bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the effects of hyperbaric oxygen and extracorporeal shock wave therapy on healing in osteotendinousjunctional injuries: an experimental study of the rabbit model
Authors: HALİL Bilgin , ÖZKAN Yüksel , AKALIN Yavuz , ÇEVİK Nazan , ÖZTÜRK Alpaslan
Published: July 2019

Objectives:
To
biomechanically and histopathologically compare the effects on healing in the
osteotendinous region of the treatment methods of hyperbaric oxygen (HBO) and
extracorporel shock wave (ESW) on an injury created at the osteotendinous
junction in an experimental rabbit model. Methods: The study included 36 New Zealand rabbits.The
patellar tendon tibial osteotendinous junction was cut and then repaired. Group
1 was evaluated as the control group, with no further intervention.In Group 2,
a single session of ESW was applied at 14 hz/750 Impulse/10 mins to an area 1×1
cm2 in the repaired area under fluoroscopy guidance. The animals in
Group 3 were applied with 100% oxygen as HBO at 2.4 ATA/110 min for 7 days. At
the end of 6 weeks, 6 animals from each group were applied with a tension test
and 6 animals were processed for histopathological examination. Results: In Group 1, the forces at the start of the
separation of the osteotendinous junction, at a 2 mm separation and at full
rupture were lower than those of Group 2 and Group 3 (p = 0.001 and p = 0.001, respectively). The highest separation force values were
determined in Group 3 (p
= 0.001).
Histopathologically, a statistically significant difference was determined in
respect of the fibrocartilage tisssue formation, and fusion with new bone
tissue between Group 1 and Group 2 and between Group 1 and Group 3 (p
< 0.05). No statistically significant difference was determined between
Group 2 and Group 3 (p = 0.310).

Conclusions: It was observed that the application of HBO
and ESW improved biomechanical resistance and healing in the injuries in the
osteotendinous junction by increasing the bone-tendon fusion in this area.The
application of HBO and ESW increased biomechanical resistance compared to the
control group.In the histopathological evaluation, the ESW group was better than
the control group and the HBO group was evaluated as the best.
PEMBELAJARAN BERBASIS DIGITAL: STUDI PENGGUNAAN GEOGEBRA BERBANTUAN E-LEARNING UNTUK MENINGKATKAN HASIL BELAJAR MATEMATIKA
Authors: Sudihartinih Eyus , Wahyudin Wahyudin
Published: July 2019

Abstrak Penelitian ini menggambarkan pembelajaran berbasis digital, yaitu penggunaan Geogebra berbantuan e-learning, untuk meningkatkan hasil belajar mahasiswa pada konsep bidang dan garis dalam ruang. Penelitian ini adalah pre-experimental dengan jenis one-shot case study dengan partisipan mahasiswa calon dosen matematika pada semester II yang terdiri dari  14 orang laki-laki dan 30 orang perempuan dari salah satu universitas di Indonesia. Hasil penelitian menunjukkan penggunaan Geogebra berbantuan e-learning efektif untuk meningkatkan hasil belajar mahasiswa pada konsep bidang dan garis dalam ruang. Hal ini terlihat dari sebagian besar mahasiswa memperoleh hasil belajar yang maksimal, dan hanya sebagian kecil mahasiswa yang hasil belajarnya masih minimal. Penelitian ini merekomendasikan penggunaan Geogebra dan e-learning pada pembelajaran konsep geometri lainnya.

AbstractThis study describes digital-based learning, namely the use of Geogebra assisted by e-learning, to improve student learning outcomes in the concepts of fields and lines in space. This study was pre-experimental with a type of one-shot case study with participants of mathematics teacher candidates in the second semester consisting of 14 men and 30 women from one university in Indonesia. The results showed that the use of Geogebra assisted by e-learning was effective in improving student learning outcomes in the concepts of fields and lines in space. This can be seen from the majority of students obtaining maximum learning outcomes, and only a small percentage of students whose learning outcomes are still minimal. This study recommends the use of Geogebra and e-learning in learning other geometry concepts.
Az egészség, a környezet és az étkezés kapcsolata – Szakirodalmi áttekintés
Authors: Kiss Virág Ágnes , Dombi Mihály , Szakály Zoltán
Published: July 2019

