bluuebunny/crossref_metadata_2025 huggingface dataset:
Complexidade e criatividade no processo de produção musical em estúdio: uma perspectiva sistêmica
Authors: Rosa Gilberto Assis , Manzolli Jônatas
Published: September 2019

Este artigo propõe que o processo de produção musical em estúdio seja investigado em analogia com os sistemas complexos. De natureza colaborativa, suas etapas (planejamento, gravação, edição, mixagem e masterização) podem ser entendidas como subsistemas cujas interações produzem novidades consideradas aqui como propriedades emergentes. A partir da exploração das diferentes etapas do processo de produção musical, dentro de uma perspectiva sistêmica, este artigo coloca em discussão a figura do(a) artista, as funções dos agentes envolvidos, a criatividade e a visão polarizada entre ações técnicas e estéticas dentro do estúdio de gravação. Como resultado, a analogia do processo de produção musical com os sistemas complexos ressaltou a dificuldade em estabelecer distinções entre ações técnicas e artísticas dentro do estúdio, ao mesmo tempo que possibilitou uma abordagem da criatividade, não como algo individualizado, mas como elemento emergente de uma rede intrincada de inter-relações inerente aos processos colaborativos. Concluímos, também, que qualquer ação dentro do estúdio cria um tipo de reação em cadeia cujo impacto no resultado da obra não pode ser premeditado. Assim, o imprevisível surge durante o processo na forma de novidades ou propriedades emergentes, cujas inter-relações e interações com os demais elementos contribuem para a configuração da obra musical.
Analysis of the Contribution of Rainwater Recycling (RWR) to the Campus Area
Authors: Bekar Makbulenur , Yalçınalp Emrah , Meral Alperen
Published: September 2019

The reserves of water, which is one of the most important requirements for human life, gradually decreases under current conditions and rapidly depletes despite being one of the renewable resources. Considering the global water reserves, it became imperative to implement measures to protect the anticipated water reserves. The fact that the amount of quality water per capita decreases every day in the world and the increasing competition in water management could be considered among the indicators of the above-mentioned case. In recent years, as the effects of this adversity became increasingly more evident, several sustainable methods were adopted all over the world such as rain gardens and rainwater storage facilities. These sustainable techniques could be observed in many areas, especially in urban centers. In the present study, the area with the highest water collection was determined at Karadeniz Technical University Kanuni Campus and identified as the study area. Precipitation per square meter and surface runoff volume were identified based on the GIS (Geographic Information System) data, annual water collection volume was calculated, and information on economic and ecological recycling of the water was provided. In conclusion, the precipitation data for 11 years were compared, and it was calculated that the average annual precipitation was 64.06 kg/m2 and annual surface runoff water was 552.77 m3. Based on the surface runoff water volume in the months when no irrigation is conducted, a reservoir was designed under the vehicle road and water recycling recommendations were developed.
The potential of different Autotaxin inhibitor types regulating catalysis-dependent and -independent signalling
Authors: Salgado Polo Fernando , Perrakis Anastassis
Published: September 2019

Autotaxin (ATX) is a secreted lysophospholipase D, catalysing the conversion of lysophosphatidylcholine (LPC) to bioactive lysophosphatidic acid (LPA). LPA acts through two families of G protein-coupled receptors (GPCRs) controlling key cellular responses, and is implicated in many physiological processes and pathologies. ATX has therefore been established as an important drug target in the pharmaceutical industry. Structural and biochemical studies of ATX have shown that it has a bimetallic nucleophilic catalytic site, a substrate-binding (orthosteric) hydrophobic pocket that accommodates the lipid alkyl chain, and an allosteric tunnel that can accommodate various steroids and LPA. Here we first review what is known about ATX-mediated catalysis, crucially in light of allosteric regulation. We then present the known ATX catalysis-independent functions, including binding to cell-surface integrins and proteoglycans. In light of these data we then discuss the four types of ATX inhibitors, as classified depending on their binding to the orthosteric and/or the allosteric site. Finally, we analyse the binding mode of known members of all four types and discuss how mechanistic differences might differentially modulate the activity of the ATX-LPA signalling axis, and clinical applications including cancer.
Dietary Patterns Independent of Fast Food Are Associated with Obesity among Korean Adults: Korea National Health and Nutrition Examination Survey 2010–2014
Authors: Kim Do-Yeon , Ahn Ahleum , Lee Hansongyi , Choi Jaekyung , Lim Hyunjung
Published: September 2019

Background: Few studies have examined multifaceted aspects of fast food consumption and dietary patterns for their effects on obesity. We examined the independent associations of obesity with fast food consumption and dietary pattern in Korean adults. Methods: A total of 19,017 adults aged 19–64y participated from KNHANES 2010-2014. Fast food items were removed from diet and then dietary patterns were generated. Multivariate logistic regression analysis was used to examine the odds for overweight/obesity and central obesity according to fast food consumption and dietary patterns. Results: Fast food consumers were about 10% of Korean adults. Both of White rice and kimchi pattern and Meat and alcohol pattern were associated with low intakes of fiber, calcium, vitamin C, grains, fruit, and milk(p<0.05). Fast food consumers had higher the Meat and alcohol pattern and the Grains, fruit, and milk pattern, and they had lower the White rice and kimchi pattern than non-fast-food-consumers. Fast food consumer were not associated with overweight/obesity, whereas the participants with Meat and alcohol pattern had 14% higher overweight/obesity(95%CI:1.01,1.28) and 16% higher central obesity(95%CI:1.00,1.34). Conclusions: Fast food consumption was not directly associated with obesity, whereas the Meat and alcohol pattern had independent associations with overweight/obesity and central obesity among Korean adults.
Spatial Gap-Filling of ESA CCI Satellite-Derived Soil Moisture Based on Linear Geostatistics
Authors: Llamas Ricardo M. , Guevara Mario , Rorabaugh Danny , Taufer Michela , Vargas Rodrigo
Published: September 2019

