bluuebunny/crossref_metadata_2025 huggingface dataset:
OECD Ülkelerinde Uzun Dönemli Bakım Hizmetlerinin Etkinliğinin Değerlendirilmesi
Authors: DEMİRCİ Şenol , YETİM Birol , KONCA Murat
Published: February 2020

Doğumda beklenen yaşam süresinin artması ve doğurganlık hızının azalması sonucu ülkelerin yaşlı nüfus oranları artmaktadır. Kronik ve mental rahatsızlıklardan kaynaklı olarak yaşlılar uzun dönemli bakım hizmetlerinden daha fazla faydalanmaktadır. Yaşlı bireylerin uzun dönemli bakım hizmetleri kullanımının artması uzun dönemli bakımda etkinlik konusunda çalışmalar yapılmasını zorunlu kılmaktadır. Bu çalışmada, seçilmiş OECD ülkelerinin uzun dönemli bakım hizmetleri etkinlik düzeyleri 2015, 2016 ve 2017 yılları bazında Veri Zarflama Analizi (VZA), Malmquist Toplam Faktör Verimliliği Endeksi (MTFV) ve Tobit regresyon analizleri ile incelenmiş, etkinliğe etki eden değişkenler ortaya konmuş ve etkinlik ile ilgili sorun yaşayan ülkeler için önerilerde bulunulmuştur.
Eğitim Fakültesi Birinci Sınıf Öğrencilerinin Üniversite Yaşamına Uyumları: Akran Desteğinin Yordayıcı Rolü
Authors: ÖZTÜRK Nilgün
Published: February 2020

Bu araştırma, akran desteğinin üniversite birinci sınıf öğrencilerinin üniversiteye uyum düzeylerini yordamadaki rolünü incelemek amacıyla yapılmıştır. Araştırmada ilişkisel tarama yöntemi kullanılmıştır. Araştırmanın örneklemini 468 eğitim fakültesi öğrencisi oluşturmaktadır. Veri toplama aracı olarak “Üniversite Yaşamına Uyum Ölçeği” ve “Akran Desteği Ölçeği” kullanılmıştır. Verilerin analizi için Basit Regresyon Analizi yöntemi ve Pearson Momentler Çarpımı Korelasyon Katsayısı kullanılmıştır. Çalışmanın sonucunda, öğrencilerin üniversite yaşamına uyumları ile akran desteği arasında pozitif yönde ve anlamlı ilişkilerin olduğu belirlenmiştir. Bulgular, akran desteğinin üniversite yaşamına uyumu anlamlı bir şekilde yordadığını göstermiştir. Bulgular alan yazın ışığında tartışılmış ve ileride yapılacak araştırmalara yönelik bazı önerilerde bulunulmuştur.
Should anaesthesia method for prostate biopsy be the same for every patient? A randomised prospective study to determine the risk factors for pain
Authors: AVCI Sinan , ONER Sedat , ÖNEN Efe , ÇAĞLAYAN Volkan , KILIÇ Metin , ŞAMBEL Murat
Published: February 2020

Objectives: To evaluate the risk factors for pain occurring during prostate biopsy. Methods: This study included 123 patients were applied with prostate needle biopsy under transrectal ultrasonography. The patients were randomly separated into 3 groups of 41 individuals. For periprostatic nerve blockage, 10 cc 2% lidocaine was applied to Group 1, 10 cc 0.25% levobupivacaine to Group 2, and 10 cc 0.25% bupivacaine to Group 3. A 10 cm Visual Analogue Scale (VAS) was used to evaluate patient pain. The pain of the patients was evaluated in 4 stages. VAS 1: Pain score during the injection of the anaesthetic agent; VAS 2: Pain score during the biopsy when half the procedure was completed; VAS 3: Pain score following removal of the rectal probe immediately after the biopsy; and VAS 4: Pain score at 1 hour after the biopsy. Results: There were significant negative correlations between VAS 3 pain scores and age in group 1, group 3 and for entire cohort (p = 0.013, p = 0.031 and p = 0.033, respectively). In group 1 both total and free PSA showed significant negative correlations with VAS 3 pain scores (p = 0.020 and p = 0.010, respectively). In group 2 VAS 4 pain scores of the patients with suspicious digital examination findings were found to be significantly higher than those of the patients with benign digital examination findings (p = 0.025). Conclusions: Of all patients to be applied with prostate biopsy, those of a younger age, with a lower PSA level, with suspicious digital rectal examination findings constitute a relatively higher risk group in respect of pain.
Dental implantlarda stabilite ölçüm yöntemleri: Derleme
Authors: İZGİ Eda , ŞİMŞEK Mehmet
Published: February 2020