Az elmúlt hetven év az emberiség számára történelme talán leggyorsabb fejlődési szakaszát jelentette. Az emberek széles rétegei tudták maguk mögött hagyni a szegénység és éhezés kínzó kötelékeit, miközben a kommunikáció, kereskedelem és közlekedés terén végbement robbanásszerű technológiai előrelépések megnyitották az utat a fogyasztás, a szabadság és a tudomány demokratikus térnyerése előtt. Ennek a folyamatnak viszont kétségtelenül azonosíthatók az árnyoldalai is: paradox módon egyre szélesedő ismereteink és tudásunk ellenére egyre kétségesebb az, hogy hagyományos kulturális értékeink, egészségi állapotunk és a természeti környezetünk hosszú távon javulni tudnak.Szakirodalmi áttekintésünkben annak a lehetőségét vizsgáljuk, hogy a hosszú távú gazdasági fejlődés fentebb bemutatott „káros mellékhatásai” közül lehetséges-e érdemben többet együttesen „kezelni”. A fenntartható fejlődéssel – vagy újabban körkörös (cirkuláris) gazdasággal – foglalkozó szakirodalom egyre inkább összpontosít a különböző ökológiai és társadalmi problémák közötti kapcsolatra az igen összetett fenntarthatósági kérdésekre adott hibás környezetpolitikai reakciók elkerülése érdekében. Cikkünkben az egyik legnagyobb jelentőségű ilyen kapcsolatrendszer bemutatására teszünk kísérletet, ez az élelmiszerfogyasztás, és annak a természeti erőforrásokkal, valamint az egészségmegőrzéssel fennálló kölcsönhatásai. A fogalmakat önmagukban, majd a szakirodalomban fellelhető, őket összekapcsoló modellek mentén mutatjuk be.
JEL-kódok: F64, I12, O13, Q4, Q5
The Effect of Consumer Perceived Trust and Image Toward Food Brands on Consumers’ Willingness to Buy
Authors: Abdalrahman Mohammed , Lehota József
Published: July 2019

Purpose – consumers’ buying process is affected by many variables in which branding strategy is indeed an important variable to be considered. This paper aims to evaluate the influence of three branding elements – brand name, packaging, and country of origin – on Palestinian consumers’ willingness to buy food products to understand better their buying. Methodology – The study was conducted in the Palestinian market, the sample was selected according to simple random sampling technique, and a structured questionnaire was prepared, then it was electronically distributed by using emails and social media. The questionnaire contains 35 questions depending on a balanced Fifth Likert Scale and a single-item 7-point differential semantic scale, the questions intended to determine the influence of the selected branding elements on consumers’ willingness to buy food products. The data were analysed depending on the descriptive analysis and one sample t-test. Findings – according to the results of the data analysis it was found that product features and attributes were the factors of the highest importance that influenced the consumers’ willingness to buy, while the branding elements variables came at second rank of importance. Also, the results show that the effect of three chosen branding elements on consumer willingness to buy is significant. The outcomes of this study may be advantageous for firms working in food sectors, since the Palestinian market is lacking such a scientific study and help them in creating marketing strategies to increase the sales volume of their products.
JEL Codes: M31, M39
A HÍR védjegy ismertsége és beágyazódottsága a magyar fogyasztók körében
Authors: Török Áron
Published: July 2019

A Hagyományok-Ízek-Régiók (HÍR) program már több mint 20 éve indult el az EU-s Euroterroirs kezdeményezéshez kapcsolódóan Magyarországon, s célja a hagyományos és tájjellegű magyar élelmiszerek ismertségének növelése, illetve gazdasági hasznosulásuk javítása. Mindezeken túl immáron több mint 15 éve bejegyzésre került a HÍR védjegy is, amelynek használatára 2010 óta pályázhatnak a termelők, csoportosulások. A HÍR védjegy használata kézzelfogható termékdifferenciálási eszköz az arra jogosult felhasználóknak. 2018 végén 92 védjegyhasználati jogosult (termelő, csoportosulás) összesen 176 HÍR védjegyes termékkel rendelkezett. A 2015-ben indult Földrajzi Árujelzők Programja (korábban Eredetvédelmi Program) – amely az EU-s földrajzi árujelzőkkel rendelkező magyar termékek számának növelését célozza meg – is alapvetően a HÍR védjegyes termékekre épít, hangsúlyozva ezeknek a termékeknek a jelentőségét. Ugyan a hagyományos és tájjellegű magyar élelmiszereknek jelentős szakirodalma van és a HÍR védjegyes termékek előállítóiról is naprakész információkkal rendelkezünk, a HÍR védjegy és a fogyasztók kapcsolata egy meglehetősen feltáratlan terület. A tanulmány célja éppen ezért az, hogy a HÍR védjegy ismertségének, továbbá az ilyen tanúsítással ellátott termékek fogyasztását meghatározó tényezőket beazonosítsa és ismertesse.Egy nemzetközi felmérés magyarországi részeként a HÍR védjegyhez kapcsolódó online lekérdezés 2017. második felében történt meg, összesen 444 fogyasztó válaszai kerültek elemzésre. Az eredmények alapján elmondható, hogy a HÍR védjegy ismertsége közel 40%, ami messze meghaladja az EU-s földrajzi árujelzők ismertségének európai átlagát. A HÍR védjegyes termékeket ugyanakkor csak a címkét ismerő fogyasztók alig több mint 10%-a keresi tudatosan. A HÍR védjegyes termékeket rendszeresen vásárlók leginkább húsból készült élelmiszereket keresnek. Az ökonometriai számítások eredményeként megállapítható, hogy a HÍR védjegyet leginkább a nők, az idősebbek, illetve az alacsonyabb jövedelmi kategóriához tartozó fogyasztók ismerik. A címkét ismerők sokkal nagyobb valószínűséggel kerülnek ki azok közül a vásárlók közül, akik jellemzően bio boltokban, vagy közvetlenül a termelőtől vásárolnak élelmiszert, továbbá akik étrendjüket tekintve nem vegetáriánusok. A HÍR védjegyes termékek rendszeres vásárlói leginkább a férfiak, illetve azok a fogyasztók, akik elsősorban szupermarketekben és diszkontokban vásárolnak élelmiszert, s ez utóbbi bolttípusok emiatt potenciális értékesítési csatornát jelentenek.
JEL-kódok: M31, M37, O13, O34, Q13
ANALYSIS ON VENTILATION SYSTEM IN HOLES C1 UNDERGROUND MINES OF PT. NUSA ALAM LESTARI, DESA SALAK, KECAMATAN TALAWI, SAWAHLUNTO, WEST SUMATERA
Authors: Nata Refky Adi , Nanda Heru Firma
Published: July 2019

