bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise discursiva dos memes sobre o sujeito professor
Authors: França Thyago Madeira , Vieira Wânia Gomes Mariano
Published: December 2019

Traçamos como objetivo analisar os memes e o enunciado verbo-visual sobre o sujeito professor, considerando os possíveis diálogos sobre a identidade docente. Esta análise apresenta algumas reflexões teóricas fundamentadas no Círculo de Bakhtin para análise e compreensão do enunciado verbo-visual a partir de materialidades discursivas dos memes, pesquisados no Facebook sobre a temática do sujeito professor e os estereótipos formados a partir dos diversos efeitos de sentido que emanam dos enunciados dos memes. Os estereótipos como representações sociais cristalizadas podem levar o sujeito a ter sua identidade representada de forma pejorativa no meio social. Temos como orientação principal o eixo discursivo-dialógico-ideológico da linguagem. Desse modo, nos ancoramos nas reflexões teórico-metodológicas partindo das concepções de diálogo, interação verbal, gênero discursivo e enunciado (BAKHTIN, 1997, 2011; VOLÓCHINOV, 2017), e estereótipo (AMOSSY, 2008). Nessa perspectiva, os enunciados verbo-visuais dos memes que versam sobre a temática docente permitem compor determinadas situações discursivas quenão corroboram para a construção de uma imagem forte e promissora sobre o sujeito professor.
O funcionamento dos grêmios estudantis e a gestão democrática das escolas: possíveis relações
Authors: Zambon Gabriel Franco De Oliveira , Santos Leonardo Bis dos
Published: December 2019

No presente artigo, definimos como objetivo principal pensar as relações entre o funcionamento dos grêmios estudantis de três unidades de ensino municipais da Serra (ES) e a gestão democrática das escolas, implantada no Brasil sob o contexto do neoliberalismo, na década de 1990. Para tal, examinamos os livros de atas dos grêmios estudantis, observamos a atuação dos estudantes à frente de tais entidades durante a aplicação de um curso voltado a eles, e pesquisamos a bibliografia relativa a implantação da gestão democrática das escolas no Brasil, bem como a sua situação atual nas escolas municipais da Serra. Concluímos que a forma como a gestão democrática têm sido implementada nos sistemas de ensino brasileiros, desde o seu início, sob a égide do neoliberalismo, até os dias de hoje, tem prejudicado o funcionamento dos grêmios estudantis, quando os analisamos sob o aspecto da representação dos interesses discentes e como espaço de apropriação do conhecimento.
Las fundaciones empresariales en el cumplimiento de los ODS: una mirada desde los sectores de minería e hidrocarburos
Authors: Munévar Ángela Sofía
Published: December 2019

La implementación de los objetivos de desarrollo sostenible (ODS) requiere de la parti­cipación de actores externos al gobierno, como los sectores privado y social. A partir de ello, se realiza un análisis sobre el aporte de las funda­ciones empresariales de los sectores de minería e hidrocarburos a los ODS relacionados con pobreza, hambre, salud, educación y género, que conforman el pilar personas de la agenda. Este estudio se realiza a partir de las temáticas atendidas por la inversión social privada (ISP) y su alineación con las metas e indicadores de los ODS; de la articulación con el gobierno y las entidades públicas de orden local, regional y nacional, y de las alianzas con organismos internacionales y el acceso a recursos de coo­peración internacional.
El papel del Estado en la definición de la política argentina de hidrocarburos ¿Hacia cuál referencial sectorial?
Authors: Solanas Facundo , Martínez Adriana Verónica
Published: December 2019

El propósito de este trabajo es analizar el papel del Estado en Argentina en las últimas tres décadas, a partir de las políticas de hidrocar­buros, en especial las referidas al petróleo, a fin de dar cuenta de sus diversas transformaciones. Si los años noventa se caracterizaron por un abrupto cambio referencial en el papel del Estado y, en particular, en su capacidad pro­ductiva y regulatoria en materia de hidrocar­buros, pese a la crisis del paradigma neoliberal a comienzos del nuevo milenio, las políticas energéticas en la materia siguen estrategias sectoriales propias del referencial anterior. A partir del análisis de fuentes documen­tales y datos cuantitativos, este trabajo propone demostrar de qué forma la política petrolera, pese a la compra por parte del Estado de 51 % de las acciones de Yacimientos Petrolíferos Fiscales (YPF), continúa siendo establecida por el mercado.
Specifics of generating explosively formed projectiles of variable shape from metal liners
Authors: Kruglov P.V. , Kolpakov V.I. , Bolotina I.A.
Published: December 2019

We propose using charges generating explosively formed projectiles of variable shape to remotely demolish structurally unsound concrete or brick walls of buildings and other structures. The paper considers the charges required, their design and operation. The operation of such a charge involves the explosive material accelerating a metal liner, covering a distance of up to several hundred charge diameters. The metal liner deforms while moving and assumes a compact shape. We used variable thickness copper liners, the external and internal surfaces of which are formed by a combination of spherical surfaces. A planar shock wave generator featuring a variable detonation wave slope is considered as the initiation system for the charge. We present the results of numerically simulating our explosive charge operation in order to determine how charge parameters affect performance. We estimated charge performance via two projectile parameters: its shape and velocity. The study also evaluated the effect of the planar shock wave generator slope on the projectile shape. We obtained projectile velocity and aspect ratio as functions of the slope of the converging detonation wave. We determined that decreasing the slope of the converging detonation wave front leads to an increase in the aspect ratio and velocity of the explosively formed projectile.
Mathematical simulation of coolant flow in the cooling channel of a liquid rocket engine combustion chamber featuring an extremely high degree of ribbing
Authors: Aleksandrenkov V.P. , Kovalev K.E. , Yagodnikov D.A.
Published: December 2019

