bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the sciatic nerve block quality of anterior and posterior approaches: A randomised trial
Authors: Yektaş Abdulkadir , Balkan Bedih
Published: October 2019

Background: The co-administration of sciatic nerve and femoral nerve blocks may provide anaesthesia and analgesia in patients undergoing lower extremity surgeries. Several approaches to sciatic nerve block have been described, including anterior and posterior approaches.
Methods: Our study included 58 patients, randomly assigned to receive either an anterior (Group A , n = 29) or posterior (Group P, n = 29) approach. After the blocks were performed, we determined sensory and motor block start and end times, first fentanyl requirement time after block and before operation starts, first fentanyl requirement time after the operation starts, the mean fentanyl dose administered per patient after block and before operation starts, the mean fentanyl dose administered per patient after the operation starts, the time to first diclofenac sodium administration, and the total dose of diclofenac sodium required. The date of trial registration was retrospectively registered in 11.07.2018
Results: Comparison of the two groups revealed that Group P exhibited significantly shorter times to starting the sensory block (12.88±4.87 min for Group A, 7.70±2.05 min for Goup P) p=0.01 and first fentanyl requirement time after block and before operation starts (00.00±00.00 min for Group A, 4.05±7.47 min for Group P) p=<0.01 and a significantly higher first fentanyl requirement time after operation starts (31.20±27.79 µg for Group A, 44.03±23.78 µg for Group P) and a significantly higher the mean fentanyl dose administered per patient after block and before operation starts (00.00±00.00 min for Group A, 16.24±57.13 min for Group P) p=0.01 and a significantly lower the mean fentanyl dose administered per patient after operation starts (147.75±122.30 µg for Group A, 11.51±12.87 µg Group P). Patient satisfaction (p=<0.01), anesthesia quality (p=0.006), and surgical quality (p=0.047) were significantly higher in Group P.
Conclusions: Sciatic nerve block can be performed with anterior and posterior approach in patients who will be operated due to malleolar fracture. However, analgesia should be performed before starting the patient in the posterior approach and after the operation in the anterior approach.
Prevalence of surgical site infection and associated factors after cesarean section in Ethiopia: systematic review and meta-analysis
Authors: Getaneh Temesgen , Negesse Ayenew , Dessie Getenet
Published: October 2019

Background

Surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure. It is a significant cause of surgical patient morbidity, mortality and human and financial costs threat. The national prevalence of surgical site infection among mothers who undergo for cesarean section and its risk factors are not well investigated in Ethiopia. Therefore, this systematic and meta-analysis conducted to estimate the pooled prevalence of surgical site infection and associated factors after cesarean section in Ethiopia.Methods

Original articles were searched in PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), and Cochrane Library. Data were extracted using a standard data extraction checklist that developed according to Joanna Briggs Institute (JBI). The I2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias. A fixed effect model was used to estimate the pooled prevalence of surgical site infection. Odds Ratio (OR) with 95% Confidence Interval (CI) was also used to determine the association of identified variables with surgical site infection. Statistical analysis was conducted using STATA software.Result

From initial 179 identified articles, 11 were eligible for inclusion in the final meta-analysis. The pooled estimate of surgical site infection after cesarean section in Ethiopia was 9.72% (95%CI: 8.38, 11.05). PROM >12hrs (OR=5.02, 95%CI: 2.65, 9.51), duration of labor>24hrs (OR=3.69, 95%CI: 2.41, 5.65), chorioamnionitis (OR=9.11, 95%CI: 5.21, 15.93), anemia (OR=4.75, 95%CI: 2.42, 9.33) and having vertical skin incision (OR=4.17, 95%CI: 2.90, 6.02) were factors significantly associated with surgical site infection after cesarean section.Conclusion

The prevalence of surgical site infection after cesarean section in Ethiopia was high. Therefore, Minister of Health with its stake holders should emphasis on community and institution based programs in manner to prevent those factors listed above that have significant effect on surgical site infection.
Assessment of proliferating cell nuclear antigen (PCNA) expression at the invading front of oral squamous cell carcinoma
Authors: Lu Emily Ming-Chieh , Ratnayake Jithendra , Rich Alison Mary
Published: October 2019

Background: Accurate prediction of the behaviour of oral squamous cell carcinoma (OSCC) is necessary to determine prognosis and provide appropriate treatment. Therefore, it is important to investigate potential prognostic markers to determine their predictive ability. Histological assessment of specific features at the invading front of oral squamous cell carcinomas has shown to provide accurate and reproducible prognostic information. Proliferating cell nuclear antigen (PCNA) is a nuclear marker known to reflect cell turnover and may be used as a marker for tumour aggressiveness. Methods: 20 cases of OSCC were histologically assessed to evaluate the correlation between proliferating cell nuclear antigen expression and invasive front grading. Each case was first assessed on a haematoxylin and eosin stained slide and an invading front grading (IFG) score was determined. In order to obtain a PCNA score, immunohistological staining was carried out using the peroxidase-labeled streptavidin-biotin technique with the monoclonal antibody PC10. Results: In all cases tumour islands had a periphery of intensely stained proliferating cell nuclear antigen positive epithelial cells. The average IFG score was 8  1.8 and the average PCNA score was 75%  11.2. Regression analysis was done using data from the IFG score and PCNA score and taking the latter as the predictor variable. The Pearson correlation coefficient was 0.134, with a p-value of 0.572. Conclusion: Since the correlation between PCNA score and IFG score was not significant (p>0.05), we conclude that there is no association between cell proliferation at the invading tumour front and the histological grading of OSCC.
Analysis of the causes of cervical lymphadenopathy using Fine-Needle Aspiration Cytology combining cell block in Chinese Patients with and without HIV infection
Authors: Sun Lei , Zhang Liang , Yang Kun , Chen Xiang-mei , Chen Jia-min , Xiao Jiang , Zhao Hong-xin , Ma Zhi-yuan , Qi Li-ming , Wang Peng
Published: October 2019

