bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Scraped Surface Heat Exchanger Process Parameters for Manufacture of Bottle Gourd Halwa
Authors: Velpula Suresh , AG Bhadania , SV Pinto , T Aravind , KS Umapathy
Published: September 2019

The present investigation has been aimed to study the effect of various process parameters of scraped surface heat exchanger (SSHE) on the sensory characteristics of fresh bottle gourd halwa. The horizontal SSHE designed and fabricated at the Institute was used to manufacture bottle gourd halwa. The freshly prepared bottle gourd halwa samples were analyzed for their sensory characteristics prepared at different scraper speed (R1, R2, R3 at 20, 30 and 40 rpm respectively), and operating steam pressure (G1, G2, G3 at 0.75, 1.0 and 1.5 kg/cm2 respectively) for varying batch size (B1, B2, B3 of 2, 3 and 4 kg respectively). A uniform quality product with respect to flavor, body and texture, color and appearance, and overall acceptability (sensory scoring) was obtained employing the combination of treatments G2B3S2 among the rest of combinations. Cost analysis of bottle gourd halwa prepared in SSHE under operating condition G2B3S2 was computed at `150.35; the raw materials cost and operating cost was `116.82 and `33.53, respectively.
A aprendizagem da performance musical na visão sociocognitiva: aportes da Abordagem Multidimensional da Autorregulação
Authors: Veloso Flávio Denis Dias , Araújo Rosane Cardoso de
Published: September 2019

O desenvolvimento da expertise instrumental demanda a mobilização de competências comportamentais, motivacionais, emocionais e cognitivas. Nessa direção, o constructo da autorregulação apresenta-se como uma alternativa às iniciativas investigativas e intervencionista no domínio da performance e educação musical. A autorregulação da aprendizagem diz respeito aos processos mobilizados por alunos para direcionar seus pensamentos e ações para o alcance de metas, envolvendo uma postura autônoma e engajada no planejamento, monitoramento e avaliação dos desempenhos musicais. O presente texto apresenta um estudo de natureza teórica – orientado metodologicamente por uma ampla revisão da literatura – cujo objetivo foi compreender as relações entre o desenvolvimento instrumental e a aprendizagem autorregulada, concebendo a autorregulação a partir de suas dimensões e subprocessos e indicando caminhos para a superação de alguns dos desafios da aprendizagem instrumental. Os resultados sugeriram duas contribuições centrais: (1) a exposição da “Abordagem Multidimensional da Autorregulação” voltada à aprendizagem da performance musical e (2) a aproximação sistemática dos constructos da “autorregulação” e “metacognição” com base nos estudos de Albert Bandura (1991a) e John Flavell (1979). Vislumbramos a associação entre estes autores para fundamentar uma abordagem da autorregulação alinhada às especificidades da aprendizagem musical. Almejamos que as considerações aqui apontadas promovam a expansão das reflexões (bem como das iniciativas científicas e educacionais) concernentes ao ensino e aprendizagem da performance musical.
Mental disorders and obstetric diseases in high risk gestations
Authors: Albuquerque Denyse Sales Veloso , Campos Eugenio de Moura , Santos Joao Paulo Lima , Rodrigues Joao Paulo de Oliveira , Araujo Isadora Wanderley , Lima Ilana Leila Barbosa de , Gomes Igor Emanuel Vasconcelos e Martins
Published: September 2019

Objectives: To analyze the prevalence of major depression disorder, anxiety disorders and substance abuse in women with high-risk pregnancy and identify maternal-fetal pathologies and other variables associated with higher prevalence of mental disorders. Methodology: This cross-sectional study included 46 women in the high-risk gestation outpatient clinic of the Maternidade Escola Assis Chateaubriand in Fortaleza - Ceará. A sociodemographic and a clinical data questionnaire were applied, as well as Abuse Assesment Screen, Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory and Alcohol Smoking and Substance Screening Test. Mini International Neuropsychiatry Interview (MINI) was applied to women with positive screening in the mentioned scales. Results: Using the screening tools, the prevalence was 30.4% for depression and 52.2% for anxiety; with the MINI the prevalence was 30,4% and 34,8%, respectively. Pregnant women with cardiac diseases had a 66,7% depression prevalence and a 77.8% anxiety prevalence, both higher than those with other pathologies. Depression and anxiety were also associated with unwanted pregnancy and domestic violence during life. Conclusion: The prevalence of depression and anxiety was high in this sample of pregnant women and the associated risk factors need to be understood, so that better interventions in the treatment of pregnant women can be implemented.
Identificação de casos de near miss neonatal: que critérios são usados no cenário brasileiro – revisão integrativa
Authors: Carvalho Ocilia Maria Costa , Xavier Ana Tallita de Oliveira , Gouveia Ana Paula Mendes , Augusto Matheus Costa Carvalho , Carvalho Francisco Herlanio Costa
Published: September 2019