Osseointegrasyon, protezi desteklemek için
temel oluşturabilecek bir implant gövdesine doğrudan bir kemik ankrajının
olması olarak tanımlanır. İmplant stabilitesi, kemik ve implant yüzeyi arasında
direk yapısal ve fonksiyonel bağlantı olan osseointegrasyon için önemli rol
oynamaktadır. İmplant stabilitesi, primer ve sekonder stabilite olarak 2
aşamada meydana gelmektedir. Primer stabilite, çoğunlukla kortikal kemik ile
mekanik bağlanma sonucu ortaya çıkarken; sekonder stabilite, kemik
rejenerasyonu ve remodelasyonu yoluyla biyolojik stabilite sunar. Başarılı ve
sürdürülebilir implant stabilitesi istenen başarılı bir klinik sonuçtur. Bu
nedenle implant stabilitesinin ölçüm yöntemleri implant başarısının
değerlendirilmesi bakımından oldukça önemlidir. İmplant stabilitesini
değerlendirmek amacı ile çeşitli yöntemler kullanılmaktadır. Bu derlemede
literatürdeki bilgiler ışığında yöntemlerin avantaj ve dezavantajları,
birbirleriyle karşılaştırılarak yöntemlerin klinik kullanımları hakkında
detaylı bilgi verilmesi amaçlanmıştır.
Puberte prekokslu kızlarda anti-Müllerian hormon(AMH) düzeyinin folikül sayısı ve büyüklüğü ile ilişkisi
Authors: MURATOĞLU ŞAHİN Nursel , ÖZCAN Hatice Nursun , ARASLI YILMAZ Aslıhan , ÇETİNKAYA Semra , SAVAŞ ERDEVE Şenay , AYCAN Zehra
Published: February 2020

Amaç: Yetişkinlerde AMH ile antral folikül sayısı arasında pozitif korelasyon vardır. Peripubertal sağlıklı kızlarda da AMH ile toplam folikül sayısı ve folikül büyüklüğü arasında ilişki saptanmıştır. Çalışmamızda; santral puberte prekoks (SPP) tanısı almış kızlarda AMH düzeyi ile folikül sayı ve büyüklüğünün ilişkisi araştırıldı.Gereç Ve Yöntemler: Santral puberte prekoks tanılı 32 kız olgu çalışmaya alındı. Hastalardan AMH için kan örneği alınarak pelvik ultrasonografi ile overde folikül sayımı yapıldı. Foliküller büyüklüklerine göre; küçük (1-4,4 mm), orta (4,5-9,4 mm) ve büyük (≥9,5mm) olarak sınıflandırıldı. Hastalar puberte evrelerine ve antral folikül sayısına göre gruplandırıldı.Bulgular: Hastaların AMH düzeyi ile küçük, orta, büyük folikül sayısı, küçük/orta folikül oranı, en büyük folikül boyutu ve toplam folikül sayısı arasında anlamlı bir ilişki saptanmadı (p > 0,05). Hastalar meme evrelerine göre sınıflandırıldığında da grupların AMH düzeyleri, küçük, orta ve büyük folikül sayısı, küçük/orta folikül oranı, en büyük folikül boyutu ve toplam folikül sayısı farklı değildi (p>0,05). Birden fazla antral folikülü olanların AMH düzeyi [median:0,23 ng/ml, (0,06-0,56)], en fazla bir antral folikülü olanların AMH düzeyinden [median:0,17ng/ml (0,05-0,48)] anlamlı olarak daha yüksekti (p:0,035).Sonuç: Puberte prekokslu kızlarda AMH düzeyi ile folikül sayı ve boyutu arasındaki ilişkinin ilk defa incelendiği çalışmamızda; AMH düzeyi ile over hacmi, folikül sayı ve büyüklüğü arasında anlamlı bir ilişki saptanamamış olması hastalarımızın erken pubertal evrede olmasından kaynaklanıyor olabilir. Bununla birlikte; puberte prekoksta folikül gelişim paterninin normal puberteden farklı olabileceği ya da folikül sayısı dışında AMH’ya etkili başka faktörlerin de olabileceği ihtimali de dışlanamaz.
Predict Arrival Time by Using Machine Learning Algorithm to Promote Utilization of Urban Smart Bus
Authors: Md Noor Rafidah , Seong Yik Ng , Kolandaisamy Raenu , Ahmedy Ismail , Hossain Mohammad Asif , Alvin Yau Kok-Lim , Md Shah Wahidah , Nandy Tarak
Published: February 2020

The impact of the accurate estimated time of arrival (ETA) is often overlooked by bus operators. By providing accurate ETA to riders, it gives them the impression of bus services is efficient and reliable and this promotes higher ridership in the long run. This research project aims to predict bus arrival time by using the Support Vector Regression (SVR) model which is based on the same theory as the Support Vector Machine (SVM). Urban City Bus data covering part of the Petaling Jaya area (route name PJ03) is used in this research work. Features related to traffic such as travel duration, a distance of the road, weather and operation at peak or non-peak hour have been used as input in the training of the SVR model. By using kernel trick and specifying optimum parameters, all the features in higher dimensions are efficiently calculated and the SVR model achieves convergence. The model is evaluated with the test set of data split from the original dataset. The experimental result indicates the SVR model displays good prediction ability with its low average error on the prediction result. However, weather data has not been influential to the prediction model as the results of the model trained with and without weather data show a negligible difference.
Global Incidence and Mortality Patterns and Forecast of Pedestrian Road Traffic Injuries by Socio-Demographic Index Findings from the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study
Authors: Khan Moien A. B. , Grivna Michal , Nauman Javaid , Soteriades Elpidoforos S. , Cevik Arif Alper , Hashim Muhammad Jawad , Govender Romona , Al Azeezi Salma Rashid
Published: February 2020

