ1 gene polymorphisms and type 2 diabetes in the population of northwestern China and a meta-Analysis
Authors: Xu Jing , Zhang Wei , Song Wei , Cui Jiaqi , Tian Yanni , Chen Huan , Huang Pan , Yang Shujun , Wang Lu , He Xin , Wang Lin , Cui Wei , Shi Bingyin
Published: July 2019

Aims

The purpose of this study was to explore the correlation between Potassium Voltage-Gated Channel Subfamily Q Member 1 (KCNQ1) gene polymorphisms and the risk of type 2 diabetes mellitus (T2DM) and its clinical indicators in the population of northwestern China, and conducted a meta-analysis on two polymorphic loci that have been studied frequently and controversial.

Methods

A case control study was conducted, involving 508 patients and 503 healthy individuals in the population of northwest China, and evaluated the associations using the χ2 test, Fisher's exact test, T test, and genetic model analyses.

Results

We discovered that rs2237895 rs2283228, rs163184, and rs163177 were associated with susceptibility to T2DM. Rs231362 rs231356, rs8181588 were related to the risk of T2DM after stratification. The results of meta-analysis also confirmed that rs2237895 and rs2283228 were strongly correlated with T2DM risk, especially in the East Asian population.

Conclusions

This study provides evidence for the correlation between KCNQ1 gene polymorphisms and T2DM in the population of northwestern China.
Assessing the variability and predictability of adipokines (adiponectin, leptin and resistin and their ratios) in non-obese and obese women with polycystic ovary syndrome
Authors: Obirikorang Christian , Owiredu William K.B.A. , Adu-Afram Sandra , Acheampong Emmanuel , Asamoah Evans Adu , Antwi-Boasiakoh Enoch Kwabena , Owiredu Eddie-Williams
Published: July 2019

Objectives

To assess the variability in adiponectin, leptin, and resistin between ovulatory women, and non-obese and obese women with polycystic ovary syndrome (PCOS). The study also explores the ratios of the adipokines and evaluated their predictability for PCOS.

Results

The PCOS group presented with lower adiponectin [13.0(10.49-16.59) vs 18.42(15.72-19.92) µg/ml, p<0.0001], adiponectin: leptin ratio [0.60(0.35-0.88) vs 1.19(0.92-1.37), p<0.0001], and adiponectin: resistin ratio [0.30(0.21-0.43) vs 0.42(0.32-0.62), p<0.0001] but a higher leptin [20.02(14.54-26.80) vs 16.17(14.51-18.36) ng/ml, p<0.0001] and leptin: resistin ratio [0.53(0.37-0.82) vs 0.40(0.27-0.48), p<0.0001] compared to the ovulatory group. The obese PCOS group presented with lower adiponectin [11.04(5.66-13.25) vs 14.18(11.04-18.02) µg/ml, p<0.0001 and 18.42(15.72-19.92) µg/ml, p<0.0001], adiponectin: leptin ratio [0.36(0.27-0.44) vs 0.78(0.61-1.16), p<0.0001 and 1.19(0.92-1.37), p<0.0001], and adiponectin: resistin ratio [0.24(0.17-0.38) vs 0.40(0.23-0.58), p<0.0001 and 0.42(0.32-0.62), p<0.0001] but a higher leptin [26.80(14.28-32.09) vs 17.95(14.86-21.26) ng/ml, p<0.05 and 16.17(14.51-18.36) ng/ml, p<0.0001] and leptin: resistin ratio [0.63(0.46-1.03) vs 0.41(0.30-0.61), p<0.0001 and 0.40(0.27-0.48), p<0.0001] compared to the non-obese PCOS and ovulatory control group, respectively. Adiponectin: leptin ratio presented with the best discriminatory power in predicting PCOS (AUC=0.83) followed by adiponectin alone (AUC=0.79), and leptin: resistin ratio and leptin alone (both AUC=0.69). Resistin alone presented with the poorest discriminatory power (AUC=0.48).
Predictors of Health Care Seeking Pace Among Newly-Diagnosed Pulmonary Tuberculosis Patients In Cebu City, Philippines: A Cross-Sectional Study
Authors: DUAVIS1 MARK JOHNUEL MATABILAS
Published: July 2019

Background

Tuberculosis remains a major public health dilemma in the Philippines. While free and effective TB diagnosis and treatment have been made available since 1996, a number of patients still delay accessing them re­sulting to increased TB mortality and community transmission. This study is aimed at determining the significant variables that can predict a TB patient’s pace in seeking appropriate health care.