The paper presents a computational analysis of coolant distribution in the cooling channel of a liquid rocket engine combustion chamber, performed in order to develop a set of practical guidelines towards increasing efficiency of a cooling system featuring an extremely high degree of ribbing. We created a three-dimensional mathematical model comprising a closed system of hydrodynamic equations as well as initial and boundary conditions for an element of the liquid rocket engine chamber we modelled, the chamber featuring longitudinal cooling channel arrangement manufactured via additive technology. We computed velocity and pressure fields in characteristic cooling channel regions for various levels of coolant mass flow rate, which confirmed the feasibility of the layout proposed in terms of uniform coolant distribution in the cooling channel of the liquid rocket engine modelled. We obtained the friction loss ξ as a function of coolant mass flow rate and particle size of the powder used in the additive technology to manufacture the combustion chamber wall and cooling channel.
How Can Law Support Development of Genomics and Precision Medicine to Advance Health Equity and Reduce Disparities?
Authors: Wolf Susan M. , Bonham Vence L. , Bruce Marino A.
Published: December 2019

There is growing recognition that the genomic and precision medicine revolution in health care can deepen health disparities. This has produced urgent calls to prioritize inclusion of historically underrepresented populations in research and to make ge­nomic databases more inclusive. Answering the call to address health care disparities in the delivery of genomic and precision medicine requires a consideration of impor­tant, yet understudied, legal issues that have blocked progress. This article introduces a special issue of Ethnicity & Disease, which contains a series of articles that grew out of a public conference to investigate these legal issues and propose solutions.This 2018 conference at Meharry Medical College was part of an NIH-funded project on “LawSeqSM” to evaluate and improve the law of genomics in order to support appro­priate integration of genomics into clinical care. This conference was composed of pre­sentations and interactive sessions designed to specify the top legal barriers to health equity in precision medicine and stimulate potential solutions. This article synthesizes the results of those discussions.Multiple legal barriers limit broad inclusion in genomic research and the development of precision medicine to advance health equity. Problems include inadequate privacy and anti-discrimination protections for re­search participants, lack of health coverage and funding for follow-up care, failure to use law to ensure access to genomic medi­cine, and practices by research sponsors that tolerate and entrench disparities.Analysis of the legal barriers to health equity in precision medicine is essential for progress. Progressive use of law is vital to avoid worsening of health care dispari­ties. Ethn Dis. 2019;29(Suppl 3):623-628; doi:10.18865/ed.29.S3.623
Can Precision Medicine Reduce the Burden of Diabetes?
Authors: Burke Wylie , Trinidad Susan Brown , Schenck David
Published: December 2019

Precision medicine is a new health care concept intended to hasten progress toward individualized treatment and, in so doing, to improve everyone’s opportunity to enjoy good health. Yet, this concept pays scant attention to opportunities for change in the social determinants that are the major driv­ers of health. Precision medicine research is likely to generate improvements in medical care but may have the unintended conse­quence of worsening existing disparities in health care access. For prevention, precision medicine emphasizes comprehensive risk prediction and individual efforts to accom­plish risk reduction. The application of the precision medicine vision to type 2 diabe­tes, a growing threat to population health, fails to acknowledge collective responsibility for a health-promoting society.Ethn Dis. 2019;29(Suppl 3):669-674;doi:10.18865/ed.29.S3.669
Strategies to Assist Distance Doctoral Students in Completing Their Dissertations
Authors: Lim Janine , Covrig Duane , Freed Shirley , De Oliveira Becky , Ongo Mordekai , Newman Isadore
Published: December 2019

Completing doctoral dissertations is difficult work and may be harder for distance students physically separated from institutional and collegial supports. Inability to complete independent research contributes to doctoral student attrition. Factors impacting completion include institutional factors, student characteristics, and supervisory arrangements (Manathunga, 2005). This paper shares proactive strategies used by a Midwestern university in the United States to support distance doctoral students. Strategies and technology tools are described that (a) cultivate a shared culture of responsibility and commitment, (b) increase effective communication between researchers, and (c) grow departmental and institutional services and technologies for faculty and students. This paper suggests the use of a specific framework to help students develop a shared culture of responsibility. This framework encourages students to discuss their social network, as well as teaches students how to manage their split life by using a tool which evaluates a student’s readiness for the dissertation process and maps out where dissertation skills and knowledge are developed throughout the program. Strategies for effective communication include availability, effective feedback, trust, and humor. Services and technologies provided to build capacity include the use of online and library resources, campus-wide use of research software, writing and research services, and department supports and processes to promote student research. These mechanisms for accountability, mentoring, training, and trust increase the likelihood of success.
PEMBUATAN GENTENG BERSERAT TANDAN KOSONG KELAPA SAWIT
Authors: Tarkono Tarkono , Nandang Nandang
Published: December 2019

