bluuebunny/crossref_metadata_2025 huggingface dataset:
NATURAL HISTORY AND MERISTICS OF AN ALLOPATRIC POPULATION OF RED CORNSNAKES, PANTHEROPHIS GUTTATUS (LINNAEUS, 1766) IN CENTRAL KENTUCKY, USA
Authors: Bird William M. , Peak Philip , Baxley Danna L.
Published: March 2020

Life history, morphological variation, and basic biology of Pantherophis guttatus (Linnaeus, 1766), the Red Cornsnake, are not well known, particularly for the allopatric populations in Kentucky. To address some of the information gaps for this species, we report field observations, including activity patterns, reproduction, and meristics of P. guttatus in Kentucky. In 2003 and 2004 we conducted field surveys using drift fences, artificial cover, manual searching, and driving on roads and captured 101 P. guttatus in Edmonson and Hart counties, Kentucky. We found that artificial cover was the best method of detection with 77% of snakes captured using this method. Numbers of encounters peaked in April-May and August-September suggesting bimodal activity patterns similar to other colubrid snakes. Males had signifi cantly higher subcaudal scale counts than females while females had significantly higher ventral scale counts than males. We detected more individuals in 2003 than in 2004, most likely influenced by severe drought conditions in Kentucky during 2004. Size-class distribution of snakes was skewed towards large individuals (> 70 cm SVL). The absence of individuals in juvenile size classes (30 cm -70 cm) may be an artifact of lower detection probabilities for smaller size classes, different habitat use by juveniles, or may indicate low recruitment.
A STUDY OF THE DEFENSIVE BEHAVIORS OF FREE-RANGING DEKAY’S BROWNSNAKES, STORERIA DEKAYI (HOLBROOK, 1836)
Authors: Gray Brian S.
Published: March 2020

The defensive behaviors of free-ranging Dekay’s Brownsnakes, Storeria dekayi, were studied at a site in Erie County, Pennsylvania, USA. Twenty-nine unique sequences of defensive behavior were documented. A total of 50 individual snakes (26 males and 24 females) provided 88 observations during the initial phase, of which 78% (n = 69) were of snakes that remained in place. Snakes were tapped with the investigator’s hand to elicit defensive behaviors during the contact phase. Snakes were more than twice as likely to attempt to flee during the contact phase (46%) than during the initial phase (22%). During the contact phase, mean surface body temperatures were significantly higher in snakes attempting to flee (22.3 ± 1.3 °C) than those that remained in place (16.1 ± 2.2 °C). The most frequently observed response during the contact phase was dorso-ventral flattening of the head and body (n = 42). During capture, most snakes (94%) smeared their cloacal contents on themselves and the investigator’s hand.
COLONIZATION OF NORTHERN LOUISIANA BY THE MEDITERRANEAN GECKO, HEMIDACTYLUS TURCICUS
Authors: Reid Matthew L. , Battaglia Charles D. , Rice Chris L. , Carr John L.
Published: March 2020

The Mediterranean Gecko, Hemidactylus turcicus, is known to have colonized nearly every state in the southern United States. In Louisiana, the Mediterranean Gecko has been documented in many of the southern parishes, but records for the northern portion of the state are limited. We sampled northern Louisiana parishes to document the presence of the Mediterranean Gecko. We sampled a total of 21 parishes in northern Louisiana and found geckos in 17 of those parishes, 16 of which represent new distribution records for the species. This indicates a significant range expansion of this introduced species throughout northern Louisiana. Geckos were found across a temperature range of 14.0–28.0°C and had a strong association with buildings. The species’ affinity for anthropogenic association and the continual nature of anthropogenic expansion facilitate the high vagility of this species. The result is a successful colonization throughout much of Louisiana and likely continued range expansion throughout the southern United States.
PRESENCE AND PREVALENCE OF BD (BATRACHOCHYTRIUM DENDROBATIDIS) IN CENTRAL PENNSYLVANIAN WOODLAND VERNAL POOLS
Authors: Coury Kristen S. , Neal Brennan A. , Shin Michael J. , Lindquist Erik D.
Published: March 2020

Batrachochytrium dendrobatidis (Bd), a virulent chytrid fungus responsible for dramatic amphibian declines, has been detected in the northwestern and southeastern regions of Pennsylvania. However, little environmental Bd testing has been performed in central Pennsylvania, particularly in the unique and speciose habitats of woodland vernal pools. Our study included sampling in four vernal pools over a period of three months during amphibian breeding periods. Skin swabs were taken from three caudate and two anuran species, during the course of late winter and spring migrations (n = 143). Low Bd zoospore equivalent loads were detected in only a few individuals, in three of the five species but in all four vernal pools sampled. No significant trends were seen between zoospore loads and ambient temperature or migration timing across the species sampled.
EFFECT OF RECREATIONAL TRAIL TRAFFIC LEVEL ON EASTERN RED-BACKED SALAMANDER (PLETHODON CINEREUS) RELATIVE ABUNDANCE
Authors: Smith Geoffrey R. , Burger Anthony C. , Marlowe Brett W. , Tristano Elizabeth P. , Rettig Jessica E.
Published: March 2020