(1) Background: Pedestrian injuries (PIs) represent a significant proportion of road traffic injuries. We aimed at investigating the incidence and mortality of PIs in different age groups and Socio-demographic Index (SDI) categories between 1990 and 2017. (2) Method: Estimates of age-standardized incidence and mortality along with trends of PIs by SDI levels were obtained from the Global Burden of Disease from 1990 to 2017. We also calculated forecasts until 2040. (3) Results: Globally, PIs incidence increased by 3.31% (–9.94 to 16.56) in 2017 compared to 1990. Men have a higher incidence of PIs than women. Forecasted incidence was 132.02 (127.37 to 136.66) per 100,000 population in 2020, 101.52 (65.99 to 137.05) in 2030 and reduced further to 71.02 (10.62 to 152.65) by 2040. Globally across all SDI categories, there was a decreasing trend in mortality due to PIs with the global estimated percentage reduction of 37.12% (–45.19 to –29.04). (4) Conclusions: The results show that PIs are still a burden for all SDI categories despite some variation. Although incidence and mortality are expected to decrease globally, some SDI categories may require particular attention in addition to specific vulnerable age groups. Further studies addressing incidence and mortality patterns in vulnerable SDI categories are needed.
Triplet Test on Rubble Stone Masonry: Numerical Assessment of the Shear Mechanical Parameters
Authors: Angiolilli Michele , Gregori Amedeo
Published: February 2020

Rubble stone masonry walls are widely diffused in most of the cultural and architectural heritage of historical cities. The mechanical response of such material is rather complicated to predict due to their composite nature. Vertical compression tests, diagonal compression tests, and shear-compression tests are usually adopted to experimentally investigate the mechanical properties of stone masonries. However, further tests are needed for the safety assessment of these ancient structures. Since the relation between normal and shear stresses plays a major role in the shear behavior of masonry joints, governing the failure mode, triplet test configuration was here investigated. First, the experimental tests carried out at the laboratory (LPMS) of the University of L'Aquila on stone masonry specimens were presented. Then, the triplet test was simulated by using the Total Strain Crack Model, which reflects all the ultimate states of quasi-brittle material such as cracking, crushing and shear failure. The goal of the numerical investigation was to evaluate the shear mechanical parameters of the masonry sample, including strength, dilatancy, normal and shear deformations. Furthermore, the effect of (i) confinement pressure and (ii) bond behavior at the sample-plates interfaces were investigated, showing that they can strongly influence the mechanical response of the walls.
Rewetting of Three Drained Peatlands Drives Congruent Compositional Changes in Pro- and Eukaryotic Soil Microbiomes through Environmental Filtering
Authors: Weil Micha , Wang Haitao , Bengtsson Mia , Köhn Daniel , Günther Anke , Jurasinski Gerald , Couwenberg John , Negassa Wakene , Zak Dominik , Urich Tim
Published: February 2020

Drained peatlands are significant sources of the greenhouse gas (GHG) carbon dioxide. Rewetting is a proven strategy to protect carbon stocks; however, it can lead to increased emissions of the potent GHG methane. The response to rewetting of soil microbiomes as drivers of these processes is poorly understood, as are biotic and abiotic factors that control community composition. We analyzed the pro- and eukaryotic microbiomes of three contrasting pairs of minerotrophic fens subject to decade-long drainage and subsequent rewetting. Also, abiotic soil properties including moisture, dissolved organic matter, methane fluxes and ecosystem respiration rates. The composition of the microbiomes was fen-type-specific, but all rewetted sites showed higher abundance of anaerobic taxa compared to drained sites. Based on multi-variate statistics and network analyses we identified soil moisture as major driver of community composition. Furthermore, salinity drove the separation between coastal and freshwater fen communities. Methanogens were more than tenfold more abundant in rewetted than in drained sites, while their abundance was lowest in the coastal fen, likely due to competition with sulfate reducers. The microbiome compositions were reflected in methane fluxes from the sites. Our results shed light on the factors that structure fen microbiomes via environmental filtering.
Limiting Values and Functional and Difference Equations
Authors: Wang N.-L. , Agarwal Praveen , Kanemitsu S.
Published: February 2020

Boundary behavior of a given important function or its limit values are essential in the whole spectrum of mathematics and science. We consider some tractable cases of limit values in which either a difference of two ingredients or a difference equation is used coupled with the relevant functional equations to give rise to unexpected results. This involves the expression for the Laurent coefficients including the residue, the Kronecker limit formulas and higher order coefficients as well as the difference formed to cancel the inaccessible part, typically the Clausen functions. We also state Abelian results which yield asymptotic formulas for weighted summatory function from that for the original summatory function
Site Classification and Evaluation of Eucalyptus urophylla × Eucalyptus grandis Plantation in Southern Yunnan, China
Authors: Lu Haifei , Xu Jianmin , Li Guangyou , Liu Wangshu , Wu Yuqiang , Zhang Yundong , Bai Jun , Su Guolei , Jiang Cheng
Published: February 2020