Objetivo: Analisar as evidências científicas brasileiras acerca de critérios usados para identificação de casos de near miss neonatal. Método: Estudo de revisão integrativa nas bases de dados Pubmed/Medline, Scielo e Lilacs. Foram incluídos artigos originais de autoria brasileira que abordassem critérios para identificação de near miss neonatal; texto completo; publicados em português, inglês ou espanhol; período de publicação compreendido entre 2007 a 2017; com apresentação consistente dos resultados, métodos e população. Os termos de busca foram: near miss, neonatal, mortalidade neonatal e morbidade neonatal nas versões português e inglês. Resultados: Cinco estudos contemplaram a revisão, dois estudos transversais, dois estudos de coorte e um estudo descritivo de base de dados. Observou-se inexistência de uma definição para determinar o near miss neonatal. Os marcadores Apgar de 5 minutos < 7 e ventilação mecânica parecem mais concordantes entre os autores; variações ocorrem entre as idades gestacionais e os pesos de nascimento. Conclusões: Houve uma mostra restrita, ainda que crescente, de estudos nacionais, estes não apresentaram consenso sobre os critérios, mas alguns marcadores comuns mostraram-se capazes de identificar e predizer o near miss neonatal, notadamente os baixos peso ao nascer, idade gestacional e Apgar do quinto minuto de vida.
Hemofilia sem diagnóstico prévio: um desafio na cirurgia pós‑trauma
Authors: Castro Júnior Danival Ferreira de , Soares Lorena Passos , Frazão Caio Túlio Vale , Alves Natália Cristina , Frazão Júnior Gentil Augusto , Carvalho Rodrigo da Costa , Minghini Wagner
Published: September 2019

A hemofilia A leve é uma discrasia sanguínea hereditária rara que normalmente não se manifesta com sangramentos, a menos que haja traumas ou procedimentos cirúrgicos. O diagnóstico prévio, tanto no pré como no pós-operatório, é um obstáculo a ser vencido. Trata-se de um paciente hemofílico A sem diagnóstico prévio, vítima de acidente motociclístico, com formação de hematoma retroperitoneal e submetido a uma laparotomia exploradora, evoluindo com hemorragias persistentes. Foi submetido a atos cirúrgicos até o estabelecimento do diagnóstico e estabilização do quadro após reposição do fator VIII.
Tumor epitelial e estromal misto do rim: relato de caso
Authors: Barbosa Francisco Flávio , Oliveira Adriana Regina Vilarinho de , Sousa Emília Tomé , Hirth Carlos Gustavo
Published: September 2019

O tumor epitelial e estromal misto do rim é uma neoplasia rara, caracterizada pelo seu padrão histopatológico bifásico, formado por elementos epiteliais e estromais. Predomina no sexo feminino, na perimenopausa e sua patogênese ainda é desconhecida. Relata-se o caso de uma paciente de 54 anos, que iniciou crises recorrentes de dor em flanco direito e disúria. Os exames de imagem evidenciaram lesão cística complexa em rim esquerdo e paciente foi submetida à nefrectomia. O exame histopatológico e a imuno-histoquímica confirmaram o diagnóstico.
Relato de caso – gestação espontânea em paciente com falência ovariana precoce
Authors: Lucena Aline Freire , Sena Michele Coelho Fontenele , Queiroz Paulo Cruz de
Published: September 2019

Objetivos: O trabalho visa mostrar a importância do diagnóstico de falência ovariana precoce (FOP), diminuindo as comorbidades associadas a esta patologia e relatar um caso de gestação espontânea após início de terapia de reposição hormonal (TRH). Metodologia: Revisão de prontuário de paciente atendida no serviço de climatério da Maternidade Escola Assis Chateaubriand. Discussão: Paciente de 21 anos, nuligesta, com desejo de gestar, procura atendimento queixando-se de amenorreia secundária e fogachos intensos. Diagnosticada com FOP após avaliação da anamnese, exame físico e exames laboratoriais. Após 10 meses de tratamento e melhora dos sintomas, engravidou espontaneamente. A FOP incide em 0,1% das mulheres com menos de 30 anos, e a taxa de gestação espontânea nesses casos varia de 3-10%. A FOP tem grande impacto na vida da mulher, sendo causa de infertilidade e aumentando a incidência de comorbidades relacionadas à deprivação estrogênica, como osteoporose e risco cardiovascular desfavorável. A maioria das pacientes só engravida após uso de técnicas de reprodução assistida. Conclusão: O diagnóstico precoce para implementação de tratamento multidisciplinar nas pacientes com FOP é de extrema importância para manutenção da saúde física e mental das pacientes. Incomumente, gestação espontânea pode acontecer, sendo mandatório realizar teste de gravidez se atraso menstrual.
Protocolo de Controle Glicêmico Hospitalar
Authors: Martins Luizianne Mariano , Martins Manoel Ricardo Alves , Fontenele Eveline Gadelha Pereira , Montenegro Junior Renan Magalhães , Magalhães Rejane Araújo , Queiroz Paulo Cruz de , Alencar Renata Carvalho de , Quidute Ana Rosa Pinto , D'Alva Catarina Brasil , Mota José ítalo Soares , Junqueira Ana Flávia Torquato de Araújo , Coretti Fabiana Maria Lustosa Martins , Fernandes Virginia Oliveira , Gadelha Daniel Duarte , Carvalho Manuela Montenegro Dias de , Vitoriano Maria Airtes Vieira , Braga Fernanda Nogueira Holanda Ferreira , Puster Rainardo Antônio , Mendes Ângela Delmira Nunes
Published: September 2019