Methods

A descriptive, correlational cross-sectional survey was done to 127 newly-diagnosed TB patients from 10 government-owned TB DOTS facilities in Cebu City. Participants were categorically grouped into Prompt Health Seekers and Delayed Health Seekers using a norm-referenced median dichotomy. Descriptive and inferential analysis utilized included Chi-square Test, Pearson’s Correlation and Discriminant Analysis.

Results

A mean health care seeking delay of 59 days (median=49) was recorded. Most of the participants experienced unexplained cough which they perceived as only slightly dangerous. 38% of them reported not knowing any symptom related to TB while 39% were not aware of the free public TB services. Most patients have made 2-3 prior health recourses, mostly through self-medication, before finally contacting a DOTS facility. Marital status (p=0.004), the number of symptoms experienced (p=0.000), first symptom experienced (p=0.016), perceived dangerousness of all symptoms experienced (p=0.009), perceived dangerousness of the first symptom experienced (p=0.001), perceived social stigma (p=0.035) and, perceived social support (p=0.002) were found to be significantly associated with the patients’ health care seeking pace. Extending to multivariate analysis, five independent variables namely marital status (p=0.037), number of symptoms experienced (p=0.018), perceived dangerousness of all the symptoms experienced (p=0.028), perceived social stigma (p=0.026) and, perceived social support (p=0.001) can significantly predict the patients’ health care seeking pace.

Conclusion

A considerable health care seeking delay of 59 days was documented, especially among those with lower perception of social support, higher perception of social stigma and those who do not currently have partners. Patients who experienced more symptoms and those who view these symptoms as less dangerous were, however, likely to seek immediate health care. Reducing health care seeking delays through intensified health information campaigns, strengthening social support systems and reducing social stigma is recommended.
Tachysystole and risk of cesarean section after labor induction using misoprostol: a cohort study
Authors: Sichitiu Joanna , Vial Yvan , Panchaud Alice , Baud David , Desseauve David
Published: July 2019

Background
In western countries, induction of labor is a common obstetrical intervention. Uterine tachysystole frequently manifests after cervical ripening by misoprostol vaginal inserts. Currently, there is insufficient evidence regarding the clinical impact of tachysystole during induction of labor. Therefore, the objective of the current study is to examine if tachysystole is associated with an increased risk of cesarean section following induction of labor by misoprostol vaginal inserts.

Methods
We conducted a retrospective cohort study of 446 women over 37 weeks of gestation admitted for labor induction by misoprostol vaginal inserts between May 2016 and May 2017. Fetal heart rate and uterine activity tracings were assessed for tachysystole, defined as ≥ 6 contractions per 10 minutes, averaged over a 30-minute window. Univariate analysis was performed by using t-test and Chi-square, comparing demographics, pregnancy characteristics, intrapartum monitoring, mode of delivery, neonatal outcomes (Apgar score < 7 at 5 minutes, umbilical cord artery pH < 7.10, neonatal intensive care unit admission) and maternal outcomes, with regard to the presence of tachysystole. The association between tachysystole and cesarean section was evaluated after adjusting for potential confounders by a modified Poisson regression model, expressed as an adjusted risk ratio and 95% confidence intervals.

Results
A total of 140 women (31.4%) presented with tachysystole. The median duration of tachysystole was 2 hours 12 minutes. The rate of cesarean section was 25.0% (N=35) among patients with tachysystole and 19.6% (N=60) for those without tachysystole. Presence of tachysystole during induction of labor with misoprostol vaginal inserts was not associated with cesarean section (adjusted risk ratio,1.0; 95% confidence interval, 0.7 to 1.4). Neonatal and maternal outcomes were similar between mothers who did and did not experience tachysystole.