PT. Nusa Alam Lestari merupakan perusahaan tambang yang beroperasi pada tambang bawah tanah. Berdasarkan hasil pengamatan di lapangan, perusahaan hanya melakukan perencanaan penambangan belum mempunyai perencanaan ventilasi. Penelitian ini menganalisis sistem ventilasi aktual di lubang C1, menganalisis kualitas udara dan gas pada lubang C1 berdasarkan KepMen No. 555.K/26/M.PE/1995, dan memodelkan sistem ventilasi yang baik untuk lubang C1 menggunakan simulasi perangkat lunak Ventsim visual 5.2. Hasil penelitian  menyimpulkan belum optimalnya kinerja blower utama yang di pasang pada mulut tambang dalam mengalirkan udara bersih kedalam tambang yang disebabkan oleh rendahnya kapasitas hembus yang hanya 10.4 m/s dan panjangnya jalur udara pada sistem ventilasi aktual. Kualitas udara dan gas tambang pada lubang C1 cukup baik, sedangkan untuk temperatur rata-rata tiap front penambangan memiliki temperatur 30o yang melewati ambang batas yang ditetapkan yaitu antara 18-24oC dan kelembaban rata-rata tiap front penambangan memiliki kelembaban 70%, hal ini masih dibawah nilai ambang batas yang ditetapkan yaitu <85%. Setelah melakukan model sistem ventilasi untuk lubang C1, perencanaan menggunakan software Ventsim visual dengan bentuk gambaran ventilasi yang akan digunakan pada lubang C1 tambang bawah tanah PT. Nusa Alam Lestari. Dengan mengalirkan udara segar menggunakan blower dengan kapasitas 12.6 m3/s dan tiga blower bantu kapasitas 5.8 m3/s. Kata-kata kunci: ventilasi, blower, Ventsim visual
Classification of Alzheimer's Disease with and without Imagery Using Gradient Boosted Machines and ResNet-50
Authors: Fulton Lawrence V. , Dolezel Diane , Harrop Jordan , Yan Yan , Fulton Christopher P.
Published: July 2019

Alzheimer's is a disease for which there is no cure. Diagnosing Alzheimer's Disease (AD) early facilitates family planning and cost control. The purpose of this study is to predict the presence of AD using socio-demographic, clinical, and Magnetic Resonance Imaging (MRI) data. Early detection of AD enables family planning and may reduce costs by delaying long-term care. Accurate, non-imagery methods also reduce patient costs. The Open Access Series of Imaging Studies (OASIS-1) cross-sectional MRI data were analyzed. A gradient boosted machine (GBM) predicted the presence of AD as a function of gender, age, education, socioeconomic status (SES), and Mini-Mental State Exam (MMSE). A Residual Network with 50 layers (ResNet-50) predicted CDR presence and severity from MRI's (multi-class classification). The GBM achieved a mean 91.3% prediction accuracy (10-fold stratified cross validation) for dichotomous CDR using socio-demographic and MMSE variables. MMSE was the most important feature. ResNet-50 using image generation techniques based on an 80% training set resulted in 98.99% three class prediction accuracy on 4,139 images (20% validation set) at Epoch 133 and nearly perfect multi-class predication accuracy on the training set (99.34%). Machine Learning methods classify AD with high accuracy. GBM models may help provide initial detection based on non-imagery analysis, while ResNet-50 network models might help identify AD patients automatically prior to provider review.
Tracing Volcanic Activity Chronology from a Multiparameter Dataset at Shinmoedake Volcano (Kirishima), Japan
Authors: Yamada Taishi , Ueda Hideki , Mori Toshiya , Tanada Toshikazu ,   National Research Institute for Earth Science and Disaster Resilience (NIED) 3-1 Tennodai, Tsukuba, Ibaraki 305-0006, Japan,   Geochemical Research Center, Graduate School of Science, The University of Tokyo, Tokyo, Japan
Published: July 2019