Background and Objectives: The site types of Eucalyptus urophylla × Eucalyptus grandis clonal plantations in southern Yunnan were compared, aiming to provide basis for site selection and scientific plantations management. Materials and Methods: In this study, 80 standard plots were set up in the 6−9-year-old Eucalypts plantations in Pu'er City and Lincang City. Furthermore, the quantitative theory I model and canonical correlation analysis were used to analyze the relationship between dominant tree growth traits and site factors, and evaluate the growth potential of E. urophylla × E. grandis plantation. Results: The multiple correlation coefficient between 8 site factors (altitude, slope, slope level, soil thickness, slope direction, texture, soil bulk density, and litter thickness) and the quantitative growth of the dominant wood was 0.825 (P < 0.05). According to the correlation coefficient of the quantitative regression model, slope, altitude, and soil thickness were the main factors for the classification of E. urophylla × E. grandis plantations in southern Yunnan. In addition, E. urophylla × E. grandis plantations grew best downhill and mid uphill at relatively low altitude, where the soil layer was thick and composed of weathered red soil. Contrastingly, E. urophylla × E. grandis plantation growth was extremely poor in uphill sites at higher altitude, where the soil layer was thin and composed of semi-weathered purple soil. Furthermore, total N, and available B, Cu, and Zn content, as well as soil organic matter content in the soil had a great influence on the growth of E. urophylla × E. grandis. Conclusions: Nitrogen and phosphate fertilizer as well as trace elements such as B, Zn, and Cu can be properly applied in middle- and low-yield forests to promote the growth and development of E. urophylla × E. grandis plantations.
Predictive Modeling of Henry’s Law Constant in Chemical Structures Using LSSVM and ANFIS Algorithms
Authors: Wang Qikai , Yao Aiqin , Shokri Manouchehr , Dineva Adrienn A.
Published: February 2020

Henry’s constants for different existing compounds in water have great importance in transfer calculations. Measurement of these constants face different difficulties including high costs of experiment and low accuracy of measurement apparatus. Due to these facts, proposing a low cost and accurate approach becomes highlighted. To this end, adaptive neuro-fuzzy inference system (ANFIS) and least squares support vector machine (LSSVM) have been used as Henry’s constant predictor tools. The molecular structure of compounds has been used as inputs of models. After training the models, the visual and mathematical studies of outputs have been done. The coefficients of determination of LSSVM and ANFIS algorithms are 0.999 and 0.990 respectively. According to the comprehensiveness of databank and accurate prediction of algorithms, it can be concluded that LSSVM and ANFIS algorithms are accurate methods for prediction of Henry’s constant in wide range of chemical structure of compounds in water.
Research on Globalization Policies of Exchange Programs in Higher Education
Authors: Yang Susan Hui-yun , Haseltine Patricia
Published: February 2020

Teachers of English as a foreign language in Taiwan are challenged to organize multi-dimensional language activities for foreign students coming from ASEAN countries, including Japan, the Philippines, South Korea, and Vietnam. With different cultural backgrounds, these students have different prior knowledge of Taiwanese culture, and, because of the similarities and differences between Taiwan and these countries, it is meaningful to explore the development of globalization with the students, who are learning both English and Chinese. The different historical backgrounds, various cultural and religious differences, and social conditions, such as gender relationships in working places, are significant topics for class discussions. When teachers serve as discussion facilitators, they encourage students to express their own multi-identities and expectations for the exchange program. Most interesting of all is to find out about their own short-term and long-term career goals. 32 foreign students from the Philippines and Vietnam were recruited for research. Questionnaires were used to assess their foreign language learning motivation and strategies, as well as to discover the learning environment they prefer and their globalization prospects. It was found that multi-lingual language policies for promoting globalization in higher education are very likely to influence the success of foreign student study in Taiwan.
Thrombocytosis in an Infant with a TRPV4 Mutation: A Case Report
Authors: Thom Christopher S. , Brandsma Erik , Lambert Michele P.
Published: February 2020

Mutations in the calcium channel gene Transient Receptor Potential cation channel subfamily V member 4 (TRPV4) cause autosomal dominant skeletal dysplasia, with phenotypes ranging from mild to perinatal lethality. A recent report detailed murine thrombocytosis in the absence of functional TRPV4, but no prior reports have described platelet count abnormalities in the context of human TRPV4 disease. Here, we report a case of prolonged thrombocytosis in the context of TRPV4-associated metatropic dysplasia that was lethal in the infantile period.
La vertiente antropofágica de Ferreira Gullar
Authors: Araujo Pereira Diana
Published: February 2020

Este trabajo tiene por objetivo acercar la poética del brasileño Ferreira Gullar a una vertiente de la poesía críticamuy productiva en América Latina, que está involucrada en los procesos sociohistóricos del continente, y en particulara la poética del peruano Antonio Cisneros. También busca vincular ambas poéticas a toda una genealogía derivadade los proyectos vanguardistas de Brasil y el Perú, a través de una breve incursión por la antropofagia
Presencia liminar del percepto poético en Marfa, Texas, de Coral Bracho
Authors: Méndez González Iván
Published: February 2020