A hiperglicemia é uma complicação frequente, cuja prevalência ocorre em até 38% dos pacientes internados. Tal condição pode ser decorrente do diabetes previamente conhecido, de estresse responsivo a doenças ou tratamentos associados ou devido ao diabetes somente diagnosticado durante a internação. A presença de hiperglicemia nosocomial associa-se ao prolongamento do tempo de internação, ao aumento da demanda de recursos humanos e custos hospitalares e na piora do desfecho clínico. Diante das dificuldades de manejo da hiperglicemia de pacientes internados, as unidades hospitalares, seguindo as recomendações das sociedades e diretrizes internacionais e nacionais que trata da hiperglicemia do paciente internado, têm desenvolvido protocolos de controle glicêmico hospitalar e criado comissões interdisciplinares para tal fim. O Hospital Universitário Walter Cantídio (HUWC-UFC), baseado nas principais diretrizes internacionais e nacionais de tratamento ao diabetes, apresenta o seu protocolo de controle da hiperglicemia numa abordagem multi e interdisciplinar de cuidados ao paciente internado.
VARDİYALI ÇALIŞMA SİSTEMİNİN ÇALIŞANLARIN İŞTEN AYRILMA NİYETİNE ETKİSİ ÜZERİNDE İŞ YAŞAM DENGESİNİN ARACILIK ROLÜ
Authors: ÖZTOP Sezai , DEĞİRMENCİOĞLU Mine
Published: September 2019

Bu çalışma, havacılık sektöründe vardiyalı çalışma düzeninin çalışanların işten ayrılma niyeti üzerindeki etkisini ve bu nedensellik ilişkisinde iş yaşam dengesinin aracılık rolünü tespit etmek için gerçekleştirilmiştir. Bu amaca yönelik olarak, literatür taraması sonrasında, Antalya Havalimanı’nda toplam 517 çalışanı olan bir yer hizmetleri şirketinde 256 çalışan üzerinde anket tekniğine dayalı bir araştırma gerçekleştirilmiştir. Anketlerden elde edilen veriler, SPSS 22 istatistik yazılımı ve PROCESS makrosu kullanılarak analiz edilmiştir. Araştırmadan elde edilen bulgulara göre, vardiyalı çalışma sisteminin işten ayrılma niyeti üzerindeki etkisinin istatistiksel olarak anlamlı olduğu tespit edilmiştir (β= .49; p<0.00). İkinci aşamada ise vardiyalı çalışma sistemi, iş yaşam dengesi ve işten ayrılma niyeti değişkenleri birlikte analiz edilerek vardiyalı çalışma sisteminin işten ayrılma niyeti üzerindeki etkisi anlamsızlaşmıştır (β=.41; p>0.05). Bu aracılık ilişkisi, Sobel (1982) testiyle incelendiğinde iş yaşam dengesinin, vardiyalı çalışma sistemi ile işten ayrılma niyeti arasındaki ilişki üzerindeki aracılık etkisinin istatistiksel olarak anlamlı olduğu saptanmıştır (z= 5,29, p<0.01).
GÖSTERİŞÇİ TÜKETİM ÖRNEĞİ OLARAK POTLAÇ KÜLTÜRÜ VE GÜNÜMÜZÜN KÜRESEL KAPİTALİST DÜNYASINDAKİ YANSIMALARI
Authors: KİTAPCI İsmail
Published: September 2019

Potlaç kültürü günümüzdeki gösterişçi tüketimin ilk örnekleri sayılabilir. Potlaç kültüründe sosyal statü ve itibar kazanmak için yapılan gösterişçi harcamaların hem maddi hem manevi amaçları bulunmaktadır. Potlaç kültüründe sosyal itibarı kaybetmek ruhu kaybetmek anlamına gelmektedir. Aynı zamanda potlaç kültürünün vermek, karşılıklılık ve yeniden dağıtım gibi unsurlardan oluşmaktadır. Potlaç kültürü bir tür armağan ekonomisi olarak da adlandırılmaktadır. Esas köklerinde Amerikan Kızılderilileri’nin ritüelizminin olduğu potlaç kültüründe sosyal statü ve cömertlik her zaman birbirine özdeş olarak kabul edilmiştir. Modern yaşamda maddi ve manevi olan birbirinden ayrılırken potlaç kültüründe maddi ve manevi olan tek bir bütün halinde bulunmakta ve toplumsal yaşamın tüm alanları çağdaş yaşam açısından irrasyonel denilebilecek bir mantık tarafından belirlenmektedir. Bu çalışmada en ilkel çağlardan günümüzün küresel kapitalist dünyasına gelinen süreçte potlaç kültürünün gösterişçi tüketim anlayışının hangi biçimlere dönüştüğü ve ortaya çıkardığı farklı yansımaları anlatılmaya çalışılmaktadır.
Huff-N-Puff Gas Injection for Enhanced Condensate Recovery in Eagle Ford
Authors: Ganjdanesh Reza , Yu Wei , Fiallos Torres Mauricio Xavier , Sepehrnoori Kamy , Kerr Erich , Ambrose Raymond
Published: September 2019

As the pressure drops below dew point in an unconventional gas-condensate reservoir, the liquid drops out of gas phase and forms an oil phase in matrix and fracture. The volume of oil phase formed in the matrix mostly stays below the residual oil saturation, i.e., the oil will be trapped in matrix permanently if enhanced oil recovery techniques are not applied. The huff-n-puff process has been performed and shown the potential of improving the recovery from tight oil reservoirs. The objective of the study was to investigate the feasibility of huff-n-puff EOR in a gas condensate reservoir in Eagle Ford. The studied section of the field contains 13 horizontal producers. The wells have been producing for 4 to 8 years and the oil production rate of each well declined below 10 barrels per day.

