bluuebunny/crossref_metadata_2025 huggingface dataset:
Gestational diabetes mellitus is associated with antenatal hypercoagulability and secondary hyperfibrinolysis: a case control study of Chinese women
Authors: Liu Yan , Sun Xiaofang , Tao Junxian , Song Bin , Wu Wei , Li Ying , Sun Xing , Lu Dan , Zhu Danmo , Liu Chao , Cui Ji
Published: October 2019

Background: To determine the relationship between gestational diabetes mellitus (GDM) and coagulation/fibrinolysis abnormality in antenatal Chinese women.
Methods: Case control study. Fifty women had GDM and 132 did not (the NGDM group) grouping by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Maternal plasma biochemistry and previous medical history were collected from perinatal health records. Antenatal coagulation/fibrinolysis activity(CFA) parameters was assessed using thromboelastography and routine CFA parameters respectively. Univariate and multiple regression analyses were used to evaluate the associations between GDM and CFA parameters.
Results: The women with GDM were significantly older than those without GDM (30.3 vs. 28.6 years, P=0.012). Compared with the NGDM group, the GDM group had a significantly higher prevalence of cesarean delivery (56.0% vs. 37.9%, P=0.027) and higher values of fibrinogen (FIB) (4.7vs. 4.3 g/L P=0.001), activated partial thromboplastin time (APTT) (30.9 vs. 29.5 seconds P=0.010).There were no significant differences in the prevalence of maternal thrombotic events or neonatal events.GDM was significantly associated with higher APTT (β 1.41seconds, 95% CI 0.29–2.53), FIB (β 0.38g/L, 95% CI 0.14–0.61), and percentage reduction in clot lysis after 30 min(LY30)(β 1.14%, 95% CI 0.15–2.13) after adjustment for potential confounding factors.
Conclusions: GDM is significantly associated with hypercoagulability and secondary hyperfibrinolysis in these antenatal Chinese women.
Effects of synbiotic supplementation on energy and macronutrients homeostasis and muscle wasting of critical care patients: study protocol and a review of previous studies
Authors: Seifi Najmeh , Safarian Mohammad , Nematy Mohsen , Rezvani Reza , Khadem-Rezaian Majid , Sedaghat Alireza
Published: October 2019

Background Among critically ill patients, regardless of the heterogeneity of disease state, an extreme and persistent dysbiosis occurs. Dysbiosis in critically ill patients may make them prone to hospital-acquired infections, sepsis, multi-organ failure (MOF), energy homeostasis disturbance, muscle wasting, and cachexia. Modulation of gut microbiota through synbiotics can be considered as a potential treatment for muscle wasting and macronutrients homeostasis disturbances.Methods This is a prospective, single center, double-blind; a parallel randomized controlled trial that aimed to evaluate the effects of synbiotic supplementation on energy and macronutrient ‎homeostasis and muscle wasting in critical care patients.‎ All eligible patients (20 subjects in each group) will receive standard hospital gavage as enteral nutrition through a nasogastric tube (NGT) in the 24-48h after admission. In the intervention group, patients will receive Lactocare (ZistTakhmir) capsules 500 mg every 12h for 14 days. Patients in the control group will receive a placebo capsule which contains only the sterile maize starch and is similar to synbiotic capsules. The synbiotic and placebo capsules will be given through nasogastric tube, separately from gavage, after feeding.Discussion Gut microbiota modulation through synbiotics is proposed to improve clinical prognosis and reduce infectious complications, ventilator dependency and ICU stay by improving energy and macronutrient homeostasis and reducing muscle protein catabolism.Trials registration The trial protocol has been approved in Iranian Registry of Clinical Trials at 2019-03-17. The registration reference is IRCT20190227042857N1.
Protocol for the process evaluation of a cluster randomised controlled trial to determine the effectiveness and cost-effectiveness of independent pharmacist prescribing in care home: the CHIPPS study
Authors: Bond Christine , Holland Richard , Alldred David , Arthur Antony , Baton Garry , Birt Linda , Blyth Annie , Desborough James , Ford Joanna , Handford Christine , Hill Helen , Hughes Camel , Maskrey Vivienne , Myint Phyo , Norris Nigel , Poland Fiona , Shepstone Lee , Zermansky Arnold , Wright David
Published: October 2019