Soil moisture plays a key role in the Earth’s water and carbon cycles, but acquisition of continuous (i.e., gap-free) soil moisture measurements across large regions is a challenging task due to limitations of currently available point measurements. Satellites offer critical information for soil moisture over large areas on a regular basis (e.g., ESA CCI, NASA SMAP), however, there are regions where satellite-derived soil moisture cannot be estimated because of certain circumstances such as high canopy density, frozen soil, or extreme dry conditions. We compared and tested two approaches--Ordinary Kriging (OK) interpolation and General Linear Models (GLM)--to model soil moisture and fill spatial data gaps from the European Space Agency Climate Change Initiative (ESA CCI) version 3.2 (and compared them with version 4.4) from January 2000 to September 2012, over a region of 465,777 km2 across the Midwest of the USA. We tested our proposed methods to fill gaps in the original ESA CCI product, and two data subsets, removing 25% and 50% of the initially available valid pixels. We found a significant correlation coefficient (r = 0.523, RMSE = 0.092 m3m-3) between the original satellite-derived soil moisture product with ground-truth data from the North American Soil Moisture Database (NASMD). Predicted soil moisture using OK also had significant correlation coefficients with NASMD data, when using 100% (r = 0.522, RMSE = 0.092 m3m-3), 75% (r = 0.526, RMSE = 0.092 m3m-3) and 50% (r = 0.53, RMSE = 0.092 m3m-3) of available valid pixels for each month of the study period. GLM had lower but significant correlation coefficients with NASMD data (average r = 0.478, RMSE = 0.092 m3m-3) when using the same subsets of available data (i.e., 100%, 75%, 50%). Our results provide support for OK as a technique to gap-fill spatial missing values of satellite-derived soil moisture products across the Midwest of the USA.
Penggunaan Peta Konsep Sebagai Instrumen Penilaian Terhadap Pemahaman Konseptual Peserta Didik Melalui Model Pembelajaran PDEODE Pada Materi Asam Basa
Authors: Chandra Annisa , Suhartono Suhartono , Fitriani Ella
Published: September 2019

Penelitian ini bertujuan untuk mengetahui penggunaan peta konsep sebagai instrumen penilaian terhadap pemahaman konseptual peserta didik melalui model pembelajaran PDEODE pada materi asam basa. Penelitian ini menggunakan metode kualitatif, yang  dilakukan di SMAN Jakarta pada semester dua. Subjek pada penelitian ini yaitu peserta didik kelas XI MIPA di salah satu SMA Negeri Jakarta yang melibatkan 36 peserta didik. Perlakuan yang diberikan berbasis Predict-Discuss-Explain-Observe-Discuss-Explain (PDEODE). Data diperoleh dari penilaian peta konsep, observasi, dan wawancara. Penilaian peta konsep pada penelitian ini menggunakan rubrik penilaian Novak dan Gowin yang ditambahkan konsep. Hasil penelitian menunjukkan peta konsep dapat digunakan sebagai instrumen penilaian pemahaman konseptual peserta didik. Model pembelajaran PDEODE berdampak terhadap proses peserta didik dalam memahami konsep asam basa. Pemahaman konseptual peserta didik tergolong dalam kategori sedang dan rendah. Melalui peta konsep dapat diidentifikasi miskonsepsi yang dialami oleh peserta didik terutama pada teori asam basa.

Kata kunci

Peta Konsep, Pemahaman Konseptual, PDEODE, Asam Basa, Penilaian
Pengaruh Strategi “REACT” Terhadap Literasi Kimia Peserta Didik Kelas X MIA Pada Pembelajaran Reaksi Redoks
Authors: Hadinugrahaningsih Tritiyatma , Rosita  , Kurniadewi Fera
Published: September 2019

Penelitian ini bertujuan untuk mengetahui pengaruh strategi REACT terhadap literasi kimia peserta didik kelas X MIA pada pembelajaran reaksi redoks.  Penelitian dilakukan pada semester genap tahun ajaran 2018/2019 di salah satu SMA di Jakarta. Metode penelitian yang digunakan adalah Quasi Exsperiment dengan desain penelitian Posttest Only Control Group Design. Sampel yang digunakan dalam penelitian diperoleh melalui teknik purposive sampling, kelas X MIA 2 ditetapkan sebagai kelas eksperimen dengan menerapkan strategi REACT dan kelas X MIA 1 sebagai kelas kontrol yang menerapkan strategi pembelajaran active. Data yang diambil berupa nilai pretest dan posttest menggunakan instrumen literasi kimia. Hasil penelitian menunjukkan bahwa rata-rata nilai posttest literasi kimia kelas eksperimen (67,324) lebih besar daripada kelas kontrol (54,030). Berdasarkan perhitungan uji t diperoleh nilai thitung (3,8274) dan  ttabel (1,668) pada taraf signifikansi 5%. Oleh karena nilai thitung > ttabel, maka H0 ditolak dan H1 diterima, oleh karena itu dapat disimpulkan bahwa penggunaan strategi REACT berpengaruh positif terhadap literasi kimia peserta didik pada materi reaksi redoks.