Compositional reservoir simulation was used to predict the performance of enhanced oil recovery. A sector model was built for the area selected as the prospective candidate for gas injection. The embedded discrete fracture model (EDFM) was used for modeling the fractures. A Peng-Robinson equation-of-state model was prepared based on the early produced samples from the wells. The only available gas for injection was the produced gas from the surrounding producers. A thorough phase behavior analysis was conducted to understand the miscibility of the injected gas and the in-situ fluid.

The field production data was used to history match the sector model. The field data of the initial huff-n-puff cycles were incorporated into the history match to fine tune the model. The robust sector model was employed to forecast the performance of gas huff-n-puff in 4 infill wells for 5 years of EOR operation.
Convergent degeneration of olfactory receptor gene repertoires in marine mammals
Authors: Liu Ake , He Funan , Shen Libing , Liu Ruixiang , Wang Zhijun , Zhou Jingqi
Published: September 2019

Background: Olfactory receptors (ORs) can bind odor molecules and play a crucial role in odor sensation. Due to the frequent gains and losses of genes during evolution, the number of OR members varies greatly among different species. However, whether the extent of gene gains/losses varies between marine mammals and related terrestrial mammals has not been clarified, and the factors that might underlie these variations are unknown.
Results: To address these questions, we identified more than 10,000 members of the OR family in 23 mammals and classified them into 830 orthologous gene groups (OGGs) and 281 singletons. Significant differences occurred in the number of OR repertoires and OGGs among different species. We found that all marine mammals had fewer OR genes than their related terrestrial lineages, with the fewest OR genes found in cetaceans, which may be closely related to olfactory degradation. ORs with more gene duplications or loss events tended to be under weaker purifying selection. The average gain and loss rates of OR genes in terrestrial mammals were higher than those of mammalian gene families, while the average gain and loss rates of OR genes in marine mammals were significantly lower and much higher than those of mammalian gene families, respectively. Additionally, we failed to detect any one-to-one orthologous genes in the focal species, suggesting that OR genes are not well conserved among marine mammals.
Conclusions: Marine mammals have experienced large numbers of OR gene losses compared with their related terrestrial lineages, which may result from the frequent birth-and-death evolution under varied functional constrains. Due to their independent degeneration, OR genes present in each lineage are not well conserved among marine mammals. Our study provides a basis for future research on the olfactory receptor function in mammals from the perspective of evolutionary trajectories.
Epidemiological study of scarlet fever in Shenyang , China
Authors: Chen Huijie , Chen Ye , Sun Baijun , Wen Lihai , An Xiangdong
Published: September 2019

Background : Since 2011, the rising incidence of scarlet fever has exerted a marked influence on people. The main objective of this study was to depict the Spatiotemporal epidemiological characteristics of the incidence of scarlet fever in Shenyang, China, in 2018 so as to provide the scientific basis for effective strategies of scarlet control and prevention. Methods: Excel 2010 was used to demonstrate the temporal distribution at the month level and ArcGIS10.3 was used to demonstrate the spatial distribution at the district/county level. Moran’s autocorrelation coefficient was used to examine the spatial autocorrelation and the Getis-Ord statistic was used to determine the hot-spot areas of scarlet fever. Results: A total of 2,314 scarlet fever cases were reported in Shenyang in 2018 with an annual incidence of 31.24 per 100,000. The incidence among males was higher than that among females（ p ＜0.001). A vast majority of the cases (96.89%) were among children aged 3 to 11 years. The highest incidence was 625.34/100,000 in children aged 5-9 years. There are two seasonal peaks occurred in June (Summer-peak) and in December (Winter-peak) in 2018. The incidence of scarlet fever in urban areas was significantly higher than that in rural areas( p ＜0.001).The incidence of scarlet fever was randomly distributed in Shenyang. There are hotspot areas located in seven districts. Conclusions: Urban areas are the hot spots of scarlet fever and joint prevention and control measures between districts should be applied. Children in the kindergartens and the primary schools are the main population of scarlet fever and measures for prevention and control in kindergartens and primary schools may be the key to control the epidemic of scarlet fever.
Randomised controlled trial on vitreoretinal surgery with and without oral anticoagulants: surgical complications, visual results and perioperative thromboembolic events
Authors: Andonegui Jose , Capdevila Ferran , Zubicoa Alicia , Ibáñez Berta
Published: September 2019

Abstract Background Vitreoretinal surgery in anticoagulated patients is a challenging situation for vitreoretinal surgeons, who have to choose between being faced with the systemic thromboembolic risks that the interruption of anticoagulation involves, or the intra and postoperative haemorrhagic risks associated with maintenance of this therapy. So far, no trial has compared, in a prospective and randomized manner, perioperative complications and the visual results associated with continuation or interruption of oral anticoagulant therapy before pars plana vitrectomy under retrobulbar anaesthesia. The main objective of this trial is to compare haemostasis-related perioperative complications of PPV in patients maintaining anticoagulant therapy before surgery compared to patients who interrupt this therapy before surgery. Methods Ninety six patients will be randomly assigned to either the control group, to whom oral anticoagulant therapy will be interrupted and substituted with subcutaneous heparin according to local clinical practice, or the intervention group to whom oral anticoagulant therapy will not be interrupted before surgery. Patients will be stratified according to the oral anticoagulant they were taking (direct or indirect anticoagulation). They will be followed-up for 12 weeks, and the primary outcome, and haemorrhagic complications until 15 days after surgery, will be evaluated. Discusion This trial will provide novel information on the possibility of continuing anticoagulant therapy during PPV. The benefits expected from the change in the current surgical management paradigm for anticoagulated patients would be a decreased risk in the incidence of perioperative thromboembolic events and the possibility of performing surgery without delay and without the need for patients to change their usual anticoagulation protocol to the more complex and less safe substitutive therapy.
The Status of Job Burnout and its Influence on the Working Ability of Copper-Nickel Miners in Xinjiang, China
Authors: Sun Xuemei , Ge Hua , Zhang Li , Zhang Chen , Liu Jiwen
Published: September 2019