The utilization of oil empty bunches palm (EFBP) is limited, while the supply of EFBP is abundant. The most utilization of EFBP is in agriculture, while EFBP fibers have the opportunity to be developed in the field of engineering, for example as a composite material reinforcement material. In the construction field, EFBP fibers can contribute as a mixture of substances for cement tile products. The purpose of adding fiber is to distribute the stress on fibrous cement roof tiles. With evenly distributed stress, the strength of the tile will be higher. The production process of EFBP fibrous cement board is carried out without combustion, with materials in the form of portland cement, marble powder, CaCo3 powder and EFBP fiber and water. Based on the mechanical test that the fibrous EFBP tile can still be applied as a roof, this is evidenced by the majority of its mechanical properties meeting SNI standards. However, fibrous EFBP roof tiles have a flame spread value of 61.5 which means that they still need to be repaired so that the tile is not flammable. Thus, EFBP fibers can be used as an alternative fiber cement tile in order to improve product quality.Keywords: cement tile , fibre, EFBP
Processos de mudança climática durante a “Pequena Idade do Gelo” sob o enfoque de ciência do sistema terra
Authors: Carneiro Celso Dal Ré , Franco Lucca Martins , Freitas Gabriel Bueno Fagundes de , Gonçalves Pedro Wagner
Published: December 2019

Há incertezas sobre a exata duração da “Pequena Idade do Gelo”, entre os séculos XVI a XIX. Houve resfriamento intenso em distintas regiões do Hemisfério Norte e alguns efeitos globais, como expansão da calota polar, redução das temperaturas médias no verão e aumento da precipitação no inverno. Motivada pelo interesse didático do tema, esta revisão buscou recompor o conhecimento científico e o debate sobre hipóteses, modelos de evolução climática do Holoceno e interpretações sobre possíveis causas. Estudamos os mecanismos que condicionam mudanças climáticas abruptas. A despeito da divergência entre climatólogos sobre a datação de registros glaciais, extraímos pontos convergentes que esboçam uma visão sistêmica dos fatores determinantes do clima global na atualidade.
Objetivos de desenvolvimento sustentável e geografia escolar
Authors: Soares Fabiana Pegoraro
Published: December 2019

Os Objetivos de Desenvolvimento Sustentável (ODS) são o principal eixo da atual Agenda 2030 da ONU e, para que sejam efetivos, é imprescindível educar, de modo formal e informal, crianças, jovens e adultos para uma mudança nas relações sociais, políticas e com a natureza. Os objetivos deste trabalho são analisar a relação entre os ODS e os conteúdos da Geografia escolar propostos pela BNCC e trazer algumas reflexões sobre sua potencial aplicação nas aulas e projetos interdisciplinares que envolvem a disciplina. Para isso, utilizou-se como base teórica textos da ONU e da UNESCO sobre ODS, além da BNCC de Ensino Fundamental. Por fim, os assuntos e conteúdos referentes aos ODS 1, 2, 3 e 4 e à BNCC de Geografia foram comparados e estabeleceu-se uma lista de possíveis relações entre eles e os exemplos de abordagens e métodos de aprendizagem para os ODS propostos pela UNESCO.
Divulgação geocientífica inclusiva
Authors: Pontin Juliana , Imbernon Rosely Aparecida Liguori
Published: December 2019

O Brasil apresenta um contingente de mais de 6,5 milhões de pessoas com deficiências visuais, sendo 582 mil cegas e 6 milhões com baixa visão. Neste universo, poucas iniciativas educacionais em geociências são identificadas, e, em geral, não fazem uso de vídeos educativos. O presente estudo tem como objetivo a apropriação do recurso da audiodescrição em vídeos educativos, com foco no ensino de ciências, especificamente, conteúdos relativos às geociências e meio ambiente. A produção de materiais de divulgação científica para deficientes visuais, com foco na educação básica, carece de recursos didáticos, tal como a audiodescrição, que auxiliem ao professor e propiciem ao aluno com deficiência visual acesso a vídeos encontrados no YouTube. A audiodescrição (AD) baseia-se em técnicas de transformação do visual em verbal, abrindo-se um leque de possibilidades de acesso à cultura e à informação, promovendo a inclusão social, cultural e escolar de indivíduos com deficiências visuais, e pode ser aplicada em espaços formais e não formais de educação. A audiodescrição, por se tratar de uma temática muito recente no campo social e científico, e que envolve a educação inclusiva, necessita de pesquisas sistemáticas, para que se possa desenvolver normas de audiodescrição que uniformizem a técnica em diferentes países em que a AD é aplicada. Assim, as atividades que permearam esse estudo foram efetivadas no âmbito do projeto “Cinco Pedrinhas”, componente do Programa Espaço Ciência Cultura Educação (ECCE), da Escola de Artes, Ciências Humanidades (EACH-USP). A audiodescrição foi desenvolvida para ser incorpora ao vídeo em stop motion publicado no YouTube, “Cinco pedrinhas saem em aventura”, propiciando assim uma narração descritiva em áudio. Para compor essa audiodescrição foram utilizadas referências nacionais e internacionais de técnicas que permitiram o desenvolvimento dos textos, além do acompanhamento de um audiodescritor para correção e direcionamento do trabalho, e estudos de campo por meio do acompanhamento de peças teatrais e musicais nas quais a audiodescrição estava disponível.
Relational Comportment: Embodying Caring as a Contemplative Journey
Authors: Maykut Colleen , Wild Carol
Published: December 2019