Kata kunci

Literasi kimia, reaksi redoks, strategi REACT
Identifikasi Miskonsepsi Siswa pada Konsep Ikatan Kimia Menggunakan Tes Four-Tier Multiple-Choice (4TMC)
Authors: Islami Dini , Suryaningsih Siti , Bahriah Evi Sapinatul
Published: September 2019

Ikatan Kimia merupakan salah satu materi kimia dengan konsep yang abstrak, dan diakui sulit dipahami serta sering kali menimbulkan miskonsepsi pada siswa. Penelitian ini bertujuan untuk mengidentifikasi miskonsepsi siswa pada konsep Ikatan Kimia. Metode yang digunakan dalam penelitian adalah deskriptif kuantitatif. Penelitian dilaksanakan pada 31 Januari sampai dengan 6 Februari 2018. Subjek penelitian ini adalah siswa kelas X tahun ajaran 2017/2018 dengan jumlah sampel sebanyak 48 siswa. Identifikasi miskonsepsi dilakukan menggunakan instrumen tes berbentuk four-tier multiple-choice (4TMC). Jawaban siswa dari tes 4TMC tersebut kemudian dianalisis dan dikategorikan berdasarkan tingkatan pemahaman siswa. Hasil menunjukkan bahwa terjadi miskonsepsi sebesar 30,31% (kategori rendah). Miskonsepsi signifikan teridentifikasi pada 8 dari 13 subkonsep Ikatan Kimia yaitu subkonsep Struktur Lewis dan Kaidah Oktet (33,33%), Ikatan Logam dan Sifat Logam (20,83%), Senyawa Ionik dan Senyawa Kovalen (27,08%), Teori VSEPR (20,83%), Teori Domain Elektron (18,75%), Kepolaran Molekul (27,08%), Gaya van der Waals (14,58%), dan Ikatan Hidrogen (29,17%). Hasil identifikasi miskonsepsi siswa ini diharapkan dapat membantu dalam menangani miskonsepsi pada siswa lebih awal agar tidak menghambat siswa dalam pembelajaran.

Kata kunci

Miskonsepsi, Ikatan Kimia, Four-Tier Multiple-Choice Test
Analisis Pemahaman Konsep Siswa pada Pembelajaran Larutan Elektrolit dan Non-Elektrolit dengan 8E Learning Cycle
Authors: Fitriyani Dewi , Rahmawati Yuli , Yusmaniar Yusmaniar
Published: September 2019

Penelitian ini bertujuan untuk mengembangkan pemahaman konsep siswa pada materi larutan elektrolit dan non-elektrolit menggunakan model pembelajaran 8E Learning Cycle. Subjek penelitian adalah 36 siswa kelas X MIA. Teknik pengumpulan data dilakukan dengan wawancara, tes pemahaman konsep, observasi, reflektif jurnal dan lembar kerja siswa. Berdasarkan penelitian, siswa selama mengikuti model pembelajaran 8E learning cycle mengalami pengembangan pemahaman konsep pada sub-materi karakteristik larutan dan sifat larutan. Berdasarkan grafik, pemahaman konsep siswa meningkat sampai 96% di sub-materi karakteristik larutan dan di sub-materi sifat larutan pemahaman siswa meningkat sampai 80%. Miskonsepsi terbesar terjadi pada tahap explore, karena siswa masih menggunakan pengetahuan awalnya. Siswa dapat mengelompokkan dengan benar larutan elektrolit dan non-elektrolit berdasarkan daya ionisasi larutan, namun siswa masih belum bisa menghubungkan larutan elektrolit dan non-elektrolit dengan jenis ikatannya. Model pembelajaran 8E learning cycle, selain berperan dalam mengembangkan pemahaman konsep siswa, model ini juga berperan mengembangkan keterampilan komunikasi dan berkolaborasi dalam pembelajaran kimia.

Kata kunci

Model pembelajaran 8E learning cycle, pemahaman konsep, larutan elektrolit dan non elektrolit
WRITING BIOGRAPHICAL FICTION
Authors: Caulfield Janice
Published: September 2019

Biographical fiction narratives—often of famous artists—have, claims David Lodge (2014), become ‘a fashionable form of literary fiction’. Yet in writing about famous people, the novelist is most often faced with countless biographies and archival materials in letters, literary notes, diaries, and in the works (and reviews) of the subject author/artist themselves, to say nothing of the academic scholarship surrounding the subject and their work. The problem for the novelist then in researching their subject, is where to draw the line. This paper examines the challenge for biographical fiction writers in imagining the lives of their subjects beyond that which has been documented—the ‘what is left over’, after reading the extant literature. The paper’s focus is on my own work in progress: a biographical novel about the life of the South African writer and social theorist, Olive Schreiner.
Effect of GOR on Gas Diffusivity in Reservoir-Fluid Systems
Authors: Ratnakar Ram R. , Dindoruk Birol
Published: September 2019

Molecular diffusion plays a dominant role in various reservoir processes, especially in the absence of convective mixing. In general, gas diffusion in oils depends on several factors such as pressure, temperature, oil viscosity, and gas/oil ratio (GOR). Out of these factors, the effects of GOR and live-oil-compositional changes on diffusivity are rare or not available in the literature. The current work fills this gap and presents the experimental observations on the effect of GOR on gas diffusivity in reservoir-fluid systems.

