bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of the outcomes of potent topical steroids versus topical tretinoin in patchy alopecia areata of scalp
Authors: Hussain Asma Arif
Published: December 2019

Background: Alopecia areata (AA) is a common condition causing patchy alopecia of scalp. It can follow an unpredictable course with spontaneous exacerbations and remissions. Various therapeutic options have been tried to alleviate the cosmetic concern of the patient. The objective of this study is to compare the efficacy and safety of potent topical steroid versus topical 0.05% tretinoin in limited patchy alopecia areata of scalp.

Methods: In this study 50 patients of age group above 5 years and of both sexes having localized alopecia areata of scalp (<5 patches and <25% scalp involvement) were included in the study after taking an informed consent. It was a randomized prospective study done for a period of 12 weeks. Excluding the age and sex bias, patients were distributed into two treatment groups A and B.  Group A was treated with 0.05% betamethasone dipropionate (BMD) cream applied twice daily. Group B was treated with topical 0.05% tretinoin cream applied twice daily. The response was assessed in every patient subjectively as well as objectively by alopecia grading scale and regrowth score (RGS) at the end of 12 weeks.

Results: We found that 72% of patients in Group A showed statistically significant clinical improvement (RGS 3 and 4) when compared to 36% patients in Group B.

Conclusions: It can be concluded that 0.05% BMD is still the most effective and economical topical treatment in less extensive forms of AA. However topical 0.05% tretinoin also gives a fairly  good response. But further studies with tretinoin are needed to establish its role in limited alopecia areata.
Borderline tuberculoid hansens with type 1 reaction in a HIV patient: an IRIS phenomenon over an unusual site
Authors: Rao Chitralekhya , Anchala Parthasaradhi
Published: December 2019

Immune reconstitution inflammatory syndrome (IRIS) is an acute symptomatic expression of a latent infection during the recovery of the immune system and it occurs as a response to antiretroviral therapy. Opportunistic infections can act as a trigger for IRIS. Hansens disease is an infection caused by Mycobacterium leprae. There are very few case reports reporting the development of borderline tuberculoid hansens with type 1 reaction as IRIS. We here report a unique case of IRIS in a HIV patient who presented with borderline tuberculoid leprosy with type 1 lepra reaction presenting over unusual site following highly active antiretroviral therapy administration.
And the truth comes limping after
Authors: Berentson-Shaw Jess
Published: December 2019

Keynote Address for ANZEA Conference, July 2018, Wellington
Flight of Leaves: Creation of Worldly Space
Authors: Kim Bo Sun
Published: December 2019

This case study presents (1) children’s learning as continual engagement with phenomena and people, and (2) learners and the world as entangled becomings. In particular, the flight of leaves experiment shows the process of how thoughts were created through encounters and relations; how the children became-with drawings, experiments, each other, and material realities; and how the teacher and the researcher responded to and became entangled in a pedagogical relationship with children and material realities.
Entanglements with Reggio in Northern Ontario, Canada
Authors: Kelly Julie , Edwards Sophie Anne , Speir Sharon
Published: December 2019

In the fall and spring, water beckons to us to “jump the fence” and follow the pathways created by seasonal water changes within the watershed. Inspired by Reggio Children’s Dialogues with Places and their pedagogies of listening and relationality, we wonder how paying attention to water might open a different, imaginative space as we question our ongoing colonial relationships with land and water intended to keep water at a distance. Through photos and artwork, we make visible some of the dialogic and empathetic relationships between children and water while making the case that these Reggio principles are relevant to our engagements with children and place.
Authentic Family Learning: Reconceptualizing Intergenerational Education Initiatives in Jamaica and England Through Cross-Cultural Conversation
Authors: Hardacre Charlotte , Kinkead-Clark Zoyah
Published: December 2019

This paper shares a set of cross-cultural conversations between two family learning practitioner-researchers, one from Jamaica and one from England. Our concern that global education policies reflect and reproduce a social investment perspective, positioning family learning as a way to generate productive citizens, drives this paper. Using Charlotte Hardacre’s authentic family learning as a conceptual framework, we reexamine ourongoing work with families. An analysis of these cross-cultural conversations reveals that along with valuing the existing agency and identity of participants, there is also a need to balance the role of power enacted by practitioners; ultimately reconceptualizing power as a positive force that does not require inversion, minimization, or removal.
Improvement on Flexural Performance of UHPFRC with Hybrid Steel Fiber
Authors: YAVAŞ Altuğ , BİROL Tamer , TÜRKER Kaan , HASGÜL Umut , YAZICI Halit
Published: December 2019

This study investigates the flexural behavior of Ultra-High Performance Fiber Reinforced Concrete (UHPFRC) with hybrid steel fiber referencing the ASTM standard C 1609. Two types of end-hooked fibers in macro fiber concretes and one type short straight fiber in micro fiber concretes were used in mono and hybrid forms. In order to determine the flexural response of UHPFRC, a series of prismatic beam specimens with a dimension of 100 x 100 x 400 mm were tested under the four-point loading and following parameters were compared and discussed in terms of the first cracking load and pattern, flexural strength, deflection capacity, toughness and residual strength capacity under bending loads. The test results showed that as the fiber amount of specimens with the mono fiber increases, in general, better flexural behavior may be ensured. It should be also noted that the hybrid use enhanced the flexural behavior compared to the macro fiber usage.
Determinants of Preparing Healthy Breakfast and Snacks for School Children by Mothers
Authors: Rakhshanderou Sakineh , Gaffari Mohtashame , Pooresmaeildorosteh Ameneh
Published: December 2019

