bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing mastoid and posterior cervical muscles vibration effects on eye movement in normal subjects
Authors: Shaabani Moslem , Naghibi Najmeh , Bakhshi Enayatollah
Published: September 2019

Background and Aim: Vibration is a method for stimulating the vestibular system. This met­hod can unmask asymmetry between two vesti­bular systems (such as unilateral peripheral ves­tibular disorders). The occurrence of vibration-induced nystagmus (VIN) in healthy subjects can affect the diagnosis of patients with uni­lateral peripheral vestibular disorders. Thus, the evaluation of VIN in healthy subjects is critical to help the diagnosis of unilateral peripheral vestibular disorders.
Methods: This study was carried out on 72 hea­lthy subjects (mean ± SD age: 27.12 ± 4.97 years) in the Auditory and Balance Clinic of Rofeideh Rehabilitation Hospital. Vibration sti­mulation with a frequency of 30 and 100 Hz was used on mastoid and posterior cervical mus­cles (PCMs) and simultaneously eye movements were recorded and analyzed using videonystag­mography.
Results: The mastoid vibration with a frequ­ency of 30 and 100 Hz, respectively produced VIN in 16.67% and 27.78% of subjects and VIN observed in PCMs vibration with a frequency of 30 and 100 Hz in 4.17% and 9.72% of the subjects.
Conclusion: The occurrence of VIN in healthy subjects was more probable with mastoid vib­ration in 100 Hz. In this study, VIN was pre­dominantly horizontal, its direction was toward the stimulated side, and its slow phase velocity was lower than 5 deg/s. These criteria could be used for differentiation between normal and abnormal subjects.
EXAMINING THE CLARITY OF EXPRESSIONS IN DESCRIBING THE BLACK WOMAN’S OPPRESSION IN KENNEDY'S “FUNNYHOUSE OF A NEGRO”
Authors: Alsanafi Ismael Hasan , Mohd Noor Siti Noor Fazelah , Abdul Kadir Zulida Binti
Published: September 2019

Purpose of study: This study tries to figure out whether Adrienne Kennedy’s play “Funnyhouse of a Negro” was direct and clear or indirect and implicit when she expresses a black woman’s struggle with identity.

Methodology: This study adopts a mix mode approach of Martin and white (2005) attitudinal category of Appraisal theory so as to analyze, frame, and to answer the research questions by which is proposed for this full research paper.

Main Findings: The inscribed instances have exceeded the invoked ones in the whole corpus of “Funnyhouse of a Negro”, concerning how did Sarah; the protagonist, as well as her split figures, have portrayed her white mother and a black father. The outcomes suggest that Kennedy was very clear and direct to deliver her moral judgment to her audiences/readers regarding the status of African American women in American based on analyzing the discourses of the main characters in the play.

Implications/Applications: Therefore, this play has gained very much respect and admiration from critics, readers, and audiences because of the playwright’s direct descriptions of Sarah and her parents in the American arena as well as her attempt to form new status as an individual human being who have a right to live such as any white American civilian.

Originality/Novelty of Study: The appraisal approach is a fairly new extension in the area of Systemic Functional Linguistics. It has been applied mainly to non-fictional discourse, particularly to certain texts with an argumentative task such as journalistic and political speeches. There is an increasing interest in the utilization of this theory to the analysis of literary texts, involving narrative fiction (Alsanafi&Mohd Noor, 2019). The researcher does not find any study employs Appraisal category to discover the clearness of expressions to describe woman’s oppression in Adriane Kennedy’s “Funnyhouse of a Negro”.
Relacje turystyki i sportu w aspekcie organizacji nauki o turystyce
Authors: Kotus Jacek
Published: September 2019

Szczegółowym celem artykułu jest podjęcie dyskusji nad wzajemnymi relacjami turystyki i sportu, a w szerszym kontekście zwrócenie uwagi na, być może nadmierne, poszerzanie przedmiotu zainteresowań turystyki jako nauki. W tak wyznaczonym zakresie rozważań autor podejmuje dyskusję nad turystyką jako aktywnością społeczną, a także nad przedmiotem zainteresowań konceptualnych i badawczych. Pytania badawcze stanowiące drogowskaz dociekań intelektualnych sprowadzają się do kwestii, czy turystyka ma obszary wspólne z szeroko rozumianym sportem? Jeśli tak jest to czy aktywność w tych obszarach jest nadal aktywnością turystyczną? Czy też należy wyłączyć tego rodzaju aktywność „sportowo-turystyczną” z dyskursu na temat przedmiotu zainteresowania turystyki jako dyscypliny naukowej ze względu na jej inny niż turystyczny charakter? Literatura przedmiotu wskazuje, iż pewna grupa aktywności człowieka leży na pograniczu poczynań turystycznych i sportowych. Autor stawia tezę, iż pomiędzy tymi dwoma polami aktywności społecznej rozciąga się strefa buforowa w postaci działalności odkrywczej/poznawczej wychodzącej poza turystykę i sport. Aktywność turystyczna i sportowa różnią się między sobą.
Accessibility of One Stop Service Centers: Perspectives of Persons With Disabilities and One Stop Center Staff
Authors: Smith Tammy Jorgensen , Dillahunt-Aspillaga Christina J. , Ehlke Sarah
Published: September 2019