En su más reciente libro de poesía, Marfa, Texas (2015), la poeta mexicana Coral Bracho festeja la pulsión matéricadel lenguaje poético, su capacidad de hacerse presente como instancia liminar del espacio del poema: la lenguainscrita en el ámbito del poema se convierte en percepto, un dispositivo perceptual de emergencia del sentidoobservable como tensión poemática. El enfoque neurofenomenológico y la hermenéutica se consideran como redesde conocimiento, que generan campos de mostración donde la identidad se difumina en virtud de que el observadorse incluye en el hábitat de observación. Esto se lleva a cabo al vertebrar el topos de inserción básica que seríaespacio poemático por medio de las posibilidades del lenguaje para captar el instante y densificarlo.
Desespediente: la máscara mortuoria de la burocracia
Authors: Aguilera López Jorge
Published: February 2020

El propósito del presente trabajo es realizar un análisis estilístico del poema «Desespediente» de Pablo Neruda, incluido en el libro Residencia en la tierra (1935). A través de dicho análisis, buscamos mostrar que las nociones estéticas de este autor, basadas en la noción de «impureza», implican un trabajo formal que consigue transmitir el ambiente y la percepción de espacio mortuorio con el cual se relaciona el ámbito temático del texto: la rutina burocrática. El trabajo a nivel del lenguaje, así como su particularsistema de adjetivación, posibilitan la lectura desde la forma del poema, más allá de la anécdota vital que da origen al texto. Lo que proponemos entonces es una interpretación que imbrica la posición estética del autor, al menos en esta época, con la voluntad de estilo y el lenguaje particular que caracterizan la obra nerudiana de la época en la cual fue escrito Residencia en la tierra.
La gran avenida: Efraín Huerta y Jaime Sabines
Authors: Castañeda Barrera Eva
Published: February 2020

El propósito de este trabajo es analizar la importancia de Efraín Huerta y Jaime Sabines en el contexto de lapoesía mexicana del siglo XX. Nuestro acercamiento toma como punto de partida la herencia que la vanguardia mexicana, el estridentismo, dejó a estos escritores. Consideramos que las innovaciones lingüísticas son un reflejo de un cambio de paradigma que definiría la escritura poética de un grupo de un nutrido número de autores que, a partir de la década de 1950, incorporarían a la lírica nacionalelementos que años atrás eran considerados antipoéticos; por una parte, la inclusión de la ciudad como personaje principal; por otro, un léxico que reflejaba una voluntad contestataria e irreverente frente a la idea tradicional de lo lírico. Así entonces, Efraín Huerta y Jaime Sabines enarbolan este cambio de paradigma.
El arte de la poética (Borges: verso a verso)
Authors: Fallas Selene
Published: February 2020

El presente artículo realiza un análisis (verso a verso) del «Arte poética» de Jorge Luis Borges y, de esta manera, y encontrando los parámetros en algunas de sus obras, se intenta llegar al universo lírico del afamado poeta argentino.
Magnitude of iodine deficiency disorder and associated factors in Dawro zone, southwest Ethiopia; the hidden hunger: a cross-sectional study
Authors: Asfaw Agize , Belachew Tefera
Published: February 2020

Background: Iodine deficiency disorder (IDD) is continued to be a major public health problem in Ethiopia. The problem is worse but the data is scarce in some pocket areas of the country. This study was aimed to assess the magnitude of IDD and associated factors in southwest Ethiopia by using different biochemical and clinical indicators.
Methods: Both community and school based cross- sectional study was conducted on school age children (6-12 years) from March 1 to 24, 2017. Simple random and systematic sampling techniques were applied to select districts and eligible children respectively. Household data was collected from children’s primary care takers by using structured questionnaire. A trained surgeon examined all children (n=652) for goiter. Urine sample was collected from 20% of children (n=130).
Results: A total of 652 school children were participated in the study. Total goiter rate and median urinary iodine concentration (UIC) was 54.8 % and 96.12μg/l respectively. In multivariable logistic regression analyses student’s age was significantly (P<0 05) associated with both goiter and median UIC. However; sex of students and family income were significantly (P<0.001) associated with goiter and cassava consumption was significantly (P<0.001) associated with UIC.
Conclusion: As indicated by the median UIC, there was mild iodine deficiency in this study community. However; chronic iodine deficiency was still a severe public health problem (high goiter prevalence). In addition, there was low concentration of iodine in the salt and increased cassava cultivation and consumption indicating the potential risk in the area. Therefore, it is necessary to intensify IDD elimination activities along with teaching communities on techniques of cassava processing for household consumption.
Trial registration: PACTR201809544276357. Retrospectively registered on 14, Sept 2018.
Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)
Authors: Xie Yuting , Liu Fang , Huang Fansu , Lan Chunna , Guo Jia , He Jing , Li Lezhi , Li Xia , Zhou Zhiguang
Published: February 2020

Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications of diabetes’, ‘managing psychological issues’, ‘physical activity’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed by remote learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.
Characterization of genetic determinants of the resistance to phylloxera, Daktulosphaira vitifoliae, and the dagger nematode Xiphinema index from muscadine background
Authors: Rubio Bernadette , Lalanne-Tisné Guillaume , Voisin Roger , Tandonnet Jean-Pascal , Portier Ulysse , Ghelder Cyril Van , Lafargue Maria , Petit Jean-Pierre , Donnart Martine , Joubard Benjamin , Bert Pierre-Francois , Papura Daciana , Cunff Loïc Le , Ollat Nathalie , Esmenjaud Daniel
Published: February 2020

Muscadine ( Muscadinia rotundifolia ) is known as a resistance source to many pests and diseases in grapevine. The genetics of its resistance to two major grapevine pests, the phylloxera D. vitifoliae and the dagger nematode X. index , vector of the Grapevine fanleaf virus (GFLV) was investigated in a backcross progeny between the F1 resistant hybrid material VRH8771 ( Muscadinia-Vitis ) and V. vinifera cv. ‘Cabernet-Sauvignon’. Phylloxera resistance was assessed by monitoring root nodosity number in an “ in planta ” experiment and larval development in a root “ in vitro ” assay. Nematode resistance was studied using 10-12 month long tests for the selection of durable resistance and rating criteria based on nematode reproduction factor and gall index. A major QTL for phylloxera larval development, explaining more than 70% of the total variance and co-localizing with a QTL for nodosity number, was identified on LG 7. Additional QTLs were detected on LG 3 and LG 10, depending on the “ in planta ” or “in vitro” experiments, suggesting that various loci may influence or modulate nodosity formation and larval development. Using a Bulk Segregant Analysis approach and a proportion test, markers clustered in three regions on LG 9, LG 10 and LG 18 were shown to be associated to the nematode resistant. All these results open the way to the development of marker-assisted selection in grapevine rootstock breeding programs based on muscadine derived resistance to phylloxera and to X. index in order to delay GFLV transmission.
Forecasting incidence of infectious diarrhea using random forest in Jiangsu Province, China
Authors: Fang Xinyu , Liu Wendong , Ai Jing , Mike He , Wu Ying , Shi Yingying , Shen Wenqi , Bao Changjun
Published: February 2020

Background: Infectious diarrhea can lead to a considerable global disease burden. Thus, the accurate prediction of an infectious diarrhea epidemic is crucial for public health authorities. This study was aimed at developing an optimal random forest (RF) model, considering meteorological factors used to predict an incidence of infectious diarrhea in Jiangsu Province, China. Methods: An RF model was developed and compared with classical autoregressive integrated moving average (ARIMA)/X models. Morbidity and meteorological data from 2012 to 2016 were used to construct the models and the data from 2017 were used for testing. Results: The RF model considered atmospheric pressure, precipitation, relative humidity, and their lagged terms, as well as 1–4 week lag morbidity and time variable as the predictors. Meanwhile, a univariate model ARIMA(1,0,1)(1,0,0)52 (AIC=−575.92, BIC=−558.14) and a multivariable model ARIMAX(1,0,1)(1,0,0)52 with 0-1 week lag precipitation (AIC=−578.58, BIC=−578.13) were developed as benchmarks. The RF model outperformed the ARIMA/X models with a mean absolute percentage error (MAPE) of approximately 20%. The performance of the ARIMAX model was comparable to that of the ARIMA model with a MAPE reaching approximately 30%. Conclusions: The RF model fitted the dynamic nature of an infectious diarrhea epidemic well and delivered an ideal prediction accuracy. It comprehensively combined the synchronous and lagged effects of meteorological factors; it also integrated the autocorrelation and seasonality of the morbidity. The RF model can be used to predict the epidemic level and has a high potential for practical implementation.
Association between levels of tumor-infiltrating lymphocytes in different subtypes of primary breast tumors and prognostic outcomes: A meta-analysis
Authors: He Lin , Wang Yaling , Wu Qian , Song Yuhua , Ma Xuezhen , Wang Haiji
Published: February 2020