Roach's (2002) six Cs (confidence, conscience, commitment, compassion, competence, and comportment) and relational ethics (Bergum, 2002; Bergum & Dossetor, 2005) are two distinct philosophical approaches which inform nursing practice. Although notable differences exist, it was through entanglement, an explicit conceptualization between the approaches, that synergy was conceived. This entanglement was conceptualized as relational comportment. Relational comportment is the embodiment of a contemplative journey of being and becoming persons of care by the nurse. Entangling enriches and provides the opportunity for the actualization and expression of caring.
Novice RNs' Lived Experience Providing End-of-Life Care: A Hermeneutic Phenomenology
Authors: Chu Ruby Z. , Taliaferro Donna
Published: December 2019

This hermeneutic study explored the lived experience of novice RNs who care for dying patients in acute care settings to understand to meaning of their experience. Fourteen novice RNs participated in individual telephone semi-structured interviews. Transcripts were analyzed using Colaizzi's method. Results obtained were based on the hermeneutic circle. The findings identified 3 major themes: (a) obstacles in end-of-life care; (b) personal response; and (c) coping strategies and 12 subthemes. Despite the obstacles in care, compassionate care was provided that resulted in professional growth.
Psychometric Evaluation of the Filipino Version of Caring Nurse-Patient Interaction Scale-Patient
Authors: Soriano Gil P.
Published: December 2019

The purpose of the study was to evaluate the psychometric properties of the Filipino version of Caring Nurse-Patient Interaction Scale-23 Patient (F-CNPI). The internal consistency reliability, linguistic, content, and construct validity was performed. Results revealed that the Filipino version of CNPI-Patient have a good fit model. The content validity index of the items ranges from 0.83 to 1.0 and the scale content validity index (S-CVI) was 0.87. The internal consistency coefficient of CNPI-Patient was 0.874. The results revealed that CNPI-Patient was revealed to be a valid and reliable instrument for measuring caring behaviors of Filipino nurse.
Edino Krieger e sua escrita para o violino: contexto, estilo, idiomatismo e interpretação de Sonâncias II (1981)
Authors: Berbert Bruna Caroline De Souza , Biaggi Emerson Luiz de
Published: December 2019

A composição Sonâncias de Edino Krieger é considerada uma das obras mais representativas de sua produção para o violino. Neste artigo, buscamos evidenciar as características estilísticas, idiomáticas e interpretativas presentes na escrita de Edino Krieger para o seu próprio instrumento, a partir da análise de Sonâncias II (1981) para violino e piano. Após a introdução, tecemos uma síntese biográfica do compositor (concentrando-nos em sua relação com o violino) e abordamos as particularidades de sua linguagem musical, além de sua produção para o instrumento. A seguir, expomos conceitos e critérios utilizados na análise estrutural, estilística e idiomática da peça selecionada. Examinamos como esta obra manifesta particularidades da terceira fase composicional de Krieger e como seu estilo e escrita influenciam as escolhas interpretativas no processo de construção da performance. Constatada a vivência do compositor como violinista, relacionamos sua escrita às características idiomáticas do instrumento. Verificamos que em Sonâncias II (1981) os intervalos (melódicos e harmônicos) são utilizados como uma unidade estrutural básica. Seu idiomatismo revela um profundo domínio do compositor na escrita para o instrumento, apesar de não manuseá-lo durante este processo e de ter abandonado sua carreira como violinista ainda no início de sua idade adulta. Com este artigo, que constitui uma primeira abordagem sobre a escrita para violino de Edino Krieger, buscamos contribuir para uma melhor compreensão e difusão da música brasileira para o instrumento.
Resenha do livro Especialização em Educação Musical: reflexões e pesquisas
Authors: Abreu Delmary Vasconcelos de
Published: December 2019

O texto apresenta uma resenha do livro Especialização em Educação Musical: reflexões e pesquisas, organizado por Cássia Virgínia Coelho de Souza e publicado em 2018. A obra resenhada reúne oito textos de professores e estudantes do curso de pós-graduação lato sensu em Música. Cada capítulo foi escrito por autores que desenvolveram suas pesquisas no âmbito da pós-graduação em diferentes contextos em que há práticas educativo-musicais em um município localizado na região Sul do Brasil. A resenha não tem o intuito de tecer críticas ao conteúdo apresentado, mas de socializar e dialogar com a obra que se inscreve no campo da educação musical.
The Effect of Admission Year and Effort-Reward Imbalance Model on Engagement
Authors: Hwang Jung Eun , Kim Na Jin , Kim Su Young
Published: December 2019

Engagement has not been widely studied in the field of medical education. The purpose of this study was to determine the relationship between admission year and engagement, assuming that characteristics of admission cohorts might be different depending on year. Association between effort-reward imbalance (ERI) model and engagement was also reinvestigated. Data were collected from 164 students in The Catholic University of Korea, College of Medicine. Ninety-nine (18.97%) students in 2017 and 65 (12.38%) students in 2018 answered an online questionnaire measuring demographic variables, ERI, over-commitment (OC), negative affect, and engagement. Participants’ admission years were determined based on years in school they responded. Affiliation and year in school were removed because of their high correlation with admission year. Categorical regression analysis was performed. Admission year, binary ERI, and OC were significant explanatory variables in this categorical regression model (R2 = .312, Adjusted R2 = .255, F = 5.444, p = .000). Admission year, binary ERI, and OC accounted for 13.4%, 27.9%, and 9.4% of the importance in this model, respectively. Quantification plots for admission year and binary ERI showed that engagement was the highest in 2018 admission cohort but the lowest in 2013 admission cohort; being reciprocally rewarded for efforts was associated with higher scores of engagement. A certain admission cohort can be more engaged or less engaged in learning. This study also confirms that receiving proper rewards for efforts could be related to increase in engagement.
Dil Bilgisi Eğitim-Öğretiminin Araştırma Kapsamı ve İnceleme Yöntemlerinin İncelenmesi
Authors: SÖNMEZ Hülya
Published: December 2019