The effects of roads and trails on terrestrial salamanders, primarily plethodontids, can be important. The abundance of terrestrial salamanders often increases with distance from roads. Less is known about the effects of recreational or hiking trails on terrestrial salamanders than is known about the effects of roads. We explored how low and high traffic trails in a suburban biological reserve affect the relative abundance of Eastern Red-backed Salamanders (Plethodon cinereus). We found more salamanders under cover objects next to low traffic trails compared to either high traffic trails or wooded areas without trails. At wooded sites, we found only striped morphs whereas at high traffic sites we found only unstriped morphs. Low traffic sites included a range of color morph frequencies. The proportion of females found in each site did not differ, nor did the mean size of the salamanders. Our results suggest that the impact of recreational walking trails needs to be examined more closely to see how and why the distributions of P. cinereus, and potentially other woodland salamanders, are affected and what trail characteristics are important in driving the apparent effects. Such information will contribute to the design and maintenance of walking trails in natural areas that minimize effects on terrestrial salamanders, and likely other organisms.
EFFECT OF RACCOON (PROCYON LOTOR) REDUCTION ON BLANDING’S TURTLE (EMYDOIDEA BLANDINGII) NEST SUCCESS
Authors: Urbanek Rachael E. , Glowacki Gary A. , Nielsen Clayton K.
Published: March 2020

The Lake County Forest Preserve District has monitored a state-endangered Blanding’s Turtle (Emydoidea blandingii) population at two adjoining nature preserves along the Illinois–Wisconsin border since 2004. Prior to predator management, 92.3% of documented and unprotected natural Blanding’s Turtle nests (12 of 13) and 88% of monitored artificial nests have been at least partially depredated. The goal of this study was to determine the efficacy of subsidized Raccoon (Procyon lotor) removal efforts in increasing the nest success of Blanding’s Turtles. During April–May 2013 and 2014, we captured and euthanized 78 Raccoons from our 2 km2 study area. We estimated pre-removal abundance estimates using the Leslie depletion method; it appeared that we removed 83–89% of the Raccoons from the study area each year and pre-removal density estimates were 37.5% lower in 2014 than 2013. During the study period, we monitored 22 Blanding’s Turtle in situ unprotected nests. In 2013, one of seven (14%) Blanding’s Turtle nests was partially depredated and no nests were completely depredated, indicative of a successful impact of Raccoon removal on Blanding’s Turtle nest success. However in 2014, nine of 15 (60%) Blanding’s Turtle nests were depredated. Our results provide some evidence that removal of Raccoons may have increased Blanding’s Turtle nest success but other factors, such as a functional response of surviving Raccoons or depredation by other subsidized predators may be contributing to decreased nest success.
The Influence of Trauma-Informed Yoga (TIY) on Emotion Regulation and Skilled Awareness in Sexual Assault Survivors
Authors: Nicotera Nicole , Connolly Margaret Megan
Published: March 2020

This study examined a Trauma-Informed Yoga (TIY) intervention created specifically for sexual assault survivors and delivered in a community-based group setting. Much of the existing research on this type of intervention has been conducted in clinical trials as opposed to community-based venues. As sexual assault is a common type of trauma and results more commonly in posttraumatic stress disorder (PTSD), the current study aimed to shed light on the potential benefits of a trauma-sensitive yoga and mindfulness intervention for survivors of sexual assault in the natural setting of a community-based organization. The intervention was developed and implemented by licensed mental health providers and registered yoga teachers and modeled on the evidence-based work of the Trauma Center at the Justice Research Institute. The study employed a traditional quantitative one-sample, pre- and posttest design. Survey items were drawn from two existing measures: (1) Five Facet Mindfulness Questionnaire and (2) Difficulties in Emotion Regulation Scale. The majority of the sample (n = 37) identified as White (67.6%), followed by Latina (13.5%), African American (8.1%), multiracial (5.4%), and other (2.7%). The mean age of participants was 29 years (standard deviation 8 years, range 18–56 years). All participants identified as female. Findings demonstrated statistically significant changes in participants’ emotion regulation and skilled awareness, both of which have the potential to reduce PTSD symptomatology. The present discussion considers the results in light of previous research and presents study limitations.
Análise comparativa de oportunidades de aplicação do fator terra no Estado de Goiás
Authors: Thomazini João Paulo , Nunes Clayton Luiz de Melo , Abdala Klaus de Oliveira
Published: March 2020

A incerteza sobre a rentabilidade no setor primário é uma discussão recorrente, dado o elevado custo de oportunidade do fator terra. O presente trabalho analisou comparativamente o investimento em terra para produção de soja em municípios selecionados do Estado de Goiás em relação a outras oportunidades de investimentos no mercado de capitais. O resultado classifica as regiões selecionadas por ordem de rentabilidade acumulada no investimento em terra para produção de soja e evidencia aqueles municípios nos quais este investimento foi mais rentável que os investimentos alternativos, permitindo apresentar considerações sobre a racionalidade do investimento em terras para produção agrícola. Foi possível concluir que as propriedades rurais de todos os nove municípios estudados tiveram seus valores de mercado valorizados acima da inflação, medida pelo IGP-DI. Os municípios de Jataí e Mineiros se destacaram como os que tiveram valorização mais acentuada e Goiatuba, Rio Verde e Santa Helena de Goiás foram os de menor evolução patrimonial, constituindo investimentos menos rentáveis do que qualquer uma das alternativas financeiras.
Atropelamento de idosos em vias públicas: caracterização e evolução do evento no período de 2007 a 2017, em um município brasileiro
Authors: Kerber Vera Lúcia , Santos Natália Quevedo dos , Branco Bráulio Henrique Magnani , Bertolini Sonia Maria Marques Gomes , Bortolozzi Flávio , Marques Amélia Pasqual
Published: March 2020