Research indicates that One Stop Service Centers may not be universally accessible as required by law. This article includes an overview of the Workforce Innovation and Opportunity Act (WIOA) and the results of two surveys: a statewide survey of persons with disabilities (customer survey) and a self-report checklist (provider survey) of One Stop system administrators and staff. The surveys assess perspectives on the accessibility of One Stop services for persons with disabilities. Findings suggest that improvements in the areas of outreach, staff training, and environmental adaptations may make the One Stops more accessible and user-friendly. The article provides implications for rehabilitation counselors and presents strategies for conducting a comprehensive program evaluation, which may improve access and service delivery within One Stop Service Centers.
A Qualitative Analysis of the Employment Needs and Barriers of Individuals With Intellectual and Developmental Disabilities in Rural Areas
Authors: Adams Chithra , Corbin Amanda , O'Hara Luke , Park Mirang , Sheppard-Jones Kathleen , Butler Laura , Umeasiegbu Veronica , McDaniels Bradley , Bishop Malachy L.
Published: September 2019

In this article we present the results of a needs assessment evaluating the employment-based needs of individuals with intellectual and developmental disabilities (IDD), from the perspectives of self-advocates, their families and care givers, and IDD service providers in a primarily rural state. Participants were recruited through statewide distribution of a questionnaire about key issues and barriers to employment. A total of 467 adults participated. Employment was identified as a top concern across the groups. An inductive thematic analysis approach was used to analyze the qualitative comments provided by respondents about their employment needs. The results were generally consistent with prior research among Americans with IDD, in that employer expectations, transportation barriers, disability benefits, limited opportunities to develop employment skills, and broader economic factors influencing the community were identified as key issues. However, the results demonstrate the magnified impact of these barriers in rural areas, particularly rural areas facing economic challenges. The results of this needs assessment are discussed in terms of the broad national implications, and in terms of the local process of engaging multiple stakeholder groups to identify potential solutions.
The Existence of Decision Norms of the Constitutional Court as a Source of Legislative and Executive Laws
Authors: Kartika Adhitya Widya
Published: September 2019

Norms are behavioral guidelines in the Indonesian legal state. Norms continue to exist in the legislation and juridical consequences of constitutional court decisions, and in particular, that of the Constitutional Court. Legal norms have principles that are applied to a wider hierarchy of legal norms and the production of legislation. In essence, the Constitutional Court's rulings have consequences on the actions of the government and therefore the action of governance. Including decision norms in the Constitutional Court's ruling has juridical consequences for the hierarchy of regulations and state legal actions in carrying out the function of government. This article aims to find out how to apply decision norms if there an identical or related decision exists within a different judicial institution. In government institutions bound by the Constitutional Court's decisions, application of decision norms resulted in chaos for the application and enforcement of the law. The implementing agency is faced with the same legal product, namely a verdict in another judicial institution. This causes no legal certainty. Rather than a solution or outcome, implementing agencies are faced with an identical legal response yet no legal certainty. The absence of legal certainty has consequences for government institutions that are bound by the Constitutional Court's decision. By utilizing a hierarchy of legal norms, the issue of rigidity and uncertainty caused by decision norms can be resolved. Likewise, in the legislature, the Constitutional Court's decision is the source of making legal norms. As the Constitutional Court’s decision is the source of legal norm production in the legislature, espousing a hierarchy of legal norms will enable laws and regulations that are formed to reflect justice, certainty and benefit.

Keywords: Court Decision, Legal Norms, Government.
Introducción
Authors: Branciforte Laura
Published: September 2019

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Materialist and queer feminism in France: Politics of Counter-Hegemony = Féminisme matérialiste et queer en France: Politiques contre-hégémoniques
Authors: Noyé Sophie
Published: September 2019

Abstract: This article questions the relationship between materialist feminism and queer movement in France. It addresses the pluralization of feminist emancipation in France since the mid-1990s in light of the conflict between materialist and queer feminisms, which started as the queer theory was developed in France in the nineties. The starting point is the hypothesis that the link between these two political theoretic discourses is possible since it actually takes places in the current “queer-feminist” movement’s activist practices. The article argues that this combination is meaningful and deserves to be better theorized because it carries with it a radical message of inclusiveness. The alliance of the two approaches questions the definition of the feminist subject, and especially the formulation of a political unity that is not essentialist. The article analyses the extent to which the counter-hegemonic approach provides with tools to answer this issue.Key words: Materialist feminism, queer movement, feminist subject, Politics of Counter-Hegemony.Résumé: Cet article interroge le rapport entre le féminisme matérialiste et le mouvement queer en France. Il envisage la pluralisation des formes d’émancipation féministe en France depuis le milieu des années 1990 à la lumière de la controverse entre les féminismes matérialiste et queer, qui a comencé quand la théorie queer s’est développée en France dans les années 1990. Mon hypothèse initiale postule que le rapprochement entre ces deux visions théorico-politiques est possible car il se pratique concrètement dans les mouvements queer-féministes actuels. Cet article affirme que cette articulation est pertinente et mérite ainsi d’être théorisée davantage car elle propose une forme d’inclusivité radicale. L’alliance entre ces deux courants questionne en effet la définition du sujet féministe, et, en particulier, une unité politique qui soit non essentialiste. Cet article analyse dans quelle mesure la stratégie contre-hégémonique donne des outils intéressants pour répondre à cet enjeu.Mots-clés: Féminisme matérialiste, mouvement queer, sujet féministe, contre-hégémonie.
Feminidades y masculinidades en la Historiografía de Género
Authors: Vargas Martínez Ana
Published: September 2019