Synthetic live oils were created by combining stock-tank oil (STO) and methane in various ratios. Constant-composition-expansion (CCE) experiments were performed with these oils to obtain their bubblepoints and liquid densities in relation to GOR. Methane diffusivity in these oils was obtained from pressure-decay (PD) tests at high-pressure/high-temperature (HP/HT) conditions. The diffusion and solubility parameters were estimated from PD data using the diffusion model and integral-based linear regression presented in previous work (Ratnakar and Dindoruk 2015, 2018). The experimental and modeling methodologies are presented here in sufficient detail to allow readers to replicate and evaluate the results.

In this work, we experimentally investigated the effect of GOR on methane diffusivity in oils at HP/HT conditions using PD tests. In particular,

We present experimental data for bubblepoints and liquid density of synthetic oils with various GOR values. For the range of GORs considered, these measurements show that the bubblepoint pressure increases linearly with GOR. Late-transient solution (LTS) of the PD model was used to obtain diffusivity parameters by regressing against experimental data. It is found that as the GOR value increases (that is, when oil becomes lighter), the diffusivity value increases, which is in accordance with the Stokes-Einstein relation. Most importantly, an empirical correlation is developed on the basis of a limited data set to describe the variation in diffusivity values with GOR. This can be important when experimental data are available for the STO but not for the live oils. It can also be extremely useful in gas-injection processes where the amount of gas dissolved in the oil varies, leading to variations in diffusivity.
Risk factors associated with Hepatitis B virus infection among pregnant women attending antenatal clinic at Felegehiwot referral hospital, Northwest Ethiopia, 2018: An institution based cross sectional study
Authors: Gedefaw Getnet , Waltengus Fikadu , Akililu Almaz , Gelaye Kihinetu
Published: September 2019

Objective

This study aimed to determine the magnitude of serum HBsAg and the risk factors for Hepatitis B virus infection among pregnant women in Bahir Dar. An institution based cross sectional study was implemented from February 1 to May 1, 2018 among 338 pregnant women attending antenatal care clinic at Felegehiwot referral hospital, Bahir Dar, 2018. Systematic random sampling technique was implemented. Blood sample was taken from 338 study participants and serum was tested for Hepatitis B surface antigen (HBsAg) using Enzyme Linked ImmunoSorbent Assay.Results

The overall prevalence of hepatitis B virus infection among pregnant women were 16(4.7%) (95% CI= 2.7, 7.7). Having a history of blood transfusion (AOR=5.2; 95% CI=1.2-22.3), having a history of multiple sexual partners (AOR=4.6; 95% CI=1.1-19.6) and having a history tonsillectomy (traditional surgical procedure) AOR=3.4; 95% CI=1.1-10.1) were the significant risk factors for Hepatitis B virus infection.
Elevated expression of AGGF1 predicts poor prognosis and promotes the metastasis of colorectal cancer
Authors: Zhang Xin , Sun Huimin , Chen Wanyuan , He Xianglei
Published: September 2019

Abstract
Background: Angiogenic factor with G-patch and FHA domains 1 (AGGF1) can promote angiogenesis and increasing evidence has highlighted the important roles of AGGF1 in tumorigenesis. However, the expression patterns as well as the biological functions of AGGF1 in colorectal cancer (CRC) remain to be established. The purpose of the present study is therefore to identify the effect of AGGF1 on prognosis and metastasis in CRC patients.
Methods: The expression level of AGGF1 in CRC was examined by qPCR, western blot and immunohistochemistry in a tissue microarray containing 101 CRC specimens. And the effect of AGGF1 on CRC cell malignance was investigated in our established stable AGGF1 upregulated and knockdown CRC cell lines.
Results: The expression level of AGGF1 in CRC tissue was not significantly different to that in adjacent normal mucosa at the mRNA level. However, at the protein level, AGGF1 expression in CRC tissues was significantly higher than in paired normal mucosa, which showed a clear association with TNM stage, AJCC stage, vascular invasion, and differentiation. Further, we revealed an apparent correlation between AGGF1 expression and poorer disease-free survival and overall survival of CRC patients. In addition, we discovered that AGGF1 significantly promoted CRC cell wound healing, migration, and invasion in vitro and distant metastasis in vivo .
Conclusions: Our study demonstrates the aberrant expression of AGGF1 in CRC and provides a basis on which to explore the application of AGGF1 as a novel prognostic biomarker for CRC patients, especially for CRC patients with distant metastasis.
MiR-376a inhibits non-small cell lung cancer cell progression by regulating Rab1A
Authors: Cao Zheng-Hao , Cheng Jing-Liang , Zheng Xian-Zhao , Lv Qing-Qing , Ma Jin-Xin , Zhang Yong
Published: September 2019

Post transcriptional gene regulation of microRNA-376a (miR-376a) plays a crucial role for tumorigenesis and cancer development. However, the potential role of miR-367a in non-small cell lung cancer (NSCLC) remains unclear. In this study, we investigated the crucial role of miR-376a in NSCLC by analyzing miR-376a expression as well as its target genes. Through overexpression strategies, we uncovered the molecular mechanisms underlying miR-376a-mediated tumorigenesis. Quantitative real-time PCR analysis demonstrated miR-376a levels to be significantly decreased in NSCLC cells compared with non-tumorigenic counterparts. Interestingly, miR-376a overexpression potentially repressed NSCLC cell proliferation, migration, and invasion, but increased apoptosis in A549 cells. Using bioinformatic approaches, we predicted that miR-376a targets Rab1A, and further luciferase fusion assay demonstrated Rab1A was a direct target of miR-376a and miR-376a inhibited cell proliferation by regulating the mRNA and protein levels of Rab1A in NSCLC cells. Overall, our findings uncover the miR-376a could suppress NSCLC cells progression via directly targeting Rab1A.
Temporal expression of polysaccharide biosynthesis genes in the leaves of Cyclocarya paliurus at different developmental stages
Authors: Lin Weida , Chen Huanwei , Wang Jianmei , Zhen Yongli , Lu Qiuwei , Li Yueling , Jin Zexin , Lv Hongfei , Li Junmin
Published: September 2019