Routine volcano monitoring increasingly involves multiparameter datasets. Databases that include multi-disciplinary datasets have great potential to contribute to the evaluation of ongoing volcanic eruptions and unrest events. Here, we examine the characteristics of a multiparameter dataset from Shinmoedake volcano (Kirishima) in Japan for the period of 2010–2018 to examine how the chronology of volcanic activity can be traced. Our dataset consists of global navigation satellite system (GNSS), seismic, tilt, infrasound, sulfur dioxide (SO2) column amount, and video records. We focus mainly on the period after 2012, particularly a series of ash emissions in 2017 (hereafter the 2017 eruption), lava effusion, and Vulcanian eruptions in 2018 (hereafter the 2018 eruption). Our dataset shows that the GNSS observations successfully captured the gradual inflation of the volcano edifice, suggesting magma intrusion or pressure buildup in the magma storage region prior to the 2017 and 2018 eruptions. The number of volcanic earthquakes also gradually increased from 2016 toward the eruptions, particularly events occurring beneath Shinmoedake. Tilt data captured a precursor tilt event prior to the 2017 eruption and a magma chamber deflation during the lava effusion of the 2018 eruption. Tilt, seismic, infrasound, SO2 gas column, and video data record signals accompanying periodic degassing during the lava effusion and explosive degassing accompanying the Vulcanian eruptions, which have similar characteristics to those reported for past eruptions at Shinmoedake and other volcanoes. This similarity suggests that multidisciplinary databases will be an important reference for future evaluations of ongoing volcanic activity and unrest.
THE INFORMATION STRUCTURE IN ARABIC-JAVANESE TRANSLATION: CASE STUDY IN THE BOOK OF BIDAYAH AL-HIDAYAH
Authors: Anis Muhammad Yunus , Farhah Eva , Arummi Afnan
Published: July 2019

Communication involves the actual use of language in real. As we have known that language is the main medium for communication. One of the important thing to develop the effective communication is by packaging the structure of information. There are two basic elements in the information, they are: theme and rheme. Theme had been considered as the known information and the rheme absolutely had been considered as new information. This paradigm based on the Systemic Functional Linguistics (SFL). Halliday considers language as having three main functions: (1) the ideational function; (2) the interpersonal function; and (3) the textual function. This paper will focus in the textual function and “clause as a message”. Arabic language has a unique structure of clauses, we can find two basic notions (mubtada’+khabar) and (fi’l+fa’il), in the other hand, semantically, we can find (musnad+musnad ilaih), so this article tried to find the correlation between the structure of Arabic clauses with (theme+rheme) construction. This article also will find out the kinds of theme in Arabic language (multiple themes, clause as themes, and predicated themes). Theme as an initial element in SFL should be described by looking the rheme in the text. The method in this research was divided into three parts: (1) collecting the data from the book of Modern Written Arabic and also some articles in the Arabic-Javanese translation book Bidayah al-Hidayah, the data is the clauses with nominal and verbal initial; (2) analysis data, using the descriptive analysis and distributional method; and (3) reporting the data (formal and informal). The result of this article had concluded that there is a near connection between (mubtada’+khabar), (fi’l+fa’il), and (musnad+musnad ilaih) with the theme and rheme construction based on the SFL theory.
Orthopaedic Tips: A Comprehensive Review of Midshaft Clavicle Fractures
Authors: Honeycutt M. Wesley , Fisher Michael , Riehl John T.
Published: July 2019

Clavicle fracture is a common orthopaedic injury, which represents up to 5% of all fractures. The middle third of the clavicle is the most commonly fractured region, primarily because of its unique osseous anatomy and surrounding soft tissue attachments. Management of midshaft clavicle fractures has shifted substantially over the past 20 years, as the operative indications have become increasingly better defined with newer randomized controlled trials. This article presents a comprehensive review of the epidemiology, relevant anatomy, clinical assessment, and management of midshaft clavicle fractures.
Analysis of Boundary-Dominated Gas Well Production Data
Authors: Mohammed Shaibu , Anumah Prosper , Sarkodie-Kyeremeh Justice , Morgan Anthony , Acheaw Emmanuel
Published: July 2019

Arps’ hyperbolic model has historically been used to analyze and forecast gas well performance. This is largely due to its simplicity and explicit nature. Unfortunately, because of the variations of viscosity-compressibility product with average reservoir pressure during boundary-dominated flow (BDF) period, the Arps’ hyperbolic model overestimates gas reserves and future rates. Consequently, existing rate-decline models rely heavily on pseudotime. Unfortunately, pseudotime requires iteration, which is time-consuming.