Background
Prescribing, monitoring and administration of medicines in care homes could be improved. A cluster RCT is ongoing to evaluate the effectiveness of an independent prescribing pharmacist assuming responsibility for medicines management in care homes compared to usual care.
Aims and Objectives
To conduct a mixed methods process evaluation of the RCT, in line with MRC process evaluation guidance, to inform interpretation of main trial findings and if the service is found to be effective and efficient, to inform subsequent implementation.
Objectives
1. To describe the intervention as delivered in terms of quality, quantity, adaptations and variations across triads and time.
2. To explore the effects of individual intervention components on the primary outcomes.
3. To investigate the mechanisms of action.
4. To describe the perceived effectiveness of relevant intervention components (including PIP training and care home staff training) from participant (GP, care home, PIP and resident/relative) perspectives.
5. To describe the characteristics of GP, care home, PIP and resident participants to assess reach.
6. To estimate the extent to which intervention delivery is normalised among the intervention healthcare professionals and related practice staff.
Methods
A mix of quantitative (surveys, record reviews) and qualitative (interviews) approaches will be used to collect data on the extent of the delivery of detailed tasks required to implement the new service, to collect data to confirm the mechanism of action as hypothesised in the logic model, to collect explanatory process and final outcome data, and data on contextual factors which could have facilitated or hindered effective and efficient delivery of the service.
Discussion
Recruitment is ongoing and the trial should complete in early 2020. The systematic and comprehensive approach that is being adopted will ensure data is captured on all aspects of the study, and allow a full understanding of the implementation of the service and the RCT findings. With so many interrelated factors involved it is important that a process evaluation is undertaken to enable us to identify which elements of the service were deemed to be effective, explain any differences seen, and identify enablers, barriers and future adaptions.
SIP SMART: A parallel group randomised feasibility trial of a tailored pre-treatment Swallowing Intervention Package compared with usual care for patients with head and neck cancer
Authors: Govender Roganie , Smith Christina H , Barratt Helen , Gardner Benjamin , Taylor Stuart
Published: October 2019

Background: Dysphagia or difficulty in swallowing affects quality of life for most patients with head and neck cancer. SIP SMART – [Swallowing Intervention Package: Self-Monitoring, Assessment, Rehabilitation Training] aims to improve post-treatment swallowing outcomes through a targeted and tailored pre-treatment intervention. This feasibility study assessed 1) recruitment and retention, 2) patient acceptability of randomisation and participation, 3) patient adherence, and 4) sought to identify a suitable primary outcome for a definitive trial, including sample size estimation. Methods: This two-arm parallel group non-blinded randomised feasibility trial took place within a head and neck centre at a teaching hospital in London, UK. Patients newly diagnosed with stage III/IV head and neck cancer were recruited and underwent 6-month follow-up. Patients were randomised to SIP-SMART or usual care via an online web-based system. SIP SMART comprised two 45-minute consultations including a baseline clinical and instrumental swallowing assessment, relevant educational information, targeted swallowing exercises, and specific behaviour change strategies to increase exercise adherence. Usual care comprised a single session including a baseline clinical assessment and generic information about the likely impact of treatment on swallowing. Results: A total of 106 patients were identified at pre-screening, 70 were assessed for eligibility. Twenty-six patients did not meet eligibility criteria [0.37, 95% CI 0.27 to 0.49]. Five of 44 [0.11, 95% CI 0.05 to 0.24] eligible patients were not approached by researchers during clinic. Seven [0.18, 95% CI 0.08 to 0.33] of the 39 approached declined participation. Target recruitment (32 consented patients) was achieved within the timeframe. At 6-months 29/32 [0.91, 95% CI 0.76 to 0.97] patients remained in the trial. Acceptability of randomisation and participation in the intervention was favourable, and adherence to the exercises exceeded the pre-defined 35% minimum criterion. The MD Anderson Dysphagia Inventory swallow related quality of life measure was selected as the most suitable primary outcome for sample size estimation. No adverse effects arose from the intervention, or study participation. Conclusions: A definitive trial of the SIP SMART intervention compared to usual care is feasible and can be undertaken with patients with head and neck cancer treated within the NHS. Trial Registration: ISRCTN40215425
Total Hip Replacement vs. Internal Fixation in the Treatment of Femoral Neck Fractures in the Elderly
Authors: Xu Yangjun , Zheng Weiping , Zhou Jinjun , Jiang Dingjun , Lu Xiao
Published: October 2019

Background: To evaluate the effects of total hip replacement and internal fixation on the outcome of femoral neck fractures in the elderly. Methods: A retrospective study was conducted in a total of 79 individuals diagnosed with Garden I or Garden II femoral neck fractures aged from 56-71 years old from October 2012 to May 2019. Patients treated with total hip replacement were grouped into group 1, while those treated with internal fixation were grouped into group 2. Baseline characteristics were compared between the two groups to eliminate extra factors. Postoperative activity time, blood loss, length of hospital stay, and length of surgical incision were compared between the two groups. Besides, postoperative complications and hip function (Harris score) were detected to evaluate the final effects in the two groups. Results: Baseline characteristics were similar between the groups, but the mean duration of surgery was more in group 1 than that in group 2 ( p <0.0001). Blood loss and length of surgical incision were both larger in group 1. However, the incidence of such postoperative complications as lung infection, urinary tract infection and thrombosis of lower limb was lower in group 1 compared with those in group 2. Moreover, the hip function (Harris score) was also better after total hip replacement compared with that after internal fixation. Conclusions: Total hip replacement provides satisfactory clinical outcomes, but with longer operation time and increased blood loss compared with internal fixation.
Neonatal eye screening for 203 healthy term newborns using a wide-field digital retinal imaging system
Authors: Leong Kenneth Teow Kheng , Kassim Siti Nur Amira Abu , Sidhu Jasvinjeet Kaur , Zohari Zayani , Sivalingam Thivakar , Ramasamy Sunder , Khialdin Safinaz Mohd , Nordin Noraihan Mohd , Rahmat Jamalia
Published: October 2019

