bluuebunny/crossref_metadata_2025 huggingface dataset:
Routine Use of Feeding Jejunostomy in Pancreaticoduodenectomuy: A Metaanalysis
Authors: Vasavada Bhavin , Patel Hardik
Published: June 2020

Aims and Objectives: The primary aim of our study was to evaluate morbidity and mortality following feeding jejunostomy in pancreaticoduodenectomy compared to the control group. We also evaluated individual complications like delayed gastric emptying, post operative pancreatic fistula, superficial and deep surgical site infection. We also looked for time to start oral nutrition and requirement of total parentral nutrition. Material and Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. [9,10]. We searched pubmed, cochrane library, embase, google scholar with keywords like “feeding jejunostomy in pancreaticodudenectomy”, “entral nutrition in pancreaticoduodenectomy, “total parentral nutrition in pancreaticoduodenectomy’, “morbidity and mortality following pancreaticoduodenectomy”. Two independent authors extracted the data (B.V and H.P).The meta-analysis was conducted using Open meta-analysis software. Heterogeneity was measured using Q tests and I2, and p < 0.10 was determined as significant , the random-effects model was used. The Odds ratio (OR) was calculated for dichotomous data, and weighted mean differences (WMD) were used for continuous variables. Both differences were presented with 95% CI. Results: Four studies including Total of 1639 patients were included in the analysis. Total 843 patients were included in Feeding jejunostomy group and 796 patients included in control group without feeding jejunostomy. Over all morbidity was significantly higher in feeding jejunostomy group. (odds ratio 1.39, p = 0.001). However, there was no significant difference between both the group. (p=0.07). Delayed gastric emptying was significantly higher in Feeding jejunostomy group. [p=0.021]. There was no significant difference in development of pancreatic fistula between the two group. (p=0.536). Deep surgical site infection were significantly higher in feeding jejunostomy group. (p=0.013). Hospital stay was significantly more in feeding jejunostommy group, weighted mean difference of 2.094 days. (p<0.0001). There was no significant difference between readmission (p=0.536) and TPN requirement between the two group. Time to start oral feed was significantly more in feeding jejunostomy group. Conclusion: Feeding jejunostomy seems to be associated with increased morbidity, increased complications, increased length of stay without any significant benefits.
Why Children Are Less Affected by COVID-19 Than Adults: Potential Immunological Factors and the Renin-Angiotensin System Associated Mechanisms
Authors: Krogh-Jensen Olga , Nikitina Irina , Donnikov Andrew , Lenyushkina Anna , Degtyareva Nataliya , Degtyareva Anna
Published: June 2020

The spread of the infection caused by the new coronavirus SARS-CoV-2 (COVID-19) became pandemic on March 11, 2020. From the time of the first cases (in November 2019, Wuhan, China), to date, a large number of COVID-19 observations have been accumulated in different age groups of patients both in China and abroad. Published scientific data allows us to conclude that children suffer from COVID-19 much less often than adults and tolerate the disease in a milder form, often appear to be asymptomatic. There is currently no final answer why children are less susceptible to this virus; however, scientists are increasingly inclined to consider a complex effect of the immune response and components of the renin-angiotensin system (RAS), which according to recent studies affects not only the cardiovascular system, but is also responsible for the activation of inflammatory reactions. A hypothesis of genetic predisposition to the development of severe forms of COVID-19 has recently been made. We conducted a search for publications in the databases and showed current scientific ideas about COVID-19 pathogenesis and factors influencing the disease development in childhood. Childhood immunity may have several protective features against SARS-CoV-2: immaturity of particular elements of the innate immune response, constitutional lymphocytosis with a shift towards anti-inflammatory Th2-response, as well as "trained" immunity. The influence of renin-angiotensin system reactions in this review is shown from two perspectives: expression of ACE2 receptors and polymorphisms of certain genes of this system. It was established that ACE2 transmembrane protein is not only the entry point for the virus but also plays a regulatory role, turning the pro-inflammatory vasoconstrictor angiotensin II into anti-inflammatory angiotensin (1-7), which has vasodilating properties. Higher ACE2 content in children compared with adults helps maintain balance in the renin-angiotensin system and prevents the development of complications. It was also shown that the presence of certain genetic polymorphisms (AGTR1, AGTR2, ACE2, ACE) could determine the imbalance inside the RAS, leading to more pronounced reactions of alveolocytes, vascular endothelium and smooth muscle fibers in response to SARS-CoV-2 infection due to a shift towards vasoconstrictor, proliferative and profibrotic mechanisms.
O O processo formativo de estudantes de direito diante da temática violência contra as mulheres
Authors: Araújo Ricardo Gabriel de , Francisco Marcos Vinicius , Noguchi Cinthia de Sousa
Published: June 2020