Background: Job burnout is increasingly common among occupational groups, and it is evolving into a new occupationally harmful phenomenon. The purpose of this study was to investigate the status of job burnout and its influence on the working ability of copper-nickel miners in Xinjiang, China, and to provide a theoretical basis for alleviating job burnout and improving the working ability of copper and nickel miners.
Methods: A cross-sectional survey was carried out in June 2017 to September 2018 in Hami City, Xinjiang Autonomous Uygur Region, China. According to the main production process stratification of copper-nickel ore (mining unit, beneficiation unit, smelting unit), a self-administered questionnaire survey on the general situation of miners was conducted on the basis of the Chinese Maslach Burnout Inventory and Work Ability Index Questionnaire among 1400 miners registered in the human resources department of copper and nickel mines by stratified cluster sampling.
Results: There were significant differences in the degree of burnout according to sex, age, education level, monthly income, and work unit (p < 0.05). The level of male burnout was higher than that of females. Miners aged 35-40 years, with a high-school education, a monthly income of less than 2500 yuan, and who belonged to the smelting unit had the highest job burnout.There were significant differences in working ability among miners with different burnout level (p < 0.01). Partial correlation analysis showed that work ability was negatively correlated with emotional exhaustion, reduced sense of achievement, and total burnout score (p < 0.001). Multinomial logistic regression analyses showed that the education level, professional title,work units and job burnout level had a pronounced impact on the working ability of miners (p < 0.001); The reduced level of education, primary title, smelting unit, and the increase in job burnout are risk factors for the reduction of working ability.
Conclusions: Our results indicate that job burnout is common among copper and nickel miners. Furthermore, working ability decreases with an increase in job burnout, and reducing job burnout can improve the working ability of copper and nickel miners.
1g versus 2g Daily Intravenous Ceftriaxone in the Treatment of Community Onset Pneumonia –a propensity score analysis of data from a Japanese multicenter registry
Authors: Hasegawa Shinya , Sada Ryuichi , Yaegashi Makito , Morimoto Konosuke , Mori Takahiro
Published: September 2019

Objectives: Community-onset pneumonia (COP) is a supplant concept of community acquired pneumonia, which includes the previous classification of healthcare-associated pneumonia. Although ceftriaxone (CRO) is one of the treatment choices for COP, it is unclear whether 1 or 2 g CRO daily has better efficacy. We compared the effectiveness of 1 g with 2 g of CRO for COP treatment. We hypothesized that 1 g CRO would show non-inferiority over 2 g CRO. Methods: This study was an analysis of prospectively registered data from four Japanese hospitals for patients with COP (the Adult Pneumonia Study Group-Japan: APSG-J). Subjects who were initially treated solely with 1 or 2 g of CRO were enrolled. The propensity score was estimated from the 33 pre-treatment variables, including age, sex, weight, pre-existing comorbidities, prescribed drugs prior to admission, risk factors for aspiration pneumonia, vital signs, laboratory data, and findings from chest xrays. The primary endpoint was the cure rate, for which a non-inferiority analysis was performed with a margin of 0.05. In addition, we performed three sensitivity analyses; using data limited to the group in which CRO solely was used until the completion of treatment, using data limited for inpatient cases, and including a generalised linear mixed-effect logistic regression analysis to assess the primary outcome after adjusting for random hospital effects. Results: Of the 3,817 adult subjects with pneumonia who were registered in the APSG-J study, 290 and 216 were initially treated solely with 1 or 2 g of CRO, respectively. Propensity score matching was used to extract 175 subjects in each group. The cure rate was 94.6% and 93.1% in the 1 and 2 g CRO groups, respectively (risk difference, 1.5%; 95% confidence interval, −3.1 to 6.0; p = 0.009 for non-inferiority). The results of the sensitivity analyses were consistent with the primary result. Conclusions: The propensity score-matched analysis of multicenter cohort data from Japan revealed that the cure rate for COP patients treated with 1 g CRO was non-inferior to that of patients treated with CRO.
Genome-wide identification, expression profiles and regulatory network of MAPK cascade gene family in barley
Authors: Cui Licao , Yang Guang , Yan Jali , Pan Yan , Nie Xiaojun
Published: September 2019