Purpose This study aimed to determine the proportion and types of ocular abnormalities detected in healthy term newborns and also the risk factors associated with retinal haemorrhages. Method This cross-sectional study comprised of 203 participants, all healthy term newborn infants in the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a six months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared with similar studies previously published in the literature. Results Total ocular abnormalities were detected in 34% infants. The most common finding was retinal haemorrhage in 29.6% infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly four times higher risk of newborns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1 minute increment in the duration of 2nd stage of labour. Newborns delivered via SVD with episiotomy had 2.5 higher odds of developing retinal haemorrhage in newborns compared to SVD without episiotomy. Conclusion Universal eye screening for all newborns using a wide-field digital imaging system is possible, safe and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage. Although most resolve spontaneously, a longitudinal study is needed to study the long term effect of retinal haemorrhages in these infants.
Intention to quit water pipe smoking among Iranian women: A qualitative directed content analysis
Authors: sabzmakan leila , Eslami Fatemeh , Sighaldeh Shirin Shahbazi , Izuka Nkeonye Judith
Published: October 2019

Background Water-pipe smoking is the most common type of tobacco used among Iranian women. The aim of this study was to explain the women’s perceptions of their intention for quitting water-pipe smoking based on theory of planned behavior.Methods The study was a qualitative content analysis which was carried out over four months in 2016 in Tehran-Iran. The participants were 26 females of ages 18 to 45-years-old who smoked water-pipe and were selected through snowball sampling. The study was performed in hookah cafes, parks, and homes. The data were collected through individual interviews. Directed content analysis was used to analyze the data.Results Findings showed that the women did not intend to quit water-pipe in that time. The most important perceived factors of having no intention for cessation were; positive attitude toward hookah smoking, false beliefs, social pressure, and low motivation to comply. Although, the females felt some internal and external obstacles for cessation, they claimed a high self-efficacy to overcome the barriers.Conclusion Theory of planned behavior provided a useful framework to explain the women’s intention for quitting water-pipe smoking. Therefore, theory-based interventions should be designed and implemented to identify factors associated with having no intention for water-pipe cessation and modify these factors by applying appropriate techniques.
Theoretical characterisation of strand cross-correlation in ChIP-seq
Authors: Anzawa Hayato , Yamagata Hitoshi , Kinoshita Kengo
Published: October 2019

Background: Strand cross-correlation profiles are used for both peak calling pre-analysis and quality control in chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis. Despite its potential for robust and accurate assessments of signal-to-noise ratio (S/N) of ChIP-seq samples, it remains unclear what aspects of quality such strand cross-correlation profiles actually measure. Results: We introduced a simple model to simulate the mapped read-density of ChIP-seq and then derived the theoretical maximum and minimum of cross-correlation coefficients between strands. The results suggest that the maximum coefficient of typical ChIP-seq samples is directly proportional to the number of total mapped reads and the square of the ratio of signal reads, and inversely proportional to the number of peaks and the length of read-enriched regions. We also developed PyMaSC to efficiently generate strand cross-correlation profiles. Simulation analysis supported our results and evaluation using 790 ChIP-seq data obtained from the public database demonstrated high consistency between calculated cross-correlation coefficients and estimated coefficients based on the theoretical relations and peak calling results. In addition, we found that the mappability-bias-correction improved sensitivity, enabling differentiation of maximum coefficients from the noise level. Conclusions: We present the first theoretical insights into the strand cross-correlation and the results reveal the potential and the limitations of strand cross-correlation analysis. Our work will help in the establishment of better QC metrics using strand cross-correlation.
The non-traditional and familial risk factors for preeclampsia in the FINNPEC cohort
Authors: Jaatinen Noora Sofia , Jääskeläinen Tiina , Laivuori Hannele , Ekholm Eeva
Published: October 2019

Background Considering the burden of preeclampsia (PE), it is important to understand better the underlying risk factors involved in its etiology. In this nationwide study, we studied the association of background factors with PE with an emphasis on socioeconomic factors, reproductive factors and health history enclosing the parents of pregnant women. Methods In the Finnish Genetics of Pre-eclampsia Consortium (FINNPEC) cohort participants filled in a questionnaire on background information including data on socioeconomic factors, health history and reproductive factors. The questionnaire data was available from 708 women with PE and 724 control women. Two different control groups, healthy controls with uncomplicated pregnancies (n=498) and all controls (n=724, including controls with uncomplicated pregnancies and pregnancy complications other than PE), were established. Background information among PE women and the two different control groups were compared. Results PE women had similar socioeconomic status and more often non-communicable diseases including type I diabetes, chronic hypertension and hyperlipidemia than the two control groups (p<0.05 for all). Depression was more common among PE women (11.4%) than among all controls (7.6%) (p=0.019). Subfertility (estimated by time to pregnancy) was more common among PE women (p=0.013 for healthy controls, p=0.019 for all controls). PE women had earlier menarche (p=0.001 for healthy controls, p=0.022 for all controls). Hypertension was more common in both parents of PE women (p<0.001), stroke in fathers (PE women 6.2 %, healthy controls 3.2 % (p=0.020) and all controls 3.5 % (p=0.022)) and diabetes in mothers (PE women 7.5 %, healthy controls 3.1 % (p=0.001) and all controls 4.3 % (p=0.012)). Mental disorders including depression were more common in mothers of PE women compared to controls (PE women 7.2 %, healthy controls 3.7 % (p=0.013) and all controls 3.9 % (p=0.007)). Conclusions In this Finnish nationwide FINNPEC cohort, PE women had similar socioeconomic status, more non-communicable diseases and depression, earlier menarche, more subfertility and more parental non-communicable diseases compared to controls. As a novel finding we found more mental disorders including depression in mothers of PE women.
A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence
Authors: Taylor Ros , Ellis Jonathan , Gao Wei , Searle Liz , Heaps Kate , Davies Robert , Hawksworth Claire , Garcia-Perez Angela , Colclough Giles , Walker Steven , Wee Bee
Published: October 2019