Conclusions
This study illustrates that tachysystole is not associated with an increased risk of cesarean section after induction of labor by misoprostol vaginal inserts. The impact of excessive uterine activity on the fetal wellbeing defined by the frequency of uterine contraction alone is probably insufficient. Further research on the development of accurate measures of uterine contractility is necessary to better understand its effect on fetal well-being.
Mapping maternal and newborn healthcare access in West African Countries
Authors: Ononokpono Dorothy , Baffour Bernard , Richardson Alice
Published: July 2019

Background: The Sustainable Development Goal (SDG) three emphasizes the need to improve maternal and newborn health, and reduce global maternal mortality ratio to less than 70 per 100 000 live births by 2030. Achieving the SDG goal 3.1 target will require evidence based data on concealed inequities in the distribution of maternal and child health outcomes and their linkage to healthcare access. The objectives of this study were to estimate the number of women of reproductive age, pregnancies and live births at subnational level using high resolution maps and to quantify the number of pregnancies within user-defined distances or travel times of a health facility in three poor resource West African countries: Mali, Guinea and Liberia.
Methods: The maternal and newborn health outcomes were estimated and mapped for the purpose of visualization using geospatial analytic tools. Buffer analysis was then performed to assess the proximity of pregnancies to health facilities with the aim of identifying pregnancies with inadequate access (beyond 50km) to a health facility.
Results: Results showed wide variations in the distribution of maternal and newborn health outcomes across the countries of interest and districts of each of the countries. There was also clustering of health outcomes and health facilities at the urban capital cities of Bamako, Conakry, and Greater Monrovia.
Conclusion: To bridge the gap in inequity in healthcare access, and improve maternal and newborn health in the study countries, there is need for equitable distribution of human resources and infrastructure within and across the various districts.
Effect of Prenatal EPA and DHA on Maternal and Cord Blood Insulin Sensitivity: A secondary analysis of the mothers, omega 3, and mental health study
Authors: England Joey A. , Jain Joses , Holbrook Bradley D. , Schrader Ronald , Qualls Clifford , Mozurkewich Ellen
Published: July 2019

Background

We sought to determine whether prenatal supplementation with the omega-3 fatty acids eicosapentaenoic acid (EPA) or docosahexanoic acid (DHA) would increase markers of insulin sensitivity in maternal or cord blood compared with placebo supplementation and to evaluate the association of serum EPA and DHA fractions as well as plasma 25-OH vitamin D with adiponectin, leptin and the adiponectin:leptin ratio (ALR). We hypothesized that omega-3 fatty acid supplementation would increase markers of insulin sensitivity in maternal and umbilical cord plasma.

Methods

We analyzed stored plasma samples collected from a prior 3-arm prospective, double-blinded, randomized controlled trial in which 126 women with singleton pregnancies between 12- and 20-weeks gestation were randomized to receive: 1) an EPA-rich fish oil supplement, 2) a DHA-rich fish oil supplement, or 3) a soy oil placebo. Maternal venous blood samples were collected at 12-20 weeks gestation (before supplementation) and at 34-36 weeks gestation. At delivery, cord blood was collected. Samples were analyzed using sandwich enzyme-linked immunosorbent assay kits to quantify leptin and adiponectin levels which were utilized to calculate the ALR, a proxy measure for insulin sensitivity.

Results

We found no difference in adiponectin, leptin, and the ALR between the treatment and placebo groups at baseline, after supplementation, or in umbilical cord blood. In regression analyses, higher maternal serum DHA fraction was associated with increased ALR before (p = 0.01) and after (p = 0.04) DHA supplementation. Vitamin D at enrollment was also significantly associated with adiponectin (p < 0.05). Early pregnancy BMI was significantly associated with maternal leptin levels at baseline and in late pregnancy (p < 0.001) and was inversely associated with the ALR (p < 0.001). The ALR decreased significantly between the early and late pregnancy visits (p < 0.001). There was no association of EPA fraction with any measure of insulin sensitivity. Cord blood DHA fraction was significantly associated with cord plasma leptin (p = 0.02).