Purpose To investigate the impact of the elevation of tumor-infiltrating lymphocytes (TILs) in different molecular subtypes of primary breast cancer, i.e. a 10% increment of TILs in tumor and lymphocyte-predominant breast cancer (LPBC), on long-term survival and pathological complete response (pCR) and to compare the presentation of high-level TILs across these molecular subtypes. Methods Citation retrieval was performed in the PubMed, Cochrane Library, Embase and Web of Science databases. All statistical calculations were performed by the software of StataSE version 12.0. Results Twenty-two eligible clinical trials including 15676 unique patients were included for meta-analysis. The 10% increment of TILs in human epidermal growth factor receptor 2 (HER2)-overexpression (pooled Hazard ratio (HR), 0.92; 95% CI, 0.89-0.95) and triple-negative (TN) (pooled HR, 0.90; 95% CI, 0.89-0.92) breast tumors significantly improved overall survival (OS) but in Luminal tumor subtype was inert to improve that (pooled HR, 1.06; 95% CI, 0.99-1.13). It was also associated with an increased pCR rate in breast cancers (pooled Odds ratio (OR), 1.27; 95% CI, 1.19-13.5). LPBC was significantly related with a higher pCR rate (OR, 2.73; 95% CI, 2.40-3.01) than non-LPBC. This significant difference was also shown in different molecular subtypes of LPBC compared with those of non-LPBC. HER2-amplified (OR, 3.14; 95% CI, 1.95-5.06) and TN (OR, 4.09; 95% CI, 2.71-6.19) phenotypes of breast cancers expressed significantly elevated high-level TILs than Luminal tumor subtype, although the presentation of those between the former two subsets was not significantly different (OR, 1.30; 95%CI, 0.83-2.04). Conclusion The elevation of TILs in breast tumors predicts promising prognostic outcomes, particularly in the HER2-overexpression and TN subtypes. These benefits in Luminal tumor subtype need to be warranted.
Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated OA care model: Secondary analyses from a cluster-randomised stepped wedge trial
Authors: Moseng Tuva , Dagfinrud Hanne , Bodegom-Vos Leti van , Dziedzic Krysia , Hagen Kåre Birger , Natvig Bård , Røtterud Jan Harald , Vlieland Thea Vliet , Østerås Nina
Published: February 2020

Background: To address the well-documented gap between hip and knee osteoarthritis (OA) treatment recommendations and current clinical practice, a structured model for integrated OA care was developed and evaluated in a stepped-wedge cluster-randomised controlled trial. The current study used secondary outcomes to evaluate clinically important response to treatment through the Outcome Measures in Rheumatology Clinical Trials clinical responder criteria (OMERACT-OARSI responder criteria) after 3 and 6 months between patients receiving the structured OA care model vs. usual care. Secondly, the study aimed to investigate if the proportion of responders in the intervention group was influenced by adherence to the exercise program inherent in the model.
Methods: The study was conducted in primary healthcare in six Norwegian municipalities. General practitioners and physiotherapists received training in OA treatment recommendations and use of the structured model. The intervention group attended a physiotherapist-led OA education program and performed individually tailored exercises for 8-12 weeks. The control group received usual care. Patient-reported pain, function and global assessment of disease activity during the last week were evaluated using 11-point numeric rating scales (NRS 0-10). These scores were used to calculate the proportion of OMERACT-OARSI responders. Two-level mixed logistic regression models were fitted to investigate differences in responders between the intervention and control group.
Results: 284 intervention and 109 control group participants with hip and knee OA recruited from primary care in six Norwegian municipalities. In total 47% of the intervention and 35% of the control group participants were responders at 3 or 6 months combined; showing an uncertain between-group difference (OR adjusted 1.38 (95% CI 0.41, 4.67). In the intervention group, 184 participants completed the exercise programme (exercised ≥2 times/week for ≥8 weeks) and 55% of these were classified as responders. In contrast, 28% of the 86 non-completers were classified as responders.
Conclusions: The difference in proportion of OMERACT-OARSI responders at 3 and 6 months between the intervention and control group was uncertain. In the intervention group, a larger proportion of responders were seen among the exercise completers compared to the non-completers.
Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-infected and HIV-uninfected patients with deep vein thrombosis
Authors: Jackson Brandon S , Goncalves Julien Nunes , Pretorius Etheresia
Published: February 2020

Background Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. Methods We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen- Emtricitabine, Tenofovir and Efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties (using thromboelastography-TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. Results DVT patients (HIV positive and HIV negative) have raised inflammatory markers. The HIV positive-DVT group has anaemia in keeping with anaemia of chronic disorders. DVT patients have a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient’s red blood cells (RBCs) and platelets demonstrates inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. Conclusions It is well-known that HIV infection is linked to inflammation and inflammation is linked with the presence of a hypercoagulable state. The presence of DVT is also associated with inflammation. Whether HIV is the cause of the DVT is not certain. Although there were trends that HIV infected patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV uninfected patients, there were no significant differences between the 2 groups. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV infected patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.
Comparison of Hemodialysis and Peritoneal Dialysis Patients’ Dietary Behaviors
Authors: Kim Seonmi , Kang Byung Chin , Kim Hyun-Jung , Kyung Min-Sook , Oh Hyung Jung , Kim Jung-Hyun , Kwon Oran , Ryu Dong-Ryeol
Published: February 2020