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α-Defensin HD5 Stabilizes Human Papillomavirus 16 Capsid/Core Interactions
Authors: Gulati Neetu M. , Miyagi Masaru , Wiens Mayim E. , Smith Jason G. , Stewart Phoebe
Published: September 2019

Background: Human papillomavirus (HPV) is linked to nearly all cases of cervical cancer. Despite available vaccines, a deeper understanding of the immune response to HPV is needed. Human α-defensin 5 (HD5), an innate immune effector peptide, blocks infection of multiple serotypes of HPV, including high-risk HPV16. While a common mechanism of α-defensin anti-viral activity against nonenveloped viruses such as HPV has emerged, there is limited understanding of how α-defensins bind to viral capsids to block infection. Methods: We have used cryo-electron microscopy (cryoEM), mass spectrometry (MS) crosslinking and differential lysine modification studies, and molecular dynamics (MD) simulations to probe the interaction of HPV16 pseudovirions (PsVs) with HD5. Results: CryoEM single particle reconstruction did not reveal HD5 density on the capsid surface. Rather, increased density was observed under the capsid shell in the presence of HD5. MS studies indicate that HD5 binds near the L1 and L2 capsid proteins and specifically near the C-terminal region of L1. MD simulations indicate that favorable electrostatic interactions can be formed between HD5 and the L1 C-terminal tail.Conclusions: A model is presented for how HD5 affects HPV16 structure and cell entry. In this model, HD5 binds to disordered regions of L1 and L2 protruding from the icosahedrally ordered capsid. HD5 acts to cement interactions between L1 and L2 and leads to a closer association of the L2/genome core with the L1 capsid. This model provides a structural rationale for our prior observation that HD5 interferes with the separation of L1 from the L2/genome complex during cell entry.
THE CORRELATION BETWEEN PATIENT SATISFACTION AND PEOPLE EQUITY AMONG PARAMEDIC STAFFS IN INPATIENT ROOMS
Authors: Puspitasari Sendhi Tristanti
Published: September 2019

Background: One of the elements controlling the quality of hospital health services is patient and employee satisfaction. The mean value of patient satisfaction with all parameters of inpatient rooms at the Islamic Hospital in Surabaya from January to August 2016 was 61.3% which is less than the standard of ≥ 90%. Whereas, people equity is a concept of human resource management that signs organizational performance.Aims: This study examined the correlation between patient satisfaction and people equity among paramedic staffs especially in inpatient rooms of the Islamic Hospital in Surabaya.Methods: This study focused on measuring people equity, patient satisfaction, and the correlation between people satisfaction and people equity. The questionnaire used in this study adopted RATER dimensions (Reliability, Assurance, Tangible, Empathy, and Responsiveness).Results: The study found that three inpatient rooms (Muzdalifah, Arofah, and Shofa) did not meet three elements of people equity (Alignment, Capabilities, and Engagement). Patient satisfaction with the inpatient rooms was good, except for the tangible dimension especially room cleanliness which is still relatively low. People equity among the paramedic staff has strong relevance and is directly proportional to patient satisfaction with the inpatient rooms of the Islamic Hospital in Surabaya.Conclusion: Internalizing an organizational culture that considers patient satisfaction and patient equity among paramedic staffs is essential to harmonize the goals, vision, and mission between the hospital and its staffs. This study recommends that there should be a more serious evaluation of the cleanliness of all service units at the Islamic Hospital in Surabaya.Keywords: Patient satisfaction, People equity, Human Resource Management, Service performance.
THE RELATIONSHIP BETWEEN DISCIPLINE AND EMOTIONAL INTELLIGENCE TOWARDS EMPLOYEE PERFORMANCE
Authors: Linda Dian Rosa , Astuti Puji , Wijaya Satriya
Published: September 2019