This paper proposes an empirical rate-decline model for a gas well producing at a constant pressure during BDF. The proposed model utilizes a drawdown correlating parameter that accounts for formation and water compressibilities, as well as the variations of gas properties with pressure. Due to its explicit nature, the proposed rate-decline model can be used to forecast future gas well performance. An explicit model for estimating the decline exponent for a gas well is also proposed. In addition, this paper presents a semi-empirical flowing material balance (SE-FMB) method that allows the estimation of initial gas-in-place, real gas productivity index and estimated ultimate recovery. The advantages of the proposed SE-FMB over the existing methods are two-folds: first, it is iterationless; and second, it avoids the use of a functional relation (or curve fitting) of viscosity-compressibility product and pressure.

The results of this study suggest that the decline exponent for a gas well is time-independent at early-time BDF period and time-dependent at late-time BDF period. At very late-time BDF period, the decline exponent tends to zero. Thus, gas well production data exhibit a hyperbolic decline at early-time BDF period and a transition period at late-time BDF period. At very late-time BDF period, an exponential decline is expected. While the exponential-decline period is not observed in practice due to economic-rate constraints, the hyperbolic-decline period is observed in practice. The transition period may or may not be observed in practice depending on the magnitude of the drawdown parameter and the economic-rate constraints. Comparison of the models results indicates that the proposed rate-decline and the classical Arps’ hyperbolic models are consistent with the rate history during the hyperbolic-decline period; however, the proposed rate-decline model out-performs the classical Arps’ hyperbolic model when the transition period prevails. The results of this study also indicate that ignoring the formation and water compressibilities lead to an overestimation of gas reserves even for a normally-pressured gas reservoir. Simulated and field data have been used to demonstrate the validity and applicability of the proposed model and analysis method.
A Non-Resistivity Approach for Estimating Water Saturation A Case Study in Niger-Delta, Nigeria
Authors: Awuyo Olabode , Sunday Abel , Fadairo Adesina
Published: July 2019

The notion of Water Saturation is of importance in determining the hydrocarbon saturation (1-Sw) in reservoirs, calculating hydrocarbon in place, hence a vital evidence of reliable formation evaluation. Preconceptions in reserves quantification and hydrocarbon in place estimations arise once the outcome of the water saturation value is erroneous. Several models in the literature have been used for estimating water saturation and oftentimes the variance in confidence level of their results lead to substantial variance in original hydrocarbon in place volumes. Obtaining a better resolution with deeper understanding of the gaps observed in the existing approaches for estimating water saturation (Sw) values have been a major challenge in accurate calculation of hydrocarbon in place.

This paper presents a non-resistivity approach for estimating water saturation using Leverett J-function and Reservoir Quality Index with dependency on fluid and facies Values. The innovative approach involves the use of Saturation Height Modelling through Leverett J- function, build facies through Magnetic Resonance Graphical-Based clustering (MRGC) option, use of Regression method and making a simple scripting using logging language (LOGLAN) program in Geolog to achieve the purpose. This current approach has been applied to Niger-Delta alternate shale-sand formation in optimisation of somewhat low recovery of the hydrocarbon reserves due to probably erroneous over estimation of Water Saturation value from Resistivity-based approach. Reliable results from current non-resistivity approach were obtained with average Water Saturation value of 25% as compared to resistivity approach presented by Juhasz with average water saturation value of 32% and non-resistivity approach presented by Brooks-Corey with average water saturation value of 26% and Leverett J- function with average water saturation values of 27% respectively.
Legal and Policy Requirements of Basic Health Insurance Package to Achieve Universal Health Coverage in a developing country
Authors: Hayati Ramin , Kavosi Zahra , Bastani Peivand , Kabir Mohammad Javad , Sobhani Ghasem , nasab Hamide Javadi
Published: July 2019

Objectives: This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view.
Results: All the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into 3 main themes and 11 subthemes. The main themes include three kinds of requirements at three level of Third party insurer, Health care provider and Citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.
Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections.
Authors: Pieniawska-Śmiech Karolina , Bar Kamil , Babicki Mateusz , Śmiech Karol , Lewandowicz-Uszyńska Aleksandra
Published: July 2019

Background

Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 300 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 207 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics ward of J.Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with primary immunodeficiency (PID) and children with recurrent respiratory tract infections (RRTI) by assessment of their height and weight. All of parameters were evaluated using centile charts suitable best for the Polish population.

Results

The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 20% of them had their height situated below 3rd percentile. No statistically relevant differences have been found between them and RRTI group. The statistically significant difference was between the nutritional status of PID patients and the control group.