Neste artigo assumiu-se como objetivo problematizar o processo de formação de estudantes do curso de Direito, de uma universidade privada, no interior do estado de São Paulo, acerca das discussões sobre a violência contra as mulheres. Participaram da pesquisa de abordagem qualitativa, estudantes ingressantes e concluintes do curso. Os dados foram coletados por meio da aplicação de um questionário e da realização de grupo focal, a partir da exibição do filme "Vidas Partidas". Constatou-se que em momento algum de sua formação os/as estudantes iniciantes presenciaram discussões sobre o processo histórico da violência contra as mulheres, em consonância com os estudos de gênero. Dentre os/as concluintes, sua presença foi mencionada de maneira pontual e técnica por meio da Lei Maria da Penha.
It’s Raining Calves: History and Sources of a Spurious Citation from Avicenna in Albert the Great’s 'Meteorology'
Authors: Ivanov Sergey
Published: June 2020

The paper investigates the textual history of a citation attributed by Albert the Great to Avicenna and demonstrates its use, primarily in the debates on spontaneous generation, throughout the Middle Ages and Renaissance.
Tradition and Success of a Physical Treatise. The Reception of Contarini’s 'De elementis' in the Last XVIth Century
Authors: Burzelli Luca
Published: June 2020

This article aims to reconstruct the tradition of Gasparo Contarini’s physical treatise De elementis, comparing all the extant witnesses. In the second part of the article, it is explored how the treatise reached a widespread diffusion and success in the universities, thanks to its clear exposition of Aristotle’s doctrine. A special attention is devoted to those Renaissance philosophers and professors who quoted Contarini in order to defend Aristotle’s natural philosophy against the new theories of Telesio and Campanella.
In memoriam Gudrun Vuillemin-Diem (16.I.1931-16.XI.2018)
Authors: Beullens Pieter
Published: June 2020

In memoriam Gudrun Vuillemin-Diem (16.I.1931-16.XI.2018).
Arisan Gantangan Sebagai Perlindungan Sosial
Authors: Hidayati Shofiya , Mutmainnah Mutmainnah
Published: June 2020

Tujuan dari penelitian ini adalah untuk mengetahui bagaimana arisan gantangan dijadikan sebagai perlindungan sosial bagi masyarakat Dusun Singgang Desa Bakalrejo Kecamatan Sugio Kabupaten Lamongan. Metode penelitian yang digunakan adalah kualitatif deskriptif dengan pendekatan studi kasus. Penelitian ini menggunakan teknik pengumpulan data yaitu observasi, wawancara dan dokumentasi. Teknik pemilihan informan peneliti menggunakan teknik purposive sampling. Analisis data menggunakan teknik analisis Miles Huberman. Teknik pemeriksaan keabsahan data menggunakan triangulasi sumber. Teori yang digunakan dalam penelitian ini yakni Teori Perlindungan Sosial yang dikemukakan oleh Edi Suharto. Hasil penelitian ini menunjukkan bahwa arisan gantangan dijadikan sebagai perlindungan sosial. Arisan ini memiliki sistem order atau dapat diminta pada saat salah satu anggota arisan akan mengadakan hajatan (pernikahan dan sunatan). Adapun manfaat perlindungan sosial yang dirasakan warga masyarakat Dusun Singgang melalui arisan gantangan sebagai berikut : 1) Bisa memenuhi biaya hajatan; 2) Digunakan untuk membayar hutang; 3) Dapat membebaskan masyarakat dari jeratan kemiskinan; 4) Digunakan untuk biaya pendidikan; 5) Hasil dari arisan dapat digunakan untuk membeli barang atau peralatan sehari-hari untuk mempermudah pekerjaan.
Konstruksi Sosial Bujuk Tamoni
Authors: Hidayatullah Syarif , Mutmainnah Mutmainnah
Published: June 2020