Este estudo teve como objetivo caracterizar os atropelamentos de idosos nas vias públicas de Maringá (PR), no período de 2007 a 2017. Trata-se de um estudo de abordagem quantitativa do tipo transversal descritivo. Foram pesquisados dados de natureza secundária nos Relatórios de Atendimento do Socorrista - RAS, do 5º Grupamento de Bombeiros de Maringá. Das 4213 ocorrências de atropelamentos registradas, 21,78% (918 casos) envolveram idosos. Aplicando-se o teste para comparação de proporções entre os sexos, não foram identificadas evidências amostrais suficientes de diferença significativa entre ambos (p = 0,508). Em 53,81% o veículo caracterizava-se como automóvel. Verificou-se uma grande variação do número de ocorrências anuais ao longo do período avaliado. O mês de maio teve maior ocorrência (11,33%). Identificou-se uma grande quantidade de escoriações no membro superior esquerdo (33%). Verificou-se que 22,11% dos acidentes foram no centro da cidade. Conclui-se que prevalecem como vítimas de atropelamento no município de Maringá idosos jovens, sem diferenças significativas em relação ao sexo. Apesar de preocupante, o número de ocorrências de atropelamento vem se mantendo estável nos últimos anos e os automóveis são os principais veículos envolvidos.
Sala de espera: educação em saúde em um ambulatório de gestação de alto risco
Authors: Mazzetto Fernanda Moerbeck Cardoso , Prado Julia Tavares de Oliveira , Silva Joyce Caroline Calixta da , Siqueira Fernanda Paula Cerântola , Marin Maria José Sanches , Escames Letícia , Kim Cristina Jin Sil
Published: March 2020

O objetivo deste trabalho foi identificar as necessidades das gestantes referentes a assuntos que possam ser abordados em atividades de educação em saúde, no momento de espera, em um ambulatório de referência de gestação de alto risco. Trata-se de um estudo descritivo, qualitativo e de campo, utilizando a análise de conteúdo temática de Bardin. Participaram 35 gestantes presentes no dia da consulta de pré-natal. Emergiram então seis categorias: Percepção de desconforto durante o momento de espera; Sentimento de abandonado no momento de espera e preocupação com o retorno ao trabalho; Referência a sintomas de ordem física e emocional; Participação (ou não) de educação em saúde; Sugestão de desenvolvimento de atividades educativas no momento de espera; Proposição de oferta oportuna de lanches durante o momento de espera. Assim, a partir das necessidades identificadas, sugere-se a prática de educação em saúde como forma de otimizar o tempo de espera para a consulta de pré-natal deste serviço.
Women directors and exporting activity: The moderating role of network advice
Authors: Idris Bochra , Saridakis George
Published: March 2020

We use data from Small and Medium Sized Enterprises (SMEs) in the UK to examine the link between the presence of women directors and exporting activity. To do this, we build on resource-based view (RBV) and resource dependence theory (RDT) and show that SMEs with women on the board of directors are less likely to be involved in exporting activity compared to SMEs without women directors. Nevertheless, this negative relationship is moderated by seeking network advice, which can be explained through the social network theory (SNT).
Providing new products by innovative entrepreneurs in Europe
Authors: Velilla Jorge , Ortega Raquel
Published: March 2020

This paper addresses the individual factors that determine the provision of new products by entrepreneurs in Europe. To that end, we use the GEM 2014 Adult Population Survey, for sixteen European Countries, focusing on the  demographic, economic, and environmental characteristics of this specific group of entrepreneurs. Our results indicate that education, experience, entrepreneurial skills, and income levels are the primary determinants in offering a new product. We also show that, in the case of ‘baby’ business owners, only the fear of failure and knowing other entrepreneurs are significant factors, while for nascent entrepreneurs, age, education, family size, income, and the social consideration of entrepreneurship also show significant correlations with the probability of offering new products.
José Antonio Valente: ascesis y lascivia
Authors: Yurkievich Saúl
Published: March 2020

Sin resumen
Del manuscrito al texto: algunas calas en la génesis textual de Rapsodia, de Pere Gimferrer
Authors: Lanz Juan José
Published: March 2020

Resumen: A partir de los planteamientos desarrollados por la genética textual y la crítica genética, atendiendo a sus últimas aportaciones y considerando otras perspectivas complementarias, como las de la filología de autor o la filología de los textos modernos, entre otras, se lleva a cabo en este artículo un análisis de la génesis textual de Rapsodia (2011), de Pere Gimferrer, realizando unas calas en el manuscrito original, que revelan ciertos rasgos del «taller del poeta». En función de dicho análisis, se establecen una serie de conclusiones generales válidas para el estudio de los manuscritos y borradores de textos poéticos contemporáneos. Palabras clave: crítica genética; Pere Gimferrer; manuscritos; poesía española contemporánea.  Abstract: From the approaches developed by textual genetics and genetic criticism, taking into account their latest contributions and considering other complementary perspectives, such as those of author’s philology or the philology of modern texts, among others, an analysis of the textual genesis of Rhapsody (2011), by Pere Gimferrer, based on some studies in the original manuscript, which reveal certain features of the «poet’s workshop», is carried out in this article. Based on this analysis, some general conclusions valid for the study of manuscripts and drafts of contemporary poetic texts will be established. Key words: Genetic criticism; Pere Gimferrer; manuscripts; Contemporary Spanish poetry.
The 21 May 1960 Mw 8.1 Concepción Earthquake: A Deep Megathrust Foreshock That Started the 1960 Central-South Chilean Seismic Sequence
Authors: Ojeda Javier , Ruiz Sergio , del Campo Francisco , Carvajal Matías
Published: March 2020