Background: Cyclocarya paliurus (Batal.) Iljinskaja is a common endemic tree species. The leaves of C. paliurus are used as a Chinese medicine and the main active components are polysaccharides. However, the temporal pattern of polysaccharide synthesis at different leaf developmental stages has not been reported to date. Results: With the development of leaves, the content of polysaccharides increased first and the highest content was found at the F3 stage (the third larger full expanded leaf). A total of 499710194 clean reads were obtained using C. paliurus genomic data and were assembled into 296593 unigenes. Among 4708 identified DEGs, 429 DEGs were up-regulated and 451 DEGs were down-regulated from F1 stage (the smallest full expanded leaf) to F2 stage (the second larger full expanded leaf), 630 DEGs were up-regulated and 60 DEGs were down-regulated from F2 stage to F3 stage, and 1833 up-regulated and 1816 down-regulated DEGs from F3 stage to F4 stage. Forty DEGs associated with GT belong to 13 GT families. Among them, only one gene was down-regulated from F1 stage to F2 stage, two genes were down-regulated from F2 to F3 stages, and 23 genes were down-regulated and 15 genes were up-regulated from F3 stage to F4 stage, respectively. A significant correlation exists between the five unigenes and the polysaccharide content. UDP-glucose 4-epimerase gene was significantly positively correlated with the polysaccharide content. A pathway map for the biosynthesis of C. paliurus polysaccharide was proposed. Among 150 transcription factors identified from DEGs, the majority was members of the AP2/ERF family (21, 14%), followed by the C2H2 family (14, 9.33%), the MYB family (12, 8%), the C2C2-GATA family (10, 6.67%), the GRAS family (9, 6%), and the zf-HD family (7, 4.67%). Conclusions: These results identified genes involved in the biosynthesis of Cyclocarya paliurus polysaccharides during different leaf developmental stages and provided evidence for the change of polysaccharide content during the development of C. paliurus leaves. Possible synthetic pathways and related transcription factors were suggested. This study provides information for the screening of polysaccharide biosynthesis related genes and elucidates the mechanism underlying polysaccharide biosynthesis in C. paliurus.
Designing a Framework of Technical Hospital Information Systems Requirements and Evaluating the Systems Implemented through this Framework
Authors: Farzandipour Mehrdad , Meidani Zahra , Nabovati Ehsan , Jabali Monireh Sadeqi , Banadaki Razieh Dehghan
Published: September 2019

Background Hospital Information System (HIS) implementation is complex and costly compared to other information systems. Therefore, the present study was conducted with the aim of designing and evaluating technical HIS requirements.Methods This study was conducted in 2016 in two parts: designing technical requirements and evaluating the HIS. The first part of the study was performed through the Delphi technique. In the second part of the study, evaluation of systems was done using a checklist based on the approved requirements.Results In the first part of the study, the final list of technical HIS requirements was designed with 73 items in four domains including ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’. In the second part, the results of the evaluation indicated that the approved requirements had been observed in 63.8%, 65.5%, 72.4%, and 76.3% of the HIS software programs in the dimensions of ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’, respectively.Conclusions The technical HIS evaluation tool was designed to be used in the evaluation and selection of the system. The evaluation results also indicated that the studied HISs were weaker in ‘communication service’ and ‘system architecture’ domains compared to the other two domains under study.
Development and Implementation of a clinical pathway to reduce inappropriate admissions among patients with Community acquired pneumonia in a private health system in Brazil: An observational cohort study and a promising tool for efficiency improvement.
Authors: Moreira Rodrigo , Mendonça Hugo T. F. , Farias Ayla M. , Sznejder Henry , Lang Eddy , Wilson Margaret M.
Published: September 2019

Background: Patients with community-acquired pneumonia (CAP) at low risk of death by CURB-65 scoring system are usually unnecessarily treated as inpatients generating additional economic and clinical burden. We aimed to implement an evidence based clinical pathway to reduce hospital admissions of low risk CAP and investigate factors related to mortality and readmissions within 30 days.Methods: From November 2015 to August 2017 a clinical pathway was implemented at twenty hospitals. We included patients aged >18 years, with a diagnosis of CAP by the attendant physician. The main outcome was the monthly proportion of low risk CURB-65 admission after implementation of the clinical pathway. Logistic regression models were performed to assess variables associated with mortality and readmission in the admitted population within 30 days.Results: We included 10909 participants with suspected CAP. The proportion of low risk CAP admitted decreased from 22.1% to 12.8% in the period. Among participants with low risk, there has been no perceptible increase in deaths (0.80%) or readmissions (6.92%). Regression analysis identified that CURB-65 variables, presence of pleural effusion (OR= 1.74; 95%IC=1.08-2.8; p=0.02) and leucopenia (OR= 2.47; 95%IC=1.11-5.48;p=0.02) were independently associated with 30-day mortality whereas a prolonged hospital stay (OR= 2.09; 95%=1.14-3.83;p=0.01) were associated with 30-day readmission in the low risk population.Conclusion: The implementations of a clinical pathway diminished the proportion of low risk CAP admissions with no apparent increase of clinical outcomes within 30 days. Nonetheless, additional factors influences the clinical decision about site of care management in low risk CAP.
Comparisons of cryptococcal meningitis caused by Cryptococcus neoformans between HIV-negative patients with and without lung infection in two Chinese university hospitals
Authors: Yang Ming , Sun Fengjun , Liu Fu , Feng Wei , Yuan Qian , Wang Yu , Cheng Lin , Xia Peiyuan
Published: September 2019