Background
Mitogen-activated protein kinase (MAPK) cascade is a conserved and universal signal transduction module in organisms. Although it has been well characterized in many plants, no systematic analysis has been conducted in barley.
Results
Here, we identified 20 MAPKs, 6 MAPKKs and 156 MAPKKKs in barley through a genome-wide search against the updated reference genome. Then, phylogenetic relationship, gene structure and conserved protein motifs organization of them were systematically analyzed and results supported the predictions. Gene duplication analysis revealed that segmental and tandem duplication events contributed to the expansion of barley MAPK cascade genes and the duplicated gene pairs were found to undergone strong purifying selection. Expression profiles of them were further investigated in different organs and under diverse abiotic stresses using the available 173 RNA-seq datasets, and then the tissue-specific and stress-responsive candidates were found. Finally, co-expression regulatory network of MAPK cascade genes was constructed by WGCNA tool, resulting in a complicated network composed of a total of 72 branches containing 46 HvMAPK cascade genes and 46 miRNAs.
Conclusion
This study provides the targets for further functional study and also contribute to better understand the MAPK cascade regulatory network in barley and beyond.
Characterization of SCCmec, spa types and Multi Drug Resistant of meticillin-resistant Staphylococcus aureus isolates among inpatients and outpatients in a referral hospital in Shiraz, Iran.
Authors: hashemizadeh zahra , hadi nahal , mohebi samane , kalantar-Neyestanaki davood , bazargani abdolla
Published: September 2019

Objectives: Molecular typing such as spa typing is used to control and prevent of Staphylococcus. aureus widespread in hospitals and community acquired. Hence, the aim of this study was to find the common types of S. aureus strains circulating in Shiraz via spa and SCCmec typing methods. Results: Total of 159 S. aureus isolates were collected from two tertiary hospitals in Shiraz. Isolates were identified by biochemical tests. Antimicrobial susceptibility tests were performed by standard disk diffusion method and then genetic analysis of bacteria was performed using SCCmec and spa typing. In this study 31.4% of the isolates were methicillin-resistant S. aureus. The majority of isolates were SSC mec type ІІІ. Spa type t030 was the most prominent type among MRSA strains. In this study, for the first time in Iran, spa003, t386, t1877, t314, t186, t1816, t304, t325, t345 were reported. It was shown that there is a possibility that these spa types are natives to this region. Our findings showed that SCCmec ІІ, ІІІ and IV disseminate from hospital to community and vice versa. Thus, effective monitoring of MRSA in hospital and community is desirable. Keyword: Staphylococcus aureus , methicillin-resistant S. aureus (MRSA), SCCmec typing, spa typing
Intentions to leave and associated factors among laboratory professionals working at Amhara National Regional State public hospitals, Ethiopia: An institution-based cross-sectional study
Authors: Dellie Endalkachew , Andargie Gashaw , Asrade Geta , Gebremedhin Tsegaye
Published: September 2019

Objective

Laboratory professionals play a vital role in the detection, diagnosis, and treatment of diseases. Knowledge of workplace variables that either motivates staff to keep working or quit their jobs is important for decision making. Thus, this study aimed to assess intentions to leave workplace and associated factors among laboratory professionals working at public hospitals of the Amhara National Regional State, Ethiopia. Results

An institution-based cross-sectional study was conducted from February 16 to March 14, 2016, among 336 randomly selected laboratory professionals. The study revealed that 65.5% (95% CI: 60-70) of the professionals had intentions to leave their hospitals. Dissatisfaction with the provision of educational opportunities (AOR: 3.59, 95% CI: 1.61-7.99), poor pays and benefits (AOR: 3.89, 95% CI: 1.53-9.89), lack of recognition (AOR: 2.69, 95% CI: 1.35-5.38), poor working environments (AOR: 2.77, 95% CI: 1.45-3.30), high workload (AOR: 1.94, 95% CI: 1.04-3.63), low affective commitment (AOR: 2.05, 95% CI: 1.10-3.82), and being unmarried (AOR:2.46, 95% CI: 1.32-4.58) were factors significantly associated with intentions to leave. Magnitude of laboratory professionals’ intention to leave was so high. Healthcare policymakers and hospital managers need to develop and institutionalize evidence-based retention strategies to reduce the intention of laboratory professionals to leave their workplace.
Analysis of Five Deep-sequenced Trio-genomes of the Peninsular Malaysia Orang Asli and North Borneo Populations
Authors: Deng Lian , Lou Haiyi , Zhang Xiaoxi , Bhooma Thiruvahindrapuram , Lu Dongsheng , Marshall Christian , Liu Chang , Xie Bo , Xu Wanxing , Wong Lai-Ping , Yew Chee-Wei , Farhang Aghakhanian , Ong Rick Twee-Hee , Hoque Mohammad Zahirul , Thuhairah Abdul Rahman , Jong Bhak , Phipps Maude E. , Scherer Stephen W. , Teo Yik-Ying , Kumar Subbiah Vijay , Hoh Boon Peng , Xu Shuhua
Published: September 2019