Background: One of problems in an organization or company is poor performance of employees. For instance, they do not complete tasks or finish their job responsibilities on time. The preliminary data taken from one of companies in Surabaya showed that 184 employees did not come to work without any explanations, and 288 employees worked late.Aim: This study analyzed the relationships between discipline and emotional intelligence towards employee performance at the company.Method: The design of this research was analytical using a cross sectional approach. The population of this study was employees at Production and Maintenance Section of one company in Surabaya comprising of 155 people. Out of 155 employees, 89 respondents were taken as samples using a stratified random sampling technique. Then, the data were collected through a questionnaire and analyzed using Spearman’s rank correlation test with a significance level of α 0.05.Results: This study showed that most of the respondents were very highly disciplined (94.4%) and had a highly emotional intelligence (74.2%). Lastly, most of them perform satisfyingly (50.6%). The results of the analysis test with Spearman’s rank correlation yielded p-value of 0.002 <α 0.05. It means there was a correlation between  discipline attitude and employee performance. The p-value 0.001 which was less than α-value of 0.05 showed that there was a correlation between emotional intelligence and employee performance.Conclusion: Discipline and emotional intelligence are prominent to determine employee performance at PT X. In order to improve the discipline and intelligence in the performance of the employees, the company should provide rewards based on employee’s achievements in the workplace. Key words: Emotional intelligence, Employee performance, Discipline.
Efeito da nodulação natural no desenvolvimento de leguminosas em solos de cerrado no Tocantins
Authors: Chagas Junior Aloísio Freitas , Dos Santos Gil Rodrigues , Melo Rogério Cézar de Lima , De Oliveira Ariádila Gonçalves , Vizioli Bruno , Chagas Lillian França Borges , Costa Jefferson da Luz
Published: September 2019

Experiments were performed in a greenhouse to evaluate the effect of natural nodulation in the development of Pacara Earpod Tree (Enterolobium contorsiliquum) and Leucaena (Leucaena leucocephala) is soil with different uses in Tocantins. We used three soil samples of woods, cultivated areas four and in a degraded area, in pots in a completely randomized design with four replications. In both species nodulation was observed in all soils studies areas with better nodulation occurring in soil cultivation, providing a higher accumulation of biomass. Soil from the degraded area the two species showed nodule number and biomass of nodules significant, with potential for use in disturbed areas, with characteristics of degraded soils.
Aplikasi dan Tinjauan Kinetika Hasil Fraksinasi Produk Pirolisis Cangkang Biji Jambu Mete Uji sebagai Antijamur Candida albicans
Authors: Ustamuni Ustamuni , Nurliana Laily , Musta Rustam
Published: September 2019

Research on application and kinetics study of fractionation pyrolysis product from cashew nut shell as antifungal of Candida albicans has been carried out. This study aims to determine the constituent compounds, antifungal activity and chemical kinetics including order and rate constants antifungal activity C. albicans from fractional distillation results of cashew nut shell pyrolysis products. Cashew nuts were hydrolyzed and purified using a fractional distillation device. The results of the antifungal activity test C. albicans from fractional distillation results of cashew nut shell pyrolysis products showed that the inhibitory power varied from each concentration variation of 12.5%, 25%, 50%, 75%, and 100%. The concentration of 100% was the highest inhibitory characterized by the formation of a clear zone of 18.23 mm which indicates that the inhibitory force is a strong category. The clear zone that has been formed was calculated in terms of its chemical kinetics including the reaction order and the activity rate constant. The reaction order of antifungals C. albicans from the results of fractional distillation of cashew nut shell pyrolysis products is 0.15 with a constant activity rate of 8.74.
Improving Quality-of-Service in LoRa Low-Power Wide-Area Networks through Optimized Radio Resource Management
Authors: Sallum Eduardo , Pereira Nuno , Alves Mário , Santos Max
Published: September 2019

Low Power Wide Area Networks (LPWAN) enable a growing number of Internet-of-Things (IoT) applications with large geographical coverage, low bit-rate and long lifetime requirements. LoRa (Long Range) is a well-known LPWAN technology which uses a proprietary Chirp Spread Spectrum (CSS) physical layer, while the upper layers are defined by an open standard - LoRaWAN. In this paper, we propose a simple yet effective method to improve the Quality-of-Service (QoS) of LoRa networks by fine-tuning specific radio parameters. Through a Mixed Integer Linear Programming (MILP) problem formulation, we find optimal settings for the Spreading Factor (SF) and Carrier Frequency (CF) radio parameters, considering the network traffic specifications as a whole, to improve the Data Extraction Rate (DER) and to reduce the packet collision rate and the energy consumption in LoRa networks. The effectiveness of the optimization procedure is demonstrated by simulations, considering realistic scenarios. In relation to the traditional LoRa radio parameter assignment policies, our solution leads to an average increase of 30% in DER, and a number of collisions 17 times smaller. In comparison to networks with dynamic radio parameter assignment policies, there is an increase of 10.5% and 4% of DER, and a number of collisions 13.5 and 7.5 times smaller than equal-distribution and random distribution, respectively. Regarding the network energy consumption metric, the proposed optimization obtained an average consumption 3.6 and 2.74 times lower than the equal-distribution and random dynamic allocation policies, respectively. Furthermore, we approach the practical aspects on how to implement and integrate the optimization mechanism proposed in LoRa, guaranteeing backward compatibility with the standard protocol.
A New Model on Cation Distribution in Cation-Disordered Li1+xTM1-xO2 Cathodes
Authors: Huang Yang , Liu Long , Gao Min
Published: September 2019