Background Cervical lymphadenopathy refers to a frequently observed clinical presentation in numerous pathological conditions. A wide spectrum of diseases can cause cervical lymphadenopathy, irrespective of the fact that the patients are infected with HIV or not. The present study focuses on validating whether the causes of cervical lymphadenopathy differ significantly in HIV and non-HIV patients by using fine-needle aspiration cytology (FNAC) combining cell block.Methods A total of 589 patients with cervical lymphadenopathy were recruited in the FNA clinic. The samples were obtained by an auto-vacuumed syringe that benefited the sampling more materials. The cytological smears were prepared by Hematoxylin and Eosin (HE), Periodic Acid Schiff (PAS), Gomori’s methenamine silver (GMS) and acid-fast staining. Cell blocks were made if required, and immunohistochemistry stain was performed on the cell block section.Results The study found 453 (76.9%) patients with HIV and 136 (23.1%) patients without HIV infection. The average age of HIV-infected patients was 34.8 ±10.2 years, which was significantly lower than that of non-HIV-infected patients (42.9 ±18.1 years) (p<0.01). Of all patients infected with HIV, 390 (86.1%) were males. This proportion was significantly higher than that of non-HIV-infected patients [65/136 (47.8%)] (p<0.01). The major causes of cervical lymphadenopathy in HIV positive patients were mycobacterial infection (38.4%), reactive hyperplasia (28.9%), non-specific inflammation (19.9%), and malignant lesions (4.2%). In contrast, the most common causes in HIV negative patients were reactive hyperplasia (37.5%), malignancy (20.6%), non-specific inflammation (19.1%) and mycobacterial infection (12.5%). Opportunistic infections such as non-tuberculous mycobacteria (4.2%), cryptococcosis (1.5%), Talaromyces marneffei (1.5%) and other fungi (0.4%) were found only in HIV-infected individuals. Non-Hodgkin’s lymphoma (2.4%) was the most common malignant lesion in patients with HIV infection, followed by Kaposi's sarcoma (0.9%) and metastatic squamous cell carcinomas (0.7%). However, the most common malignancy in non-HIV-infected patients was metastatic carcinomas (14%) including small cell carcinomas, adenocarcinomas, squamous cell carcinomas and hepatocellular carcinoma, which were noticeably greater than the HIV patients (p<0.01).Conclusions There were significantly different causes of cervical lymphadenopathy in HIV infected and non-HIV infected patients. FNAC was a useful diagnostic method for differential diagnosis of cervical lymphadenopathy.
Transcriptomic analysis on the effects of melatonin in gastrointestinal carcinomas
Authors: Ao Lu , Li Li , Sun Huaqin , Chen Huxing , Li Yawei , Huang Haiyan , Wang Xianlong , Guo Zheng , Zhou Ruixiang
Published: October 2019

Background : Melatonin has been shown with anticancer property and therapeutic potential for tumors. However, there lacks a systematic study on the molecular pathways of melatonin and its antitumor effects in gastrointestinal carcinomas. Methods : Using the gene expression profiles of four cancer cell lines from three types of gastrointestinal carcinomas before and after melatonin treatment, including gastric carcinoma (GC), colorectal carcinoma (CRC) and hepatocellular carcinoma (HCC), differentially expressed genes (DEGs) and biological pathways influenced by melatonin were identified. Results : There were 17 pathways commonly altered by melatonin in the three cancer types, including FoxO signaling pathways enriched by the upregulated DEGs and cell cycle signaling pathways enriched by the downregulated DEGs, confirmed the dual role of melatonin to tumor growth, pro-apoptosis and anti-proliferation. DEGs upregulated in the three types of cancer tissues but reversely downregulated by melatonin were commonly enriched in RNA transport, spliceosome and cell cycle signaling pathways, which indicate that melatonin might exert antitumor effects through these pathways. Our results further showed that melatonin can downregulate the expression levels of 5-FU resistance-related genes, such as thymidylate synthase in GC and ATR , CHEK1 , BAX and MYC in CRC, suggesting that melatonin might increase the sensitivity of 5-FU in GC and CRC patients. Conclusions : Melatonin exerts the effects of pro-apoptosis and anti-proliferation on gastrointestinal carcinomas, and might increase the sensitivity of 5-FU in GC and CRC patients.
Fatty acid biosynthesis and transcriptional regulation of Stearoyl-CoA Desaturase 1 (SCD1) in Buffalo milk
Authors: Li Zhipeng , Lu Suyu , Cui Kuiqing , Shafique Laiba , Rehman Saif ur , Luo Chan , Wang Zhiqiang , Liu Qingyou
Published: October 2019

