bluuebunny/crossref_metadata_2025 huggingface dataset:
浅谈煤矿企业如何提高安全管理水平
Authors: 庆明 郭 , 望龙 马
Published: March 2019

煤矿企业随着管理人员素质和文化水平的提高，安全管理水平也不断提高。煤矿企业属于高危行业，在工作中，我们只有将安全责任落实，做好人、机、环、管四个方面管控，企业才能取得更好的成绩。安全生产管理工作只有真正做到领导重视，制度制定落实到位、措施落实到位、隐患排查整改到位、考核到位，加强班组建设，严格奖惩兑现，不断提高安全管理水平，才能确保安全生产，此外，对于高危行业来说，还需要全面开展安全生产薄弱环节的排查、识别、分析和管控，杜绝或减少因薄弱环节管控不到位而引发的各类风险和事故。强化安全生产基础，提升安全管理水平，为实现安全生产目标奠定坚实基础。
顶推法桥梁施工实践报告
Authors: 绍朋 李
Published: March 2019

浅谈桥梁施工中顶进法施工技术的相关内容，明确施工方法及程序。

桥梁是线路的重要组成部分，每当运输工具发生重大变化,便推动了桥梁工程技术的发展。19世纪20年代,随着铁路的出现，桥梁工程建设技术不断翻新,从工程技术的角度来看，桥梁发展分为古代、近代和现代三个时期：古代桥梁一般为倒躺树木自然形成；在近代桥梁施工中钢材成为重要的造桥材料；20世纪30年代，预应力混凝土和高强度钢材相继出现，材料塑性理论和极限理论的研究，桥梁振动的研究和空气动力学的研究，以及土力学的研究等进展使近代桥梁施工技术应运而生。目前桥梁施工有悬臂浇注施工、顶锥法施工等方法。现在单对桥梁顶推施工方法进行了研究，本文阐述了其施工原理和施工工艺，指出其优缺点和不足之处，为以后同类工程施工提供一定的借鉴。
层次分析法在隧道-滑坡体系安全评价中的应用
Authors: 宜驰 路 , 治林 任
Published: March 2019

隧道-滑坡体系-整治结构是地质环境和隧道支护结构相结合的一个复杂体系,对其进行安全性评价是一个多因素的综合分析和评价问题。引入安全系统工程的方法对其进行安全性分析和评价,运用系统工程的分析原理和方法,能更好的综合分析各影响因素对隧道安全性的影响。
浅析非对称预应力筋双端张拉伸长量计算方法
Authors: 记良 聂
Published: March 2019

在桥梁施工中，预应力施工是关键工序，直接影响桥梁的结构稳定性和安全性。为保证预应力施工数据准确可靠，通过数据计算、分析、对比，对非对称双端张拉预应力筋伸长量的计算方法进行总结，以期达到指导施工，提升预应力工程施工水平。
The relationship between prosocial behaviours, aggression types and moralâ€”social rule knowledge in preschool children
Authors: Dereli Esra
Published: March 2019

The objective of the present study was to investigate prosocial behaviour, aggression types and moral and social rule knowledge perceptions of 4â€“5 year old preschool children. The study sample included 310 children (154 female and 156 male), who were attending a pre-school education institution during the 2017â€“2018 academic year. A personal information form, Pre-School Social Behavior Scale-Teacher Form and Moral and Social Rule Knowledge Perception Scale were used as data collection instruments. The data were analysed with descriptive analysis, Pearson product-moment correlation coefficient and stepwise regression analysis. In the study, it was determined that there were moderate significant correlations between prosocial behaviour, aggression types and moral and social rule knowledge perceptions of 4â€“5 year old preschool children. It was also determined that prosocial behaviour and aggression types scores of the children significantly predicted their moral and social rule knowledge perception scores.

Keywords: Prosocial behaviours, aggression types, moral rule knowledge, social rule knowledge.
The content analysis of the English as an international language-targeted coursebooks: English literature or literature in English?
Authors: Solhi Andarab Mehdi
Published: March 2019

The integration of literature and literary works has always played an undeniable role in language education. Despite the existence of a wealth of literature in non-native English-speaking countries, in the majority of the coursebooks, the entire attention is devoted to literary works of the native English-speaking countries. In this study, five coursebooks claiming to be based on English as an international language (EIL) were randomly selected and analysed to investigate to what extent they have incorporated the literatures of native and non-native English-speaking countries. The criteria for the content analysis of the claimed EIL-based coursebooks were based on Kachruâ€™s Tri-Partide Model to categorise the countries, and culture with a small c and Culture with a capital C dichotomy. Results indicated that although the chosen coursebook purports to be based on EIL, less or nearly no attention is given to the literary works of the non-native speakers of English.