The search for new materials that could improve the energy density of Li-ion batteries (LIB) is one of today’s most challenging issues. Recently, cation-disordered lithium-excess metal oxides have emerged as a promising new class of cathode materials for LIB, due to their high reversible capacities and nice structural stability. However, a full structural model of the Li-transition metal (TM) sharing sublattice and the origin of short range ordering (SRO) of cation ions requires further investigation. In this work, we put forward a Monte Carlo strategy of building a cation-disordered rocksalt material supercell model. The cation ions of Li1.0Ti0.5Ni0.5O2 (LTNO) are placed at the FCC sublattice sites with the constraint of Pauling’s electroneutrality rule, instead of a random way. This constraint causes the Li-Ti and Ni-Ni clustering (the cation short range ordering). Based on this model, we discussed the relationship between the short range ordering, the local distorting, the theoretic capacity and the order-disorder strengths. A unified understanding of these factors in cation-disordered materials may enable a better design of disordered-electrode materials with high capacity and high energy density.
A concepção funcional de bens jurídicos, para a unificação dos efeitos do princípio ne bis in idem na seara extrapenal sancionadora disciplinar
Authors: Dezan Sandro Lúcio , Herkenhoff Henrique Geaquinto
Published: September 2019

O presente artigo busca investigar a inter-relação complexa entre duas espécies de ramos punitivos do Estado, o direito penal e o direito administrativo disciplinar, especificamente acerca dos efeitos do princípio ne bis in idem, sentidos por esses ramos jurídicos. Por meio do método hipotético-dedutivo, a dialogar com a doutrina nacional e estrangeira, há de se indagar se o referido princípio jurídico possui efetividade extrassistêmica, para abarcar outros ramos epistemológicos do direito sancionador geral do Estado. Nesse contexto, concluir-se-á que as noções de legalidade e de tipicidade são necessariamente moldadas pelo fim e pela função impostas pelos bens jurídicos dependentes de proteção em cada face punitiva estatal. Com isso, ramos distintos requerem, com exclusividade, tipicidades protetivas de objetos jurídicos também distintos, obstativas, por obra do próprio legislador, de ocorrências de mais de uma punição pelo mesmo fato gerador.
Regulação da infraestrutura, exigências contratuais e elaboração do projeto básico: análise do papel do estudo preliminar na execução de obra pública
Authors: Moura Emerson Affonso da Costa
Published: September 2019

Em que medida os arranjos jurídico-normativos da ordem estatal brasileira acabam por inviabilizar ou dificultar a atuação dos sujeitos públicos e da iniciativa privada no que tange a expansão da infraestrutura necessária ao desenvolvimento econômico é o tema posto em debate, a partir da análise da exigência legal da elaboração do projeto básico nas licitações públicas e as falhas decorrentes do seu mal dimensionamento produzindo uma vinculação formal ineficiente do processo de seleção pública da contratação. Tem-se como hipótese preliminar, que a gestão pública mal dimensiona a obra ou serviço público e acaba por produzir projetos de licitação mal elaborados que resulta em execuções ineficientes.
Improved cookstoves and the prevalence of metabolic syndrome in the rural Peruvian Andes: a quasi-experimental study
Authors: Sanchez-Samaniego Giuliana , Mäusezahl Daniel , Carcamo Cesar , Probst-Hensch Nicole , Verastegui Héctor , Hartinger Stella Maria
Published: September 2019

Background: Household air pollution increases the risk of non-communicable diseases, such as cardiovascular diseases and metabolic syndrome. This study hypothesised that the reduction of household air pollution through the installation of improved cookstoves is associated with the prevalence of metabolic syndrome. We compared the prevalence of metabolic syndrome between adults using open fire stoves and using improved cookstoves in high altitude provinces of Cajabamba and San Marcos in rural Peruvian Andes.Methods: This is a quasi experimental study nested within a randomised controlled trial (parent study) of 317 children randomised in four study arms. The parents study applied a 2x2 factorial design with three single intervention arms (improved cookstove (ICS), early child development (ECD) and Control) and one combined arm (ICS-ECD). This study was conducted 6-10 months after the ICS intervention was implemented and all parents of the 317 children in the parent study were eligible to participate. Ventilated improved cookstoves using biomass fuel were provided to intervention homes. All participants answered a 24-hour food recall and underwent a physical examination for metabolic syndrome diagnosis. Results: A total of 385 participants were allocated to two groups of improved cookstove users with 190 (112 women and 78 men) and open-fire stove users with 195 (123 women and 72 men). Metabolic syndrome was detected in 21% of all participants and more frequently in women than men (26% versus 13%). In women, the improved cookstove intervention was a protective factor for metabolic syndrome (Prevalence Ratio= 0.70 (0.46 to 1.08), p=0.11). In addition, PR increased with age in women. In both gender, significantly lower PR was found in participants living ≥2500 meters above sea level (PR=0.65 (0.42 to 1.00), p=0.051 in women; (PR=0.25 (0.07 to 0.71), p=0.009 in men).Conclusions: The improved cookstove intervention reducing household air pollution is associated with a lower prevalence of MetS in women users. In addition, residential altitude is an important risk factor for metabolic syndrome even in high altitude populations. Keywords: biomass fuel ventilated improved cookstove, household air pollution, metabolic syndrome, high altitude, Peru Trial registration: Trial registration number ISRCTN26548981 at www.srctn.com . Registered retrospectively, Jan. 15 2018.
First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases
Authors: Hu Jilin , Zhang Jinman , He Guilin , Zhu Shu , Tang Xinhua , Zhu Baosheng , Su Jie , Li Qian , Kong Yamin
Published: September 2019