Background: Nutritionally, buffalo milk is of immense importance due to high contents of fatty acid (FA), highly energetic and nutritive value. The composition of FA has been regarded as functional food component, which facilitate to manufacture a variety of processed milk products. Moreover, Buffalo milk contains more unsaturated FAs (UFA) such as oleic and linolenic acids, which have been shown to exert a number of physiological effects. However, inadequate information reported about the chemical composition and mechanism of FA synthesis in buffalo milk. Our conducted research hypothesize that, the expression of SCD1 gene could alter the biosynthesis of fatty acid (FA) in epithelial cells of mammary gland and subsequently affect the FA contents in buffalo milk. Present study investigated transcriptional and biological role of Stearoyl-CoA Desaturase 1 (SCD1) in the buffalo mammary epithelial cells (BMECs) during FA and triacylglycerol (TAG) synthesis. Results: Results showed that unsaturated fatty acid contents are much higher in concentration in buffalo milk as compared to Holstein cow. Significantly, higher expression level of FAS, ACACA, SREBP1, PPARG, GPAT and AGPAT genes were also been observed with the expression of the SCD1 in buffalo milk. Moreover, studies showed that, SCD1 gene alteration in BMECs also causes the change in the expression of FA synthesis related genes mentioned above and subsequently affect the FA composition in the cells. Overexpression of SCD1 significantly increased the expression of genes associated with FA and TAG synthesis and also improved the FA and unsaturated FA contents in BMECs, while down-regulation of SCD1 appear opposite consequences. Conclusion: Thus, present study clearly demonstrated that, alteration in the expression of SCD1 plays an important role in FA and TAG synthesis and can directly or indirectly affect biosynthesis and metabolic pathways in BMECs and may be used as a symbol for important mechanism that contributes the characterization of buffalo milk.
Differential basal expression of immune genes confers Crassostrea gigas resistance to Pacific Oyster Mortality Syndrome
Authors: Julien de Lorgeril , Petton Bruno , Lucasson Aude , Perez Valérie , Stenger Pierre-Louis , Dégremont Lionel , Montagnani Caroline , Escoubas Jean-Michel , Haffner Philippe , Allienne Jean-François , Leroy Marc , Lagarde Franck , Vidal-Dupiol Jérémie , Gueguen Yannick , Mitta Guillaume
Published: October 2019

Background As a major threat to the oyster industry, Pacific Oyster Mortality Syndrome (POMS) is a polymicrobial disease affecting the main oyster species farmed across the world. POMS affects oyster juveniles and became panzootic this last decade, but POMS resistance in some oyster genotypes has emerged. While we know some genetic loci associated with resistance, the underlying mechanisms remained uncharacterized. So, we developed a comparative transcriptomic approach using basal gene expression profiles between different oyster biparental families with contrasted phenotypes when confronted to POMS (resistant or susceptible).Results We showed that POMS resistant oysters show differential expression of genes involved in stress responses, protein modifications, maintenance of DNA integrity and repair, and immune and antiviral pathways. We found similarities and clear differences among different molecular pathways in the different resistant families. These results suggest that the resistance process is polygenic and partially varies according to the oyster genotype.Conclusions We found differences in basal expression levels of genes related to TLR-NFκB, JAK-STAT and STING-RLR pathways. These differences could explain the best antiviral response, as well as the robustness of resistant oysters when confronted to POMS. As some of these genes represent valuable candidates for selective breeding, we propose future studies should further examine their function.
Wall Shear Stress Regulates the Proliferation and Migration of Vascular Smooth Muscle Cells Depending on a TGF-β1 Manner
Authors: Jia Lan , Wei Fang , Wang Lihua , Chen Haiyan , Yu Haibo , Lu Zhi , Wang Bo , Jiang Aili
Published: October 2019