One of the most notable seismic sequences in modern times was recorded in May 1960 along the southern Chilean subduction zone. The sequence started on 21 May with the Mw 8.1 Concepción earthquake; 33 hr later the Mw 9.5 Valdivia megathrust earthquake occurred, the largest ever recorded in the instrumental period. These events changed the geomorphology of the coast along more than 1000 km, generated extensive structural damage in the main cities of central-south Chile, and triggered a Trans-Pacific tsunami. Observed land-level changes due to both earthquakes were reported in 1970. These observations were ascribed to both events but have been used to study only the general source properties of the 22 May Valdivia mainshock. Here, we separate these data to constrain for the first time the slip distribution of the 21 May Concepción earthquake, applying a Bayesian approach that considers uncertainties in the data. Our results show that the Mw 8.1 Concepción earthquake ruptured a deep segment of the megathrust, concentrated in a compact zone below the Arauco peninsula between depths of 20 and 50 km. Tsunami generation from this deep source agrees well with the tsunami arrival times and small amplitudes recorded by tide gauges along the Chilean coast. Our study highlights the importance of the 21 May 1960 Concepción earthquake in the context of large historical Chilean earthquakes.
The Damaging Earthquake of 9 October 859 in Kairouan (Tunisia): Evidence from Historical and Archeoseismological Investigations
Authors: Bahrouni Nejib , Meghraoui Mustapha , Hinzen Klaus , Arfaoui Mohamed , Mahfoud Faouzi
Published: March 2020

The city of Kairouan, the capital of the Aghlabides Dynasty (A.D. 800–909), and its surrounding areas were affected by a damaging earthquake on 8 Rajab 245 Hijri (9 October 859). Contemporaneous accounts by local travelers to the Abassides Califat (A.D. 750–1258) and reported by the chroniclers and historians Al Baghdadi (1980) and Al Tabari (A.D. 838–923) (1967) describe the damage to the city and report that 13 villages experienced extensive destruction, leading to a large number of people homeless. In the city of Kairouan, the dome and other holy places of the Great Mosque (minbar and mihrab), houses, fortifications, and bridges all suffered severe damage. The aqueduct that supplied Kairouan with fresh water from the western mountains was badly damaged at a location about 20 km west of the city. New archaeoseismic field investigations of the aqueduct using laser scanning and radiocarbon dating characterize the damaged features. Recent field investigations in the region taking into account the construction types and the inferred damage distribution suggest a macroseismic intensity reaching IX–X Medvedev–Sponhauer–Karnik scale. The seismotectonic context suggests a seismic source along the major Sbiba east–west-trending transpressive fault that includes the Cherichira, Sfaia, and El Baten folding system near Kairouan. An active fault system affecting late Quaternary units made up of ∼30-kilometer-long thrust-related en echelon folds associated with the east–west-trending fault is identified and characterized as seismogenic at a location about 20 km west of Kairouan.
Nontuberculous mycobacteria in patients registered in a tuberculosis control program in Southwestern Colombia, 2014-2017
Authors: Delgado Luis Eduardo , Escobar Daniela Rocío , Hoyos Diana Marcela , Luna Lucy , Pacheco López Robinson , Ferro Beatriz E.
Published: March 2020

Introduction: Pulmonary disease produced by nontuberculous mycobacteria and pulmonary tuberculosis can share clinical signs and symptoms. It is important to discern one from the other in order to provide the proper treatment and programmatic management.

Objective: To describe the frequency of nontuberculous mycobacteria isolated from patients registered in the tuberculosis control program in Cali.

Methods: We conducted a descriptive study to know what extent of the pulmonary tuberculosis load in Cali-Colombia corresponds to nontuberculous mycobacteria, in a four-year period, 2014-2017. Demographic (sex, age, health insurance), clinical (diagnosis dates, laboratory data, comorbidities) and programmatic data (tuberculosis treatment initiation and duration) was collected for statistical analysis.

Results: Of 3,651 patients registered in the local tuberculosis program with an initial diagnosis of pulmonary tuberculosis, 2,904 had sputum culture and among them 1.5% (43/2904) had nontuberculous mycobacteria isolation rather than Mycobacterium tuberculosis. Most of the nontuberculous mycobacteria isolates were not identified at the species level; M. fortuitum and M. abscessus were the most common species identified. 86% of patients initiated unnecessary tuberculosis treatment.

Conclusion: Nontuberculous mycobacteria isolation from pulmonary samples could be frequent in patients registered in the tuberculosis program in Cali, Colombia. The lack of clinical suspicion, the limited laboratory infrastructure, and the absence of a reporting system could be contributing factors to underestimate the importance of nontuberculous mycobacteria in this setting. We recommend that nontuberculous mycobacteria identification should be considered for public health intervention.
Review of Broken: Institutions, Families, and the Construction of Intellectual Disability by Madeline C. Burghardt
Authors: Riley Alexis
Published: March 2020

No abstract available.
Review of Autistic Disturbances: Theorizing Autism Poetics from the DSM to Robinson Crusoe by Julia Miele Rodas
Authors: Cherney Kristeen E.
Published: March 2020

No abstract available.
Review of The Rhetoric of Widening Participation in Higher Education and Its Impact: Ending the Barriers Against Disabled People by Navin Kikabhai
Authors: Karpicz Julia Rose
Published: March 2020

No abstract available.
Review of Foucault and the Feminist Philosophy of Disability by Shelley Tremain
Authors: Beard Lauren
Published: March 2020