Background
Recent advances in genomic technologies have facilitated genome-wide investigation of human genetic variations. However, most efforts have focused on the major populations, yet trio genomes of indigenous populations from Southeast Asia have been under-investigated.
Results
We analyzed the whole-genome deep sequencing data (~30×) of five native trios from Malaysia, and discovered approximately 6.9 million single nucleotide variants (SNVs), 1.2 million small insertions and deletions (indels), and 9,000 copy number variants (CNVs) in the 15 samples. We found 2.7% SNVs, 2.3% indels and 22% CNVs were novel, implying the insufficient coverage of population diversity in existing databases. We identified a higher proportion of novel variants in the Orang Asli (OA) samples, i.e., the indigenous people from Peninsular Malaysia, than that of the North Bornean (NB) samples, likely due to more complex demographic history and long-time isolation of the OA groups. We used the pedigree information to identify autosomal de novo variants and estimated the mutation rates to be 0.81×10-8–1.33×10-8 , 1.0×10-9–2.9×10-9, and ~0.001 per site per generation for SNVs, indels, and CNVs, respectively. The trio-genomes also allowed for accurate haplotype phasing with high accuracy, which serves as references to the future genomic studies of OA and NB populations. In addition, high-frequency inherited CNVs specific to OA or NB were identified. One example was a 50-kb duplication in DEFA1B detected only in the Negrito trios, implying plausible effects on host defense against the exposure of diverse microbial in tropical rainforest environment of these hunter-gatherers. The CNVs shared between OA and NB groups were much fewer than those specific to each group. Nevertheless, we identified a 142-kb duplication in AMY1A in all the 15 samples, and this gene is associated with the high-starch diet. Moreover, novel insertions shared with archaic hominids were identified in our samples.
Conclusion
Our study presents a full catalogue of the genome variants of the native Malaysian populations, which is a complement of the genome diversity in Southeast Asians. It implies specific population history of the native inhabitants, and demonstrated the necessity of more genome sequencing efforts on the multi-ethnic native groups of Malaysia and Southeast Asia.
Trends in maternal use of snus and smoking tobacco in pregnancy. A register study in Southern Norway
Authors: Rygh Ellen , Gallefoss Frode , Grøtvedt Liv
Published: September 2019

Background
The use of tobacco products including Swedish snus (moist snuff) in pregnancy may cause adverse health outcomes. While smoking prevalence has decreased among fertile women in Norway, snus use has increased during the last years. We investigated whether these trends were reflected also during pregnancy in a population of women in Southern Norway.
Methods
Data on smoking tobacco and snus use at three time points before and during pregnancy for 20 844 women were retrieved from the electronic birth record for the years 2012-2017. The results for the three-year period 2015-2017 were compared with a previously studied period 2012-2014. Prevalence and quit rates of tobacco use within groups of age, parity and education were reported. Within the same groups adjusted quit rates were analyzed using logistic regression. Mean birthweight and Apgar score of offspring were calculated for tobacco-users and non-users.
Results
There was an increase of snus use before pregnancy from the period 2012-2014 to the period 2015-2017 from 5.1% (CI; 4.6 to 5.5) to 8.4% (CI; 7.8 to 8.9). Despite this, the use of snus during pregnancy did not increase from the first to the second period, but stabilized at 2.8% (CI; 2.5 to 3.2) in first trimester and 2.0% (CI; 1.7 to 2.2) in third trimester. Cigarette smoking decreased significantly both before and during pregnancy. Snus use and smoking during pregnancy were associated with a reduction in average birthweight, but no significant effects on Apgar scores. Odds ratios for quitting both snus and smoking tobacco during pregnancy were higher for women aged 25-34 years, for the primiparas and for those with a high level of education. Pregnant women were more likely to have quit tobacco use in the last time period compared to the first.

Conclusions
While smoking during pregnancy was decreasing, the use of snus remained constant, levelling off to around 3% in first trimester and 2% in third trimester. Approximately 25% of those that used snus, and 40% that smoked before pregnancy, continued use to the third trimester. This calls for a continuous watch on the use of snus and other nicotine products during pregnancy.
Association of PD-1 polymorphisms with the risk and prognosis of lung adenocarcinoma in the northeastern Chinese Han population
Authors: huang Kun , Hu Erqiang , Li Wan , Lv Junjie , He Yuehan , Deng Gui , Xiao Jinling , Yang Chengcheng , Zhao Xinyu , Chen Lina , Wang Xinyan
Published: September 2019

Introduction Lung cancer is a leading cause of death from cancer worldwide, especially non-small cell lung cancer (NSCLC). The marker of progression in lung adenocarcinoma has been rarely studied. PD-1 is an effective drug target for the treatment of non-small cell lung cancer. The study of the effect of polymorphism on the progression of lung adenocarcinoma in the Han population of Northeast China may provide a valuable reference for the research and application of these drugs. Methods Chi-square test, Wilcoxon rank sum test, and classification efficacy assessment were used to teste SNPs of PD-1 in 287 patients and combined with clinical information. Results We successfully identified biomarkers (rs2227981, rs2227982, and rs3608432) that could distinguish the early stages and late stages of lung adenocarcinoma. Multiple clinical indicators showed significant differences among different SNP typing and cancer stages. Furthermore, this gene was confirmed to effectively distinguish the staging of lung adenocarcinoma with RNA-seq data in TCGA. Conclusions This indicated that the PD-1 gene and the SNPs on it could be used as markers for distinguishing lung adenocarcinoma staging in the Northeast Han population.
Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure
Authors: Ambreen Atiqa , Jamil Muhammad , Rahman Muhammad Aqeelur , Mustafa Tehmina
Published: September 2019

Background

Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it.

Methods

New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured.

Results

Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase.