Background Lung infection may cause many symptoms, such as fever and headache, that may be confused with cryptococcal meningitis (CM) symptoms. This study aimed to investigate the discrepancy in clinical features and outcomes of CM between HIV-negative patients with and without lung infection.Methods We retrospectively reviewed the medical records of patients with CM admitted to two hospitals in Southwest China from 1 January 2014 to 31 December 2018.Results A total of 71 patients was included during the 5 years, among which 35 (49.3%) patients had lung disease. CM occurred more frequently in male (62.9% vs. 44.4%, P=0.12) and young (≤30 years, 31.4% vs. 16.7%, P=0.30) patients with lung infection than in the patients without lung infection, with more fever (77.1% vs. 30.6%, P=0.001) and less central nervous system symptoms (5.7% vs. 16.7%, P=0.28) and vomiting (25.0% vs. 14.3%, P=0.26). In addition, patients with lung infection presented higher percentages of white blood cell (WBC) counts ˂20×106/L (45.7% vs. 22.2%, P=0.036) and lower percentages of ethmoid sinusitis, maxillary sinusitis, paranasal sinusitis, and otitis media than patients without lung infection (8.6% vs. 30.6%, P=0.02). The Cryptococcus neoformans isolates were sensitive to itraconazole, voriconazole, fluconazole, and amphotericin B but resistant to flucytosine. Patients with lung infection had higher mortality at discharge compared with patients without lung infection (8.6% vs. 0, P=0.12). Multivariable analyses showed that WBC counts ˂20×106/L was significantly associated with treatment outcome (OR=0.01, 95% CI=0-0.833, P=0.041).Conclusions There were significant discrepancies in clinical features between CM patients with and without lung infection. Clinicians must consider the divergences in the diagnosis of CM in patients with lung infection.
Ultraconserved non-coding DNA within insect phyla
Authors: Brody Thomas , Yavatkar Amar , Kuzin Alexander , Odenwald Ward F.
Published: September 2019

Background Presence of ultra-conserved sequence elements in vertebrate enhancers suggest that transcription factor regulatory interactions are shared across phylogenetically diverse species. To date evidence for similarly conserved elements among evolutionarily distant insects such as flies, mosquitos, ants and bees, has been elusive. This study has taken advantage of the availability of the assembled genomic sequence of these insects to explore the presence of ultraconserved sequence elements in these phylogenetic groups.Results To investigate the integrity of fly regulatory sequences across ~100 million years of evolutionary divergence from the fruitfly Drosophila melanogaster , we compared Drosophila non-coding sequences to those of Ceratitis capitata , the Mediterranean fruit fly and Musca domestica , the domestic housefly. Using various alignment techniques, Blastn, Clustal, Blat, EvoPrinter and Needle, we show that many of the conserved sequence blocks (CSBs) that constitute Drosophila cis -regulatory DNA, recognized by EvoPrinter alignment protocols, are also conserved in Ceratitis and Musca . We term the sequence elements shared among these species ultraconserved CSBs (uCSBs). The position of the uCSBs with respect to flanking genes is also conserved. Blastn alignments also detect putative cis -regulatory sequences shared among evolutionarily distant mosquitos Anopheles gambiae and Culex pipiens and Aedes aegypti. We have also identified conserved sequences shared among bee species. Side by side comparison of bee and ant EvoPrints identify uCSBs shared between the two taxa, as well as more poorly conserved CSBs in either one or the other taxon but not in both.Conclusions The results suggest that CSBs represent the point of interaction of multiple trans-regulators whose functions and interactions are conserved across divergent genera. Analysis of uCSBs in dipterans, mosquitos and bees will lead to a greater understanding of their evolutionary origin and the function of their conserved non-coding sequences.
Characterizing the ribosomal tandem repeat and its utility as a DNA barcode in lichen-forming fungi
Authors: Bradshaw Michael , Grewe Felix , Thomas Anne , Harrison Cody H. , Lindgren Hanna , Muggia Lucia , Clair Larry L. St. , Lumbsch H. Thorsten , Leavitt Steve
Published: September 2019