Bu çalışmanın amacı, dil bilgisi eğitimi-öğretimiyle ilgili yapılan çalışmaları inceleyerek bu araştırmaların kapsamı, kullanılan araştırma modeli, veri toplama araçları, veri çözümleme yöntemleri ve örneklem özelliklerini belirlemektir. Araştırmada genel tarama modeline başvurulmuştur. Genel tarama modeline uygun olarak toplanan veriler, betimsel analiz yöntemiyle incelenmiştir. Betimsel olarak analizi yapılan 51 çalışma, iki yönden ve altı alt başlıkta incelenmiştir. İlk olarak örneklem grubundaki çalışmaların amaçlarına göre bu çalışmaların kapsam özellikleri belirlenmiştir. İnceleme sonucunda dil bilgisi eğitimi-öğretiminde kapsamla ilgili sıkça kullanılan özellikler arasındaki ilişki değerlendirilmiştir. İkinci aşamada ise ilgili çalışmaların yöntemleri, veri toplama araçları, veri analiz yöntemleri ve örneklem sayıları incelenmiştir. Bu bölümdeki veriler örneklem grubundaki araştırmaların yöntem bölümünden alınmıştır. İnceleme sonucunda kullanılan araştırma yöntemi, veri toplama aracı, veri analiz yöntemlerinin kullanım sıklığı, etkililiği ve işlevselliğiyle ilgili değerlendirmeler yapılmıştır. Araştırmanın sonunda bulgularla ilgili tartışmalara yer verilmiştir. Araştırmanın bulguları ve sonuçlarından hareketle dil bilgisi eğitimi-öğretiminin kapsamı, araştırma yöntemleri, veri toplama araçları, veri analiz yöntemleri ve örneklem sayılarının incelenmesiyle ilgili önerilerde bulunulmuştur.
Thoughts on Natural Medicinal Chemistry
Authors: Peng Xing , Li Meilan
Published: December 2019

Natural products, with novel structures and broad biological activities, are the main sources of drug lead compounds. Over years, natural products have made outstanding contributions to the fight against viruses. Herein, the article briefly shares some thoughts about natural medicinal chemistry as references for chemists and biologists.
Determination of the FIFO-stack size for the algorithm of the image region growing
Authors: Tsviatkou V. Yu.
Published: December 2019

The aim of the work is to derive an expression that allows determining the size of the FIFO-stack for storing the coordinates of adjacent pixels depending on the image size for the segmentation algorithm based on region growing. The FIFO stack, organized on the principle of a ring multi-bit shift register, is considered. The conditions for maximum loading of the FIFO stack are formulated, for which an expression is obtained that allows one to accurately determine the required size of the FIFO stack, which provides memory savings.
Analysis of factors associated with dropping-out from HIV antiretroviral therapy in Kunming City, China
Authors: Liao Bin , Zhang Xiao-Wen , Wang Jing-Ying , Liu Jun , Liang Jun , He Wen-Jie , Hong Biao , LI YI
Published: December 2019

Background:The implementation of national antiretroviral therapy (ART) and expanded ART policies results in that more and more HIV-infected patients receive ART in Kunming, Yunnan province, China. At the same time, however, the number of patients, who drop-out from ART, are also increasing. In this study, we explored the factors that may account for drop-out.
Methods: Four hundred and thirty-nine HIV-infected patients, who received or used to receive ART, were recruited in this study. Their age is among 18 and 75. All patients were divided into two group: ART group (187 patients) and drop-out group (252 patients). Appropriate bio-statistics analysis, including univariate analysis and Multivariate analysis, were used to identify factors associated with drop-out.
Results: Data from all patients were analyzed. Univariate analysis suggested that the factors associated with drop-out may include age, residential area, educational level, occupation, monthly income, the access to minimum living allowance, HIV transmission route, and living status. On the other hand, factors including area, monthly income, the access to minimum living allowance, and referral methods of follow-up institutions account for drop-out in multivariate analysis.
Conclusions: This study identified a number of factors associated with drop out from ART.Based on our findings,appropriate interventions should be introduced decrease drop-out.
Factors associated with the self-management practices of Type 2 diabetes among the middle-aged population of rural area of Pakistan
Authors: Ansari Rashid M , Harris Mark , Hosseinzadeh Hassan , Zwar Nicholas
Published: December 2019