 

Keywords: ELT coursebooks, English as an international language, Kachruâ€™s Tri-Partide model, literature in English
Students’ social studies-oriented academic risk-taking behaviours and autonomous learning skills
Authors: Karademir Cigdem Aldan , Akgul Aysun
Published: March 2019

The learning process, defined as behaviour change, does not only involve learning; the individual is also expected to take an active role in this process and an academic risk in uncertain situations. In this study, descriptive survey model was utilised. Participants were secondary school students (11–13 years) from Turkey. ‘Social Studies-Oriented Academic Risk Taking Scale’, ‘Autonomous Learning Scale’ and personal information form were used for data collection tools. Students’ social studiesoriented academic risk taking levels and autonomous learning levels were determined. The results show a moderate-level correlation between autonomous learning skills and academic risk-taking behaviours. The results also indicate that there is a difference in favour of female students, parental attitudes have no effect on autonomous learning and maternal attitude is effective only in the ‘Avoiding Academic Risks’ sub dimension. The students who perceive themselves to be successful take more academic risks and have more efficient autonomous learning skills.
Keywords: Academic risk, academic risk-taking behaviour, autonomous learning skills, secondary school students
Vision of Moscow and Muscovites in Migrants from the Republic of Dagestan and in their Social Environment
Authors: Endryushko Anna A. , Khamidova Inzhila A.
Published: March 2019

Sociological research shows that there is intolerance towards migrants staying in Russian society. Moreover, Russian citizens express the highest level of negativism in relation to representatives of the North Caucasus, that is, citizens of our country who come to work in its other regions. Also, the representations of migrants themselves about the local residents in host societies remain unexplored. In the article, based on the theory of contact, an attempt is made to study the migratory experience of migrants from the Republic of Dagestan who are leaving for work in the capital (direct contact) and their social environment in places of permanent residence (extended contact), as well as the role of direct and indirect migration experience in the formation representations of rural residents of the republic about Moscow and Muscovites. Residents of the republic who did not have migration experience were considered as a control group. The study used quantitative and qualitative methods – questioning respondents who had never been to Moscow and in-depth interviews with labor migrants. It was found that extended contact with Muscovites does not have a significant effect on the changes in their perceptions about the descendants of rural areas of the Republic of Dagestan, their social environment of migrants and other residents of the villages under study. Also, a comparative analysis of the formation of representations of migrants and rural residents of the two North Caucasian republics – Chechnya and Dagestan. There are significant differences in the regions studied, connected, in our opinion, with the frequency of contacts with the Russian population in the places where migrants live.
“Negative Stabilization” and Factors of Population Welfare Dynamics in Post-Crisis Russia
Authors: Tikhonova Natalia E.
Published: March 2019

Recent years have been characterized by a further drop in real incomes of Russians and the spread of pessimism among them regarding their material situation (after a short-term growth of optimistic expectations during the presidential campaign). The current situation in Russia in this area can be described as “negative stabilization”, because, although the decrease in the population’s incomes has stopped, they have stabilized at a lower level than prior to the crisis of 2014–2016. Groups which differ in the dynamics of their material situation starting from 2014 also differ in the specifics of their composition and positions in the system of monetary and especially non-monetary inequalities. The higher an individual’s place in the social hierarchy of life chances, the higher the likelihood of him being in an upward mobility group and the lower the chances of winding up in a group with downward mobility, and vice versa. For the evolution prospects of Russian society’s stratification model this means an increasing polarization of the mass strata of the population. However, so far these processes proceed at a moderate pace and affect the “top” rather than the “bottom” of these strata. The most significant factors determining Russians’ assessments of the dynamics of their material situation are their health, type of locus-control and planning horizon — personal characteristics that affect the ability of developing and implementing effective adaptation strategies. The high importance of personal factors for the dynamics of one’s material situation indicates the crisis nature of modern Russian society, since for crisis societies personal qualities of an individual are more important for the vector of his mobility than structural factors or human and social capital.
Language Conflict in Various Dimensions: The Cases of Tatarstan and Bashkortostan
Authors: Arutyunova Ekaterina M.
Published: March 2019

This article presents an analysis of the linguistic conflict in republics of the Russian Federation in 2017–2018. These contradictions can be reasonably interpreted as being a conflict. Three dimensions of the conflict are considered based on the example of the republics of Tatarstan and Bashkortostan. The institutional dimension lies within the contradictions between the Federal center and regions on based on legal discrepancies between regional and Federal legislation in the field of language and education. Legal practice has not been able to resolve these contradictions, because it did not have a single direction. The nature of interaction between the Federal center and republics when contradictions arise is connected to the obvious trends of centralization and the reduction of regions’ authority. Analysis of contradictions at the level of “regional power – group of the population” leads to the conclusion that another significant reason for intensifying conflict lies within the continued lack of attention from regional authorities to issues concerning how part of the population perceives the language policy in education within the context of insufficient teaching of republican state languages. The “group – group” dimension consists of contradictions in the discourse between supporters of the compulsory study of official republican languages and supporters of the voluntary study of official languages. Language contradictions have led to activists and nationalists in the republics becoming more active (to varying degrees), while stimulating them to make new statements and partake in actions, which may have some impact on attitudes when it comes to interethnic relations and on the strengthening of ethnic borders.
The Structure and Typology of the Ethnic Identity of Members of Interethnic and Mono-ethnic Families (a comparative analysis)
Authors: Sikevich Zinaida V. , Possel Yuliya A.
Published: March 2019

This article is devoted to a comparative analysis of ethnic identity in interethnic and mono-ethnic families on the example of St. Petersburg, and is based on data from a sociological survey conducted in 2017. During the study, members of 106 interethnic families were interviewed and 45 mono-ethnic families were analyzed as a control group. The main conclusions of the study include the following. In interethnic families ethnic identity is established, in the case of a mono-ethnic identity it coincides with the identity of mothers, mostly Russians. In general, the influence of mothers on the ethnic self-identification of children is stronger than the impact of fathers. This is due to the dominance of maternal socialization, inherent in the national tradition, and also because most Russian mothers bring up their children in the Russian cultural environment. The attitude towards their ethnic identity in children is more indifferent compared to the sense of “national pride” inherent in most parents. For all categories of the sample, with the exception of fathers from interethnic families, cultural signs of self-identification are more important than others. Fathers of different cultures allot special importance to blood kinship. The main features of ethnic consolidation for all survey participants are cultural traditions and the native language. National identity for all survey participants, except for “non-Russian” fathers, prevails over ethnic self-determination. Ethnic prejudices dominate over religious prejudices. In comparison to Christians, Muslims are more rejecting. The presence of ethnic prejudice is not connected with membership in an interethnic or mono-ethnic family, and is most likely due to the personal attitudes of the respondents.
Implementação da abordagem e tecnologia BIM no processo de gestão na FIOCRUZ
Authors: Pereira Silvia Maria Soares de Araujo , Correia Marcia Castilho
Published: March 2019