Purpose: To investigate the predictive values of first-trimester maternal serum alpha-fetoprotein (MS-AFP) to preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of adverse pregnancy outcomes (APOs) regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), while the risk of stillbirth was not significantly increased (1.33, 0.40~4.41). The areas under ROC curves were 0.572 (P = 0.001), 0.597 (P = 0.060), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, stillbirth, preeclampsia and SGA, respectively. Women with MS-AFP ≥ 2.5MoM had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000) compared to those with MS-AFP < 2.5MoM, but the actual between-group differences were minuscule. Conclusion: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.
Prevalence of malocclusion in north Cyprus School
Authors: Beleva Nadejda , Kacamak Nazli Idil , Sin Cagla , Kamiloglu Beste
Published: September 2019

Background. The epidemiology of the population living in a country plays an important role in the planning and implementation of dental services. Correct identification of the need for orthodontic treatment in individuals is a very complex subject and requires detailed analysis. The aim of this study was to measure the prevalence of malocclusion among randomly selected subjects aged 12-15 years attending secondary schools regardless of any socio-economic or social status in Northern Cyprus.Methods. After the approval of the competent authorities in the Ministry of National Education and the Ministry of Health of Northern Cyprus and of the parents whose subjects were to take part in the study, the evaluation was carried out by a team of three people, two of whom are in the process of specializing in orthodontics and one doctoral student at the qualification stage. The study included a randomly selected sampling composed of 426 subjects (203 females and 223 males). Results. The statistical evaluation of the samples collected in the study found that 20.6% of the subjects had no occurrence of occlusion, 74.4% had Class I, 21.1% had Class II (part 1, 18.8%, part 2, 2.3%) and 4.5% had Class III malocclusion. Of the 419 patients, 86 (20.2%) were in need of orthodontic treatment. Although not statistically significant, it was determined that 19.7% of female patients and 20.7% of the male patients were in need for orthodontic treatment.Conclusions. The most common orthodontic malocclusion in Cyprus is Class I, the least common malocclusion is Class II division 2.
Information technology tools can automate imaging measures for Emergency Department patients with suspected pulmonary embolism
Authors: Valtchinov Vlad I , Ip Ivan , Khorasani Ramin , Cochon Laila , Lacson Ronilda , Murphy Shawn N. , Raja Ali
Published: September 2019

CT pulmonary angiography (CTPA) utilization rates for patients with suspected pulmonary embolism (PE) in the Emergency Department (ED) have increased steadily with associated radiation exposure, costs and overdiagnosis. A new measure is needed to more precisely assess efficiency of CTPA utilization normalized to numbers of patients presenting with suspected PE, based on patient signs and symptoms. This study used natural language processing (NLP) to develop, automate, and validate SPE (“Suspected Pulmonary Embolism [PE]”), a measure determining CTPA utilization in ED patients with suspected PE. This retrospective study was conducted 4/1/2013-3/31/2014 in a Level-1 ED. A NLP engine processed “Chief Complaint” sections of ED documentation, identifying patients with PE-suggestive symptoms based on four Concept Unique Identifiers (CUIs: shortness of breath, chest pain, pleuritic chest pain, anterior pleuritic chest pain). SPE was defined as proportion of ED visits for patients with potential PE undergoing CTPA. Manual reviews determined specificity, sensitivity and negative predictive value (NPV). Among 5,768 ED visits with 1+SPE CUI, and 795 CTPAs performed, SPE=13.8% (795/5,768). NLP identified patients with relevant CUIs with specificity=0.94 [95%CI (0.89-0.96)]; sensitivity=0.73 [95%CI (0.45-0.92)]; NPV=0.98. Using NLP on ED documentation can identify patients with suspected PE to computate a more clinically-relevant CTPA measure. This measure might then be used in an audit-and-feedback process to increase the appropriateness of imaging of patients with suspected PE in the ED.
Prevalence and genotyping of Toxoplasma gondii in stray cats in Mashhad area, Iran.
Authors: Khodaverdi Majid , Razmi Gholamreza
Published: September 2019