Conclusions

EPA- and DHA- rich fish oil supplementation had no effect on plasma markers of insulin sensitivity. However, maternal serum DHA fraction and plasma 25-OH vitamin D were significantly associated with markers of insulin sensitivity.
Comparison of the international terminologies SNOMED CT, LOINC and ICD-11: Applicability in a guideline-conform pathology vocabulary for urothelial carcinoma in Germany
Authors: Wüllen Franziska Van , Radke Teja Falk , Pantazoglou Elisabeth , Haroske Gunter , Thun Sylvia
Published: July 2019

Objective

With almost 30,000 new cases per year, urothelial carcinomas account for a significant proportion of cancer cases in Germany. Respective guidelines serve to help pathologists evaluate tumor material according to international classification standards, but to ensure interoperability, further regulations are required. Therefore, the study presented in this work aimed at improving the informational situation by evaluating the applicability of the international terminologies in the scope of urothelial carcinoma in Germany.

Methods

Based on the S1-guideline "Urothelkarzinom", a collection of terms recommended for a pathology vocabulary was compiled and mapped to SNOMED CT (Systematic Nomenclature of Medical Terms), LOINC (Logical Observation Identifiers Names and Codes) and ICD-11 (International Classification of Diseases 11th Revision), respectively.

Results

Of the 168 terms required, 163 (97.02%) could be mapped to SNOMED CT, 66 (39.29%) to LOINC and 70 (41.67%) to ICD-11. However, considering the equivalence of each coding and restricting the mapping accordingly resulted in significantly lower coverage. When aiming at absolute equivalence, even combining all three terminologies resulted in only 138 (82.14%) terms being mappable adequately.

Discussion

Results prove that currently even combining established terminologies does not cover the terms required for a standardized documentation of urothelial findings completely. They also highlight the importance of SNOMED CT, as within this study it provided the largest proportion of mappable terms. Results also clearly demonstrated that especially SNOMED CT and LOINC require extensive knowledge on the respective terminology itself as well as on the respective medical field to ensure reliable mappings.
An analysis about heterogeneity among cancers based on the DNA Methylation Patterns
Authors: Liu Yang , Gu Yue , Su Mu , Liu Hui , Zhang Shumei , Zhang Yan
Published: July 2019

Background: The occurrence of cancer is usually the result of a co-effect of genetic and environmental factors. It is generally believed that the main cause of cancer is the accumulation of genetic mutations, and DNA methylation, as one of the epigenetic modifications closely related to environmental factors, participates in the regulation of gene expression and cell differentiation and plays an important role in the development of cancer.
Methods: This article discusses the epigenetic heterogeneity of cancer in detail. Firstly DNA methylation data of 7 cancer types were obtained from Illumina Infinium HumanMethylation 450K platform of TCGA database. Diagnostic markers of each cancer were obtained by t-test and absolute difference of DNA differencial methylation analysis. Enrichment analysis of these specific markers indicated that they were involved in different biological functions. Secondly, important gene markers were obtained by constructing the DNA methylation correlation network and the gene interaction network in the KEGG pathway, and 317 marker genes set obtained from two networks were integrated as candidate markers for the prognosis model. The univariate and multivariate COX regression models were used to select specific independent prognostic markers for each cancer, and a risk-score model was constructed to divide patients of each cancer into two groups, highly-risky and lowly-risky groups.
Results: Kaplan-Meier survival analysis showed that there was significant difference in survival between the two groups. In the verification set, there was also a difference in survival between the highly and lowly risky groups.
Conclusions: This study screened out reliable prognostic markers for different cancers, providing a further explanation for the heterogeneity of cancer at the DNA methylation level and more targets for clinical conversion studies of cancer.
Kewords: DNA methylation; cancer; epigenetic heterogeneity; survival analysis
O VALOR CAUSATIVO DO PREFIXO [DES-]: UM ESTUDO LÃ‰XICO-SEMÃ‚NTICO
Authors: Buthers Chritiane Miranda
Published: July 2019