A FIOCRUZ é uma autarquia fundacional, com presença nacional, que objetiva a produção e o compartilhamento de conhecimentos e tecnologias voltados para a saúde. A adoção do BIM (Building Information Modeling) em gestão de espaços, ativos e manutenção, gestão de processo de projeto e de parque edificado é explorado neste artigo que relata a experiência do Departamento de Arquitetura e Engenharia (DAE), da COGIC-FIOCRUZ. A COGIC é responsável pelo gerenciamento do espaço físico da FIOCRUZ como um todo, prestando desde serviços básicos até executando obras, manutenção civil e de equipamentos. Em edificações atua em todo o seu ciclo de vida: concepção, elaboração de projeto, construção, uso e manutenção, renovação e demolição, sendo o DAE, um dos principais executores dessas ações. O método utilizado foi pesquisa bibliográfica e pesquisa ação. Foi possível a verificação prática de algumas vantagens como a redução do retrabalho no processo de projeto, além da redução no tempo do projeto executivo e uma ampliação do tempo do anteprojeto, em função dos ajustes na compatibilização de todas as disciplinas, já nesta fase. Ao divulgar as experiências e caminhos já trilhados, pode-se auxiliar outros órgãos públicos na implementação de um processo de inovação e de mudança de cultura.
The effect of endodontic filling agents on the activity of the regeneration processes of bone tissue in the experiment
Authors: Han Iryna , Musij-Sementsiv Khristina , Zubachyk Volodymyr
Published: March 2019

Introduction. Highly important is to regenerate the inflammatory destructive processes of bone tissue outside the apical area of the tooth that would optimize reparative bone formation, mineralization of tooth tissues, restoration of periodontal function and stability of tooth to occlusive loads, especially with acquired extensive root apex. Low efficiency of endodontic treatment led to the searching of the new osteotropic drugs of osteoconductive action and biorevitalization to stimulate the repairing and regeneration of tissues outside the apical area and dense obturation of the apex of the tooth root.Aim. of our research was to determine the dynamics of reparative processes in the bone tissue under the influence of drugs and compositions for endodontic treatment based on an analysis of indicators of a mineral metabolism, marker enzymes and an activity of antioxidant system and lipid peroxidation.Material and Methods. An experiment was conducted on 120 white rats. It was created a bone defect, which was filled with studied biomaterials or left with a blood clot. From the experiment the rats were taken out on 14 and 90 day. In homogenates of bone tissue it was examined the activity of lysosomal enzymes — alkaline (ALP) and acid (AP) phosphatases and the content of microelements — calcium and phosphorus. In the blood of rats it was studied the concentration of general protein, lipid peroxidation products — malonic dialdehyde (MDA) and the enzyme activity of antioxidant system — catalase (CAT) and superoxide dismutase (SOD).Results and conclusions. Results of conducted experimental research of the effect of endodontic filling materials on the activity of the regeneration processes of bone tissue show that proposed compositions based on hydroxyapatite and beta-tricalcium phosphate, due to their osteoconductive and biorevitalization qualities, promote more active stimulation of bone tissue regeneration processes compared to generally accepted drugs.
HPV-related HNC – new challenge and hope for head and neck cancer subjects
Authors: Szyfter Krzysztof , Kiwerska Katarzyna , Wierzbicka Małgorzata
Published: March 2019

In recent years there are observed substantial changes in epidemiology of head and neck cancer. An incidence of laryngeal cancer is declining as a consequence of decreased tobacco smoking. Contrary, oropharyngeal cancer associated with HPV infection transmitted on sexual way is becoming much more frequent. The latter one is characterized with a better prognosis that most likely does not require intensive therapy. De-escalation of therapy in case of HPV-associated tumor is a matter of current studies.
Minimally invasive treatments revitalizing facial skin - a case study
Authors: Matthews-Brzozowska Teresa , Łącka Monika , Kawałkiewicz Weronika , Mojs Ewa , Kubisz Leszek
Published: March 2019

The increasing longevity of today’s societies has created a considerable need for the revitalization of facial skin undergoing the ageing processes. It is important to undertake preventive measures and start therapy when the first signs of ageing appear. This makes it possible to achieve a satisfactory effect while using minimally invasive procedures. Among them, treatments based on autologous preparations occupy a significant place, such as those using stem cells and concentrated growth factors (CGF), which have recently been introduced on the Polish market. Such a procedure was used on the patient described in this paper. In a series of instrumental studies, after three administrations of CGF-Harmony, improved values for the measurements reflecting skin elasticity were obtained, which was confirmed by instrumental examination of the skin using a Cutometer Dual MPA 580. Instrumental analysis of the mechanical parameters of facial skin makes it possible to demonstrate the effectiveness of treatment in the field of facial aesthetic medicine.
Folliculitis decalvans – a case study and an overview of literature
Authors: Wróbel Joanna , Sadowska-Przytocka Anna , Jenerowicz Dorota , Bowszyc-Dmochowska Monika , Czarnecka-Operacz Magdalena
Published: March 2019