Objectives Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days.Methods Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with experts. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category.Results A total of 1252 abstracts were reviewed, resulting in 10 broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed.Conclusions A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.
Adaptive evolution of low salinity tolerance and hypoosmotic regulation in a euryhaline teleost, Takifugu obscurus
Authors: Zhang Hanyuan , Hou Jilun , Liu Haijin , Zhu Haoyong , Xu Gangchun , Xu Jian
Published: October 2019

Background The mechanism of osmoregulation is crucial for maintaining growth, development, and life activities in teleosts. Takifugu obscurus, the only euryhaline species in the genus Takifugu, is a proper model organism for studying the mechanism of low salt-tolerance and hypoosmotic regulation.Results In this study, whole genome sequencing data were obtained from 90 pufferfish representing five species within this genus, T. rubripes, T. obscurus, T. flavidus, T. niphobles, and T. bimaculatus. Using a phylogeny, PCA, and population structure analyses, we observed similar amounts of population genetic differentiation among species. The five species are closely related to each other and have differentiated within a relatively short period, while T. bimaculatus and T. flavidus shared the most similar genetic backgrounds. We further identified hundreds of genes under selection related to hypoosmotic regulation between T. obscurus and other Takifugu species, including 16 representative genes involving ion transporters ( atp1a3 , atp2a2 , atp2a3 , slc13a1 , slc5a8 , slc12a2 , slc12a4 , slc26a2 , scn1b , and kcna 2/3/10), genes involved in hormone regulation ( fyn , prlr , and grb2 ), and a gene associated with water absorption ( aqp3 ). Conclusions: Our findings provide preliminary insight into the mechanism of osmoregulation and will facilitate follow-up validation of candidate genes related to osmoregulation in T. obscurus .
Prognostic potential of pre-partum blood biochemical and immune variables for postpartum mastitis risk in dairy cows
Authors: Guan Ruowei , Wang Diming , Wang Beibei , Jiang Luyi , Liu Jianxin
Published: October 2019

Background Mastitis is one of the most frequent diseases for transition cows, causing significant economic losses. Identification of potential biomarkers for diagnosis of mastitis is important for its prevention. Thus, this study was conducted to investigate alterations in blood inflammatory cells and serum variables that are related to health in postpartum cows. Results Seventy-six healthy Holstein dairy cows at week 4 before calving were selected. Blood samples were collected at weeks -4, -3, -2, -1, 1, 2, 3 and 4 relative to calving, respectively. Milk yield and composition were recorded weekly. According to the cutoff of somatic cell counts (SCC) for diagnosis of mastitis, 33 cows with SCC ≥ 500,000 ml -1 , 22 cows with 200,000 ≤ SCC < 500,000 ml -1 , and 23 cows with SCC < 200,000 ml -1 were defined as high, middle, and low SCC, respectively. Serum concentrations of β-hydroxybutyrate were higher ( P < 0.01) during all weeks, and non-esterified fatty acids were elevated from weeks -3 to 2 relative to calving in high SCC cows compared to low SCC cows. Higher serum concentrations of superoxide dismutase ( P < 0.01) and lower malondialdehyde levels ( P < 0.01) in low SCC than in high SCC cows indicate that the latter suffered from oxidative stress. In addition, high SCC cows exhibited higher blood neutrophil to lymphocyte ratio (NLR, P < 0.01) and platelet to lymphocyte ratio (PLR, P < 0.01) than low SCC cows, with a higher NLR ( P < 0.01) in middle SCC than in low SCC cows. The high SCC cows had lower levels of anti-inflammatory factors including IL-10 ( P = 0.05), CD4 ( P < 0.01) and CD8 ( P < 0.01), but higher levels of proinflammatory factors such as IL-6 ( P < 0.01), TNF-α ( P < 0.05), and PSGL-1 ( P < 0.01) than low SCC cows, leading to the elevated NLR and PLR in high SCC cows. Conclusions The significantly different NLR and PLR pre-partum between the middle and low SCC cows suggest their prognostic potential for postpartum mastitis risk
Efficacy of premedication with intranasal dexmedetomidine for removal of inhaled foreign bodies in children by flexible fiberoptic bronchoscopy: a randomized, double-blind, placebo-controlled clinical trial
Authors: Bi Yanmei , Ma Yushan , Ni Juan , Wu Lan
Published: October 2019