O objetivo desta pesquisa Ã© proceder Ã  anÃ¡lise do prefixo [des-], segundo as acepÃ§Ãµes semÃ¢nticas que podem ser refletidas nesse morfema. Pretende-se investigar os predicados que figuram com esse prefixo, delineando os valores semÃ¢nticos especÃ­ficos atribuÃ­dos Ã  base lexical com a qual se conecta. Adicionalmente, implementamos o sentido â€œcausativoâ€ que [des-] impÃµe sobre os verbos com os quais pode ser combinado, como, por exemplo: desacelerar, desativar, desorganizar, desinquietar, entre outros. Com o sentido causativo, [des-] pressupÃµe uma estrutura bieventiva, contendo um evento causado (evento 1)Â  que serÃ¡ modificado Â pelo evento da causaÃ§Ã£o (evento 2). O enfoque deste artigo contempla, entÃ£o, a interface do lÃ©xico com a semÃ¢ntica e a sintaxe. Observamos que o prefixo [des-] causativo se conecta a predicados de estado, atividade, processo e criaÃ§Ã£o. Nessas circunstÃ¢ncias, dois eventos estarÃ£o envolvidos, jÃ¡ que o prefixo [des-] seria responsÃ¡vel por introduzir o evento da causaÃ§Ã£o (evento 2). Ressaltamos que esses mesmos predicados podem figurar com o prefixo [des-] nÃ£o causativo. Quando isso ocorre, apenas um evento estarÃ¡ envolvido na predicaÃ§Ã£o. Utilizando de estratÃ©gias de descriÃ§Ã£o da teoria gerativa e da proposta assumida por PylkkÃ¤nen (2002) â€“ espraiamento do nÃºcleo vo com a inserÃ§Ã£o do nÃºcleo Causeo para as construÃ§Ãµes causativas â€“, verificamos que [des-] causativo Ã© a realizaÃ§Ã£o morfolÃ³gica do nÃºcleo Causeo. Dessa maneira, esse prefixo cumpre a funÃ§Ã£o de introduzir o segundo evento na predicaÃ§Ã£o. Adicionalmente, assumimos que o causativo [des-] possui uma contraparte negativa, alÃ©m do traÃ§o estativo, o qual serÃ¡ atribuÃ­do ao primeiro evento. Essa combinaÃ§Ã£o motiva a mudanÃ§a de estado desse evento.
A RELAÃ‡ÃƒO ENTRE A LITERATURA E O MEIO AMBIENTE NO CONTO â€œGOVERNADOS PELOS MORTOSâ€
Authors: Santos de Souza Junior Airton , Souza Lima Simone
Published: July 2019

O presente estudo tem por objetivo apresentar uma anÃ¡lise em torno do conto â€œGovernados pelos mortosâ€, de autoria do escritor moÃ§ambicano Mia Couto. Para isso, parte-se de um enfoque embasado nos pressupostos da Literatura e Meio Ambiente, trazidos por Fantini (2007), que declara que, ao se abordarem questÃµes relativas a espaÃ§o e a meio ambiente, a literatura faz a integraÃ§Ã£o ou o desajuste entre homem e a natureza. E, ao preocupar-se com problemas relacionados Ã  preservaÃ§Ã£o e Ã  sustentabilidade de nosso planeta, a literatura nÃ£o deixa de equacionar em que medida cada um desses elementos se vÃª limitado ou potencializado pelo outro. Toma-se ainda enquanto fundamentaÃ§Ã£o teÃ³rica, os aportes levantados por Capra (1982) em torno do pensamento sistÃªmico, que pode ser compreendido como uma nova maneira de abordagem, a qual entende o desenvolvimento humano sobre a perspectiva da complexidade e, para percebÃª-lo, a abordagem sistÃªmica lanÃ§a seu olhar nÃ£o somente para o indivÃ­duo isoladamente, mas considera tambÃ©m seu contexto e as relaÃ§Ãµes aÃ­ estabelecidas. Diante disso, este estudo busca explorar como se efetiva a relaÃ§Ã£o entre o texto literÃ¡rio e o meio ambiente, a partir do contexto da narrativa Miacoutiana, a fim de identificar como o texto literÃ¡rio se comporta diante dessas questÃµes de carÃ¡ter ambiental.
A PERCEPÃ‡ÃƒO DOS ESTUDANTES DO CURSO DE ADMINISTRAÃ‡ÃƒO A RESPEITO DO PROCESSO DE IMPLANTAÃ‡ÃƒO DE METODOLOGIAS ATIVAS DE ENSINO-APRENDIZAGEM - O DESENVOLVIMENTO DA APRENDIZAGEM SIGNIFICATIVA
Authors: Mendes AndrÃ©ia Almeida , Ventura Rita de CÃ¡ssia Martins de Oliveira , De Souza Reginaldo Adriano , Miranda NatÃ¡lia Tomich Paiva , Araujo Glaucio Luciano , Arakaki Fernanda Franklin Seixas
Published: July 2019