No abstract available.
Review of Made to Hear: Cochlear Implantation and Raising Deaf Children by Laura Mauldin
Authors: Pfister Anne E.
Published: March 2020

No abstract available.
Review of Crippled Grace: Disability, Virtue Ethics, and the Good Life by Shane Clifton
Authors: Raffety Erin
Published: March 2020

No abstract available.
Parental Knowledge, Attitudes and Practices Towards Paediatric Ear Infections in Riyadh, Saudi Arabia: A quantitative study
Authors: Alharbi Muteb M. , Almasri Mohammed S. , Aldayel Abdulrahman Y. , Alkhonezan Saleh M.
Published: March 2020

ABSTRACT: Objectives: This study aimed to assess the knowledge, attitude and care-seeking practices of parents towards childhood ear infections in Riyadh, Saudi Arabia. Methods: This quantitative cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and June 2018. An online survey was sent to a random selection of parents who were ≥18 years old with children of ≤10 years old. Associations between parental knowledge, attitude, care-seeking practices, socioeconomic status, level of education and age were assessed using the chi square test and logistic regression analysis. Results: A total of 782 subjects participated in this study (response rate: 78.2%). Most respondents were knowledgeable (76.2%), had a positive attitude (78.9%) and had positive care-seeking practices (89.5%). There was a statistically significant difference on both bivariate and multivariate analyses (P <0.05) between parental care seeking practice and knowledge. Parents who sought modern approaches to treatment were found to be almost nine times more likely to have a good attitude towards ear infections than those who did not seek treatment (odds ratio = 8.907, 95% confidence interval = 2.655–34.928; P <0.001). A statistically significant relationship was found between good care-seeking practice and age, as well as socioeconomic status (P <0.05 each). Conclusion: This study showed that knowledge, attitude and practice regarding paediatric ear infections were positive in the majority of parents in Riyadh, Saudi Arabia. Future studies should assess other factors that enhance the knowledge, attitude and practices regarding ear infections.Keywords: Otitis Media; Infection; Knowledge; Attitude; Pediatrics; Parents; Saudi Arabia.
Pulmonary Hyalinising Granuloma: A report of two cases
Authors: Kamona Ameen , Al Lawati Fatma , Kamona Atheel , Al Busaidi Nasser , Al Mahrooqi Yaqoob , Al-Tai Saqar , Al Lawati Nabil , Al-Umairi Rashid S.
Published: March 2020

ABSTRACT: Pulmonary hyalinising granuloma (PHG) is a rare fibrosclerosing inflammatory lung condition of unknown aetiology. It is characterised by solitary or multiple pulmonary nodules that are usually found incidentally while imaging the chest for other reasons. We report two cases of histologically proven PHG diagnosed at the Royal Hospital, Muscat, Oman. The first case was a 71-year-old male patient who presented in 2010 with a dry cough, weight loss and bilateral pulmonary nodules. The second case was a 58-year-old male patient who presented in 2012 and was found to have incidental bilateral pulmonary nodules on chest X-ray. Both patients were started on prednisolone and on follow-up the PHG nodules remained stable. Although there is no definitive treatment, PHG generally has an excellent prognosis.Keywords: Granuloma; X-Ray Computed Tomography; Multiple Pulmonary Nodules; Lung; Case Report; Oman.
Right Atrial Blood Cyst with Stones Suspended from the Coronary Sinus
Authors: Sabzi Feridoun , Heydari Aghigh , Asadmobini Atefeh , Heidari Mohammad B.
Published: March 2020

ABSTRACT: Cardiac blood cysts are rare benign neoplasms, usually involving the cardiac valves and are remnants of the Chiari network. They are usually detected in the first six months of life and rarely occur in children or adults. We report a 76-year-old male patient who was referred to the Imam Ali Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2018 with dyspnoea. Transthoracic echocardiography revealed a small patent foramen ovale (PFO) and a circumferential mobile cystic mass in the right atrium, with the impression of a tumour or thrombus. The patient underwent open-heart surgery with cardiopulmonary bypass to repair to PFO and remove the intra-atrial lesion. During surgical examination of the right atrial cavity, a blood cyst containing small stone-like structures on the coronary sinus valve of the right atrium was found. The post-operative course was uneventful and no recurrence of tumour was detected during six months of follow-up. To the best of our knowledge, this is the first reported case of a right atrial blood cyst with a few nodule-like stones in an adult with PFO in Iran and the second case in an adult with PFO worldwide.Keywords: Cyst; Coronary Sinus; Adult; Operative Surgical Procedure; Case Report; Iran.
Awareness of the Importance of and Adherence to Patients’ Rights Among Physicians and Nurses in Oman: An analytical cross-sectional study across different levels of healthcare
Authors: Al-Saadi Aisha N. , Slimane Salah B. A. , Al-Shibli Rawya A. , Al-Jabri Fatema Y.
Published: March 2020