Background: The traditional technique for foreign body removal is rigid bronchoscopy. However, fiberoptic bronchoscopy is becoming more popular for foreign body removal. Compared with rigid bronchoscopy, fiberoptic bronchoscopy is better suited for removing foreign bodies from the distal airways and upper lobe bronchi because of the smaller diameter and greater flexibility of the bronchoscope. Dexmedetomidine, a highly selective α2 adrenergic agonist, reduces preoperative anxiety, reduces the requirement for general anesthetics, and does not induce respiratory depression. The safety and efficacy of intravenous dexmedetomidine have been confirmed in patients undergoing fiberoptic bronchoscopy. Intranasal dexmedetomidine reportedly produce satisfactory sedation in children. We hypothesized that intranasal dexmedetomidine at 1 µg·kg−1 administered 25 minutes before anesthetic induction can reduce the incidence of adverse events during fiberoptic bronchoscopy under sevoflurane inhalation general anesthesia. Methods: Forty preschool-aged children (6–48 months) with an American Society of Anesthesiologists physical status of I or II were randomly allocated to receive either intranasal dexmedetomidine at 1 µg·kg−1 or normal saline at 0.01 ml·kg−1 25 minutes before anesthetic induction. The primary outcome was the incidence of perioperative adverse events. The heart rate, respiratory rate, separation score, tolerance of the anesthetic mask, agitation score, anesthetic induction time, consumption of sevoflurane, and recovery time were also recorded. Results: The incidence of laryngospasm, breath-holding, and coughing were significantly lower in patients who received intranasal dexmedetomidine than saline (15% vs. 50%, P=0.018; 10% vs. 40%, P=0.028; and 5% vs. 30%, P=0.037, respectively). Patients who received intranasal dexmedetomidine had a lower separation score (P=0.017), more satisfactory tolerance of the anesthetic mask (P=0.027), a significantly shorter anesthetic induction time (5.75±1.4 vs. 7.75±2.5 min, P=0.004), and less consumption of sevoflurane (38.18±14.95 vs. 48.03±14.45 ml, P=0.041). The recovery time was similar in both groups, and the frequency of postoperative agitation was significantly lower in patients who received intranasal dexmedetomidine (P=0.004). Conclusions: Intranasal dexmedetomidine at 1 µg·kg−1 can reduce the incidence of laryngospasm, breath-holding, and coughing during fiberoptic bronchoscopy for foreign body removal via its sedative and analgesic effects. Moreover, intranasal dexmedetomidine can reduce postoperative agitation without a prolonged recovery time.
Effectiveness of flipped classroom combined with team-, case-, lecture- and evidence-based learning on ophthalmology teaching for eight-year program students
Authors: Ding Chun , Li Shengguo , Chen Baihua
Published: October 2019

Background This study aimed to investigate the benefits and challenges of the flipped classroom combined with team-, case-, lecture- and evidence-based learning (FC-TCLEBL) for ophthalmology teaching for eight-year program students. Methods FC-TCLEBL and the traditional lecture-based classroom (LBC) were compared based on student and teacher feedback questionnaires, student learning burden, and scores on standardized tests as well as their effects on the abilities of clinical thinking, scientific research, active-learning, practical application, humanistic care and communication with patients. Results Both the students and teachers were more satisfied with the FC-TCLEBL model. More students in the FC-TCLEBL group agreed that the course helped them to develop skills in creative thinking, problem solving, and teamwork. Students in the FC-TCLEBL group spent significantly more time preparing for class than those in the LBC group, but the time spent on review was significantly lower in the FC-TCLEBL group. The students from the FC-TCLEBL group performed better in a post-test on diabetic retinopathy (DR) as compared to the LBC group. Conclusions FC-TCLEBL teaching model is effective and suitable for ophthalmology teaching.
Larva of greater wax moth Galleria mellonella is a suitable alternative host for the fish pathogen Francisella noatunensis subsp. orientalis
Authors: Djainal Winarti Achmad Sarmin , Shahin Khalid , Adams Alexandra , Desbois Andrew
Published: October 2019

Background Francisella noatunensis subsp. orientalis (Fno) is the etiological agent of francisellosis in cultured warm water fish, such as tilapia. Antibiotics are administered to treat the disease but a better understanding of Fno infection biology will inform improved treatment and prevention measures. However, studies with native hosts are costly and considerable benefits would derive from access to a practical alternative host. Here, larvae of Galleria mellonella were assessed for suitability to study Fno virulence. Results Larvae were killed by Fno in a dose-dependent manner but the insects could be rescued from lethal doses of bacteria by antibiotic therapy. Infection progression was assessed by histopathology (haematoxylin and eosin staining, Gram Twort and immunohistochemistry) and enumeration of bacteria recovered from the larval haemolymph on selective agar. Fno was phagocytosed and could survive intracellularly, which is consistent with observations in fish. Virulence of five Fno isolates showed strong agreement between G. mellonella and red Nile tilapia hosts. Conclusions This study shows that an alternative host, G. mellonella, can be applied to understand Fno infections, which will assist efforts to identify solutions to piscine francisellosis thus securing the livelihoods of tilapia farmers worldwide and ensuring the production of this important food source.
Factors Indicating the Accuracy of Fetal Weight Estimation in Preterm Newborns with Normal Amniotic Fluid Volume
Authors: Guralp Onur , Tuten Nevin , Tuten Abdullah , Gezer Altay
Published: October 2019