Folliculitis decalvans is a rare disease that leads to alopecia. This disease is a major challenge for physicians due to the therapeutic difficulties. This publication describes the case of a patient in whom a dermatological condition had improved after using doxycycline.
Extraction of Inundation Areas Due to the July 2018 Western Japan Torrential Rain Event Using Multi-Temporal ALOS-2 Images
Authors: Liu Wen ,   Graduate School of Engineering, Chiba University 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan, Yamazaki Fumio , Maruyama Yoshihisa
Published: March 2019

A series of heavy rainfalls hit the western half of Japan from June 28 to July 8, 2018. Increased river water overflowed and destroyed river banks, causing flooding over vast areas. In this study, two pre-event and one co-event ALOS-2 PALSAR-2 images were used to extract inundation areas in Kurashiki and Okayama Cities, Okayama Prefecture, Japan. First, water regions were extracted by threshold values from three-temporal intensity images. The increased water regions in July 2018 were obtained as inundation. Inundated built-up areas were identified by the increase of backscattering intensity. Differences between the pre-and co-event coherence values were calculated. The area with decreased coherence was extracted as a possible inundation area. The results of a field survey conducted on July 16, 2018 were used to estimate the optimal parameters for the extraction. Finally, the results from the intensity and coherence images were verified by making comparisons between a web-based questionnaire survey report and the visual interpretation of aerial photographs.
Quick Estimation Method of Property Damage and Human Casualty in the Event of a Large Earthquake
Authors: Oki Takuya ,   Tokyo Institute of Technology 2-12-1-M1-25 O-okayama, Meguro-ku, Tokyo 152-8550, Japan, Osaragi Toshihiro , Sakamoto Yoho
Published: March 2019

Techniques for quickly and easily estimating wide-area damage are required to support various activities for reducing damage in the event of a large earthquake. In this paper, using a wide-area evacuation simulator, we estimate property damage and human casualties in 32 densely built-up wooden residential areas in Tokyo, assuming a large earthquake. Furthermore, the relationships among local urban environment, property damage, and human casualties are analyzed using multiple regression analysis.
Relationships Between Accessibility of Emergency Vehicles and Local Environments in Tokyo Metropolitan Area After a Large Earthquake
Authors: Kishimoto Maki ,   Tokyo Institute of Technology 2-12-1-M1-25 Ookayama, Meguro-ku, Tokyo 152-8550, Japan, Osaragi Toshihiro
Published: March 2019

To improve the accessibility of emergency vehicles after a large earthquake, it is important to quantify the effects of risk mitigation strategies. In this paper, using a simulation model that describes the movement of emergency vehicles amidst property collapse after a large earthquake, we evaluate street network accessibility in the Tokyo Metropolitan Area. Moreover, by analyzing the relationships between local environments and street network accessibility, we discuss the effects of risk mitigation strategies on improving street network accessibility.
Analysis of Evacuation Trajectory Data Using Tensor Decomposition
Authors: Kawai Yusuke ,   Graduate School of Informatics, Nagoya University Furo-cho, Chikusa-ward, Nagoya 464-8601, Japan, Ishikawa Yoshiharu , Sugiura Kento
Published: March 2019

Owing to the advances in information technology and heightened awareness regarding disaster response, many evacuation simulations have been performed by researchers in recent years. It is necessary to develop suitable disaster prevention plans or evacuation plans using data generated by such simulations. However, it is difficult to understand the simulation results in their original form because of the detailed and voluminous data generated. In this study, we focus on tensor decomposition, which is employed for analyzing multi-dimensional data, in order to analyze the evacuation simulation data, which often consists of multiple dimensions such as time and space. Tensor decomposition is applied to the movement trajectory data generated in the evacuation simulation with the objective of acquiring important disaster or evacuation patterns.
Arthroscopic Treatment of a Low-Velocity Gunshot Injury to a Primary Total Hip Arthroplasty
Authors: Fournier Matthew N. , Rider Carson M. , Olinger Catherine R. , Dabov Gregory D. , Mihalko William M. , Mihalko Marc J.
Published: March 2019

Case:

An immunosuppressed 51-year-old man sustained a ballistic injury about the site of a primary total hip arthroplasty, which had been performed for osteonecrosis of the femoral head 2 years earlier. He was treated with arthroscopic debridement and irrigation, inspection of the implants, and removal of foreign bodies.

Conclusion:

Ballistic injury to a hip arthroplasty site with retained foreign bodies is an unusual injury. Hip arthroscopy may represent a minimally invasive treatment option for implant inspection, joint debridement, and removal of intra-articular fragments while minimizing the risk of soft-tissue complications.
When Stars Do Not Align: Overall Hospital Quality Star Ratings and the Volume-Outcome Association
Authors: Fontana Mark Alan , Lyman Stephen , Islam Wasif , MacLean Catherine H.
Published: March 2019

Background:

Volume-outcome relationships are well established for coronary artery bypass grafting and total joint arthroplasty surgery. Although the U.S. Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Ratings program includes outcome quality measures for these procedures, these outcome quality measures are not counted toward the star ratings for low-volume hospitals. We sought to assess whether excluding low-volume hospitals from surgical quality measures with known volume-outcome relationships affects the star ratings.