Objectives: This study aimed to determine the extent to which physicians and nurses in Oman were aware of the importance of and adhere to patients’ rights and whether this differed according to role, nationality, position and institutional healthcare level. Methods: This analytical cross-sectional study was carried out between December 2015 and March 2016 at various governmental healthcare institutions in Oman. A self-administered questionnaire was distributed to 1,385 practitioners at all healthcare levels. Results: A total of 1,213 healthcare practitioners (response rate: 87.58%) completed the survey, of which 685 (56.47%) were nurses and 528 (43.53%) were physicians. Overall, awareness of the importance of patients’ rights was high (91.51%), although adherence to these rights in practice was low (63.81%). The right of the patient to be informed was considered least important and was least adhered to (81.2% and 56.39%). Nationality, role and institutional level were significantly associated with awareness (P = 0.002, 0.024 and 0.034, respectively). Non-Omani staff were significantly more likely than Omani staff to be aware of (odds ratio [OR] = 1.696; P = 0.032) and adhere to (OR = 2.769; P <0.001) patient rights. Furthermore, tertiary care staff were twice as likely as primary care staff to perceive the importance of patient rights (OR = 2.076; P = 0.019). While physicians were more likely than nurses to be aware of the importance of patient rights, this difference was not significant (OR = 1.516; P = 0.126). Conclusion: These findings may help inform measures to enhance awareness of and adherence to patients’ rights in Oman.Keywords: Medical Ethics; Patient Rights; Awareness; Adherence; Physicians; Nurses; Oman.
Awareness and Attitude Towards the Premarital Screening Programme Among High School Students in Muscat, Oman
Authors: Al-Kindi Rahma M. , Kannekanti Saraswathi , Natarajan Jansi , Shakman Lina , Al-Azri Zeinab , Al-Kalbani Naifain I.
Published: March 2020

Objectives: This study aimed to explore high school students’ awareness and attitude towards premarital screening (PMS). Methods: This cross-sectional study was conducted in 10 public high schools in Muscat, Oman from May to July 2016. A three-part self-administered questionnaire was used to collect data from grade 12 students. The first part focused on respondents’ sociodemographic characteristics, while the second part dealt with awareness of the national PMS programme and the third part explored attitudes towards the national PMS programme. Results: A total of 1,541 participants (response rate: 91.1%) completed the questionnaire. Most participants (78.1%) were aware of the availability of the PMS programme and their main source of information was family and friends (34.3%). The majority of students (87.4%) believed that PMS is important and most students (87.2%) indicated that they would undergo PMS. Over half of the students (55.3%) agreed that PMS should be mandatory before marriage and approximately one-third (38.3%) were in favour of having laws and regulations to prevent consanguineous marriages. Females were significantly more in favour of making PMS mandatory (P = 0.002) and enforcing PMS laws (P = 0.010) compared to males. Conclusion: Most respondents had good levels of knowledge about the PMS programme and half thought it is important to be tested. However, some students were not in favour of PMS. Increasing awareness about Oman’s PMS programme is important and motivating students could contribute significantly to increasing the utilisation of the PMS programme and to limiting genetic blood disorders.Keywords: Awareness; Knowledge; Attitude; Secondary School; Students; Premarital Examinations; Genetic Carrier Screening; Oman.
Impact of Comorbidities on Survival Among Patients with Chronic Myeloid Leukaemia Using the Charlson Comorbidity Index: Retrospective study from Basra, Iraq
Authors: Abood Rafid A. , Hasson Hasson M. , Khalaf Asaad A. , Saleh Elaf M.
Published: March 2020

Objectives: In chronic diseases, comorbidities are known to have a strong negative association with overall survival (OS). This study aimed to use the Charlson Comorbidity Index (CCI) to examine the effect of comorbidities on OS among patients with chronic myeloid leukaemia (CML) treated with tyrosine kinase inhibitors. Methods: This retrospective study was conducted between January 2006 and October 2016 and included 247 CML patients treated at the Basra Oncology & Haematology Centre, Basra, Iraq. Information from hospital records was used to calculate CCI scores and patients were divided into groups based on scores of 2–3 (CCI1 group) or ≥4 (CCI2 group). The OS was calculated using Kaplan-Meier curves. Results: There were 177 (71.7%) patients in the CCI1 group and 70 (28.3%) in the CCI2 group. Overall, patients in the CCI1 group were significantly younger compared to those in the CCI2 group (median age: 35 versus 60 years; P <0.001); however, the gender distribution was similar in both groups (male-to-female ratio of 1:1.06 versus 1:1.18, respectively; P = 0.683). Diabetes mellitus was the most common comorbidity (17%), followed by hypertension (12%) and gastrointestinal diseases (6%). There were no significant differences in mortality between the groups (9.6% versus 8.6%; P = 0.801). In total, 69.6% of all deaths were related to CML progression rather than to the presence of comorbidities. Conclusion: No significant correlation was found between CCI score and OS among CML patients in Basra. However, larger long-term prospective studies are needed to evaluate associations with median age at diagnosis and disease severity and to develop region-specific prognostic scales.Keywords: Comorbidity; Chronic Myeloid Leukemia; Mortality; Survival Analysis; Chronic Diseases; Iraq.
Mid-Gut Carcinoid Tumour Presenting as Suspected Orbital Metastasis
Authors: Hafiz Ayman A. , Ali Syed M. , Sidahmed Salwa M. , Al-Hassan Asma , El-Naggar Nahla M. M.
Published: March 2020