Background: Venous intimal hyperplasia (VIH) is the main cause of arteriovenous fistula (AVF) dysfunction. Hemodynamic forces have an important role in VIH. The proliferation and migration of vascular smooth muscle cells (VSMCs) play a crucial role in the development of VIH and TGF-β1 just has the biological function of inducing proliferation and migration of VSMCs. We use parallel plate flow chamber system to simulate different shear stress and investigate whether shear stress regulate VSMCs proliferation and migration through TGF-β1 Methods: Shear stress (SS) was simulated with an ECs/VSMCs cocultured parallel plate flow chamber system. The coculture system was established by plating cells on the two sides of polyethylene terephthalate membrane. The EC side was subjected to different shear stress (Low-SS, Normal-SS and Oscillating-SS), whereas the opposite VSMCs side was maintained under static conditions. Computational fluid dynamics were applied to three-dimensional models of ECs/VSMCs cocultured flow chamber system to estimate the velocity and WSS. The expression of TGF-β1 were analyzed by immunofluorescence assay. VSMCs proliferation and migration assay was performed with the BrdU kit and Transwell system. Results: The expression of TGF-β1 was significantly up-regulated following application of Low-SS and Oscillating-SS, and the distribution of TGF-β1 was transferred to the cell membrane, compared with the static group. The migration and proliferation of cocultured VSMCs were significantly up-regulated after Low-SS and Oscillating-SS. Conclusion: Our results suggest that Low-SS and Oscillating-SS exerts atherosclerotic influences on the ECs and VSMCs in a TGF-β1-dependent process. TGF-β1 increases the proliferation and migration of VSMC and is thought to be a pro-atherogenic effect, which can be used as a new therapeutic target for the treatment of AVF dysfunction. The formation and development of VIH in AVF may be a local hyperplasia process by shear stress-TGF-β1 regulation, which provides new insights into the mechanisms of neointimal hyperplasia.
Identification of Hemolysin encoding Genes and their Association with Antimicrobial Resistance Pattern among Clinical Isolates of Coagulase-Negative Staphylococci
Authors: Nasaj Mona , Saeidi Zahra , Asghari Babak , Roshanaei Ghodratollah , Arabestani Mohammad
Published: October 2019

Objection : Coagulase-negative staphylococci (CoNS) are considered opportunistic pathogens which capable of producing several toxins, enzymes and also resistance genes. The current study aimed to determine the occurrence of different hemolysins and patterns of antibiotic resistance among CoNS species. Results : The highest frequency of antibiotic resistance was observed against cefoxitin in 49 isolates (53.8%), and the lowest resistance was against novobiocin in 5 isolates (5.5%). None of the isolates were resistant to vancomycin. The prevalence of hla, hla_yidD, hld, and hlb genes were determined as 87.9%, 62.6%, 56%, and 47.3%, respectively. The hla/yidD and hld genes were detected in 69.4% of S. epidermidis and the hla gene in 94.6% of S. haemolyticus ; hlb gene was detected in 53.1% of the S. epidermidis isolates. mecA gene was identified in 50 (55%) of the CoNS isolates. In conclusion, the results of statistical analysis showed that the hld gene had a significant association with resistance to levofloxacin and erythromycin and the hlb with clindamycin resistance. The results of this study showed that there is a significant relationship between hemolysin encoding genes and antibiotic resistance patterns; therefore, detection of virulence factors associated with antibiotic resistance has become a significant issue of concern.
Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative
Authors: Calise Tamara , Spitzer Natalie , Ruggiero Laura , Ryder Amanda , Wingerter Chloe , Hatcher Ashley
Published: October 2019

Background: Little is known about the intensity of multi-component initiatives (MCI) inclusive of any combination of programs, practices, policies, and environmental changes (P3E) on youth behaviors. Methods: The Healthy Schools Healthy Communities (HSHC) initiative worked to increase access to PA opportunities as part of 33 MCIs targeting school districts and respective communities. The purpose of this study was to assess whether MCIs with higher scoring PA-related strategies were associated with improved PA and sedentary behaviors among youth. PA-related interventions were assigned point values based on three characteristics: 1) purpose of initiative); 2) duration; and 3) reach. An overall composite score of all activities was calculated for each school district. Multivariate longitudinal regressions were applied, controlling for measurement period, Cohort, and district enrollment. Results: P3E scores ranged from 0.3 to 3.0 with 20% considered “higher-scoring” (score > 2.1) and 47% considered “lower-scoring” ( < 1.2 ). Average composite district P3E scores more than tripled over the evaluation period, rising from 14.8 in the first grant year to 32.1 in year 2, 41.1 in year 3, and 48.1 in year 4. For each additional point increase in average composite district P3E intensity score, the number of days per week that students reported being physically active for at least 60 minutes increased by 0.010 (p<0.01). For each additional point increase in district P3E intensity score, the number of hours per weekday that students reported engaging in screen time activities decreased by 0.006 hours (p<0.5). Conclusions: MCIs are difficult to evaluate given the variations within which they are implemented. Findings from this study suggest the value of a systematic scoring approach in assessing MCIs. In addition to tracking intensity over time, scoring can provide justification for, or against, an individual activity and ways to increase the likelihood of the MCI impacting population-health outcomes.
Growth Response of Greenhouse-Produced Muskmelon and Tomato to Sub-Surface Drip Irrigation and Soil Aeration Management Factors
Authors: Li Yuan , Niu Wenquan , Cao Xiaoshu , Zhang Mingzhi , Wang Jingwei , Zhang Zhenxing
Published: October 2019