Methods:

We identified quality measures used in CMS’s star ratings that are related to surgical procedures with a known volume-outcome relationship and tested for the presence of the volume-outcome association for each of these measures. We then imputed missing values for low-volume hospitals for each measure and otherwise identically repeated the CMS calculations in order to assess the percentages of hospitals with the same, better, or worse ratings.

Results:

Among the measures used to calculate star ratings, we identified 4 quality measures (2 related to coronary artery bypass grafting and 2 related to total joint arthroplasty) with known volume-outcome relationships that were excluded from the calculations of the star ratings for low-volume hospitals. We confirmed a volume-outcome association in the CMS data for all 4 measures. When total joint arthroplasty complications were imputed for low-volume hospitals and then included in the calculation of the star ratings, over one-third of hospitals received a different rating; both low-volume and other hospitals were more often hurt than helped. Imputing the other 3 quality measures among low-volume hospitals left the ratings unchanged.

Conclusions:

The CMS star ratings do not fully represent the risks of undergoing procedures at low-volume hospitals, potentially misrepresent quality across facilities, and hence are of uncertain utility to consumers.
Estudo retrospectivo dos diagnósticos de tristeza parasitária bovina no Oeste Catarinense
Authors: Mendes Ricardo Evandro , Gris Anderson , Henker Luan Cleber , Christ Ricardo , Piva Manoela Marchezan , Schwertz Claiton Ismael , Lucca Neuber José , Broll Fabrisio , Medeiros Diovane dos Santos , Pozzo Ildo Dal , Mori Ademar Masaaki
Published: March 2019

A Tristeza Parasitária Bovina (TPB) é um complexo de doenças causado pelas rickettsias Anaplasma marginale e/ou A. centrale, bem como pelos protozoários Babesia bovis e/ou B. bigemina, os quais produzem um quadro de anemia severa. Este trabalho tem por objetivo relatar a ocorrência da enfermidade no Oeste Catarinense, diagnosticada pelo Laboratório de Patologia Veterinária do IFC - Campus Concórdia. Para tanto, realizou-se um estudo retrospectivo dos diagnósticos em bovinos entre 2013 e 2015. No período estudado a anaplasmose representou 56% (9/17), babesiose cerebral 33% (6/17) e babesiose 11% (2/17). A partir dos dados coletados observou-se um nítido aumento consecutivo do número de casos de TPB nos três anos estudados. Conjectura-se que as alterações climáticas recentes ocasionadas pelos invernos menos rigorosos estejam contribuindo para este incremento. Além disso, os médicos veterinários que atenderam os animais relataram que o curso clínico da enfermidade está apresentando-se de modo mais agudo e severo em comparação aos anos anteriores, podendo isso estar relacionado ao método de manejo dos animais jovens utilizado na região. Conclui-se que a TPB é uma importante causa de mortalidade em bovinos na região e que a ocorrência daenfermidade vem aumentando.Palavras-chave: Patologia, babesiose, anaplasmose, bovinocultura.
Myasthenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival
Authors: Liu Fan , Wang Qiong , Chen Xueping
Published: March 2019

Background

Myasthenic crisis (MC) often requires admission to an intensive care unit (ICU).

Methods

We retrospectively investigated 115 consecutive patients with first MC admitted to the neurological ICU. Patients’ demographic, clinical and other characteristics were examined, as well as therapeutic interventions; mortality and functional outcome.

Results

MC patients admitted to neurological ICU had a mortality rate of 24.34%. PCO2 level before intubation and score on Myasthenia Gravis–Activities of Daily Living (MG-ADL) scale at MC onset correlated with duration of ventilation and length of ICU stay. Compared with patients with good functional outcome, patients with intermediate or poor functional outcome were older at first MC onset, had lower pH and PO2, and had higher PCO2 before intubation. Multivariate logistic analysis identified pre-intubation PCO2 level as an independent predictor of survival. Cox regression showed that age at first MC onset requiring ICU management was the factor which significantly influenced the mortality. Conclusions: Our results suggest that PCO2 before intubation and MG-ADL score at MC onset may be useful indicators of more severe disease likely to require extensive respiratory support and ICU management. Higher pre-intubation PCO2 indicates chronic respiratory acidosis that can increase risk of severe disability and death, especially in patients with older age at first MC onset.
Efficacy of a midwife-coordinated, individualized, and specialized maternity care intervention (ChroPreg) in addition to standard care in pregnant women with chronic disease: protocol for a parallel randomized controlled trial
Authors: de Wolff Mie , Johansen Marianne , Ersboell Anne Schoedt , Rosthoej Susanne , Brunsgaard Anne , Midtgaard Julie , Tabor Ann , Hegaard Hanne Kristine
Published: March 2019