Although metastasis of carcinoid tumours of the intestine is rare, it has been reported in several organs, mainly in the lungs, the liver and less commonly in the orbits. We report a 50-year-old male patient who presented at Hamad General Hospital, Doha, Qatar, in 2016 with central abdominal pain, distention, nausea and vomiting for the previous four days. The patient had unilateral right- sided exophthalmos for two years prior to presentation. Following an abdominal computed tomography (CT) scan and an ultrasound guided biopsy, the patient was diagnosed with extensive multi-focal metastatic carcinoid tumour of the small bowel and mesentery; histopathology confirmed the diagnosis. Subsequently, the patient underwent a laparotomy and small bowel resection and was administered somatostatin therapy. One week postoperatively, the patient developed an acute increase in his right eye exophthalmos. CT, magnetic resonance imaging and scintigraphy scans revealed an orbital metastatic lesion, which probably originated from the previously diagnosed carcinoid tumour. The orbital metastasis was treated with somatostatin therapy and the patient was lost to follow-up when he left the country.Keywords: Carcinoid Tumor; Orbital Neoplasm; Metastasis; Exophthalmos; Scintigraphy; Case Report; Qatar.
Revisiting the Prevalence of Autism Spectrum Disorder among Omani Children: A multicentre study
Authors: Al-Mamari Watfa , Idris Ahmed B. , Dakak Samar , Al-Shekaili Muna , Al-Harthi Zuwaina , Alnaamani Asia M. , Alhinai Fatma I. , Jalees Saquib , Al Hatmi Moza , El-Naggari Mohamed A. , Islam M. Mazharul
Published: March 2020

Objectives: This study aimed to provide an updated estimate of the prevalence of autism spectrum disorder (ASD) among Omani children. Methods: This retrospective descriptive study was conducted from December 2011 to December 2018. Data were retrieved from the three main autism diagnostic centres in Oman: Sultan Qaboos University Hospital, Royal Hospital and Al-Massarah Hospital. The ASD diagnosis was made by experienced clinicians based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The overall population prevalence estimates per 10,000 children aged 0–14 years old in Oman were calculated using the denominator of the mid-period population data. Results: A total of 1,705 ASD cases were identified with the majority of cases being male (78.1%). The overall prevalence rate of ASD was estimated at 20.35 per 10,000 children (95% confidence interval: 19.39–21.32) between 2012–2018. Boys were found to have a 3.4-fold higher prevalence of ASD than girls (31.23/10,000 versus 9.07/10,000). Regionally, the majority of cases were found in the capital, Muscat, where the highest prevalence was 36.51 cases per 10,000 children. Conclusion: The prevalence of ASD among Omani children is 15-fold higher than estimates from 2011. This increase can be attributed to improvements in diagnostic services, increased awareness of ASD, better screening programmes and changes in diagnostic criteria. In addition, this increase in prevalence suggests a need for a registry of developmental disabilities and more extensive diagnostic and rehabilitation services in Oman.Keywords: Autism Spectrum Disorder; Epidemiology; Prevalence; Oman.
In the Era of Social Media: Is it time to establish a code of online ethical conduct for healthcare professionals?
Authors: Al-Balushi Amal A.
Published: March 2020

Social media is becoming an invasive part of the lives of many professionals including those in the healthcare field. One of the countless implications of such an invasion is how the healthcare professional’s engagement with social media affects the traditional doctor-patient relationship. The online presence of professionals should be carefully self-monitored as it affects the individual’s reputation and society’s perception of their profession. Therefore, the contents of public and personal accounts must differ according to their purpose. In the public eye, conflicts of interest must be declared and scientifically-based medical advice should be clearly differentiated from experience-based advice, personal opinions or commercial advertisements. Online doctorpatient relationships risk the privacy of patients as well as the personal privacy of the healthcare professional. Personal accounts created for friends and family should be kept separate from public accounts created for educational, professional or commercial purposes. Published educational material should be clearly differentiated from commercial material so that it is easier for the public to make an informed decision. This paper proposes a code of online ethical conduct to be implemented in Oman.Keywords: Codes of Ethics; Social Media; Health Personnel; Privacy; Confidentiality; Conflict of Interest; Physician-Patient Relations; Oman.
Knowledge, Attitudes and Practices Related to HIV Stigma and Discrimination Among Healthcare Workers in Oman
Authors: Shah Samir , Elgalib Ali , Al-Wahaibi Adil , Al-Fori Maha , Raju Prasanna , Al-Skaiti Mahmood , Al-Mashani Huda N. , Duthade Kishor , Omaar Iyad , Muqeetullah Muhammad , Mitra Nilanjan , Shah Parag , Amin Mohammed , Morkos Essam , Vaidya Vidyanand , Al-Habsi Zeyana , Al-Abaidani Idris , Al-Abri Seif S.
Published: March 2020

Objectives: Stigma and discrimination undermine the quality of life of people with HIV and their access to health services. This study aimed to assess HIV-related knowledge, attitudes and practices among healthcare workers (HCWs) in Oman. Methods: This cross-sectional study took place between July and November 2016. A questionnaire was distributed to 1,400 government HCWs to determine HIV-related knowledge, attitudes and practices. Results: A total of 1,281 HCWs participated (response rate = 92%). Routine tasks, such as dressing wounds, drawing blood and touching clothes, were a cause of concern for 24–52% of HCWs. Only 69% correctly answered questions regarding the transmission of HIV via eating/drinking and mosquito bites. Compared to other HCWs, doctors had significantly higher knowledge (mean = 0.46, 95% confidence interval [CI]: 0.19 to 0.73; P <0.001), attitude (mean = 0.77, 95% CI: 0.31 to 1.24; P = 0.001) and practice (mean = 2.07, 95% CI: 1.59 to 2.55; P <0.001) scores. Expatriates also scored significantly higher in knowledge (mean = 1.08, 95% CI: 0.93 to 1.23; P <0.001), attitude (mean = 1.23, 95% CI: 0.98 to 1.48; P <0.001) and practice (mean = 1.08, 95% CI: 0.82 to 1.34; P <0.001) compared to Omani nationals. Finally, those with >15 years’ work experience scored significantly higher on knowledge (mean = −0.60, 95% CI: −1.12 to −0.08; P = 0.025) and attitude (mean = −0.99, 95% CI: −1.87 to −0.10; P = 0.029) compared to those with less experience. Conclusion: The high rate of HIV-related stigma among HCWs in Oman should be rectified in order to achieve the 90-90-90 target set by the Joint United Nations Programme on HIV/AIDS.Keywords: HIV; Social Stigma; Social Discrimination; Knowledge; Attitude; Professional Practice; Healthcare Providers; Oman.
Urinary Incontinence Among Omani Women: Prevalence, risk factors and impact on quality of life
Authors: Al Kiyumi Maisa H. , Al Belushi Zaleikha I. , Jaju Sanjay , Al Mahrezi Abdulaziz M.
Published: March 2020