Background Regions within the nuclear ribosomal operon are a major tool for inferring evolutionary relationships and investigating diversity in fungi. In spite of the prevalent use of ribosomal markers in fungal research, central features of nuclear ribosomal DNA (nrDNA) evolution are poorly characterized for fungi in general, including lichenized fungi. The internal transcribed spacer (ITS) region of the nrDNA has been adopted as the primary DNA barcode identification marker for fungi. However, little is known about intragenomic variation in the nrDNA in symbiotic fungi. In order to better understand evolution of nrDNA and the utility of the ITS region for barcode identification of lichen-forming fungal species, we generated nearly complete nuclear ribosomal operon sequences from approximate nine species in the Rhizoplaca melanophthalma species complex using short reads from high-throughput sequencing.Results We estimated copy numbers for the nrDNA operon, ranging from nine to 48 copies for members of this complex, and found low levels of intragenomic variation in the standard barcode region (ITS). Monophyly of currently described species in this complex was supported in phylogenetic reconstructions of the ITS, 28S, IGS, and some intronic regions; however, phylogenetic reconstructions based on the 18S provided much lower resolution. Phylogenetic analysis of concatenated ITS and intergenic spacer sequence data generated from 496 specimens collected worldwide revealed, previously unrecognized lineages in the nrDNA phylogeny.Conclusions The results from our study support the general assumption that the ITS region of the nrDNA is an effective barcoding marker for fungi. For the R. melanophthalma group, the limited number of potentially polymorphic sites generally do not correspond to fixed diagnostic nucleotide position characters separating taxa within this species complex. Previously unrecognized lineages inferred from ITS sequence data may represent undescribed species-level lineages or reflect uncharacterized aspects of nrDNA evolution.
Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review
Authors: Kragh Astrid Rolin , Folke Fredrik , Andelius Linn , Ries Emma Slebsager , Rasmussen Rasmus Vedby , Hansen Carolina Malta
Published: September 2019

Background Dispatched citizen responders are increasingly involved in out-of-hospital cardiac arrest (OHCA) resuscitation which can lead to severe stress. It is unknown which psychological assessment tools are most appropriate to evaluate psychological distress in this population. The aim of this systematic review was to identify and evaluate existing assessment tools used to measure psychological distress with emphasis on citizen responders who attempted resuscitation. Methods A systematic literature search conducted by two reviewers was carried out in March 2018 and revised in July 2018. Four databases were searched: PubMed, PsycInfo, Scopus, and The Social Sciences Citation Index. A total of 504 studies examining assessment tools to measure psychological distress reactions after acute traumatic events were identified, and 9 fulfilled the inclusion criteria for further analysis. The selected studies were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network. Results The Impact of Event Scale (IES) and The Impact of Event Scale-Revised (IES-R) were the preferred assessment tools, and were used on diverse populations exposed to various traumatic events. One study included lay rescuers performing bystander cardiopulmonary resuscitation and this study used the IES. The IES and the IES-R also have proven a high validity in various other populations. The Clinical administered PTSD scale (CAPS) was applied in two studies. Though the CAPS is comparable to both the IES-R and the IES, the CAPS assess PTSD symptoms in general and not in relation to a specific experienced event, which makes the scale less suitable when measuring stress due to a specific resuscitation attempt. Conclusions The IES and the IES-R seem to be solid measures for psychological distress among people experiencing an acute psychological traumatic event. However, only one study has assessed psychological distress among citizen responders in OHCA for which the IES-R scale was used, and therefore, further research on this topic is warranted.
(Dis)concordance of comorbidity data across ICD codes, medical charts, and self-reports
Authors: Sheriffdeen Abdullah , Millar Jeremy , Martin Catherine , Evans Melanie , Tikellis Gabriella , Evans Susan
Published: September 2019

Background Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how close these are to the “truth”. We studied the level of concordance for same-patient comorbidity data extracted from administrative data (coded from International Classification of Diseases, Australian modification,10th edition [ICD-10AM]), from the medical chart audit, and data self-reported by men with prostate cancer who had undergone a radical prostatectomy.Methods We included six hospitals (5 public and 1 private) contributing to the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) in the study. We listed eligible patients from the PCOR-Vic who underwent a radical prostatectomy between January 2017 and April 2018 for the Health Information Manager in each hospital, who provided each patient’s associated ICD-10AM comorbidity codes. Medical charts were reviewed to extract comorbidities used to generate the Charlson Comorbidity Index. The self-reported comorbidity questionnaire (SCQ) was distributed through PCOR-Vic to eligible men.Results The percentage agreement between the administrative data, medical charts and self-reports ranged from 92% to 99% in the 122 patients (from 217 eligible participants, 56%), who responded to the questionnaire. The prevalence-adjusted bias-adjusted kappa (PABAK) coefficient was from 0.83 to 0.98 for all conditions aside from cancer, reflecting a strong level of agreement for the absence of comorbidities. Conversely, the presence of comorbidities showed a poor level of agreement between data sources. There was concordance on 213/277 (77%) comorbidities when comparing medical charts and administrative data; 102/238 (30%) comorbidities when comparing medical chart and self-reports; and 34/150 (23%) comorbidities when comparing administrative data and self-reports.Conclusion Relying on a single data source to generate comorbidity indices for risk-modelling purposes may fail to capture the reality of a patient’s disease profile. There does not appear to be a ‘gold-standard’ data source for the collection of data on comorbidities.
A Study of Factors Affecting on Patients’ Length of Stay in a Surgical Ward: Toward Optimization by Technology-based Solutions
Authors: Baniasadi Tayebeh , Ghazisaeedi Marjan , Hassaniazad Mehdi , Kalhori Sharareh R. Niakan , Shahi Mehraban
Published: September 2019