Background and objectives: The number of women of childbearing age with chronic diseases is rising. Evidence has shown that obstetric complications and poor psychological well-being are more prevalent among this group, in addition to these women reporting experiences of less than satisfactory care. More research is needed to investigate how to best meet the special needs of this group during pregnancy and postpartum. Previous research has shown that care coordination, continuity of care, woman-centered care and specialized maternity care interventions delivered to women with high-risk pregnancies can improve patient-reported outcomes, pregnancy outcomes, and be cost-effective. However, no previous trials have examined the efficacy and cost-effectiveness of such interventions among pregnant women with chronic diseases. This paper describes the protocol of a randomized controlled trial (RCT) of a midwife-coordinated, individualized and specialized maternity care intervention (ChroPreg) as an add-on to standard care for pregnant women with chronic diseases.
Methods/design: This two-arm parallel group RCT study will be conducted from October 2018 – June 2020 at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark. Pregnant women with chronic diseases are invited to participate; women will be randomized and allocated 1:1 to the ChroPreg intervention plus standard care or standard care alone. The ChroPreg intervention consists of three main components: 1. Coordinated and individualized care, 2. Additional ante- and postpartum consultations, and 3. Specialized midwives.
The primary outcome is length of hospital stay (LOS) during pregnancy and postpartum period and secondary outcomes are: psychological well-being (the five-item World Health Organization Well-being Index, Edinburgh Postnatal Depression Scale, Cambridge Worry Scale), health-related quality of life (the 12-Item Short Form Survey), patient satisfaction (The Pregnancy and Childbirth Questionnaire), number of antenatal contacts, and pregnancy and delivery outcomes. Data is collected via patient-administered questionnaires and medical records.
Discussion: This trial is anticipated to contribute to the field of knowledge on which planning of improved antenatal, intra- and postpartum care for women with chronic disease is founded.
Clinical evaluation of narrow diameter implants versus standard diameter implants with bone augmentation in posterior jaws:study protocol for a randomized controlled clinical trial
Authors: Qian Shujiao , Qiao Shichong , Zhu Yu , Zhang Xiao , Mo Jiaji
Published: March 2019

Background: Nowadays, narrow diameter implants are being increasingly used in posterior regions with insufficient bone width to avoid invasive bone augmentation procedures. Recent studies have indicated that narrow implants with a diameter of 3.3 to 3.5mm showed comparable survival rate with standard diameter implants. However, there are no high-quality clinical trials comparing the clinical outcomes of narrow diameter implants to standard diameter implants with augmentation procedures in atrophic posterior region. The purpose of present study is to evaluate the clinical efficacy of narrow diameter implants in posterior jaws. Methods/Design: This study is designed as a prospective, single-center, 2-arm parallel, randomized controlled clinical trial. Patients in need of single implant crowns in posterior jaws will be included in the study according to clear defined inclusion-and-exclusion criteria. Randomized number table will be used to assign the patients into two groups: group 1: narrow diameter implant group (NDI); group 2: standard diameter implant with bone augmentation group (SDI). Implant survival rate, mechanical complications, marginal bone loss, peri-implant conditions and patients’ satisfaction will be recorded. Clinical and radiological re-evaluations will be performed at 6, 12, 36, 60 months after the final crowns delivery. Discussion: Our findings will help evaluate the clinical efficacy of narrow implant in posterior region. If the results were favorable, narrow implants might be recommended as a viable alternative for posterior region with insufficient bone width. Trial registration: Clinicaltrials.gov identifier: ChiCTR1800020426 (registered on 29 December 2018)
Precision and Agreement of Central Corneal Thickness Measured with E-pach, A-scan, Corvis ST and Pentacam
Authors: Liu Anqi , Xu Zequan , Wang Jingjing , Liu Feng , Jiang Yanming , Yang Min , Mei Lina , Ge Mei , Yang Qinghua , Huang Yifei , Wang Liqiang
Published: March 2019

Purpose

To assess the precision (repeatability and reproducibility) and agreement of central corneal thickness (CCT) measurements by E-pach, Pentacam, Corvis ST and A-scan devices in healthy eyes.

Methods

Instrument diagnostic test study. A total of 100 patients were enrolled to measure right-eye CCT by E-pach, Pentacam, Corvis ST, and A-scan devices. To assess repeatability and reproducibility, the test-retest repeatability (TRT) and intraclass correlation coefficient (ICC) were calculated. The agreement among the four devices was evaluated with Bland-Altman plots.

Results

The E-pach showed repeatability (ICC=0.9981), interobserver reproducibility (ICC=0.9971) and intersession reproducibility (ICC=0.9825); the Pentacam, Corvis ST and A-scan also showed similar repeatability (all ICC≥0.9679), interobserver reproducibility (all ICC≥0.9730) and intersession reproducibility (all ICC≥0.9647). However, the E-pach yielded CCT values that were obviously lower than those of the A-scan and Pentacam (P<0.001) but higher than those of the Corvis ST (P<0.001). The 95% limits of agreement (LoA) in the Bland-Altman plots were 44.5 µm (E-pach vs. A-scan), 34.9 µm (E-pach vs. Corvis CT) and 32.5 µm (E-pach vs. Pentacam).

Conclusions

The E-pach is a portable, reliable and inexpensive pachymeter. However, the CCT values obtained from the E-pach are not interchangeable with those from Pentacam, Corvis ST and A-scan devices.
THE ASSOCIATION BETWEEN LOCATION OF BRAIN LESION AND FINDINGS OF FLEXIBLE ENDOSCOPIC EVALUATION OF SWALLOWING (FEES) IN STROKE PATIENTS: WHICH EXERCISE IS BENEFICIAL?
Authors: Kusumaningsih Widjajalaksmi , Lestari Nur Indah , Purba Herdiman
Published: March 2019