Background: Cats as a definitive host have an important role in the epidemiology of toxoplasmosis in humans and animals. The aim of the study was to determine the frequency of Toxoplasma gondii infection and isolate and identify the genotypes of T. gondii in stray cats in Mashhad suburb .
Methods: From April 2016 to August 2017, in this study, 175 fecal samples from stray cats and 31 brain samples from cats killed in driving accidents were collected. The fecal samples were examined by fecal flotation technique and T. gondii -specific PCR. The brain samples were investigated by T. gondii -specific PCR and consequently examined by mice bioassay. The DNA of T. gondii isolated were genotyped using SAG1, SAG2, SAG3, BTUB and GRA6 as PCR-restriction fragment length polymorphism (PCR-RFLP) markers .
Results: In the present study, oocysts-like Toxoplasma were microscopically observed in 2.2% (4/175) fecal samples. The presence of Toxoplasma oocysts was confirmed in one microscopy-positive sample by PCR. In addition, T. gondii DNA was detected in 4% (7/175) microscopy-negative samples using PCR. T. gondii was isolated from one brain PCR-positive sample by mice bioassay. The isolate was avirulent and many T. gondii cysts were observed in mice brain. The isolate was successfully genotyped by PCR-RLFP analysis .The isolated genotyped was type II. Beside, eight Toxoplasma- positive fecal samples contained insufficient DNA and only amplified at SAG-3 locus in PCR. These samples were also showed type II pattern at this locus.
Conclusions: Parasitological and molecular results showed low frequency of Toxoplasma infection in the stray cats, and identified the genotype of T. gondii isolate as type II, for the first time in Mashhad area, Khorasan Razavi Province.
Clinical characteristics and relating factors of somatization symptoms of outpatients with psychological disorders: A cross-sectional observational study
Authors: Gong Shan , Zhang Yanan , Jin Chao , Ning Liang , Xiao Yi , Yu Guolong
Published: September 2019

Abstract Background:Cardiovascular disease patients associated with psychological disorders are very common clinically.It has been demonstrated in previous study that a higher prevalence of psychiatric disorders in the patients with CVD than the general population.Anxiety and depression are found to be the most common types of psychiatric disorders in the patients with CVD.Objective:Exploring the clinical characteristics and relating factors of somatization symptoms of the outpatients with psychological disorders. Methods:From August 2017 to July 2018,we used the General Anxiety Disorder-7, Patient Health Questionnaire, Patient Health Questionnaire-15 and self-made general demographic data questionnaire to investigate the outpatients suspected with psychiatric disorders in cardiology department in a general hospital,who were screened with the"three questions"method.Results:Among the 508 effective patients, the total detection rate of anxiety/depression was 81.1%(412/508),and the detection rate of somatization symptoms was 93.1%(473/508).The positive number of PHQ-15 symptom items was 8.54±2.67,and the detection rate of anxiety/depression was 78.7% in 473 patients with somatization symptoms.Among the patients with mild,moderate and severe somatization symptoms,there were significant differences in the proportion of women, the average number of the patient visits and hospitalizations in the past year(P=0.0341, 0.023),and also in GAD-7 and PHQ-9 scale scores(P=0.0282, 0.0011).Linear correlation analysis showed PHQ-15 score was significantly correlated with GAD-7(r=0.4787, P<0.001) and PHQ-9 score(r=0.5141, P<0.001).Stepwise logistic regression analysis showed that the PHQ-9,GAD-7 scores and female were positive factors on somatizations.Conclusion:The incidence of somatization symptoms is high in patients with psychological disorders in the outpatients of cardiology department.
Functional optical zone and visual quality after SMILE and FS-LASIK treatment for high myopia
Authors: Ding Xuan , Fu Dan , Li Meiyan , Wang Lin , Zhou Xingtao , Yu zhiqiang
Published: September 2019

Background We compared the functional optical zone (FOZ) and wavefront aberrations achieved after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in high-myopia patients.METHODS Thirty four and fourty high myopic (spherical equivalent refraction ≤ -6D) patients were respectively enrolled in FS-LASIK group and SMILE group, only right eye of each patient was analyzed. The planned FOZ (PFOZ), ablation depth/lenticule thickness and other data were acquired from medical records. The achieved FOZs (AFOZ) were assessed using a Pentacam at 1 month, 3 month, 6 month post-surgery. We defined the AFOZ diameter as the mean ring diameter corresponding to average total corneal refractive power (TCRP) in the central 4-mm zone plus 0.5D. The wavefront aberrations were obtained with WASCA system pre-operatively and 6-month-postoperatively.RESULTS The PFOZs in the SMILE and FS-LASIK groups were 6.57±0.22 mm vs 6.54±0.15 mm (P =0.350). In both groups, the AFOZ at every follow-up point was smaller than the PFOZ (P < 0.001). The AFOZ correlated negatively with the wavefront higher order aberrations (HOA), spherical aberration in both groups. HOA, spherical aberration (P<0.001), but not coma (P=0.477) and trefoil (P=0.812), differed significantly between the groups.CONCLUSIONS In high-myopia patients, the AFOZ was smaller than the PFOZ, irrespective of whether SMILE or FS-LASIK. In SMILE group, the AFOZ was larger and more consistent with the PFOZ, probably resulting in with less wavefront aberrations.
Paediatric Glaucoma in Scotland
Authors: Beck Daniel , Galea Martin , Loo Cheng Yi , Schmoll Conrad , Burgess Frederick R. , Montgomery Donald , Tatham Andrew J
Published: September 2019