Background: An unhealthy breakfast and the consumption of low-value meals among students are associated with adverse health consequences and chronic diseases in adulthood. The main purpose of this study was to identify the determinants of preparing healthy breakfast and snacks for school children by mothers in the city of Islamshahr.
Methods: 320 boys and girls were selected by cluster random sampling and their mothers were invited to participate in the study. Data were collected using the researcher-made questionnaire that included demographic characteristics, questions were related to knowledge, attitude, perceived benefits, perceived barriers and behavior. The reliability was assessed through the test-retest method, and in order to assess internal consistency, Chronbach’s alpha coefficient was used. Data were analyzed by SPSS 16 software, and Descriptive statistics (Percent & Frequency), Multiple regression and Kendall’s tau-b correlation tests were used.
Results: Based on the findings of this study, none of the demographic characteristics had a significant correlation with the behavior of the mother's healthy breakfast and meal (p>0.05) and among variables, knowledge (p<0.001, B=0.40) and perceived barriers (p<0.001, B=0.33) were strong and positive predictors of preparing breakfast and healthy snacks by mothers. Knowledge and perceived barriers predict %28 of variance in mothers’ behavior in preparing breakfast and healthy snacks (p<0.001, R= 0.527, R2=0.278).
Conclusion: It is better to put more emphasis on the strategies to promote the knowledge of mothers and reduce their perceived barriers in designing nutritional interventions aiming to prepare breakfast and healthy snacks for children.
Validation of Groningen Reflection Ability Scale Questionnaire and Evaluation of Reflection Ability Level of Health Care Management Students
Authors: Rostami Amirsobhan , Keshmiri Fatemeh , Askari Roohollah , Jambarsang Sara , Shafiei Milad
Published: December 2019

Background: Reflection has been extensively used in different areas for better thinking about previous experiences and reaching to new behaviors, which leads to an improvement in personal skills and knowledge. Reflection ability is one of the most essential competencies for healthcare professionals and medical students, which is emphasized in several medical courses and references. This ability is improved with practice and repetition. Therefore, reflection in medical education is very important. Thus the aim of the present study was evaluation of reliability and validity of the tool for assessing this skill and determination of reflection ability level of health care management students.
Methods: The present descriptive and cross-sectional research, performed in two phases. The study population were 30 students of health care management. In the first phase, after the translation of the questionnaire, the reliability and validity of the questionnaire was determined. In the second phase and for evaluation of reflection ability level in health care management students, the Groningen Reflection Ability Scale questionnaire was completed by students and data analyzed with independent t-test and Pearson correlation statistical tests.
Results: The reliability and validity of the questionnaire were confirmed (Cronbach's alpha = 0.73). The reflection ability score of students was 82.13 ± 4.24. After a statistical analysis of data among genders, although the reflection scores of males (83.58 ± 4.37) were higher than females (81.17 ± 3.97), but this difference was not statistically significant (P-value ≥ 0.05). Also, the difference between demographic variables and reflection ability scores was not statistically significant (P-value ≥ 0.05).
Conclusion: This study showed that the GRAS questionnaire is a useful tool for assessing the reflection ability and students have medium scores of reflection ability so educational managers should pay serious attention in planning related fields.
The impact of corporate social responsibility on community development: Evidence from Ghana
Authors: Celik Adnan , Abdul-Kareem Aleem , Ulukapi Yilmaz Hande
Published: December 2019

Corporate bodies have come to the realisation that establishing a strong rapport with surrounding communities is vital for the growth, success and survival of their organisations. This article delves into Corporate Social Responsibility (CSR) activities of business organisations operating in Ghana. Specifically, it looks at how CSR initiatives of sampled companies contribute to community development (CD). To attain this aim, both quantitative and qualitative research approaches were adopted. The purposive sampling technique was used to select companies operating in three main sectors of the economy. Secondary data sources such as companiesâ€™ periodicals, annual reports, websites, newspapers and publications by government agencies were used. The findings of the study reveal that the selected companies engaged in various forms of CSR activities that contribute to CD. There general focus of these companies is on education, health and people empowerment. It is recommended that stakeholdersâ€™ engagement needs to be fully practised in the course of CSR implementation.

Keywords: Community, community development, corporate social responsibility.
Organizational structure, environment and management innovation
Authors: Glod Wojciech
Published: December 2019

Increasing health care marketisation may be, in broader sense, perceived as a mechanism providing the foundation for seeking new ways to rationalise operations in this area. These efforts aim to increase the efficiency of the health care sector, to better adjust health care services to social needs and to improve the management of scarce resources. The core of the process is treating a health care organisation as a partner for other actors and examining its strategic partners. The study aims to present the relationships among the characteristics of the environment, organisational structure and innovation management.