Background: Dysphagia is a frequent occurrence following stroke. Various brain regions have been shown to control deglutition. However, it is still controversial as to which of the two hemispheres plays more important role in deglutition, and which injured hemisphere is more likely to cause the specific patterns of dysphagia seen in stroke patients. An accurate estimate of the incidence of dysphagia will be critical to assess benefits of dysphagia interventions.
Objective: To investigate whether patterns of dysphagia are associated with the location of brain lesion in stroke patients and to examine whether pharyngeal strengthening exercise and hyolaryngeal exercise are proper for patients, based on the findings of FEES and location of brain lesion.
Methods: The subjects were stroke outpatients who visited our clinic from January 2016 to April 2018. To localize brain lesion, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) have been employed. The locations of brain lesions were classified into cortical, subcortical, and brain stem. FEES was conducted to assess the patterns of deglutition disorders. These data were collected via retrospective chart review.
Results: Of the 11 subjects, mean age (SD) was 62.73 (8.67) years and seven (63.64%) subjects were male. All subjects got ischemic stroke, eight (72.73%) had right hemispheric lesion and three (27.27%) had left hemispheric lesion. By brain lesion, there were nine subcortical, five cortical, and four brain stem lesions. All FEES findings, especially standing secretion, penetration, residue, and reduced hypopharynx sensitivity were higher in subcortical lesion, followed by brain stem and cortical lesion successively.
Conclusion: Right hemisphere was involved more than left hemisphere in dysphagia patients. Standing secretion, penetration, residue, and reduced hypopharynx sensitivity occurs more often in subcortical lesion. Further studies on big samples in a perspective structure are needed. Based on this result, there is a place for pharyngeal strengthening exercise and hyolaryngeal complex range of motion and strengthening exercise to be implemented to the patients with neurogenic dysphagia after stroke.
Correlation of anti-acetylcholine receptor antibody levels and long-term outcomes of juvenile myasthenia gravis in Taiwan: a case control study
Authors: chou cheng che , Su I Chen , Chou I Jun , LIN Jainn Jim , Lan Shih Yun , Wang Yi Shan , Kong Shu Sing , Chen Yun Ju , Hsieh Meng Ying , Hung Po Cheng , Wang Huei Shyong , Chou Min Liang , Lin Kuang Lin
Published: March 2019

Background

Myasthenia gravis is the most common disease affecting the neuromuscular junction. The most common etiology among patients with juvenile myasthenia gravis is the production of antibodies against the acetylcholine receptor. However, the clinical outcome in relation to serum levels of anti-acetylcholine receptor antibodies in juvenile myasthenia gravis has rarely been discussed. We aimed to analyze the correlation between the presence of anti-acetylcholine receptor antibodies and outcome in juvenile myasthenia gravis.

Methods

Patients diagnosed with juvenile myasthenia gravis younger than of 20 years of age were retrospectively recruited from January 1995 to February 2017 in a tertiary referral medical center. According to the Myasthenia Gravis Foundation of America outcome scale, the primary outcome was complete symptom remission and cessation of medications for at least 1 year measured 2 years after diagnosis. Secondary outcome was complete symptom remission at the last outpatient clinic.

Results

A total of 54 patients were followed up for over 2 years. Nine patients (9/54, 16.7%) achieved complete remission without medication use at two years after diagnosis. Thirteen (24.1%) patients achieved complete remission during longer follow-up periods. Those with negative anti-acetylcholine receptor antibodies were more likely to achieve complete remission at 2 years (6/15 [40%] vs. 3/39 [7.7%], 95% Confidence interval [CI] 1.670 to 38.323) and at the last outpatient clinic follow-up (8/15 [53.3%] vs. 5/39 [12.8%], 95% CI 2.367 to 20.704). Thirteen patients with comorbid autoimmune thyroid diseases were older than those without disease (11.8 ± 5.8 years old vs. 8.0 ± 6.3 years old, 95% CI 0.018 to 7.33). Moreover, patients negative for anti-acetylcholine receptor antibodies were less likely comorbid with autoimmune thyroid disease (1/35 [2.9%] vs. 12/71 [16.9%], 95% CI 0.018 to 1.161).

Conclusions

Juvenile myasthenia gravis patients without anti-acetylcholine antibodies exhibited significantly increased complete remission rates and a reduced likelihood of comorbid autoimmune thyroid diseases compared with those with anti-acetylcholine receptor antibodies.
Impact of brief prewarming on anesthesia-related core-temperature drop, hemodynamics, microperfusion and postoperative ventilation in cytoreductive surgery of ovarian cancer a randomized trial
Authors: Kaufner Lutz , Niggemann Phil , Baum Tobias , Casu Sara , Sehouli Jalid , Bietenbeck Andreas , Boschmann Michael , Spies Claudia , Henkelmann Anne , von Heymann Christian
Published: March 2019

Background:

General (GA)- and epidural anesthesia (EDA) may cause a drop in body core-temperature (BCTdrop), and hypothermia, which may alter tissue oxygenation (StO2) and microperfusion after cytoreductive surgery for ovarian cancer. We hypothesized that forced-air prewarming (PW) during epidural catheter placement and induction of GA maintains normothermia and improves microperfusion.

Methods:

After ethics approval 47 women scheduled for cytoreductive surgery were prospectively enrolled. Women in the study group were treated with a prewarming (PW) of 43°C during epidural catheter placement. BCT (Spot on®, 3M) was measured before (T1), after induction of GA (T2) at 15 min (T3) after start of surgery, and until 2h after ICU admission (TICU2h). Primary endpoint was BCTdrop between T1 and T2. Microperfusion-, hemodynamic- and clinical outcomes were defined as secondary outcomes. Statistical analysis used the Mann-Whitney-U- and non-parametric-longitudinal tests.