Background: This study is aimed at identifying the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of rural area of Pakistan.
Methods: The sample of 200 participants was purposively recruited from the medical clinics of rural area of Pakistan. The study questionnaire consisted of three main sections: socio-demographics, the Urdu-version of Summary of Diabetes Self-care Activities (U-SDSCA), and the extended version of U-SDSCA. In addition, glycosylated hemoglobin (HbA1c) level results were obtained from the medical clinics. The study explored the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of Pakistan.
Results: The current study has demonstrated that self-management activities level among the patients of type 2 diabetes in the rural area of Pakistan was not achieved in majority of patients, and that glycemic control was unsatisfactory. The bi-variate analysis showed the differences in all the sub-scales but some of these differences are not statistically significant (p > 0.05). The exception was statistically significant exercise sub-scale (Diff.= .404; p= .047) at p<0.05. The participants with lower income tested blood glucose less often as compared to those with higher income (Diff= -.598; p = .003). The longer duration of diabetes associated significantly with poor glycemic control (Diff.= -.438; p = .032). The difference between the controlled blood glucose levels (≤ 7%) and uncontrolled (> 7%) was statistically significant (Diff= .88; p = .015). The multivariate regression analysis revealed that the participants’ characteristics accounted for 21% of the variability in the total self-management score (R²=0.211). In addition, women were more inclined to undertake appropriate diabetes self-management activities (β= .302; p = .001). Conclusion: This study has identified the factors associated with the self-management activities among the patients with type 2 diabetes in rural area of Pakistan. In order to overcome the influence of these factors, healthcare professionals should pay special attention to the patients of rural area of Pakistan to ensure that the population is aware of diabetes and its complications, emphasizing lifestyle modification with importance of adherence to treatment which would be most beneficial to their self-management activities
Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study
Authors: Sun Yue-ming , Li Shuangling , Wang Shu-Peng , Li Chen , Li Gang , Xu Jia-Xuan , Wang Hong-Zhi , Liu Fei , Yao Gai-Qi , Chang Zhi-Gang , Liu Ya-Lin , Shang Mei-Xia , Wang Dong-xin
Published: December 2019

Objectives: The requirement of prolonged mechanical ventilation (PMV) is associated with increased medical care demand and expenses, high early and long-term mortality, and worse life quality. However, no study has assessed the prognostic factors associated with 1-year mortality among PMV patients, not less than 21 days after surgery. This study analyzed the predictors of 1-year mortality in patients requiring PMV in intensive care units (ICUs) after surgery.
Design: Multicenter, retrospective cohort study
Setting: ICUs at 5 tertiary hospitals in Beijing
Participants: Patients who required PMV after surgery between January 2007 and June 2016 were enrolled.
Interventions: None
Measurements and Main Results: Of the 124 patients enrolled, the cumulative 1-year mortality was 74.2% (92/124). From the multivariable Cox proportional hazard analysis, cancer diagnosis (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.37-3.35; P<0.01), no tracheostomy (HR 2.01, 95% CI 1.22-3.30; P<0.01), enteral nutrition intolerance (HR 1.88, 95% CI 1.19-2.97; P=0.01), blood platelet count ≤150´10 9 /L (HR 1.77, 95% CI 1.14-2.75; P=0.01), requirement of vasopressors (HR 1.78, 95% CI 1.13-2.80; P=0.02), and renal replacement therapy (HR 1.71, 95% CI 1.01-2.91; P=0.047) on the 21 st day of mechanical ventilation were associated with shortened 1-year survival.
Conclusions: For patients who required PMV after surgery, cancer diagnosis, no tracheostomy, enteral nutrition intolerance, blood platelet count ≤150´10 9 /L, vasopressor requirement, and renal replacement therapy on the 21 st day of mechanical ventilation were associated with shortened 1-year survival. The prognosis in PMV patients in ICUs can facilitate the decision-making process of physicians and patients’ family members on treatment schedule.
Seed-Biopriming of Durum Wheat with Diazotrophic Plant Growth Promoting Bacteria (PGPB) Enhanced Tolerance to Fusarium Head Blight (FHB) and Salinity Stress
Authors: Brahim Adel Hadj , Jlidi Mouna , Daoud Lobna , Ben-Ali Manel , Akremi Asmahen , Hmani Houda , Feto Naser Aliye , Ben-Ali Mamdouh
Published: December 2019

Background There is growing interest in the use of bioinoculants based on plant growth promoting bacteria (PGPB) to promote plant growth under biotic and abiotic stresses. To our knowledge much work has not been, thus far, done on seedbiopriming of durum wheat for tolerance to biotic and abiotic stresses. In the present work, we report detailed account of the effectiveness a potent bacterial strain with proven plant growth-promoting ability and antimicrobial activity. The isolate was selected following screening of several bacterial strains isolated from halophytes that grow in a coastal saline soil in Tunisia for their role in enhancing durum wheat tolerance to both salinity stress and head blight disease. Results Accordingly, Bacillus strains MA9, MA14, MA17 and MA19 were found to have PGPB characteristics as they produced indole-3-acetic acid, siderophores and lytic enzymes, fixed free atmospheric nitrogen, and solubilized inorganic phosphate, in vitro. The in vivo study that involved in planta inoculation assays under control (25 mM NaCl) and stress (125 mM NaCl) conditions indicated that all PGPB strains significantly (P < 0.05) increased the total plant length, dry weight, root area, seed weight, nitrogen, protein and total mineral content. On the other hand, strain MA17 reduced Fusarium Head Blight (FHB) disease incidence in wheat explants by 64.5%, showing that the strain has antifungal activity as was also displayed by in vitro inhibition study. Conclusions Both in vitro and in vivo studies showed that MA9, MA14 MA9, MA14, MA17 and MA19 strains were able to play the PGPB role. Yet, biopriming with Bacillus strain MA17 offered the highest bioprotection against FHB, plant growth promotion, and salinity tolerance. Hence, the MA17 strain should further be evaluated under field condition and formulated for commercial production. Besides, the strain could further be evaluated for its potential role in bioprotection and growth promotion of other crop plants. We believe, the strain has potential to significantly contribute to wheat production in the arid and semi-arid region, especially the salt affected Middle Eastern Region, besides its potential role in improving wheat production under biotic and abiotic stresses in other parts of the world.
WITHDRAWN: Role of Short-wavelength Blue Light in the Formation of Cataract and Expression of Caspase-1, -11 and Gasdermin D in rat Lens Epithelium Cells: Insight into the Novel Pathogenesis of Cataract.
Authors: Wang Yamin , Zhang Min , Sun Ying , Wang Xiaohui , Song Zhaowei , Li Huazhang , Liu Kexin , Li Zhijian
Published: December 2019