Background: Hypoxia causes injury and yield loss. Soil aeration has been reported to accelerate the growth of plants and increase crop yield. The aim of this study was to examine growth response of greenhouse-produced muskmelon to 3 levels of sub-surface drip irrigation (I), 3 different installation depths of drip laterals in the soil (D), and 4 levels of supplemental soil aeration frequency (A). A fractional factorial experiment was designed to examine these treatment effects on marketable fresh fruit yield, leaf area index during 3 growth stages, and dry matter partitioning at harvest. In addition, we studied the response of fruit yield and dry matter of tomato to 2 levels of burial depths of subsurface tubing in combination with 3 frequency levels of soil aeration. Results: Results showed that soil aeration can positively influence the yield, leaf area index, dry matter and irrigation use efficiency of the muskmelon (p<0.05). The fruit yield of muskmelon and tomato were increased by 21.5% and 30.8% respectively with 1-d and 2-d aeration intervals compared with the no aeration treatment. Conclusions: The results suggest that soil aeration can positively impact the plant root zone environment and more benefits can be obtained with aeration for both muskmelon and tomato plants.
Patient Complications After Interscalene Block: A Retrospective Comparison of Liposomal Bupivacaine to Non-Liposomal Bupivacaine.
Authors: hutchins jacob , Habeck Jason , Novaczyk Zac , Campbell Richard , Creedon Christopher , Spartz Ellen , Richter Michael , Wolter Jeremy , Suryawanshi Gaurav , Kaizer Alexander , Berg Aaron A.
Published: October 2019

Background The purpose of this study was to investigate if the addition of liposome bupivacaine (LB) to an interscalene block (ISB) had an effect on the number of patients with surgical or block related complications.Methods This was a single-center retrospective chart view was performed identifying patients who received an ISB from January 1, 2014 through April 26, 2018 at the University of Minnestoa. 1,518 patients were identified who received an ISB (LB =784, non-liposomal bupivacaine =734). Patients were divided into two groups those who did receive liposome bupivacaine in their ISB and those who did not receive liposome bupivacaine in their ISB. Medical records were individually reviewed for surgical procedure, block medications, complications related to the block or surgical procedure, phone calls to the healthcare system for issues related to opioids or pain within 3 and within 30 days, readmissions within 30 days, and emergency room visits for complications within 3 and 30 days.Results There was no significant difference in the number of patients with surgical or anesthetic complications. Only phone calls for pain within 3 days was significantly different. The LB group had 3.2% of patients call compared to 5.6% in the non-liposomal bupivacaine group (aOR=1.71 [95% CI: 1.04-2.87], p=0.036). We found no significant difference in any of the other secondary outcomes.Conclusions The use of LB in an ISB demonstrated no significant difference compared to non-liposomal bupivacaine in numbers of complications, emergency room visits, and readmissions.
Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study
Authors: Hong Boohwi , Lee Sunyeul , Kim Yeojung , Lee Minhee , Youn Ann Misun , Rhim Hyun , Hong Seok-Hwan , Kim Yoon-Hee , Yoon Seok-Hwa , Lim Chaeseong
Published: October 2019

Background Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital. Methods The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity. Results The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test ( P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery. Conclusion There were no differences in 5-year overall survival between two groups in the cancer surgery.
Acupuncture for patients with insomnia disorder using resting-state functional magnetic resonance imaging: a protocol for a Randomised Controlled Trial
Authors: guo jing , Yu Siyi , Liu Chunhong , Wang Guiling , li Bin
Published: October 2019

Background: Insomnia is among the most prevalent sleep-related disorders. Insomnia disorder is associated with a brain hyperarousal state manifested by abnormal regional brain activity and resting-state functional connectivity (rs-FC). Acupuncture improves sleep quality and modulates the hyperarousal state; however, the underlying neurobiological basis for improved sleep quality is poorly understood. The purpose of this clinical trial is to study the efficacy of acupuncture in the treatment of insomnia disorder. In addition, the neural mechanism by which acupuncture affects insomnia disorder will be explored utilizing resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological parameters.
Methods and Design: A randomized, patient-assessor-blinded trial will be conducted. We will randomize (1:1 ratio) 60 eligible patients with insomnia disorder into a real acupuncture group or a sham acupuncture group. Interventions will be administered three times per week over a 4 week period, with an 8 week follow-up period. The healthy control group will consist of 30 age- and sex-matched healthy good sleepers without any treatment intervention.
All participants will undergo neuropsychological and rs-fMRI evaluations. The change of Pittsburgh Sleep Quality Index (PSQI) scores is the primary outcome parameter. The secondary outcome parameters include the Hyperarousal scale (HAS), rs-fMRI measurements, the Fatigue scale-14 (FS-14), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA), a sleep diary, and an actigraph.
Assessment of all parameters will be performed at baseline, post-treatment, and during follow-up. Analyses will be implemented based on intention-to-treat.
Discussion: The study results will be utilized to clarify the effectiveness and elucidate the mechanism by which acupuncture improves sleep quality in patients with insomnia disorder.
Comparison of 22G Standard and Franseen Needles in Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Diagnosing Pancreatic Mass Lesions: Study Protocol for a Randomized Controlled Trial
Authors: Itonaga Masahiro , Yasukawa Satoru , Shimokawa Toshio , Takenaka Mamoru , Fukutake Nobuyasu , Ogura Takeshi , Sakagami Junichi , Shiomi Hideyuki , Okura Yasushi , Inatomi Osamu , Matsumoto Hisakazu , Kurita Akira , Suzuki Azumi , Tanaka Kiyohito , Kitano Masayuki
Published: October 2019

Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was developed with the aim of further improving the diagnostic performance of endoscopic ultrasound. Although novel puncture needles have been specifically designed for collecting sufficient tissue specimens, clinical studies have indicated no clear difference in diagnostic performance between these novel needles and conventional puncture needles. Recently, a needle with Franseen geometry was developed specifically for EUS-FNA biopsy. Due to the characteristic shape of its tip, the Franseen needle is expected to be effective for scraping tissues, thus potentially increasing the diagnostic accuracy of EUS-FNA biopsy. We plan to carry out a prospective, multicenter, open-labeled, randomized, controlled trial to compare conventional and Franseen needles in terms of the diagnostic accuracy of EUS-FNA for evaluating the malignancy of pancreatic mass lesions. Methods/design The study will enroll 520 patients with pancreatic mass managed at any of 21 participating endoscopic centers. Lesion samples obtained using 22G conventional and Franseen needles will be assessed to compare the efficacy and safety of these two types of needles in EUS-FNA for evaluating the malignancy of mass lesions in the pancreas. Tissue samples will be fixed in formalin and processed for histologic evaluation. For the purpose of this study, only samples obtained with the first needle pass will be used for comparing the: (i) accuracy of the malignancy diagnosis, (ii) sensitivity and specificity for the malignancy diagnosis, (iii) procedure completion rate, (iv) sample cellularity, and (v) incidence of complications. Discussion The outcomes of this study may provide insight into the optimal needle choice for evaluating the malignancy of pancreatic solid lesions, thus aiding in the development of practice guidelines for pancreatic diseases.
Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database
Authors: Kawachi Izumi , Okamoto Shuichi , Sakamoto Mariko , Ohta Hiroyuki , Nakamura Yusuke , Iwasaki Kosuke , Yoshida Manami , Hiroi Shinzo , Ogino Mieko
Published: October 2019

Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.
Peripheral T cell lymphoma after chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report
Authors: Liu Xiao-hang , Jin Fan , Zhang Meng , Liu Mei-xi , Wang Tao , Pan Bo-ju , Zhang Lu
Published: October 2019

Background Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder in the central nervous system (CNS) with distinct clinical, radiological, and pathological characteristics. The pathophysiology of CLIPPERS still remains unclear. Because a few cases about lymphoma mimicking the manifestations of CLIPPERS were reported and the prognosis of lymphoma is much worse, early identification of lymphoma is very important. Case presentation A 31-year-old woman was admitted with 3 months’ history of diplopia, dizziness, gait ataxia and right facial numbness. The diagnosis of CLIPPERS was established based on the finding of punctate enhancing lesions in the cerebellum, thalamus, pons, medulla, and midbrain region in magnetic resonance imaging (MRI), together with the favorable clinical and radiological responses to corticosteroids. However, she was diagnosed as peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) by the pulmonary nodular and the skin biopsy almost 10 years later, and she got complete remission within 1 year after chemotherapy. Conclusion We report the first case of CLIPPERS developing PTCL-NOS. This case proposes that when brain biopsy was difficult to achieve, biopsies in extra-cerebral lesions under the assisting examination of positron emission tomography-computed tomography (PET-CT) can be helpful in further identification.
SERVICE PERIOD AS A MODERATOR TO THE BEHAVIOUR AND WORK PERFORMANCE RELATIONSHIP IN THE ORGANISATION
Authors: Khatijah Othman  , Siti Nurbaya Ismail  , Shahrul Hafifi Mohd Fuad  , Masni Md Hasim  , Fadhilah Othman  , Muhammad Rahmat Abdullah  , Norwini Zaidi  , Nur Adlina Addenan  , Nik Nadian Nisa Nik Nazli
Published: October 2019

Performance and productivity are strongly influenced by the workers’ behavioural attitudes. Committed employees’ behaviours will produce higher performance and productivity in their work. Undeniably, the better commitment would help to reduce employees’ personal problems such as differing work, absenteeism, and negligence in doing work. High performance affects employees and ensures that every task is done efficiently, and it provides employees a high level of job satisfaction. The longer the worker stays in a workplace, the higher the performance level shown towards the organisation. The objective of this study is to examine the relationship between the workers’ behaviours and work performances in the organisation, and to determine the service period as a moderator in relationship between behaviour and work performance. The method used in this study is a quantitative methodology, and the survey questionnaires have been conducted on 100 respondents consisting of professional and administrative officers in an organisation. The data analysis was performed using Structural Equation Modeling (SEM) method with the help of AMOS software version 23. The finding shows that there is a positive relationship between employees’ behaviour and work performance, and the duration of service moderated the relationship between behaviour and work performance. In this regard, workers who have worked a long period of service with an organisation exhibit the behaviour of commitments to work and produce more efficient and effective work performance in the organisation.
Enerji Etkin Bina Tasarımında Güneş Enerjisinden Pasif Yararlanma: Karataş Açık Ceza Evi Tekstil Atölyesi Projesi
Authors: YEĞİN Mustafa
Published: October 2019