Keywords: Health care, Poland, organisational structure, environment, management innovation.
Regeneration of the protected area of Lake Shkodra for sustainable tourism development
Authors: Dibra Mirjam , Baraku Sead
Published: December 2019

Nowadays, sustainable tourism development is a necessity for all countries that appeal for tourism. The local community is considered to be an important factor in supporting tourism development. Shkodra Lake, the largest lake on the Balkan Peninsula, is a very important protected area with great potentials for tourism development. The purpose of this study is to address the need for the regeneration of this area for sustainable tourism development. The survey was used as a quantitative research method. The questionnaire to the local community of Zogaj village was used as a research tool. The research results showed the community's attitudes about touristic values of Zogaj village and the importance of their use for sustainable tourism development, about the situation and the prospect for the regeneration of Zogaj village for STD. The findings of this research will help tourism planners and decision-makers to sustainable use of local resource of this area for the successful tourism development today and future.

Keywords: Sustainable tourism, local community, Shkodra Lake, Albania.
Selecting an SPA (special program in the arts) major for high school students using AHP combined with interest inventory
Authors: Lusdoc Charlotte S. , Namoco Rhoda A.
Published: December 2019

The Special Program in the Arts (SPA) is a program by the Department of Education (DepEd) for high school students with potential or talents in the arts, namely, music, visual arts, theater arts, media arts, creative writing and dance. Students enrolled in SPA-identified schools are required to take specialised 2-hour classes daily on their specific majors beginning on their first year as part of their curriculum. The Magallanes National High School (MNHS) in Agusan del Norte is one of the DepEd schools offering in the Philippines. Unfortunately, it is observed that every year, some students are changing SPA majors on their second or third year which causes a problem to the school in arranging their back subjects. Some of the common reasons for shifting include late realisation of interest, career opportunity and expenses. In this study, an interest inventory is conducted among SPA students of MNHS to determine their major inclination. The analytical hierarchy process is then used to compare their different criteria for choosing SPA majors such as late realisation of interest, career opportunity and financial consideration. The results of the study show that most of the students shift to another specialisation due to the late realisation of their field of interest. Evaluation of the students using the proposed method shows that 77% of the students evaluated coincide with the major they are currently taking. Hence, the proposed method may be used to provide assistance to incoming first-year high school students in deciding what SPA major to take to avoid shifting of majors after their first year in high school.

Keywords: Arts, special program, SPA, Magallanes National High School.
ISTRI SEBAGAI PENCARI NAFKAH UTAMA PERSPEKTIF URF DAN AKULTURASI BUDAYA REDFIELD
Authors: Kurniansyah Ahmad Agung
Published: December 2019

Fenomena ini umumnya terjadi pada umat Hindu Sudra-kasta. Kebanyakan orang di desa Tegalinggah adalah kasta Sudra. Kedatangan Islam di Desa Tegalinggah, Mundukkunci, RW Sani Sari dimulai dengan kedatangan Muslim Bugis yang bermigrasi dan tinggal di Bali. Dalam kehidupan sehari-hari mereka, orang Bugis dibimbing oleh ajaran Islam. Karena ada kontak langsung antara budaya Islam dan budaya lokal melalui transaksi perdagangan, pernikahan dan lainnya, sehingga ada akulturasi antara kedua budaya tersebut. Fenomena ini menyebabkan istri menjalankan nafkah utama sebagai pasangan Muslim. Penelitian ini bertujuan untuk mengetahui latar belakang munculnya istri sebagai pencari nafkah utama di Mundukkunci, RW Sani Sari, Singaraja Bali juga untuk mengetahui status istri sebagai pencari nafkah utama dalam perspektif akulturasi budaya oleh Redfield. Ini adalah penelitian lapangan dalam bentuk studi kasus. Data yang digunakan adalah data primer yang peneliti peroleh dari wawancara dan dokumentasi, kemudian data dianalisis menggunakan teori akulturasi budaya Redfield, untuk mengecek keabsahan data peneliti menggunakan metode triangulasi data. Hasil penelitian menunjukkan bahwa: 1. ada tiga faktor yang menjadi latar belakang munculnya fenomena istri sebagai pencari nafkah utama di RW Sani Sari, Desa Mundukkunci, Kabupaten Singaraja, dan Provinsi Bali. pertama, faktor ketidakmampuan suami untuk memenuhi kebutuhan keluarga. Kedua, karena kurangnya pendapatan suami dalam memenuhi kebutuhan rumah tangga. Ketiga, karena faktor tradisi. 2. Dalam hal Urf, fenomena istri sebagai pencari nafkah utama dibagi dua. Pertama, Urf Shohih. Kedua, Urf Fasid. Ada tiga bentuk akulturasi budaya dalam penelitian ini. Pertama: asal mula, asal mula dapat dilihat dalam hak-hak warisan yang diperoleh oleh wanita Hindu ketika mereka masuk Islam sebagai implikasi dari hak kolektif antara suami dan istri. Kedua, sinkretisme dapat dilihat dari kolaborasi dan tanggung jawab bersama antara suami dan istri untuk memenuhi kebutuhan keluarga. Ketiga, penolakan dalam kasus ini terjadi ketika istri sebagai pencari nafkah utama diganti dengan istri sebagai asisten suami atau bekerja sama dengan suaminya dalam memenuhi kebutuhan rumah tangga.
Kata kunci: istri, pencari nafkah utama, akulturasi budaya
PEREMPUAN DALAM NOVEL KHADIJAH: KETIKA RAHASIA MIM TESINGKAP KARYA SIBEL ERASLAN (ANALISIS GENDER DAN AGENSI PEREMPUAN)
Authors: Agustin Eka Francisca Fitri , Putri Endrika Widdia
Published: December 2019