Results:

BCTdrop was 0.35 °C with PW and 0.9 °C without PW (p< 0.005) and BCT remained higher over the observation period (ΔT4 = 0.9 °C up to ΔT7 = 0.95 °C, p<0.001). No significant differences in hemodynamic parameters, transfusion, arterial lactate and dCO2 were measured. In MD the ethanol ratio was temporarily, but not significantly, reduced after PW. Lactate, glucose and glycerol after PW tended to be more constant over the entire period. Postoperatively, six women without PW, but none after PW were mechanical ventilated (p< 0.001).

Conclusion: PW at 43°C reduces the BCTdrop and maintains normothermia without impeding the perioperative routine patient flow. Microdialysis indicate better preserved parameters of microperfusion.

Trial registration: ClinicalTrials.gov; ID: NCT02364219; Date of registration: 18-febr-2015
A Case of Hyperventilation leading to apnea and desaturation in PACU: A root cause analysis
Authors: Thapa Parineeta , Asish Subedi , Anjali Poudel , Pankaj Baral
Published: March 2019

Background

Respiratory adverse events are not uncommon in the post anesthesia care unit (PACU) following general anesthesia. In this regard, hyperventilation leading to apnea and desaturation is a rare entity. Here we have reported a case of a 15 year old girl who, following an uneventful general anesthesia, developed severe hyperventilation leading to apnea and desaturation in the PACU.

Case presentation

The 15 year old girl underwent cortical mastoidectomy under general anesthesia. After a smooth anesthesia and an uneventful early recovery, she developed hyperventilation after about 15 minutes in the PACU. The symptom was severe enough to lead to apnea, desaturation and severe respiratory alkalosis. She required bag and mask ventilation and the symptoms resolved only transiently with propofol sedation. Finally she responded to intravenous haloperidol and did not have any further episode after receiving haloperidol

Conclusion

Hyperventilation after a smooth recovery from anesthesia is not a common presentation. In this article we have tried to discuss the possible cause of such symptom in our patient and how we successfully managed this case. We have also proposed an algorithmic approach to diagnose and manage such a case in the PACU.
Predominance of Lactobacillus plantarum Strains in Peruvian Amazonian Fruits
Authors: SÁNCHEZ JOHANNA , VEGAS CARLOS , ZAVALETA AMPARO IRIS , ESTEVE-ZARZOSO BRAULIO
Published: March 2019

The objective of this research was the identification and characterization of lactic acid bacteria (LAB) isolated from Peruvian Amazonian fruits. Thirty-seven isolates were obtained from diverse Amazonian fruits. Molecular characterization of the isolates was performed by ARDRA, 16S-23S ITS RFLP and rep-PCR using GTG5 primers. Identification was carried out by sequencing the 16S rDNA gene. Phenotypic characterization included nutritional, physiological and antimicrobial resistance tests. Molecular characterization by Amplified Ribosomal DNA Restriction Analysis (ARDRA) and 16S-23S ITS RFLP resulted in four restriction profiles while GTG5 analysis showed 14 banding patterns. Based on the 16S rDNA gene sequence, the isolates were identified as Lactobacillus plantarum (75.7%), Weissella cibaria (13.5%), Lactobacillus brevis (8.1%), and Weissella confusa (2.7%). Phenotypic characterization showed that most of the isolates were homofermentative bacilli, able to ferment glucose, maltose, cellobiose, and fructose and grow in a broad range of temperatures and pH. The isolates were highly susceptible to ampicillin, amoxicillin, clindamycin, chloramphenicol, erythromicyn, penicillin, and tetracycline and showed great resistance to kanamycin, gentamycin, streptomycin, sulfamethoxazole/trimethoprim, and vancomycin. No proteolytic or amylolytic activity was detected. L. plantarum strains produce lactic acid in higher concentrations and Weissella strains produce exopolymers only from sucrose. Molecular methods allowed to accurately identify the LAB isolates from the Peruvian Amazonian fruits, while phenotypic methods provided information about their metabolism, physiology and other characteristics that may be useful in future biotechnological processes. Further research will focus especially on the study of L. plantarum strains.
Tillage and Biochar Effects on Wheat Productivity under Arid Conditions
Authors: Shahzad Khurram , Abid Muhammad , Sintim Henry Y. , Hussain Shahid , Nasim Wajid
Published: March 2019

Urea is an important source of inorganic N under wheat (Triticum aestivumL.) production system in Multan, Pakistan. However, the average N loss is high, ranging from 22 to 53% of applied N, which poses adverse environmental impacts. Reduced tillage and combined application of biochar and optimal N fertilizer could improve wheat productivity and reduce N losses. We evaluated the effects of two tillage (conventional and reduced tillage), two biochar (no biochar and poultry waste biochar), and three inorganic N rate (0, 60, and 120 kg ha−1) treatments on productivity and economic profitability of wheat production for two continuous growing seasons (2014–2015 and 2015–2016). Generally, reduced tillage increased wheat grain yield, protein content, and total N uptake by 0.2 Mg ha−1, 3.0 kg kg−1, and 37.0 kg ha−1, respectively, when compared with conventional tillage. Biochar application increased wheat grain yield, protein content, and total N uptake by 0.3 Mg ha−1, 6.8 kg kg−1, and 38.6 kg ha−1, respectively, compared with no‐biochar plots. Reduced tillage was economically profitable within the two cropping seasons, but biochar application was not, because of the high price of biochar (US$1.00 kg−1biochar) and application rate (10 Mg biochar ha−1). Overall, wheat production under reduced tillage, no biochar, and the 60‐kg N ha−1rate resulted in the greatest economic profit in this study.