Conclusions

There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.
Protocol for cryo-focused ion beam lift-out technique
Authors: Schaffer Miroslava , Pfeffer Stefan , Mahamid Julia , Kleindiek Stephan , Laugks Tim , Albert Sahradha , Engel Benjamin D. , Rummel Andreas , Smith Andrew , Baumeister Wolfgang , Plitzko Juergen M.
Published: July 2019

Cryo-focused ion beam milling of frozen hydrated cells for the production of thin lamellas in combination with cryo-electron tomography (cryo-ET) has yielded unprecedented insights into the cell interior. This method allows access to native structures deep inside cells, enabling structural studies of macromolecules in situ. However, it is only suitable for cells that can be vitrified by plunge freezing (<10 μm). Multicellular organisms and tissues are considerably thicker and high-pressure freezing is required to ensure optimal preservation. Here, we describe a preparation method for extracting lamellas from high pressure frozen samples with a new cryo-gripper tool. This in situ lift-out technique at cryo-temperatures enables cryo-ET to be performed on multicellular organisms and tissue, extending the range of applications for in situ structural biology.
Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial
Authors: Kim Hyerim , Lee Jung-Man , Lee Jiwon , Hwang Jin-Young , Chang Jee-Eun , No Hyun-Joung , Won Dongwook , Row Hyung Sang , Min Seong-Won
Published: July 2019

Background

Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation.

Methods

Patients were randomized to the ‘neck extension group (E group)’ or ‘neutral position group (N group)’ for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patient’s neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as to ‘success.’ We compared the success rate of tube advancement between the two groups.

Results

Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002).

Conclusion

Neck extension during tube advancement from the nasal cavity to the oropharynx before laryngoscopy could be helpful in nasotracheal intubation.
3D printed guiding device assisted bilateral crossing cervical microendoscopic laminoplasty for cervical spondylotic myelopathy: a study protocol for a randomized controlled trial
Authors: Zhang Chunlin , Feng Yang , Yan Xu , Yang Tengyue , Shao Chenglong , Shang Lijie , Liu Yang , Wu Yanyu , Zhao Xiao
Published: July 2019

Background

Cervical microendoscopic laminoplasty (CMEL) is an important surgical method for the treatment of cervical spondylotic myelopathy (CSM). It has the advantages of minimal incision and quick recovery, meanwhile, it also has disadvantages, such as its tedious to install the implants and long operative time. This study proposes a new method of 3D printed guiding device assisted bilateral crossing cervical microendoscopic laminoplasty for CSM, which can further improve the accuracy and efficiency of surgery and shorten the operative time.

Methods/design

Patients who met the surgical criteria will be randomly divided into experimental group and control group. The experimental group will be treated with 3D printed guiding device assisted bilateral crossing cervical microendoscopic laminoplasty. The control group was treated with CMEL. The primary outcomes will be incision length, operative time, intraoperative blood loss and adverse events. The secondary outcomes will be the Japanese Orthopedic Association (JOA) score, the visual analogue scales (VAS) for neck and shoulder pain, cervical curvature index (CCI), range of motion (ROM), the sagittal diameter of the spinal canal, and the healing of the grooves. These parameters will be evaluated preoperatively, intraoperatively, 1 week postoperatively, as well as 3, 6, 12, 24 months postoperatively.

Discussion

This study was the first randomized controlled trial to compare 3D printed guiding device assisted bilateral crossing cervical microendoscopic laminoplasty with CMEL. The results of this study may facilitate the development of surgical treatment of cervical spondylotic myelopathy.
A randomised controlled trial exploring the impact of a dedicated Health and Social Care Professionals team in the Emergency Department on the quality, safety, clinical and cost-effectiveness of care for older adults: Study Protocol
Authors: Cassarino Marica , Robinson Katie , O’Shaughnessy Íde , Smalle Eimear , White Stephan , Devlin Collette , Quinn Rosie , Trépel Dominic , Boland Fiona , Ward Marie E. , McNamara Rosa , O’Connor Margaret , McCarthy Gerard , Ryan Damien , Galvin Rose
Published: July 2019

Background

Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-index visit, often have increased ED length of stay and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, clinical and cost-effectiveness of care of older adults when compared to usual care.

Methods

The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcomes include ED length of stay (from arrival to discharge) and incidence of inpatient admissions from the ED. Secondary outcomes include: ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to usual care; and perceptions on implementation by ED staff members.

Discussion

This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation.
The Expression of P16 and S100 Associated with Elastin Degradation and Fibrosis of the Ligamentum Flavum Hypertrophy
Authors: hu Wei , Kan Shunli , Liu Guang , Cao Zegang , Zhu Rusen
Published: July 2019

Background: One of the characteristics of lumbar spinal stenosis (LSS) is elastin degradation and ﬁbrosis in the ligamentum ﬂavum (LF). P16 and S100 participate in scar formation and collagen development in wound healing and ﬁbrosis diseases. In this study, we investigate the association between P16 and S100 expression and the ﬁbrosis of the hypertrophic LF in LSS.