Bu çalışmada Karataş Kadın Açık Ceza Evi Tekstil atölyesi projesi tanıtılmaktadır. Yazar tarafından Haziran 2017 tarihinde Tekstil Atölyesi projesinin tasarımına başlanmış Aralık 2017’de tamamlanarak Karataş Kadın Açık Ceza İnfaz Kurumu Müdürlüğü’ne teslim edilmiştir. Çalışmada, projeye ilişkin tasarım süreci, tasarımda öne çıkan unsurlar, ergonomik faktörler, mekan kullanımları, alansal büyüklükler ve pasif tasarım ilkeleri ile elde edilen mekan kalitesi sunulmaya çalışılmıştır. 
Cartografía de los paisajes: teoría y aplicación
Authors: Chávez Eduardo Salinas , Mateo Rodríguez José Manuel , Cavalcanti Lucas Costa de Souza , Braz Adalto Moreira
Published: October 2019

El paisaje como concepto fundamental de integración en la Geografía, vuelve a tomar su papel en este nuevo siglo, caracterizado por la Globalización de la Economía y el Conocimiento y los Problemas Ambientales generados por siglos de explotación irracional de los recursos naturales de nuestro planeta y las consecuencias del Cambio Climático. Es en este contexto que presentamos aquí un análisis detallado de las principales etapas y escuelas que posibilitaron  la consolidación de una teoría del paisaje como sistema integrado y su aplicación en diferentes ámbitos y regiones como parte de los esfuerzos por lograr la planificación y ordenamiento del territorio a diferentes niveles, acorde con los retos que este siglo XXI presenta para la sociedad humana, destacando el papel de la delimitación, clasificación y cartografía de las unidades de paisaje como premisa fundamental para su evaluación y conservación y las posibilidades del uso de los Sistemas de Información Geográfica, la Teledetección y la Estadística Multivariada.
Online survey of symptoms and care seeking behavior in 7,956 questionnaire respondents with highly suspected knee arthritis in China (Preprint)
Authors: Zhuang Qianyu , Tao Liyuan , Bian Yanyan , Wang Wei , Liu Zhuang , Zhang Lei , Zhu Xiaoying , Xue Feng , Weng Xisheng
Published: October 2019

BACKGROUND

Thus far, no Chinese studies have explored knee arthritis symptoms in depth, and there are no adequate data regarding the care seeking behavior of these patients.

OBJECTIVE

To collect nationwide data in China via an online survey of people suspected of having knee arthritis, and analyze their symptoms and care seeking behavior.

METHODS

Participants were directed to a survey page via a popular health website in China. The measurement tool was a 14-item knee arthritis questionnaire, designed as a 10-point continuous measurement scale, containing 14 symptom items grouped into 3 domains: pain, inflammation, and functioning. For each single item, the respondent rated his/her level of severity as: ‘mild’ (score 1-3); ‘moderate’ (4-6); or ‘severe’ (7-10). Mean scores determined the severity of symptoms for each domain and each respondent. In analyzing correlations between the 14 symptoms, a correlation coefficient of >0.6 was regarded as a strong relationship.

RESULTS

A total of 7,956 Chinese patients completed the survey. The correlation coefficient between inflammation and functioning was 0.783, versus 0.630 between pain and inflammation, and 0.693 between pain and functioning. Most of the stronger links were observed between symptoms of the inflammation domain and those of the functioning domain. In the behavior analysis, a longer time to seek treatment was observed in females than in males (p<0.001).

CONCLUSIONS

In Chinese people with suspected knee arthritis, inflammation is found correlated with loss of function more strongly than pain. A gap in health care for Chinese patients might exist, delayed treatment and lack of standardized treatment plans being examples.
Nilai-Nilai Filosofis Gedung Pusat UGM dan Relevansinya Bagi Pengembangan Ilmu
Authors: Santoso Heri
Published: October 2019

Penelitian ini ditujukan untuk: (1) menginventarisasi, mensistematisasi, dan mengeksplisitasi nilai-nilai filsafat kehidupan yang terkandung dalam unsur-unsur utama arsitektur Gedung Pusat UGM; (2) mengevaluasi secara kritis dan menyusun suatu konsepsi relevansi filsafat kehidupan yang terkandung dalam arsitektur Gedung Pusat UGM bagi pengembangan keilmuan di pendidikan tinggi. Penelitian ini menggunakan model penelitian filosofis di lapangan, dengan memadukan data kepustakaan yang ditunjang dengan data lapangan. Hasil penelitian menunjukkan bahwa: Pertama, nilai-nilai filosofis Gedung Pusat UGM dapat digali dari sejarah dan ajaran filsafat hidup para pendirinya serta makna simbolik yang diwujudkan dalam bentuk arsitektur bangunannya. Kedua, Para pendiri Gedung Pusat UGM mengajarkan tentang keluhuran budi (pengabdian kepada bangsa, keikhlasan, kesabaran, kegigihan, keuletan dan pantang menyerah), serta keluasan ilmu dan pengetahuan yang mampu mengharmoniskan berbagai aliran pemikiran kefilsafatan yang sedang berkembang di masanya, dan merupakan puncak-puncak peradaban dunia; Ketiga, Arsitektur Gedung Pusat UGM mengajarkan tentang keberhasilan ilmuwan UGM, meramu berbagai aliran-aliran pemikiran yang berkembang di dunia dalam ramuan khas Indonesia yang berujung pada karya yang baik, benar, indah dan sakral. Keempat, filosofi Gedung Pusat UGM memberi dasar dan orientasi bagi pengembangan ilmu di UGM pada khususnya dan perguruan tinggi di Indonesia pada umumnya untuk senantiasa membangun berdasarkan jati diri, dengan tetap belajar dan bekerjasama dengan dunia luar demi kemanfaatan dan peningkatan peradaban umat manusia.
Does Faculty Perceived ICT Abilities Influence Integration of Information and Communication Technologies in Instruction? A Case of University Early Childhood Education Programmes in Kenya
Authors: Nzika Mwololo, Josephat , Begi Nyakwara
Published: October 2019