OBJECTIVE: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume.STUDY DESIGN: Three hundred and seventy-one singleton pregnancies with normal amniotic fluid volume and delivered at between 24+0 and 37+0 gestational weeks were evaluated in a retrospective study. Any possible associations between the absolute percentage error of fetal weight estimations and the maternal and fetal data were examined.RESULTS: In 135 of the 371 women (36%), the absolute percentage error was greater than 10%. The mean absolute percentage error was 8.7±7.5%. The mean absolute percentage errors were 4.1±2.7% and 16.8±6.4% in the accurate and inaccurate estimation groups, respectively.The rate of women examined during labor was significantly higher in the inaccurate estimation group compared to the accurate estimation group. There were no significant differences in age, body-mass-index, gestational age at delivery, estimated-fetal-weight, actual birth weight, days from the last ultrasound examination to delivery, small for gestational age rate, placenta localization or fetal presentation between the two groups. Examination during labor (β=0.224) was the most important factor for the prediction of the absolute percentage error, followed by gestational age at delivery (β=–0.198), presence of (β=–0.158), and body-mass-index (β=0.142).CONCLUSION: In 36% of our study population, the absolute percentage error was >10%. Examination during labor was the most important factor for the prediction of the absolute percentage error, followed by gestational age at delivery, presence of small for gestational age, and body-mass-index.
Effect of biosurfactant as a novel draw solution on photocatalytic treatment and desalination of produced water by different forward osmosis membranes
Authors: Taghizadeh Maryam , Kebria Daryoush Yousefi , Qaderi Farhad
Published: October 2019

Water stress and environmental concerns have driven research into the treatment of produced water. In this study, a combination of forward osmosis and photocatalyst system was used for simultaneous salt removal and treatment of produced water. Furthermore, biosurfactant as a novel draw solution and the three types of forward osmosis membranes (cellulose triacetate with and without titanium dioxide (TiO2) and graphene oxide (GO) nanoparticles) were investigated. The morphology and distribution of the TiO2 and TiO2/GO on the membrane surface were assessed by various analyses including field emission scanning electron microscopy, energy dispersive X-ray and contact angle analysis. The results demonstrated that the reverse salt flux was only 0.2 g/m2 h. Moreover, benzene, toluene, ethylbenzene, and xylene (BTEX) removal efficiency in the cellulose triacetate with TiO2 and TiO2/GO membrane under UVC radiation was 62% and 78%, respectively, while the data obtained in visible light reached 80%. The use of TiO2 and TiO2/GO membranes significantly improved the permeability, water flux, photocatalytic degradation of pollutants and desalination of produced water.
An experimental study on the effects of direct and indirect use of solar energy on solar seawater desalination
Authors: Bagheri Ali , Esfandiari Nadia , Honarvar Bizhan , Azdarpour Amin
Published: October 2019

The use of solar energy for increasing the amount of water heating inside the solar still unit provided an important basis for various process designs in this research. Concerning the wide use of solar energy, solar panels have been used for heating water through thermal elements. In the first setup, a cylindrical parabolic collector (CPC) was used together with 300-watt and 500-watt solar panels, the results of which were then compared with each other. Based on the results the system best performed when more powerful solar panels and a longer CPC device were used. In the second setup, solar heating was achieved by direct use of solar still units. According to comparative results between the two experimental setups, the use of direct thermal elements in the solar still unit provided better performance compared with the use of indirect thermal energy. The highest amounts of freshwater were 3.679 kg and 3.945 kg per day in the first and the second setups, respectively.
Populizm penalny — źródła i przejawy w polskim życiu publicznym
Authors: Gajos Maciej
Published: October 2019

Z przeprowadzonych badań wynika, że jedną z przyczyn krytycznych opinii Polaków o sądownictwie jest poczucie, że kary orzekane przez sądy są zbyt łagodne. Zgłaszane oczekiwania wymierzania surowszych kar połączone z przekonaniem polityków o potrzebie reagowania na nie w drodze zwiększania represyjności wpisują się w fenomen populizmu penalnego. Chociaż w literaturze można spotkać się z wyjaśnieniami, że bierze się on z braku poczucia bezpieczeństwa w społeczeństwie, jego źródła są bardziej złożone, tzn. z jednej strony, będzie to pełen zaniedbań sposób komunikowania się sądów ze społeczeństwem i z drugiej wynika z przekazów medialnych nastawionych na konstruowanie fragmentarycznej, sensacyjnej i emocjonalnej narracji. Skala oddziaływania tych dwóch czynników zdeterminowana jest dynamiką społecznych przemian związanych m.in. z globalizacją. Populizm penalny wyraźnie ujawnia się w stylu retoryki dominującym w polskiej debacie publicznej. Prowadzi on do doraźnych, bezrefleksyjnych działań legislacyjnych podejmowanych pod wpływem społecznej presji. Zazwyczaj zamiast rozwiązywać problemy, będzie podsycał konflikty społeczne i poszerzał sferę kontroli państwa.
Sağlık Okuryazarlığı Kavramı ve Sağlık Haberlerini Doğru Okumak
Authors: Utma Seçil
Published: October 2019