Artikel ini menjelaskan tentang kontruksi gender yang terdapat dalam novel Khadijah: Ketika Rahasia Mim Tersingkap karya Sibel Eraslan. Di dalam novel tersebut digambarkan tentang kontruksi gender pada zaman Jahiliyyah yang melekat dan memberatkan wanita. Berkebalikan dengan laki-laki, wanita dalam novel tersebut digambarkan sebagai sosok yang terdiskriminasi. Namun, dalam keadaan tersebut Khadijah hadir sebagai sosok agen perubahan yang memberikan warna baru dan kehidupan yang lebih baik serta berkebasan bagi wanita. Maka, secara lebih spesifik artikel ini akan menjelaskan bagaimana bentuk diskriminasi terhadap wanita yang digambarkan dalam novel tersebut, dan apa akar permasalahannya, serta bagaimana Khadijah sebagai agensi perempuan yang digambarkan dalam novel tersebut, yang dianalisis menggunakan perspektif gender dan teori agensi perempuan. Adapun hasil dari artikel ini yaitu terdapat 4 (empat) diskriminasi terhadap wanita: pertama, laki-laki superior wanita inferior: bentuk diskriminasi gender ‘subordinasi’ dan akar permasalahannya ‘sistem kelas’. Kedua, perempuan budak: bentuk diskriminasi ‘gender kekerasan’ dan akar permasalahannya ‘kultur budaya dan ideology patriakal’. Ketiga dan keempat, kebebasan berpendapat hanya milik laki-laki dan perempuan lemah laki-laki kuat: bentuk diskriminasi gender ‘stereotipe’ dan akar permasalahannya ‘budaya dan ideologi patriakal’. Adapun Khadijah sebagai agent of change– Khadijah hadir sebagai perempuan yang berpikiran maju dan memposisikan diri sebagai perempuan yang berkedudukan tinggi di masyarakat sehingga perlahan-lahan ia mampu mematahkan ideologi patriakal yang berkembang.

Kata Kunci: kontruksi gender, novel Khadijah: ketika rahasia Mim tersingkap, perpekstif gender dan agensi perempuan
Adaptation of the Multidimensional Pain Evaluation Scale: A Cross-Cultural Study
Authors: Raminelli da Silva Talita de Cassia , Saltareli Simone , Falconi Gomez Rodrigo Ramon , Chiang-Hanisko Lenny , Faleiros Sousa Fatima Aparecida
Published: December 2019

Background and Purpose

Instruments to measure pain must be cross-culturally adapted through rigorous processes, so they can provide equivalence of measure regardless of the context in which they are applied. The study aim was to perform a cross-cultural adaptation of Multidimensional Pain Evaluation Scale (MPES) for use in the United States.

Methods

Cross-cultural adaptation study entailed translation, back translation, and review by a committee, face and content validity and pilot testing with 90 participants with acute or chronic pain from United States. The Cronbach's alpha coefficient was calculated.

Results

Some items of MPES was changed to maintain the highest level of similarity between the original scales in Portuguese and adapted to English.

Conclusion

The Cronbach's alpha was high showed this scale has internal consistency and reliability.
Oral Misoprostol Versus Vaginal Prostaglandin E2 Labor Induction Efficiency, Safety, and Labor Outcomes
Authors: Alkasseh Areefa S. M. , El-Jazzaranal Muyassar , Abu Khadijah Doaa , Al-Derbaly Fatma , Al-Nemnum Reem , Yaseen Ragaa
Published: December 2019

BACKGROUND

Prostaglandin E1 (oral misoprostol) and the other Prostaglandin E2 (Dinoprostone gel) are promising agents for cervical ripening and induction of labor.

AIMS OF STUDY

To compare the efficiency and safety on maternal-fetal outcomes using 25 micrograms oral misoprostol PGE1 with 50 micrograms of intra-vaginal PGE2 for induction of labor.

METHODS

This was a retrospective study design reviewing medical records of induced labor at Al Shifa hospital in Gaza Strip.

RESULTS

In general, the results showed that women who used oral misoprostol with an age less than 30 years and parity less than 3 was effective for delivery and safe outcomes with an odds ratio (OR) of 15.8 (CI 6.9–39.8) and OR 29.2 (CI 10.7–80.3) respectively. The most common indication for labor induction in both methods was reputure of the membrane (ROM) more than 24 hours, postdates, and a medical disorder. However, the total interval hours for both methods was 8.4 hours. The mode of delivery was similar in both groups as vaginal delivery outcome was 73.6% for oral misoprostol E1 and 75% for prostaglandin E2 cases. However, PGE2 induction showed a higher cesarean delivery 25% rate versus 18.4%. Clinically the use of oral misoprostol showed a higher percentage of birth canal injury, failed induction, uterine rupture by 9.3%, 8%, 1.3% respectively. Fetal distress was found as the most common fetal complication and the most common cause for cesarean section.