Este estudo analisa a percepÃ§Ã£o dos estudantes do curso de AdministraÃ§Ã£o com relaÃ§Ã£o ao processo de implantaÃ§Ã£o de metodologias ativas de aprendizagem, processo esse iniciado em 2012. Objetiva-se analisar a adaptaÃ§Ã£o desses alunos Ã  nova metodologia de ensino bem como as vantagens e as habilidades desenvolvidas por eles. Para tanto, realizou-se uma pesquisa descritiva do tipo survey, tendo como instrumento de coleta a utilizaÃ§Ã£o de questionÃ¡rios semiestruturados aplicados a 30 alunos dos perÃ­odos finais do curso; os dados foram tabulados atravÃ©s do programa Excel. Ao se analisar a aprovaÃ§Ã£o dos alunos com relaÃ§Ã£o Ã  nova metodologia de ensino, registrou-se que 96,7% dos alunos aprovaram totalmente ou parcialmente essa utilizaÃ§Ã£o, sendo a â€œRaspadinhaâ€, o MÃ©todo do Caso e a Aprendizagem Baseada em Problemas os mÃ©todos preferidos pelos alunos. Evidenciou-se que 83,4% dos alunos acreditam que seriam os dois mÃ©todos de forma conjugada que melhor contribuiria para o melhor aprendizado; salienta-se que esses mesmos percentuais se confirmam quando os alunos foram questionados sobre sua preferÃªncia pelo mÃ©todo de ensino no decorrer das aulas. Ao se analisar as vantagens do mÃ©todo, bem como as atitudes e habilidades adquiridas pelos alunos a partir da implantaÃ§Ã£o da metodologia ativa, percebeu-se que essa nova metodologia Ã© promotora de aprendizagem significativa.
AVALIAÃ‡ÃƒO ANTOPOMETRICA DE CRIANÃ‡AS COM IDADE ENTRE 4 E 5 ANO PARA ESCOLHA DE MOBILIARIO PARA SALA DE AULA.
Authors: Franca Silva Gustavo Thayllon , Luz Flavia Aparecida
Published: July 2019

Este estudo de caso faz parte de uma pesquisa que investiga o ambiente escolar e e as adaptaÃ§Ã£o dos alunos ao mobiliÃ¡rio jÃ¡ existente. Vamos apresentar a importÃ¢ncia que o uso do mobiliÃ¡rio adequado pode influenciar no rendimento escolar. Pois tem-se observado uma grande lacuna de aplicaÃ§Ãµes e adequaÃ§Ãµes ergonÃ´micas. O estudo foi realizado com 42 crianÃ§as com idade entre 4 e 5 anos na populaÃ§Ã£o presente em uma escola da rede particular na cidade de Ipatinga â€“MG. Realizaremos estudos das medidas antropomÃ©tricas necessÃ¡rias para a escolha do mobiliÃ¡rio (mesas e cadeiras) Os resultados nos permitiram concluir queÂ  nesse ambiente que os alunos passam maior parte do tempo e que seja maior a influÃªncia dele na postura esses desconfortos serem a causa de distraÃ§Ã£o e inquietaÃ§Ã£o