Background: Understanding each of the factors affecting the length of hospitalization especially in surgery wards can play a major role in planning for the optimal use of hospital resources. This study aims to determine factors affecting the length of stay (LOS) in a surgical ward and then provide technology-based solutions .Methods: In this cross-sectional study, 310 records were selected by systematic random sampling from hospitalized patients in surgery ward of a general teaching hospital in Bandar Abbas, situated in sought of Iran. In order to determine the association of 26 variables (demographic, clinical, and non-clinical) with LOS, analytical and descriptive statistics were used. Then, the researchers reviewed relevant literature in PubMed, Scopus, and Google Scholar to introduce solutions based on health information technology (HIT) toward LOS optimization.Results: Mean and median of patients’ LOS in surgery ward were 3.30±3.71 and 2 days respectively. According to multivariate regression model, factors that exerted higher influence on length of stay includes number of para-clinical tests, surgeries, and consultation as well as type of referral and months of admission(p<0.05). Regarding HIT-based intervention, eleven general categories of suggestions were provided. Based on the findings, more accessible technologies such as hospital information system, picture archiving and communication system, telemedicine especially tele-consultation or tele-visit as well as electronic consultation and discharge planning tools alongside smart dashboards for institutions like the center under study in order to expedite the process of diagnosis and treatment, then optimizing LOS seem appropriate. Conclusions: It is important to move toward optimized LOS though understanding and control influential factors; standardize LOS along with continuous monitoring of performance indicators may help to utilize hospital resources more efficiently. HIT-based interventions may support health care providers and administrators to manage patients` admission, hospitalization, transfer, and discharge processes more properly. Keywords: Index; length of Stay; Hospital; Health Information Technology; Surgery_ward
Catha edulis (Khat) use and Demographic Correlates of Schizophrenia: A Case-Control study.
Authors: Woldemariam Abraha Gosh , Thupayagale-Tshweneagae Gloria , Gebremedihin Misgna Teklay
Published: September 2019

Objective The purpose of this study was to determine the demographic correlates of schizophrenia and the use of Catha edulis.Results Results of the present study shows that variables like age ≤ 30 year ( OR=2.6; 95%CI=1.166,5.821; p=.020 ), single marital status ( OR=4.25; 95%CI=1.86,9.72; p=.001 ), unemployment ( OR=3.82; 95%CI=1.74,8.38; p=.001 ), lifetime Catha edulis (khat) use ( OR=3.89; 95%CI=1.75,8. 64) are significantly correlated with Schizophrenia. Knowledge of the association between demographic variables and the use of Catha edulis would assist in both societal education on the diagnosis and prognosis of schizophrenia.
Pregnancy outcomes with Primary Sjogren's syndrome among Chinese women: a retrospective cohort study
Authors: Xu Jinfeng , Chen Daijuan , Tian Yuan , Peng Bing
Published: September 2019

Background Data on pregnancy outcomes in Primary Sjogren's syndrome (pSS) women are scarce, and results have been conﬂicting. The aim of our study is to analyze the adverse pregnancy outcome in patients with pSS. Methods This was a retrospective cohort study conducted at a tertiary medical center located in Chengdu, Sichuan, China, from May 2013 to November 2018. The relevant medical records of all pregnant women were retrospectively reviewed. Logistic regression analyses were performed to compute crude odds ratios (crude OR) with 95% confidence intervals (CI) for maternal and fetal outcomes. Adjusted odds ratios (aOR) were estimated by logistic regression adjusted for confounders. Results Women with pSS had a significantly higher incidence of pre-eclampsia (aOR 11.49, 95% CI 1.65-79.98), PPROM (aOR 5.09, 95% CI 1.14-22.63). Compared to general population, pregnant women with pSS were at increased risks of fetal loss (aOR 15.06, 95%CI 1.19 to 191.11), and a higher risk of fetal growth restriction (aOR 15.69, 95%CI 1.61 to 153.33), preterm birth (aOR 5.52, 95%CI 1.83 to 16.65), a cesarean section (aOR 6.53, 95%CI 3.18 to 13.42) and a neonatal intensive care unit admission (aOR 12.86, 95%CI 1.88 to 87.82) after adjusting for confounding factors. The rate of congenital heart block in the pSS group was 4.7%. Conclusions Pregnant women with pSS were at increased risk of having adverse pregnancy outcomes. Women with pSS require prenatal counseling to explain the risks involved and well control of pSS condition before conception and a close antenatal monitoring should be performed by both rheumatologists and obstetricians.
Physical, Behavioral and Sociodemographic determinants of hypertension among adult population in Nekemte town, western Ethiopia: Community based study.
Authors: Geleta Gemechis Teshome , Cheme Melese Chego , Roro Elias Merdassa
Published: September 2019

Objectives Although hypertension is a growing public health problem in many developing countries there is inadequacy of scientific evidences on community based level of hypertension among the population. The study aimed at exploring prevalence and associated factors of hypertension among adults in Nekemte town, Ethiopia. Community based cross sectional study was conducted on 711 adults selected by multistage sampling procedure and data obtained by interview. Height, Weight, Blood Pressure and waist circumference were measured with standard procedures. Data was analyzed by SPSS 20 version and multiple logistic regression models were used to determine the independent risk factors for hypertension.Result The overall prevalence of hypertension was 34.9% of which only about half (52.7%) of them knew that they were hypertensive and only 22.4% of them were on medication. Older age; age group >65 year (AOR =5.85, 95% CI; 1.74-20), 41-64 year (AOR = 2.6, 95% CI; 1.49-4.57), Obesity and overweight (AOR =1.71, 95% CI; 1.09-2.67), chat chewers in the past year (AOR =2.44, 95% CI; 1.05-5.68) and lower educational status (AOR =2.75, 95% CI; 1.26-6.03) had higher risk of hypertension.