Background: Nutritional factors are associated with high mortality and morbidity in dialysis patients, and protein-energy wasting is regarded as an important one. The modality of dialysis may affect patients’ dietary behavior and nutritional status, but no study has compared the dietary behavior, nutrient intake, and nutritional adequacy of hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: From December 2016 to May 2017, a dietary behavior survey and Semi-quantitative Food Frequency Questionnaire (Semi-FFQ) were conducted on 30 HD patients and 30 PD patients in Ewha Womans University Mokdong Hospital, and laboratory parameters were obtained. The results of prevalent HD and PD patients were then compared. Results: The mean age of HD patients was higher than that of PD patients; HD: 58.5±9.1 years, PD: 49.3±9.7 years ( p = 0.001). In the dietary behavior survey, HD patients showed more appropriate dietary behavior patterns overall than PD patients. In the dietary intake analysis with the Semi-FFQ, energy intake was significantly lower in the PD group than in the HD group due to the lower intake of carbohydrates, fat, and protein. A comparison of nutrient intake-to-recommended allowance ratio between the HD and PD groups revealed that the HD group showed higher nutrient intake than the PD group. Serum albumin and potassium levels were significantly higher in HD than in PD patients. Conclusion: According to this study, the dietary behavior and nutritional intake of prevalent PD patients were worse than those of HD patients.
The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?
Authors: Babazadeh Saleh , Hernandez Julie , Anglewicz Philip , Bertrand Jane T
Published: February 2020

Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning (FP) services, as well as service availability and quality of family planning services in Kinshasa.
Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services.
Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services.
Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa not to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services.
Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.
Alpha-enolase in viral target cells suppresses the human immunodeficiency virus type 1 integration.
Authors: Kishimoto Naoki , Yamamoto Kengo , Iga Nozomi , Kirihara Chie , Abe Towa , Takamune Nobutoki , Misumi Shogo
Published: February 2020

Background A protein exhibiting more than one biochemical function is termed a moonlighting protein. Glycolytic enzymes are typical moonlighting proteins, and these enzymes control the infection of various viruses. Previously, we reported that glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and alpha-enolase (ENO1) are incorporated into human immunodeficiency virus type 1 (HIV-1) particles from viral producer cells and suppress viral reverse transcription independently each other. However, it remains unclear whether these proteins expressed in viral target cells affect the early phase of HIV-1 replication. Results Here we show that the GAPDH expression level in viral target cells does not affect the early phase of HIV-1 replication, but ENO1 has a capacity to suppress viral integration in viral target cells. In contrast to GAPDH, suppression of ENO1 expression by RNA interference in the target cells increased viral infectivity, but had no effect on the expression levels of the HIV-1 receptors CD4, CCR5 and CXCR4 and on the level of HIV-1 entry. Quantitative analysis of HIV-1 reverse transcription products showed that the number of copies of the late products (R/ gag ) and two-long-terminal-repeat circular forms of viral cDNAs did not change but that of the integrated (Alu- gag ) form increased. In contrast, overexpression of ENO1 in viral target cells decreased viral infectivity owing to the low viral integration efficiency. Results of subcellular fractionation experiments suggest that the HIV integration at the nucleus was negatively regulated by ENO1 localized in the nucleus. In addition, the overexpression of ENO1 in both viral producer cells and target cells most markedly suppressed the viral replication. Conclusions These results indicate that ENO1 in the viral target cells prevents HIV-1 integration. Importantly, ENO1, but not GAPDH, has the bifunctional inhibitory activity against HIV-1 replication. The results provide and new insights into the function of ENO1 as a moonlighting protein in HIV-1 infection.
Biofilm forming properties of quinolone resistant Escherichia coli from the broiler production chain and their dynamics in mixed biofilms
Authors: Nesse Live L. , Osland Ane Mohr , Mo Solveig Sølverød , Sekse Camilla , Slettemeås Jannice Schau , Bruvoll Anna Eline E. , Urdahl Anne Margrete , Vestby Lene K.
Published: February 2020

Background

Quinolone resistant Escherichia coli (QREC) have been found in samples from Norwegian broiler chicken, despite quinolones not being administered to poultry in Norway. Biofilm production may be one factor contributing to the observed persistence in the broiler production chain. In the present study, 158 QREC strains from chicken caecal and retail meat samples were screened for biofilm production in microtiter plates, biofilm morphotype on Congo Red (CR) agar plates and phylotype by multiplex PCR. Furthermore, the dynamics in mixed biofilms with strains of different morphotypes were studied on glass slides and on CR agar plates.

Results

All strains but one produced biofilm in microtiter plates and/or on CR agar plates at room temperature. There were no differences between strains from chicken caecum and chicken retail meat in the mean amount of biofilm produced in microtiter plates. Furthermore, no differences in biofilm production were observed between phylotypes. However, significant differences in biofilm production were found between biofilm morphotypes. The morphotype RDAR (red dry and rough), which has both curli and cellulose in the matrix, was displayed by 70% of the strains. Mean biofilm production by these strains were significantly higher than by strains with the morphotypes PDAR (pink dry and rough) with only cellulose or BDAR (brown dry and rough) with only curli. Interestingly, the two latter morphotypes produced biofilms with the morphotype RDAR when grown together. None of the strains achieved significantly higher numbers of colony forming units (cfu) in mixed biofilms than in single strain biofilms on glass slides.

Conclusions

The results indicate that QREC can form biofilm reservoirs on both inert and organic surfaces in production environments, as well as on meat. This may contribute to persistence and dissemination of the strains. Strains with both curli and cellulose in the biofilm matrix were significantly better biofilm formers than strains lacking one of these components. However, strains with only one of the components could compensate for this by producing mixed biofilms with strains having the other component, and thereby most likely enhance their probabilities of persistence in the production environment.