Methods: The LF specimens were surgically obtained from thirty patients with single-segment LSS (SLSS) and 30 patients with double-segment LSS (DLSS). 30 patients with L4/5 lumbar disc herniation were included as control. The LF thickness was measured by axial T1-weighted Magnetic Resonance Imaging(MRI). The extent of LF elastin degradation and fibrosis were graded based on hematoxylin-eosin (H&E) and Verhoff’s Van Gieson’s (VVG) stain, respectively. The localization of P16 and S100 within the LF tissue was determined by immunohistochemistry. Linear correlation tests between LF thickness, fibrosis, P16 and S100 expression was analyzed.

Results: The Absolute and relative LF thickness were greater in the DLSS group compared with the SLSS and LDH groups (p < 0.05). The mean thickness in the DLSS group was 5.658mm (RT = 43.107), compared with 4.924 mm (RT=36.520) and 2.886 mm (RT=21.330), respectively in the SLSS and LDH groups. The amount of collagen deposition is significantly higher in the DLSS group compared with the SLSS and LDH groups (p < 0.05) as shown by the H&E staining. A higher level of elastic tissue was also seen in the DLSS group compared with the SLSS and LDH groups (p < 0.05) though VVG staining. There was a significant correlation between H&E mean rating and relative LF thickness in the DLSS group (r = 0.562; p = 0.010). The specimens in the DLSS group showed positive staining of P16. All the three groups were stained with S100 in the dorsal layer of the LF.

Conclusions: Elastin degradation and fibrosis of the LF in the DLSS patients is more severe compared with the SLSS and LDH patients. The expression of P16 may related to LF hypertrophy in the patients who suffer with LSS. LF hypertrophy process may not be associated with S100.
Community perceptions about dementia in southwestern Uganda
Authors: Owokuhaisa Judith , Rukundo Godfrey Zari , Wakida Edith , Obua Celestino , Buss Stephanie S.
Published: July 2019

Background

With the increasing number of people surviving into older age in Africa, dementia is becoming a public health problem. Understanding the social dynamics of dementia in resource-limited settings is critical for developing effective interventions. We explored community perceptions about people with dementia in southwestern Uganda.

Methods

Fifty-nine individuals (aged 19-85 years, 56% female) participated in seven focus group discussions. In addition, 22 individual in-depth interviews were conducted among individuals (aged 22-84 years, 36% female). Both interviews and focus group discussions were audio recorded, transcribed verbatim, and evaluated using a content analysis approach.

Results

Four themes were generated during content analysis: i) Labeling of the illness, ii) Presentation of the person with dementia, iii) Causation, iv) Impact of the disease on people with dementia and their caregivers. Dementia was commonly referred to as okuhuga” (also, oruhuzyo/ empugye / akahuriko) which translates as “mental retardation”. The participants reported that most people with dementia presented with forgetfulness, defecating and urinating on themselves, wandering away from home, going out naked, and picking up garbage. Some participants perceived memory problems as a normal aging process, while others attributed the cause of dementia to syphilis, cancer, allergy, old age, satanic powers, witchcraft, poor nutrition, and life stress. Participants reported multiple sources of stress for caregivers of people with dementia, including financial, social, and emotional burdens. Finally, participants suggested that community and governmental organizations should be involved in meeting the needs of people with dementia and their caregivers.

Conclusions

Communities in southwestern Uganda identified dementia as a problem that comes with advanced age, have partial knowledge about the presentation and causes of dementia, and identify significant stressors affecting people with dementia and their caregivers. Families and caregivers would benefit from more education on causes of dementia, management of symptoms, and assistance in overcoming associated financial, social, and emotional burdens.
UPLC-MS based urine untargeted metabolomic analyses to differentiate bladder cancer from renal cell carcinoma
Authors: Wang Zhan , Liu Xiaoyan , Liu Xiang , Sun Haidan , Guo Zhengguang , Zheng Guoyang , Zhang Yushi , Sun Wei
Published: July 2019

Purpose

To discover biomarker panels that could distinguish cancers(BC & RCC) from healthy controls(HCs) and bladder cancers(BC) from renal cell carcinoma(RCC), regardless of whether with hematuria.

Methods

Totallys, 403 participants were enrolled in our study, with 146 BC patients(77 without hematuria and 69 with hematuria), 115 RCC patients (94 without hematuria and 21 with hematuria) and 142 gender- and age- matched HCs. Their midstream urine samples were collected and analysed by performing UPLC-MS. The statistical methods and pathway analyses were applied to discover potential biomarker panels and altered metabolic pathways.