Information and Communication Technology (ICT) based instruction provide opportunities whereby the teacher is a facilitator and learners are active participants. ICT has tended to make learners effectively connect theory and practice. For ICT to be successfully utilised in instruction teachers need to possess the prerequisite ICT abilities. This study aimed at evaluating integration of ICT in instruction in Early Childhood Education (ECE) programmes in universities in Kenya and how faculty perceived ICT abilities related to ICT integration in instruction. A sample of 88 lecturers purposely drawn from public and private universities that were ECE pioneers and offered ECE programmes formed the study subjects. Questionnaire, observation checklist and document analysis were used to collect data. Both descriptive and inferential statistics were the methods of data analysis employed. Results from data analysed revealed that faculty were integrating basic ICT tools in instruction. It was also revealed that there was no significant difference in ICT integration in instruction by faculty in public and in private universities. The relationship between faculty perceived ICT abilities and ICT integration in instruction was highly significant at alpha value 0.05. It was recommended that there was need for university administration to organize in-service training for faculty to adequately learn how to integrate advanced ICT tools in instruction.
El concepto “minorías”. significados y usos
Authors: Rodríguez Ortiz Angélica María
Published: October 2019

Existen variedad de términos que se usan como sustantivos para nominar fenómenos, otros tantos son usados para crear y transformar la realidad social. El presente artículo pretende sustentar, desde los aportes de la filosofía analítica de Searle y Wittgenstein, que el concepto “minorías” cumple ambas funciones. Nombra—visibiliza un problema social—y a su vez al proferirlo convoca intencionalmente cambios en la realidad social. Su significado está determinado por el uso que se le ha dado en el discurso político y sus definiciones conllevan a la emisión de actos de habla perlocucionarios e ilocucionarios con los cuales intencionalmente se promueven cambios en el mundo social.
Local recurrence after surgery of locally advanced rectal cancer treated with or without preoperative chemoradiotherapy
Authors: Djuric Mladen , Lukic Dejan , Radovanovic Zoran , Ðermanovic Aleksandar , Ranisavljevic Milan , Gutic Bojana
Published: October 2019

Introduction: The ?gold standard? for patients with locally advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. Aim: Evaluation of local recurrence after surgery for locally advanced rectal cancer. Methods and patients: Retrospective study included 189 patients, who were operated at Oncology Institute of Vojvodina from January 1st 2012 until December 31st 2017. Patients were divided into two groups. In the first group 73 patients who received chemoradiotherapy were included, while 116 patients without neoadjuvant treatment were in the second group. All patients were diagnosed with locally advanced rectal cancer. The existence of operable metastases in the liver and/or lungs did not exclude patients from the study. Patients who had undergone resection of the rectum by Miles, Hartmann or local tumor excision were excluded from the study. Results: The median follow-up period was 48 months (range 13-84). In total, 23 (12.2%) patients developed local recurrence. In the chemoradiotherapy group, 15.1% (11 of 73 patients) had a local recurrence, as compared with 10.3% (12 of 116 patients) in the group without neoadjuvant treatment. In both groups, there were no correlation between rate of local recurrence with other clinical and pathological parameters such as gender, tumor location, T and N stage, histological differentiation, or lymphovascular and perineural invasion (p>0.05). We confirmed significant association between circumferential resection margin with local recurrence in patients who were treated by preoperative chemoradiation (p=0.014). Conclusion: This study has not shown reduced risk of local recurrence after neoadjuvant therapy most likely due to small number of patients. Despite our results, neoadjuvant treatment followed by surgery remains the best treatment protocol for patients with locally advanced rectal cancer.
Nodular lesion in the tongue: A rare case of low grade myofibroblastic sarcoma
Authors: Tenório Jefferson , Medeiros Frederico , Orsini Machado , dos Santos
Published: October 2019

Low grade myofibroblastic sarcoma is an atypical myofibroblastic malignant
neoplasm that rarely affects the oral cavity and presents a challenging
histological diagnosis. Here we report the case of a 38-year-old woman who
had a nodular and symptomatic lesion on the lateral border of the tongue.
After the biopsy, the histopathological analysis revealed a spindle cell
lesion with fascicular and storiform pattern. We performed
immunohistochemical analysis that showed intense labeling for vimentin,
smooth muscle actin and moderate labeling for calponin and S-100. We
emphasize the rarity of low grade myofibroblastic sarcoma such as a nodular
lesion on the tongue and the need for accurate diagnosis.