Objectives: Urinary incontinence (UI) in women is a common health problem which can have a negative impact on quality of life (QOL). This study aimed to determine the prevalence, risk factors and impact of UI on the QOL of Omani women attending primary healthcare centres in Muscat, Oman. Methods: This crosssectional study was conducted at three primary healthcare centres in Muscat from April to August 2018. Women who were 20–50 years of age, not pregnant, not in the six-month postnatal period, not seriously ill and not diagnosed with pelvic organ prolapse were included. A self-administered questionnaire using the International Consultation Incontinence Questionnaire-Short Form was used to evaluate the frequency, severity and impact of UI on QOL. Results: A total of 1,070 women were included in this study (response rate = 92.5%). The mean age was 31.39 ± 7.64 years. UI was reported by 369 (34.5%) women, of whom 182 (49.3%) had stress UI, 97 (26.3%) had urgency UI, 88 (23.8%) had mixed UI and two (0.5%) had other UI. Age, body mass index (BMI), having been married or employed, hypertension, cough, constipation and vaginal or assisted vaginal delivery during the previous birth were significant risk factors for UI. Only 41 (11.1%) out of the 369 women with UI had ever sought medical advice despite the fact that more than two thirds of the women with UI reported negative effects on their QOL. Conclusion: UI is a common medical problem in Oman. Several risk factors, including age and BMI, were identified. Despite its negative consequences for QOL, women were found to be reluctant to seek medical attention for the condition.Keywords: Urinary Incontinence; Prevalence; Risk Factors; Quality of Life; Oman.
Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study
Authors: Saadeh Rami , Khairallah Khaled , Abozeid Hussein , Al Rashdan Lama , Alfaqih Mahmoud , Alkhatatbeh Obaidallah
Published: March 2020

Objectives: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. Methods: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013–2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. Results: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study’s six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). Conclusion: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study’s findings reflect national trends.Keywords: Needlestick Injuries; Safety; Self Report; Nurses; Accident Prevention; Jordan.
Public Health and Paediatric Risk Assessment of Aluminium, Arsenic and Mercury in Infant Formulas Marketed in Nigeria
Authors: Igweze Zelinjo N. , Ekhator Osazuwa C. , Nwaogazie Ify , Orisakwe Orish E.
Published: March 2020

Objectives: Infant formulas are useful alternatives to breast milk in many circumstances but may pose health risks to infants and children due to contamination by potentially toxic metals. This study aimed to determine the aluminium, arsenic and mercury concentrations and carry out an exposure health risk assessment in commonly consumed infant formulas in Nigeria. Methods: Different brands of both locally manufactured and imported infant formulas were purchased in March 2017 from stores in Port Harcourt, Nigeria. Analysis of metals in the samples was performed by atomic absorption spectrophotometry. The health risk was assessed by comparing estimated daily intake of aluminium, arsenic and mercury with the provisional tolerable daily intake acceptable by the Joint Food and Agricultural Organization/World Health Organization Expert Committee on Food Additives (JECFA). Results: A total of 26 infant formulas were analysed. The levels of arsenic were higher in cereal-based formulas compared to milkbased formulas, but the difference was not significant (P >0.05). The intake levels of aluminium, arsenic and mercury in infant formulas were found to be 8.02–14.2%, 437.1–771% and 23.7–41.8% of the provisional tolerable daily intake JECFA threshold values, respectively. Conclusion: Commonly consumed infant formulas in Nigeria may add to the body burden of arsenic in children.Keyword: Infant Formulas; Toxicity Test; Aluminum; Arsenic; Mercury; Health Risk Appraisal; Child Health; Nigeria.
Caffey Disease in Infancy: A diagnostic dilemma for primary care physicians
Authors: Siddiqui Shahid A. , Siddiqui Gulnaz F. , Maurya Manisha , Shrivastava Anubha , Singh Mukesh V .
Published: March 2020

Caffey disease is a rare and self-limiting condition characterised by cortical hyperostosis with inflammation of adjacent fascia and muscles. It usually presents in infancy and clinical features include hyperirritability, acute inflammation with swelling of overlying soft tissues and subperiosteal new bone formation. Awareness of the existence of this rare condition and its typical clinical and radiological profile will avoid unnecessary investigations and treatment and help the physician to explain its good prognosis to parents of affected children. We report a three-month-old male infant who presented to the Outpatient Paediatrics Department at Moti Lal Nehru Medical College, Allahabad, India, in 2018 with a right shoulder mass, decreased upper limb movements and irritability. The patient was treated with ibuprofen and paracetamol. Irritability and limitation of movement improved over a treatment period of two weeks.Keywords: Caffey Disease; Infant; Prostaglandin E1; Thrombocytosis; Case Report; India.
Green Foot Syndrome
Authors: Rogel-Vence María , González-Ruiz Lucía , Carmona-Rodríguez Marcos , Santiago-SM Juan Luis
Published: March 2020

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