Results

The panel of α-CEHC, β-cortolone, deoxyinosine, flunisolide, 11b,17a,21-trihydroxypreg-nenolone and glycerol tripropanoate could distinguish the cancers from the HCs(the AUC was 0.950) and the external validation also displayed a good predictive ability (the AUC was 0.867). The panel consisiting of 4-ethoxymethylphenol, prostaglandin F2b, thromboxane B3, hydroxybutyrylcarnitine, 3-hydroxyphloretin and N'-formylkynurenine could differentiate BC from RCC without hematuria. The AUC was 0.829 in the discovering group and 0.76 in the external validation. The metabolite panel comprising 1-hydroxy-2-oxopropyl tetrahydropterin, 1-acetoxy-2-hydroxy-16-heptadecyn-4-one, 1,2-dehydrosalsolinol and L-tyrosine could significantly discriminate BC from RCC with hematuria(AUC was 0.913). Pathway analyses revealed there existed alterd lipid and purine metabolism between cancers and HCs, together with disordered amino acid and purine metablism between BC and RCC with hematuria.

Conclusions

The UPLC-MS urine metabolomic analyses could not only differentiate the cancers from HCs but also discriminate the BC from RCC. Besides, pathway analyses could demonstrate the deeper metabolic mechanism of BC and RCC.
A Novel Narrative E-Writing Intervention (NeW-I) for Parents of Children with Chronic Life-Threatening Illnesses: Protocol for an Open-Label Randomized Controlled Trial
Authors: Ho Andy Hau Yan , Dutta Oindrila , Tan-Ho Geraldine , Tan Toh Hsiang Benny , Xinyi Casuarine Low , Ganapathy Sashikumar , Ang Lee Beng , Car Josip , Ho Ringo Moon-Ho , Miao Chun Yan
Published: July 2019

Background:
Conventionally, psycho-socio-emotional interventions for parents of children with chronic life-threatening illness begin post child loss. Evidence indicates pre-loss interventions addressing anticipatory grief can improve psycho-socio-emotional well-being and grief outcomes among family caregivers of dying patients, but no known intervention addresses the unique psycho-socio-emotional needs of Asian parents facing their child’s chronic life-threatening illness. Globally, palliative care strives to holistically support patients and their caregivers at the end-of-life, but inadequacies exist both globally and locally in pediatric palliative care and parental bereavement support services.

Aim:
A novel evidence-based Narrative e-Writing Intervention (NeW-I) is developed to address this gap. NeW-I is a strength-focused, meaning-oriented and therapist-facilitated mobile app and web-based counseling platform that aims to enhance quality of life, spiritual well-being, hope and perceived social support, and reduce depressive symptoms, caregiver burden and risk of complicated grief among parents facing their child’s chronic life-threatening illness.

Methods:
The design of NeW-I is informed by an international systematic review and a Singapore-based qualitative inquiry on the lived experience of bereaved parents of children with chronic life-threatening illness. Together with four major local pediatric palliative care providers, NeW-I is implemented in Singapore as an open-label pilot randomized controlled trial with 66 parents and supplemented with a built-in accessibility and feasibility study.

Discussion:
NeW-I aspires to improve psycho-socio-emotional well-being of parents facing their child’s chronic life-threatening illness through a structured cyber-counseling platform, thereby enhancing holistic pediatric palliative care and parental bereavement support services. Findings from this pilot study can inform large-scale implementation and evaluation of NeW-I in Singapore and globally.
Development and validation of the Occupational Back Pain Prevention Behaviors Questionnaire in nursing personnel
Authors: Kazemi Seyedeh Somayeh , Tavafian Sedigheh-Sadat , Hidarnia Alireza , Montazeri Ali
Published: July 2019

Background: Occupational back pain is the most prevalent health problem among nurses and needs to be assessed by a valid and multi-factorial questionnaire. The purpose of the present study was to design and develop an instrument based on the PRECEDE-PROCEED model for assessing job-related behaviors that cause low back pain.
Methods: First an item pool of 49 items was generated. Then, content and face validity was carried out. Consequently, a cross-sectional study was conducted in Mazandaran, Iran. The questionnaire was distributed among a sample of nurses working in hospitals affiliated to Mazandaran University of Medical Sciences. Exploratory factor analysis was used to determine the factor structure of the questionnaire. The Cronbach’s alpha was estimated to assess the reliability and the intraclass correlation coefficient was calculated to examine stability.
Results: In all 155 nurses participated in the study. The mean age of respondents was 34.1 (SD = 7.66) years, and 83.2% were female. Six factors with 30 items emerged from the exploratory factor analysis: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior that jointly accounted for %66.5 of behavior change variance observed. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha=0.92). The intraclass correlation coefficient with 2-weeks interval also indicated that the questionnaire has satisfactory stability (ICC = 0.97).
Conclusions: The findings showed that the Occupational Back Pain Prevention Behavior Questionnaire is a reliable and valid instrument for measuring occupational back pain and prevention behaviors among nurses.
Keywords: Occupational Back Pain, Prevention behaviors, Psychometric evaluation, PRECEDE-PROCEED model, Nurse