CONCLUSION

The study recommended more research is needed as present evidence does not support use of oral misoprostol versus Prostaglandin E2.
CONTENT COMPREHENSION AND RETENTION OF VISUAL DETAILS: A COMPARATIVE EXPERIMENTAL ANALYSIS OF SUBTITLING AND DUBBING AS TWO MAIN MODES OF AUDIO-VISUAL TRANSLATION
Authors: Кавгић Александар Петар
Published: December 2019

The canonized view of subtitling and dubbing assumes that they differ in relation to the viewer’s experience of cinematic illusion. There is however very little empirical evidence that subtitled videos are detrimental in this respect. This pilot empirical research was devised to create and test the methodology which can fill this empirical gap in audio-visual translation (AVT). The experiment involved 68 volunteers divided into two groups watching 3-minute video clips. One group watched a video dubbed in Serbian, another subtitled in Serbian with Arabic audio, and, finally, a poorly subtitled video in Serbian with Arabic audio. The other group watched the same videos, but they were subtitled in Serbian with Arabic audio, dubbed in Serbian, and accurately subtitled in Serbian with Arabic audio, respectively. The participants were then quizzed to assess content comprehension of the text featured in dubs and/or subtitles, and for retention of visual details. The results seem to indicate that the methodology provides valuable insights into the problem, that the canonized views on differences between subtitling and dubbing are inaccurate, and that good subtitling has a positive effect on both content comprehension and on attention to visual details, thus improving the overall viewing experience.
The cosiness of in-betweenness in the works of Ottó Tolnai
Authors: Novak Aniko
Published: December 2019

A köztesség, a hibriditás, a heterogenitás Tolnai Ottó művészetének meghatározó kategóriái. A köztesség otthonossága a kezdetektől jellemző a szerző műveire műfaji és tematikus szinten egyaránt. Jelen tanulmány célja a köztes terek, identitások és határátlépések vizsgálata Tolnai Ottó 2018-ban megjelent Szeméremékszerek című regényében elsősorban Michel Foucault, Marc Augé, Andrei Pleşu és Gérard Genette vonatkozó elméleti munkái alapján. A kiválasztott mű több szempontból is kapcsolódik a köztesség képzetköréhez. Cselekménye a határzónában játszódik, de emellett az elbeszélői hangnak, identitásnak is jellemzője a köztesség. Az elbeszélő Seherezádéként mesél, kihallgatói szerint mellébeszél, e létállapot is köztes. A kihallgatásból pedig az derül ki, hogy a Tolnai-szöveguniverzum nem kényszeríthető bele előre meghatározott kategóriákba, rendszerekbe, hiszen azoknak mindig ellenáll, folyton kimozdul, egyfajta köztes állapotban létezik.
NEODREĐENA ZAMENICA ONE U PISANJU KOD NEIZVORNIH GOVORNIKA ENGLESKOG JEZIKA
Authors: Radić-Bojanić Biljana B.
Published: December 2019

Neizvorni govornici engleskog jezika u svojim esejima mešaju formalno, neutralno i neformalno izražavanje, te se istraživanje u ovom radu fokusira na ovo mešanje stilova kroz posmatranje i analizu neodređene zamenice one u studentskim esejima pisanim na engleskom jeziku kao stranom. Analizom korpusa od 325 eseja sakuplјenih u četiri univerzitetska centra (Istočno Sarajevo, Banja Luka, Beograd i Novi Sad) došlo se do podatka da se ova neodređena zamenica koristi u 35% eseja, u kojima se javlјa oko 300 puta. S obzirom na to da je neodređena zamenica one jedan od nekoliko mogućih eksponenata ličnog metadiskursa u tekstu, u radu će se posmatrati i učestalost drugih zamenica (I, me, you, we) kako kvantitativno tako i kvalitativno, da bi se potvrdila ili opovrgla hipoteza da u studentskim esejima pisanim na engleskom jeziku kao stranom dolazi do mešanja izrazito formalnog stila (upotreba neodređene zamenice one) i neutralnog i neformalnog stila (upotreba ličnih zamenica), što je, kako se pretpostavlјa, rezultat uticaja nastave u kojoj se naglašava impersonalnost, odsustvo ličnog pečata u pisanju na engleskom jeziku kao stranom.
СИСТЕМИ ПОДРШКЕ СТУДЕНТИМА У УСТАНОВАМА ВИСОКОГ ОБРАЗОВАЊА
Authors: Клеменовић Јасмина У. , Миленковић Павле
Published: December 2019

У раду су представљени савремени системи подршке студентима, широко прихваћени међу чланицама Европског простора високог образовања. Њихова намена је унапређивање квалитета образовања на принципима недискриминације и једнаких права за све кроз механизме приступа високом образовању, оптимализације дужине студирања и повећавање шанси за запослење након дипломирања. Приказани су различити модели организовања социјалне инфраструктуре високошколских установа са циљем веће ефикасности и квалитета високог образовања. Представљен је почетак модернизације система подршке на универзитетским центрима у Србији као и успостављање мреже сервиса подршке студентима Универзитета у Новом Саду, с посебним освртом на Центар за подршку студентима Филозофског факултета. Реч је о сервису психолошко-педагошке подршке студентима који у сарадњи са другим центрима, организацијама и удружењима успоставља програме за студенте различитих нивоа студија и из мање заступљених група. Активности Центра представљене су како би се стручна и шира јавност информисала и подстакла на укључивање заинтересованих сарадника и волонтера у даљи развој програма подршке студентима Универзитета у Новом Саду.
School v. Schools: Is Italy Shying Away From Italy? Understanding Government and Institutional Practices in Italy From Within an Educational Framework
Authors: Cantillo Raffaella
Published: December 2019