Background The primary aim was to estimate the incidence of primary and secondary childhood glaucoma in Scotland over a 2-year period. The secondary aim was to gauge the confidence and experience of ophthalmologists in Scotland in managing these patients. Methods A 7 question electronic survey was distributed to all consultant members of the Scottish Paediatric Club and Scottish Glaucoma Club. Respondents were asked to report the number of cases and types of childhood glaucoma they had managed in the last 2 years. Respondents were also asked about experience and confidence in a range of glaucoma procedures, number of patients requiring referral to specialist centres and interest in the development of a centre of excellence in Scotland. Results The survey returned a 56% response rate, reporting 85 new cases of paediatric glaucoma in Scotland over the preceding 2 years. 11 (12.9%) had primary glaucoma and 74 (87.1%) had secondary glaucoma. The most common subtype of secondary glaucoma was uveitic glaucoma (n=29). None of the respondents declared confidence or experience in trabeculotomy or goniotomy procedures. 11 children required referral to a specialist unit outside Scotland. 85.7% of respondents felt Scotland would benefit from a specialist unit for paediatric glaucoma. Conclusions This survey reflects an appetite for a specialist service for paediatric glaucoma in Scotland. However, further consideration is needed to determine if there is sufficient patient load to maintain such a service.
Clinicodemographical assessment of colorectal cancer with emphasis on B3GALNT2, MUC1, P53 and Ki67-related risk of metastasis
Authors: Mehrzad Jalil , Ranjbary Ali Ghorbani , Abdollahi Abbas , Hosseinkhani Saman , Tabatabaee Abbas , Dehghani Hesam
Published: September 2019

Background: The incidence of colorectal cancer (CRC) is rising, worldwide, and is attributed to genetics and epigenetic factors. We aimed to evaluate key demographical/epidemiological/molecular indicators of CRC in CRC patients from a highly populated area in northeastern Iran, retrospective clinical materials-based cohort design and patients were analyzed with respect to age, sex, colorectum anatomy, metastasis, mortality as well as to expression of molecular markers B3GALNT2, mucin I ( MUC1), P53 and Ki67.
Methods: Patients, 6260 registered CRC with 3829 underwent surgery, from three medical university hospitals in the study area, during 2006-2016, were analyzed for the clinicodemographic aspects of age, sex, stage of CRC, history of smoking, familial/occupational status and post-surgery survival period as well as mRNA/protein expression of B3GALNT2, MUC1, P53 and Ki67. Factors were set to estimate mortality and risk of metastatic CRC.
Results: ~75% of adenocarcinomatous CRC was located in colon, of which younger (with highest risk at transvers colon) and older than 50, was mainly located in rectum and colon, respectively. Post-surgery survival period of metastatic CRC patients was remarkably higher in patients aged > 50 than those < 50 years old, and worse in females than males. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression in metastatic stage III CRC were highly associated with increased metastasis and mortality. B3GALNT2 high , MUC1 high , P53 low and Ki67 high mRNA/protein expression correlated with increased risk of a progressed CRC state and mortality. The risk to develop metastatic CRC was higher in males, younger individuals, urban residing individuals and employed individuals, indicative of a plausible non-genetics/epigenetics contribution to CRC.
Conclusion: The role of possible diagnostic biomarkers, B3GALNT2, MUC1 and Ki67, but not P53, in the etiology/early detection of metastatic CRC is promising. Epigenetic contribution to metastatic CRC risk is predominant.
Knowledge, attitude and practice of Sri Lankan women towards breast cancer: A cross sectional study
Authors: Ranaweera N.D. , Dinesha P.M.C. , Pathirage C.A.K. , Weerasinghe P.W.D.N. , Senarathna D.M.K.N. , Ariyasena G.A.G.M.S. , Galgamuwa G.L.S. , Wijesiri H.S.M.S.K. , Balawardhana K.A.S.J.
Published: September 2019

Introduction: Breast cancer is a type of cancer that develops from breast tissue. Although the knowledge on breast cancer among women in Sri Lanka is high, their practice of breast self-examination is poor. This study was aimed to determine attitudes, practices and the awareness of early detection techniques and risk factors among women in Sri Lanka. Method: A study was conducted between two groups in National Cancer hospital, Sri Lanka and a peripheral women clinic consisting 317 participants in each group. Self-administered questionnaire was used to collect data regarding the awareness of early detection techniques, signs and symptoms and risk factors for breast cancers. Results: A total of 33.8 % of peripheral women clinic and 65.0 % in National Cancer hospital patients had good knowledge regarding risk factors. The knowledge of risk factors, signs and symptoms and screening methods about breast cancers was significantly high in patients attending to National cancer hospital. Older aged people have less awareness about screening methods compared to younger people. People with high education background and those have a family history of breast cancer had more aware about screening and therapeutic methods. Conclusion: Comparative to the peripheral women clinic, patients attending to National Cancer Hospital had a fairly good knowledge, practice and attitude regarding the early detection techniques, risk factors, signs and symptoms. Key words : Breast cancer, Risk factors, Early detection techniques