Background Cataracts have been verified to be associated with a number of risk factors. The sun and artificial light sources, including light-emitting diode (LED) and fluorescent light tubes, are the primary sources of short-wavelength blue light. With the increasing popularity of blue-rich LED-backlit display devices, our eyes are now exposed to more short-wavelength blue light than they were in the past. The goal of this study was to evaluate the role of short-wavelength blue light in the formation of cataract. Additionally, the pathogenesis of cataracts after short-wavelength light exposure was investigated.Methods SD rats were randomly divided into 2 main groups: a control group (10 rats each for the 4-, 8-, and 12-week groups) and an experimental group (10 rats each for the 4-, 8-, and 12-week groups). The rats in the experimental group were exposed to a short-wavelength blue LED lamp for 12 hours per day. After exposure to the blue LED lamp, the rats were maintained in total darkness for 12 hours, after which a 12-hour light/dark cycle was resumed. The intensity of the lamp was 3000 lux. At the end of the short-wavelength blue LED lamp exposure (for 4, 8, and 12 weeks), the expression levels of caspase-1, caspase-11 and gasdermin D (GSDMD) in rat epithelium cells (LECs) were examined in rat epithelial cells (LECs) using qRT-PCR and Western blotting analyses. Results After 6 weeks, cataracts had developed in the experimental rats (4/20 eyes). The clarity of the lens then gradually worsened with the duration of exposure. Twelve weeks later, all of the rat eyes had developed cataracts. Then the expression levels of caspase-1, caspase-11 and GSDMD at 4, 8, and 12 weeks were significantly higher in samples from rats exposed to a short-wavelength blue LED lamp than samples from control rat (p˂0.05). Conclusion The data indicate that pyroptosis play a key role of in cataracts induced by short-wavelength blue light exposure, highlighting caspase-1, caspase-11 and GSDMD as possible therapeutic targets for cataract treatment. This study might provide new insight into the novel pathogenesis of cataracts.
Effects of preoperative, scheduled administration of antiemetics on reducing postoperative nausea and vomiting in patients undergoing total knee arthroplasty
Authors: Chang Moon Jong , Chang Chong Bum , Kang Seung-Baik , Park Hyung Jun , Hwang Keum Min , Hwang Il-ung
Published: December 2019

Background To date, there has been no established protocol regarding the timing of the scheduled administration of antiemetics in total knee arthroplasty (TKA). Previous prospective studies analyzing the scheduled use of antiemetics differed in the timing at which the drugs were administered. However, antiemetic drugs are not administered post-operatively until noxious stimuli caused by drugs used during anesthesia and operative procedures. The purpose of this study was 1) to determine whether preoperative scheduled administration of an antiemetic drug can reduce iatrogenic postoperative nausea and vomiting (PONV) in TKA compared to postoperative administration, and 2) to determine whether there was a difference in postoperative pain, patient satisfaction, and complications after TKA between pre- and postoperative administrations.Methods This retrospective study included patients who were assigned to either intravenous administration of the antiemetic drug (ramosetron) 1 hour before surgery (pre-injection group: 50 patients) or at the end of surgery (post-injection group: 51 patients). The incidence of PONV and the frequency of rescue medicine use were recorded until 48 hours postoperation. Postoperative pain level and satisfaction were also assessed using the visual analogue scale (VAS). Possible complications associated with serotonin receptor antagonists; for example, headaches, dizziness, and drowsiness were also assessed.Results The incidence of nausea events was lower in the pre-injection group than in the post-injection group. However, there was no difference between the two groups in terms of frequency of vomiting events and the use of rescue medicine for PONV. Also, postoperative pain, satisfaction scores, and incidence of complications were not different between the two groups.Conclusions The patients with preoperative scheduled administration of antiemetics showed lower incidence of nausea events than those with postoperative administration. However, it is difficult to conclude that the extent of the effect was clinically significant. Further research is needed to determine the optimal timing and method for more effective antiemetic treatment.
The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers
Authors: Wilczyński Bartosz , Zorena Katarzyna , Wąż Piotr
Published: December 2019