Yeniliklerin kamuoyuna duyurulmasında en etkili araçların başında
yer alan medya, sağlık konusunda da benzer işlevini yerine getirmektedir.
Sağlık temalı yayınlar hedef kitle tarafından dikkatle takip edilmekte, günlük
yaşam pratikleri içerisinde kendisine yer bulmaktadır. Toplumun sağlık
bilincinin yükselmesinde önemli bir yer tutan sağlık okuryazarlığı kavramı son
yıllarda giderek tartışılan bir alan olarak karşımıza çıkmaktadır. Çalışmada
sağlık okuryazarlığı kavramı tanımlanarak, sağlığın geliştirilmesindeki rolü
ele alınmakta, sağlık okuryazarlığı düzeyinin yetersiz olması durumunda yaşanan
sorunlar ve çözüm önerileri sunulmaktadır.
Konaklama İşletmelerinde Rekabet Gücü Açısından Stratejik Maliyet Yönetimi: İstanbul’da Faaliyet Gösteren Beş Yıldızlı Oteller Üzerine Bir Araştırma
Authors: Baysal Derya , Bilici Nilgün
Published: October 2019

Turizm sektörü tüm dünyada ve ülkemizde de ekonomiye katkı sunan sektörler başında gelmekte ve gelişmeye devam etmektedir. Değişen ekonomik koşullar ve piyasa şartları işletmelerin rekabet gücünü arttırmalarını zorunlu kılmaktadır. Küreselleşme ile başlayan teknolojik gelişme turizm sektörünü de etkilemiştir. Turizm sektörü emek yoğun olmasının yanı sıra teknolojik gelişmeleri de yakından takip etmek durumundadır. İşletmeler varlıklarını sürdürebilmek adına değişen şartlara ayak uydurabilmeli, gelirlerini arttırarak devam ettirmeli ve maliyetlerini kontrol altına alabilmelidirler.  Çalışmanın amacı, konaklama işletmelerinde çağdaş maliyetleme yöntemlerinden olan stratejik maliyet yönetiminin rekabet gücü elde edilmesi noktasında sunduğu katkıyı ortaya koyabilmektir. Bu bağlamda, İstanbul ilinde faaliyet gösteren beş yıldızlı otel işletmeleri üzerinde bir anket çalışması uygulanmıştır.Çalışma sonucunda, stratejik bilginin önemi ve özellikle rekabet gücü elde edilmesi açısından sektörde fark yaratabileceği neticesine varılmıştır. Turizm ürün ve hizmetlerinin komplike yapıda oluşu, müşteri sadakatinin sağlanamaması stratejik maliyet yönetimini olumsuz etkileyebilmektedir.
The Beneficial Hemodynamic Actions of SGLT-2 Inhibitors beyond the Management of Hyperglycemia
Authors: Loutradis Charalampos , Papadopoulou Eirini , Angeloudi Elena , Karagiannis Asterios , Sarafidis Pantelis
Published: October 2019

Type 2 diabetes mellitus (DM) is a public health burden and its co-existence with hypertension
is long established in the context of the metabolic syndrome. Both DM and hypertension are
major risk factors, for end-stage renal disease, cardiovascular events and mortality. Strict blood pressure
(BP) control in diabetics has been associated with a cardiovascular and renal risk decrease. Inhibitors
of the sodium-glucose co-transporter 2 (SGLT-2) in the proximal tubule is a relatively novel
class of agents for the treatment of type 2 DM. Inhibition of SGLT-2 co-transporter combines proximal
tubule diuretic and osmotic diuretic action leading to glucose reabsorption reduction and mild
natriuretic and diuretic effects. On this basis, several studies showed that treatment with SGLT-2 inhibitors
can effectively decrease hyperglycemia but also increase BP control and reduce renal outcomes
and cardiovascular mortality. Based on such evidence, the recent guidelines for the management
of type 2 DM now suggest that SGLT-2 inhibitors should be preferred among oral agents in
combination with metformin, in patients at increased cardiovascular risk, chronic kidney disease or
heart failure. This review summarizes the existing data from studies evaluating the effect of SGLT-2
inhibitors on BP, and its potential value for cardio- and nephroprotection.
A Review of Cationic Arylfurans and Their Isosteres: Synthesis and Biological Importance
Authors: A. Ismail Mohamed , M. El-Sayed Wael , Shaaban Saad , A. Abdelwahab Ghada , S. Hamama Wafaa
Published: October 2019

The present study provides an overview of the chemistry and biological importance
of the cationic chalcophene derivatives (furans, thiophenes and selenophenes). The
summarized literature survey includes synthetic methods, reactivity and biological activities
of aryl/hetarylchalcophenes that have been reported mainly from 2001 to 2019 focusing
on monochalcophenes. A discussion demonstrating the proposed mechanisms of some
interesting synthetic routes and linking structure features to biological activities is presented.
These classes of compounds including cationic chalcophenes possess antiproliferative,
antimicrobial and antiprotozoal activities. This review highlights recent advances
for arylchalcophene derivatives and may contribute to the design and structure optimization
of new chalcophene derivatives in the future.
Hematopoietic Differentiation of Human Pluripotent Stem Cells: HOX and GATA Transcription Factors as Master Regulators
Authors: Alsayegh Khaled , Cortés-Medina Lorena V. , Ramos-Mandujano Gerardo , Badraiq Heba , Li Mo
Published: October 2019