Conclusion

Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.
Potential for non-combustible nicotine products to reduce socioeconomic inequalities in smoking: a systematic review and synthesis of best available evidence
Authors: Lucherini Mark , Smith Katherine , Hill Sarah
Published: September 2019

Background: While some experts have emphasised the potential for e-cigarettes to facilitate cessation among smokers with low socioeconomic status (SES), there is limited evidence of their likely equity impact . We assessed the potential for electronic cigarettes and other non-combustible nicotine-containing products (NCNPs) to reduce inequalities in smoking by systematically reviewing evidence on their use by SES in countries at stage IV of the cigarette epidemic.
Methods: Ten electronic databases were searched in February 2017 using terms relating to e-cigarettes, smokeless tobacco and nicotine replacement therapy (NRT); and SES. We included studies published since 1980 that were available in English and examined product use by SES indicators such as income and education. Data synthesis was based on those studies judged to be of medium- to high-quality using guidelines adapted from the Critical Appraisal Skills Programme.
Results: We identified 54 studies describing NCNP use by SES across 12 countries, of which 27 were judged of sufficient quality to include in data synthesis. We found mixed patterns of e-cigarette current use by SES, with evidence of higher use among low-income adults but unclear or mixed findings by education and occupation. In contrast, smokeless tobacco current use was consistently higher among low SES adults. There was very limited evidence on the SES distribution of NRT in adults and of all NCNPs in young people.
Conclusions: The only NCNP for which there are clear patterns of use by SES is smokeless tobacco, where prevalence is higher among low SES groups. While this suggests a potentially positive impact on inequalities in smoking (if NCNP use displaces smoked tobacco use), this has not been seen in practice. These findings do not support the suggestion that e-cigarettes have the potential to reduce social inequalities in smoking, since i) current evidence does not show a clear trend of higher e-cigarette use in population groups with higher tobacco consumption, and ii) the experience of smokeless tobacco suggests that – even where NCNP use is higher among low SES groups – this does not necessarily replace smoked tobacco use in these groups.
Relevance and usefulness of head CT-scan requests in the management of adult headaches: A cross-sectional study in two referral hospitals in Cameroon
Authors: Mbede Maggy , Tegueu Callixte Kuate , Kengne Ulrich Igor Mbessoh , Zogo Pierre Ongolo , Moifo Boniface
Published: September 2019

Background: In developing sub-Saharan Africa countries such as Cameroon, the head CT-scan, which is more available and accessible than magnetic resonance imaging, gold standard, exposes to a high irradiation dose level and is still expensive. In those countries, head CT-scan has become a routine exploration in patients with headache. In front of this inflation, it is necessary to assess CT-scan requests and their profitability in the patient management. Objective: To assess the relevance and the usefulness of head computerized tomography scanner (CT-scan) requests in the management of adult headache in two referral teaching hospitals of Cameroon, in order to improve their appropriateness. Methods: This was a prospective cross-sectional study conducted in medical imaging units of the Central Hospital of Yaounde and the Laquintinie Hospital of Douala on five months period. We confronted indication mentioned on head CT-scan requests to the recommendation grades and indication’s mentions of the referral imaging guidelines of the French Society of Radiology in order to assess the relevance on the one hand. We also confronted head CT-scan results to the expectations of the requesting physicians in order to assess the usefulness on the other hand. Data analysis: Non-parametric statistical analysis. Results: During the study period, 169 examinations requests for headaches were collected. Symptom was the main clinical data mentioned on CT-scan requests (60.4%), followed by the suspected clinical diagnosis (40.2%). Requesting physicians were general practitioners (50.3%), followed by neurologists in 14.2%. Overall, 92.3% of requests were judged appropriate while 2.4% were non-indicated. The general practitioner’s requests were non-indicated in 75% of the cases. Inappropriate requests multiplied by two the risk of having no significant abnormality on the head CT-scan. Of all the head CT-scan requests, 73.2% were useful and 100% of relevant CT-scans were also useful. 45.5% of useless head CT-scans were requested by a general practitioner. Conclusion: Physicians need to follow the guidelines and justify the use of head CT-scans in patients suffering from headache in order to improve the relevance and usefulness of head CT-scans requests.
Combination of isoflurane and propofol, a means for general anesthesia in the surgery of perioperative cerebral hypoperfusion rats to avoid cognitive impairment
Authors: Bu Xinyue , Li Tang , Wang Haiyun , Xia Zhengyuan , Guo Di , Wang Jinxin , Sun Yi , Yang Chenyi , Liu Guoqiang , Ma Ji , Yang Zhuo , Wang Guolin
Published: September 2019

Background: Perioperative cerebral hypoperfusion often occurs. However, the underlying mechanism and targeted interventions remain mostly to be determined. Anesthetic isoflurane induces neuronal injury via endoplasmic reticulum (ER) stress, whereas sub-anesthetic dose of propofol improves postoperative cognitive function. However, the effects of the combination of isoflurane plus propofol, which is a common combination of anesthesia for patient, on ER stress and the associated cognitive function remain unknown.

Methods: We therefore set out to determine the effects of isoflurane plus propofol on the ER stress and cognitive function in the rats insulted by cerebral hypoperfusion. The rats received isoflurane alone (1.9%), propofol alone (40 mg·kg -1 ·h -1 ) or a combination of isoflurane and propofol (1% and 20 mg·kg -1 ·h -1 or 1.4% and 10 mg·kg -1 ·h -1 ). Behavior studies (Fear Conditioning test) and biochemical analyses (Nissl staining and western blotting for the harvested rat brain tissues) were employed in the studies.

Results: We found that the combination of 1% isoflurane plus 20 mg·kg -1 ·h -1 propofol attenuated the cerebral hypoperfusion-induced cognitive impairment and the ER stress.

Conclusions: These data suggest that ER stress contributes to the underlying mechanism of cognitive impairment and the combination of isoflurane and propofol was able to preserve cognitive function in the rats after cerebral hypoperfusion via prevention of ER stress. These findings have established a system to study the strategy in preventing and treating perioperative cerebral hypoperfusion, leading to promotion of the future larger scale studies.