Background Participation of children and youth in sporting activities, among others in training and football competitions, is an optimistic manifestation of activation in the current trend of computerization. Unfortunately, this is also often associated with musculoskeletal injuries. An example is the association of dynamic valgus and disturbed dynamic balance with lower limb injuries. The main purpose of the studies is to determine the impact of three strengthening exercises on the parameters of dynamic knee valgus and balance of lower limbs. The secondary objectives are to investigate the dominant influence and the length of lower limb on the valgus values and to determine risk of injury to young football players. Methods 134 young footballers training at the Arka Gdynia SI club were invited to first stage of the research in order to examine anthropometric features and kinematics of the lower limb. Single Leg Squat Test was used, which was recorded. The samples were analyzed video to determine exact knee angle of valgus. During the second stage, to which players with valgus knee were qualified (≥15˚), the Y-Balance Test was additionally used. Intervention group underwent an exercise program to strengthen gluteus medius, popliteal and tibialis posterior muscles for 6 weeks to repeat tests in the third stage. Results Statistical methods used at the assumed level of significance allow to conclude that there are no differences in results of dynamic valgus (≥15˚) and dynamic balance between the intervention group and control group during the 6 week period between stages. In addition, there were results confirming the lack of influence of length and dominant lower limb on valgus. Results of composite direction in the Y-Balance Test test determine the low risk of injury in both intervention and control groups. Conclusions Intervention did not affect the dynamic valgus and knee balance in young football players. Both the length and the dominant limb did not affect the results. The "low risk" occurrence of injuries among the examined participants with valgus knee due to the values of dynamic balance was determined.
Simulation via Instant Messaging-Birmingham Advance (SIMBA) model helped improve clinicians’ confidence to manage cases in diabetes and endocrinology
Authors: Melson Eka , Davitadze Meri , Aftab Manal , Ng Cai Ying , Ooi Emma , Blaggan Parisha , Chen Wentin , Hanania Thia , Thomas Lucretia , Zhou Dengyi , Chandan Joht Singh , Senthil Latha , Arlt Wiebke , Sankar Sailesh , Ayuk John , Karamat Muhammad Ali , Kempegowda Punith
Published: December 2019

Background: Simulation-based learning (SBL) has been increasingly used in both undergraduate and postgraduate medical training curricula. The aim of Simulation via Instant Messaging-Birmingham Advance (SIMBA) is to create a simple virtual learning environment to improve trainees’ self-reported confidence in diabetes and Endocrinology. Methods: This study was done as part of the continuous professional development for Health Education England West Midlands specialty trainees in diabetes and Endocrinology. Standardized transcripts of anonymized real-life endocrinology (endocrine session) and diabetes cases (diabetes session) were used in the simulation model. Trainees interacted with moderators through WhatsApp® in this model. All cases were then discussed in detail by a consultant endocrinologist with reference to local, national and international guidelines. Trainee acceptance rate and improvement in their self-reported confidence levels post-simulation were assessed. Results: 70.8% (n=17/24) and 75% (n=18/24) strongly agreed the simulation session accommodated their personal learning style and the session was engaging. 66.7% (n=16/24) strongly felt that the simulation was worth their time. In endocrine session, there was a significant improvement in trainees’ confidence in the management of craniopharyngioma (p=0.0179) and acromegaly (p=0.0025). There was a trend towards improved confidence levels to manage Cushing’s disease and macroprolactinoma. In diabetes session, there was a significant improvement in trainees’ confidence to interpret continuous glucose monitor readings (p = 0.01). There was a trend towards improvement for managing monogenic diabetes, hypoglycaemic unawareness and interpreting Libre readings. Overall, there was a significant improvement in trainees’ confidence in managing cases that were discussed post-simulation. Conclusion: SIMBA is an effective learning model to improve trainees’ confidence to manage various diabetes and endocrine case scenarios. More sessions with a variety of other specialty case scenarios is needed to further assess SIMBA’s effectiveness and application in other areas of medical training.
The Collaborative Learning Development Exercise (CLeD-EX): an educational instrument promoting key collaborative learning behaviours in medical students
Authors: Iqbal Maha Pervaz , Velan Gary M , Sullivan Anthony O’ Sullivan J O’ , Balasooriya Chinthaka
Published: December 2019

Background: Modern clinical practice increasingly relies on collaborative and team-based approaches to care. Regulatory bodies in medical education emphasise the need to develop collaborative and teamwork competencies and highlight the need to do so from an early stage of medical training. During undergraduate medical education the focus is usually to facilitate collaborative learning and increase feedback and reflection on this learning. This article describes a novel educational instrument, the Collaborative Learning Development Exercise (CLeD-EX), which aims to foster the development of key collaborative learning competencies in medical students. Methods: In this study, the “educational design research” framework was used to develop, implement and evaluate the CLeD-EX. This involved adopting a systematic approach towards designing a creative and innovative instrument which would help solve a real-world challenge in developing collaborative learning skills. The systematic approach involved a qualitative exploration of key collaborative learning behaviours which are influential in effective collaborative learning contexts. The identified competencies were employed in the design of the CLeD-EX. The design of the CLeD-EX included features to facilitate structured feedback by tutors to students, complemented by self-evaluation and reflection. The CLeD-EX was field-tested with volunteer junior medical students, using a controlled pre-test post-test design. Analysis of the completed CLeD-EX forms, self-perception surveys (i.e. pre-test and post-test surveys) and analyses of reflective reports were used to explore the educational impact of CLeD-EX, as well as its utility and practicality. Results: After using the CLeD-EX, students showed a significant improvement in self‑directed learning, critical thinking and group process as measured by a previously validated instrument. Both students and tutors recognised CLeD-EX as an effective instrument, especially as a structured basis for giving and receiving feedback and for completing the feedback loop. CLeD-EX was also found to be feasible, practical and focused, while promoting learning and effective interactions in small group learning. Conclusion: The findings of this study support the introduction of an educational instrument such as the CLeD-EX to facilitate the development of students’ skills in collaborative learning.