This article analyses the Italian school system vis-à-vis other European systems from an objective perspective; the paper seeks to do this by elucidating some of its opaque aspects. It engages with an idea of cultural identity and what can be identified as the most obvious threats posed to it; Italy’s Gestalt at present is coterminous with that of the extant European educational framework, which formerly Italians themselves worked hard to bring about. Hence, raising awareness as to the modality that our country’s laws and agreements impact all aspects of our society becomes a main educational concern in this field of study.
A population-based cohort study of mortality of intensive care unit patients with liver cirrhosis
Authors: Huang Yu-Feng , Lin Chao-Shun , Cherng Yih-Giun , Yeh Chun-Chieh , Chen Ray-Jade , Chen Ta-Liang , Liao Chien-Chang
Published: December 2019

Background: The impact of liver cirrhosis on the outcomes of admission to intensive care unit (ICU) is not completely understood. Our purpose is to identify risk factors for mortality in ICU patients with liver cirrhosis. Methods: Using reimbursement claims from Taiwan’s National Health Insurance Research Database from in 2006-2012, 1,250,300 patients were identified as having ICU stays of more than one day, and 37,197 of these had liver cirrhosis. With propensity score-matching for socioeconomic status, pre-existing medical conditions, and cirrhosis-related morbidities, 37,197 ICU patients without liver cirrhosis were selected for comparison. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cirrhosis associated with 30-day, ICU, and one-year mortality were calculated. Results: Compared with control, cirrhotic patients had higher 30-day mortality (aOR 1.60, 95% CI 1.53 to 1.68), particularly those with jaundice (aOR 2.23, 95% CI 2.03 to 2.45), ascites (aOR 2.32, 95% CI 2.19 to 2.46) or hepatic coma (aOR 2.21, 95% CI 2.07 to 2.36). Among ICU patients, liver cirrhosis was also associated with ICU mortality (aOR 144, 95% CI 1.38 to 1.51) and one-year mortality (aOR 1.40, 95% CI 1.35 to 1.46). Associations between cirrhosis of liver and increased 30-day mortality were significant in both sexes and every age group. Conclusions: Liver cirrhosis was associated with 30-day mortality in ICU patients. Jaundice, ascites, hepatic coma, more than 4 admissions due to cirrhosis, and more than 30 days of hospital stay due to cirrhosis were exacerbated factors in cirrhotic ICU patients.
Medication Burden And Inappropriate Prescription Risk Among Elderly With Advanced Chronic Kidney Disease
Authors: Roux-Marson Clarisse , Baranski Jean-Baptiste , Fafin Coraline , Extermann Guillaume , Vigneau Cecile , Couchoud Cecile , Moranne Olivier
Published: December 2019

Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were first analyzed according to route of administration, therapeutic classification. Second, patients were classified according to their risk of potential medication-related problems, based on whether the prescription was a RIM or a PIM. RIMs and PIMs have been defined according to renal appropriateness guidelines and to Beer’s criteria in the elderly. RIMs were subclassified by 4 types of category : (a) contraindication; (b) dose modification is recommended based on creatinine clearance (CrCl); (c) dose modification based on CrCl is not recommended but a maximum daily dose is mentioned, (d) no specific recommendations based on CrCl : “use with caution”, “avoid in severe impairment”, “careful monitoring of dose is required” “reduce the dose”. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 77.0% of patients had at least 1 medication classified as a RIM. They accounted 31.3% of the drugs prescribed and 9.25% was contraindicated drugs. At least 1 PIM was taken by 57.6% and 45.5% of patients had at least one medication classified as RIM and PIM. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.
Plasma HER2ECD a promising test for patient prognosis and prediction of response in HER2 positive breast cancer: Results of a randomized study - SAKK 22/99
Authors: Eppenberger-Castori Serenella , Klingbiel Dirk , Ruhstaller Thomas , Dietrich Daniel , Rufle Daniel Alexander , Rothgiesser Karin , Pagani Olivia , Thürlimann Beat
Published: December 2019

Background The HER2 extracellular domain shed in blood (HER2 ECD ) is reported to rise and fall in parallel with HER2+ breast cancer behavior. In this study, we evaluated the clinical relevance of plasma HER2 ECD values in patients with metastatic breast cancer treated in the SAKK22/99 trial comparing trastuzumab monotherapy followed by trastuzumab-chemotherapy combination at progression versus upfront combination therapy. Methods Quantitative assessment of plasma HER2 ECD was performed in 133 patients at baseline; after 2-24 hours; at 3 weeks; at first response evaluation (8-9 weeks); and at tumor progression. Associations with tumor characteristics, disease course and trial treatment were evaluated. Results Baseline HER2 ECD levels were stable within 24 hours after the first trastuzumab injection. These plasma values correlated positively with the HER2 gene ratio (r s =0.39, P <0.001) and HER2 protein expression levels (r s =0.36, P <0.001) but not with ER/PR status of the primary tumor. HER2 ECD baseline levels were positively associated with the presence of visceral disease ( P =0.05) and poor patients’ outcome (Cox-regression: P =0.009). Patients with high baseline levels ( > 35ng/ml) had the worst overall survival ( P =0.03) if treated with upfront combination therapy. Conversely, patients with low HER2 ECD baseline values (<15ng/ml) had longer time to progression on combined trastuzumab-chemotherapy when first treated with trastuzumab monotherapy ( P =0.02). Monitoring HER2 ECD levels during the course of the trial revealed significant time ( P =0.001) and time-treatment arm interactions ( P =0.0007). Under upfront trastuzumab alone, the HER2 ECD levels remained stable until just before disease progression. In patients responding to combination treatment HER2 ECD levels decreased to > 20%. Conclusions Plasma HER2 ECD levels in patients with metastatic breast cancer reflect HER2 disease status. This robust biomarker might help identifying patients without visceral disease profiting from a sequential treatment’s modality. Monitoring HER2 ECD levels during trastuzumab monotherapy could help defining the optimal time to introduce chemotherapy.
Brucella melitensis B115-BASED ELISA TO UNRAVEL FALSE POSITIVE SEROLOGIC REACTIONS IN BOVINE BRUCELLOSIS: A FIELD STUDY
Authors: trotta adriana , Marinaro Mariarosaria , Cirilli Margie , Sposato Alessio , Adone Rosanna , Beverelli Matteo , Buonavoglia Domenico , Corrente Marialaura
Published: December 2019