Numerous human disorders of the blood system would directly or indirectly benefit from therapeutic approaches that reconstitute the hematopoietic system. Hematopoietic stem cells (HSCs), either from matched donors or ex vivo manipulated autologous tissues, are the most used cellular source of cell therapy for a wide range of disorders. Due to the scarcity of matched donors and the difficulty of ex vivo expansion of HSCs, there is a growing interest in harnessing the potential of pluripotent stem cells (PSCs) as a de novo source of HSCs. PSCs make an ideal source of cells for regenerative medicine in general and for treating blood disorders in particular because they could expand indefinitely in culture and differentiate to any cell type in the body. However, advancement in deriving functional HSCs from PSCs has been slow. This is partly due to an incomplete understanding of the molecular mechanisms underlying normal hematopoiesis. In this review, we discuss the latest efforts to generate human PSC (hPSC)-derived HSCs capable of long-term engraftment. We review the regulation of the key transcription factors (TFs) in hematopoiesis and hematopoietic differentiation, the Homeobox (HOX) and GATA genes, and the interplay between them and microRNAs. We also propose that precise control of these master regulators during the course of hematopoietic differentiation is key to achieving functional hPSC-derived HSCs.
Ferula hermonis: A Review of Current Use and Pharmacological Studies of its Sesquiterpene Ester Ferutinin
Authors: Safi Rémi , El-Sabban Marwan , Najjar Fadia
Published: October 2019

Ferula hermonis Boiss, is an endemic plant of Lebanon, locally known as “shilsh Elzallouh”. It has been extensively used in the traditional medicine as an aphrodisiac and for the treatment of sexual impotence. Crude extracts and isolated compounds of ferula hermonis contain phytoestrogenic substances having a wide spectrum of in vitro and in vivo pharmacological properties including anti-osteoporosis, anti-inflammatory, anti-microbial and anti-fungal, anti-cancer and as sexual activity enhancer. The aim of this mini-review is to highlight the traditional and novel applications of this plant’s extracts and its major sesquiterpene ester, ferutinin. The phytochemical constituents and the pharmacological uses of ferula hermonis crude extract and ferutinin specifically will be discussed.
The Increase of HIV-1 Infection, Neurocognitive Impairment, and Type 2 Diabetes in The Rio Grande Valley
Authors: De La Garza Roberto , Rodrigo Hansapani , Fernandez Francisco , Roy Upal
Published: October 2019

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The Human Immunodeficiency Virus (HIV-1) infection remains a persistent predicament
for the State of Texas, ranking seventh among the most documented HIV cases in the United States.
In this regard, the Rio Grande Valley (RGV) in South Texas is considered as one of the least investigated
areas of the state with respect to HIV infection and HIV associated comorbidities. Considering
the 115% increase in average HIV incidence rates per 100,000 within the RGV from 2007-2015,
it is worth characterizing this population with respect to their HIV-1 infection, HIV-1 Associated
Neurocognitive Disorders (HAND), and the association of treatment with combined antiretroviral
therapy (cART). Moreover, the increased rate of Type-2 Diabetes (T2D) in the RGV population is
intertwined with that of HIV-1 infection facing challenges due to the lack of knowledge about prevention
to inadequate access to healthcare. Hence, the role of T2D in the development of HAND
among the people living with HIV (PLWH) in the RGV will be reviewed to establish a closer link
between T2D and HAND in cART-treated patients of the RGV.
Recent Patents on Permeation Enhancers for Drug Delivery Through Nails
Authors: Kreutz Tainá , de Matos Sheila Porto , Koester Letícia Scherer
Published: October 2019

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The human nail is a unique barrier with a keratinized constitution that favors protection and
fine touch. However, many disorders can affect the nail, among them, are the onychomycosis and psoriasis.
Systemic oral therapy has been applied to treat these diseases, even presenting disadvantages,
including side effects, drug interactions, contraindications, toxicity, high cost and low patient compliance.
A great option to succeed in dealing with the problems associated with oral therapy is the topical
administration of drugs. However, nail composition, low diffusion through ungual route and reduced
tissue bioavailability for topical treatments are limiting factors. These drawbacks can be overcome by
promoting penetration through the nails by employing penetration enhancers. The review focuses on
patents that highlight permeation enhancers applied to nail drug delivery for the treatment of onychomycosis
and psoriasis. Literature and patent searches were conduced regarding the topic of interest.
The substantial literature and patent search revealed that permeation enhancers, especially chemicals,
are great strategies for promoting the ungual delivery of drugs. Nail topical therapy containing permeation
enhancers is an attractive option for delivering localized treatments.
Stress Corrosion Cracking of Structural Nuclear Materials: Influencing Factors and Materials Selection
Authors: Antunes Renato Altobelli , de Oliveira Mara Cristina Lopes
Published: October 2019

Stress Corrosion Cracking (SCC) plays a central role in the development of improved
structural nuclear materials. Complex interactions between microstructure, alloy composition, manufacturing
and environmental factors make the understanding of this phenomenon difficult. This
work aimed at reviewing the scientific literature on the SCC behavior of structural nuclear materials
in order to identify the main factors that govern this phenomenon. Additionally, the interaction between
these factors and materials selection is discussed in order to provide a comprehensive basis
for the successful design of metallic materials with improved resistance to SCC.