Background: Brucellosis is a zoonosis whose incidence is not declining worldwide despite the global effort to control the disease. Accurate and precise diagnosis is a crucial step in any prophylaxis program but single tests to unequivocally detect animals infected with Brucella spp. are currently unavailable. In Italy, serological diagnosis of bovine brucellosis is performed with two official tests: a rapid agglutination test (i.e., Rose Bengal Plate test, RBPT) and a complement fixation test (CFT) that detect antibodies directed mainly to the smooth lipopolysaccharide (S-LPS). Neither of the two tests is able to avoid the detection of false positive serological reactions (FPSRs) caused by bacteria sharing S-LPS components with Brucella spp. and responsible for the single reactors (SR) phenomenon. A B. melitensis R strain-based ELISA showed a good diagnostic performance in unravelling FP animals; however, since a limited number of animals were analyzed in that study, a large field study was conducted here to discriminate between Brucella-infected from FP animals, with the final aim of reducing the unnecessary slaughter of the latter. Methods: An ELISA based on a R strain of Brucella, i.e., Brucella melitensis B115, was employed to measure specific IgG responses in a collection of bovine sera (n=648). Sera were obtained from 180 farms (either officially brucellosis-free or not brucellosis-free) recruited during an extended period of time (2014-2018) and were preliminarily assayed with the official tests by the Italian Reference Centers and then subjected to the ELISA. Results: Negative sera, when subjected to the ELISA, gave O.D. values below the cutoff; SR sera, i.e. RBPT positive and CFT negative, as well as double positive (DP) sera, i.e. RBPT and CFT positive, gave O.D. values that were below the cutoff. All positive sera, i.e. from Brucella-infected animals, were RBPT positive and CFT positive (ICFTU ranging from 20 to 1280) and gave ELISA O.D. values above the cutoff. Conclusions: The B. melitensis B115-based ELISA systematically unravelled all false positive (FP) sera while confirming the diagnosis in Brucella-infected animals. Thus, the test employed in the present study may complement the official assays to avoid the costly slaughter of FP animals.
Late Diagnosis among patients with Prostate Cancer at the Uganda Cancer Institute: A retrospective cohort study
Authors: Bunani Nelson , Kisakye Angela Nakanwagi , Ssennyonjo Aloysius , Nuwaha Fred
Published: December 2019

Background Late diagnosis of prostate cancer is common in Uganda and elsewhere. Diagnosis in advanced stages is associated with high mortality, morbidity and low quality of life. We estimated time taken from perception of symptoms attributable to prostate cancer to biopsy among patients with prostate cancer at the Uganda Cancer Institute (UCI) and the associated factors. Methods We conducted a retrospective cohort analysis of records of 280 patients with histologically confirmed diagnosis of prostate cancer at UCI from January 2016 to December 2017. Time to diagnosis was obtained from the difference between the approximate date of onset of initial symptoms and date when a biopsy was taken. Late diagnosis was that when an individual was diagnosed with prostate cancer stage III or IV whereas stages I and II were classified as early. We used modified poisson regression to assess factors associated with timing of diagnosis among patients. Results The median time from first perceived symptoms to biopsy for prostate cancer patients was 12 (IQR5-24) months and 76% were diagnosed after 4 months of symptoms. Median age at time of diagnosis of patients was 70 (IQR66-74.5) years and at least 50% were aged between 65-74 years. About 81.8% of the patients were diagnosed late; of which 35.7% were in stage III and 46.1% were in stage IV. Nearly all patients presented with raised prostate specific antigen with median prostate specific antigen of 100.2 (IQR36.02-350) ng/ml of blood at the time of admission. In adjusted analysis, a patients whose biopsies were taken before 5 months of recognising symptoms were two times as likely to have cancer stage I and II compared to those patients in whom the biopsies were taken after 4 months. Conclusion More than three in four patients were diagnosed late. Taking a biopsy after 4 months of initiation of symptoms was partially responsible for the delay. To improve time to diagnosis, communities should be educated about symptoms of prostate cancer and advised to seek health care early. Health care workers should be sensitised to suspect prostate cancer among patients to allow timely referral for appropriate specialised assessment and management.
Relapse after conservative surgery combined with Triptorelin Acetate versus conservative surgery only in women with focal adenomyosis: study protocol for a multicenter, prospective, randomized controlled trial
Authors: Wang Wenwen , Ma Xiangyi , Zhang Wei , Li Zhiying , Wang Yan , Yu Zhiying , Zhang Chunlian , Hong Li , Luo Ruoyu , Xing Hui , Wang Wuliang , Yue Qingfen , Wei Jia , Zhang Minli , Wang Shixuan
Published: December 2019

Background: To preserve fertility or integrity of organs was on the rise for the most women with adenomyosis. Adenomyomectomy is now a widely applied conservative surgery, however relapse is a serious problem after operation. Postoperative treatment, such as gonadotropin-releasing hormone agonist (GnRHa) has been suggested to result in reducing the recurrence rate in patients. However, there is still a lack of evidence from randomized clinical trials comparing the efficacy of GnRHa for decreasing the postoperative recurrence rate. Method/Design：Relapse after conservative surgery combined with Triptorelin Acetate versus conservative surgery only in women with focal adenomyosis is a multicenter, prospective, randomized controlled trial. The primary outcome is relapse accessed with Visual Analogue Scale (VRS) and Numeric Rating Scale (NRS), Pictorial blood loss assessment chart (PBAC) score and the size of uterus and lesion are measured by two/three-dimensional color doppler ultrasonography (2D/3D-CDUS) or magnetic resonance imaging (MRI). The secondary outcomes include quality of life, clinical pregnancy, ovarian reserve, and adverse events, assessing by Short Form (36) Health Survey and Female Sexual Function index, serum follicle-stimulating hormone, estradiol levels and anti-muellerian hormone and so on. All these indexes are measured at 3, 6, 12, 18, 24, 30, 36 months after conservative surgery. Discussion：The result of this large multicenter randomized trial will provide evidence for one of the strategies of long-term management in focal adenomyosis after conservative operation.
Posterior only instrumented fusion provides incomplete curve control for early-onset scoliosis in type 1 neurofibromatosis
Authors: zhang Jianguo , Cai Siyi , Li zhenyao , Qiu Guixing , shen Jianxiong , zhao hong , Zhao Yu , Wang Yipeng
Published: December 2019

Background: The mid-long term outcomes of posterior spinal fusion in pediatric neurofibromatosis type 1 (NF-1) patients are rarely reported, so does the effectiveness of itsorthopeidc maintenance function. This study aims to evaluate the mid-long term surgical outcomes of posterior only instrumented spinal fusion for early-onset scoliosis (EOS) in NF-1 patients. Methods: A retrospective review was performed on a cohort of 10 NF-1 patients having EOS from 2008 to 2014 in our hospital, including four male and six female patients with an age averaged at 7.8 years old when they underwent posterior only instrumented spinal fusion for their EOS. Both general clinical data and surgical specific data of the patients were collected and reviewed, and the dystrophic progression of EOS was evaluated during the follow-up. Results: The average duration of follow-up was 54 months (24 to 88 months). All patients underwent posterior only instrumented spinal fusion at 1 stage. The primary curves of EOS were thoracic in 9 cases and 1 patient had lumbar scoliosis. Preoperative major curve was significantly corrected (from 66.1 to 31.1 degrees). However, the major curve deteriorated significantly to 40.1 degrees on average at the end of the follow-up. The T1-S1 distance increased 2.8 cm on average and kept increasing at a rate of 0.6cm/year during the follow-up. Conclusions: Posterior only fusion surgery was not a good option to treat the EOS in NF-1 patients despite the relatively short segments involvement in the disease. The maintenance of orthopedic effect after treatment was not satisfactory.
Treatment of Chronic Active Antibody-mediated Rejection in Renal Transplant Recipients – A single center retrospective study
Authors: Chiu Hsien-Fu , Wen Mei-Chin , Wu Ming-Ju , Chen Cheng-Hsu , Yu Tung-Min , Chuang Ya-Wen , Huang Shih-Ting , Tsai Shang-Feng , Lo Ying-Chih , Ho Hao-Chung , Shu Kuo-Hsiung
Published: December 2019

Background: Chronic active antibody-mediated rejection is a major etiology of graft loss in renal transplant recipients. However, there are no approved treatments. Methods: Computerized records from Taichung Veterans General Hospital were collected to identify the renal transplant biopsies performed in the past 7 years with the diagnosis of chronic active antibody-mediated rejection. The patients were divided into two groups according to treatment strategy: Group 1: aggressive treatment (double filtration plasmapheresis and one of the followings: rituximab, intravenous immunoglobulin, antithymogycte globulin, bortezomib, or methylprednisolone pulse therapy); and group 2: supportive treatment. Results: From February 2009 to December 2017, a total of 82 patients with biopsy-proven chronic antibody mediated rejection were identified. Kaplan-Meier analysis of death-censored graft survival showed a worse survival in group 2 ( P = 0.015 by log-rank test). Adverse event-free survival was lower in group 1, whereas patient survival was no significant different. Proteinuria and supportive treatment were independent risk factors for graft loss in multivariate analysis. Conclusions : Aggressive treatment was associated with better graft outcome. However, higher incidence of adverse events merit personalized treatment, especially for those with higher risk of infection. Appropriate prophylactic antibiotics are recommended for aggressive treatment patients.