Pasangan suami istri yang sulit atau tidak bisa memiliki keturunan, masyarakat percaya bahwa apabila datang ke Bujuk tamoni dengan kuasa tuhan atau izin tuhan dan melakukan beberapa rentetan ritual khusus yang harus dilakukan, maka pasangan suami istri tersebut bisa memiliki keturunan dalam jangka waktu yang tidak lama. Tujuan utama dalam penelitian ini adalah untuk mengetahui bagaimana konstruksi sosial masyarakat tentang ritual untuk mendapatkan keturunan melalui bujuk tamoni di Desa Batuan, Kecamatan Batuan, Kabupaten Sumenep. Metode yang digunakan dalam penelitian ini adalah metode penelitian kualitatif dengan menggunakan pendekatan studi kasus. Hasil dari penelitian ini menunjukkan bahwa pasangan suami istri yang sulit mendapatkan anak mempercayai bahwa apabila bernazar di kuburan bujuk tamoni akan mendapatkan keturunan sehingga hal ini menjadi sebuah konstruksi sosial dari masyarakat batuan, kecamatan batuan, kabupaten sumenep yang diciptakan sendiri oleh masyarakat melalui interaksi individu dengan individu lainnya dalam kehidupan sehari-hari mereka.
Pengaruh Fasilitas dan Lokasi Terhadap Kepuasan Pelanggan : Studi Kasus Mahfoed Life Gym
Authors: Rutjuhan Arta , Ismunandar Ismunandar
Published: June 2020

Penelitian ini bertujuan untuk menganalisis pengaruh fasilitas dan lokasi terhadap kepuasan pelanggan Mahfoed Life Gym. Jenis penelitian yang digunakan adalah asosiatif dengan menggunakan pendekatan kuantitatif. Variabel penelitian terdiri dari : fasilitas (X1) dan Lokasi (X2) sebagai variabel independen, dan Kepuasan Pelanggan sebagai variabel dependen (Y). Seluruh variabel diukur dengan menggunakan skala Likert. Jumlah sampel yang diteliti adalah 60 responden. Pengujian instrumen dengan menggunakan uji validitas dan uji reliabilitas. Alat analisis data yang digunakan adalah regresi linier berganda dengan SPSS. Hasil penelitian menunjukan garis regresi sebagai berikut : Y=10.6690-0,123X1+0,334X2+e. Nilai R (Koefisien Korelasi) yang diperoleh sebesar 0,786 atau 78,6% dan nilai R Square (Koefisisen Determinasi) sebesar 0,618 atau 61,8%. Hasil dalam penelitian ini menunjukan bahwa secara parsial Fasilitas tidak berpengaruh terhadap kepuasan pelanggan sedangkan Lokasi berpengaruh terhadap kepuasan pelanggan. Secara simultan terbukti bahwa Fasilitas dan Lokasi berpengaruh terhadap kepuasan pelanggan Mahfoed Life Gym. Sehingga dapat disarankan kepada pemilik Mahfoed Life Gym untuk melakukan peningkatan dalam hal yang berkaitan dengan lokasi Mahfoed Life Gym.
Comparative analysis of diet-associated responses in two rice planthopper species
Authors: Huang Hai-Jian , Cui Jia-Rong , Hong Xiao-Yue
Published: June 2020

Background: Host adaptation is the major determinant of insect diversification. However, knowledge of different host ranges in very close-related species remains scarce. The brown planthopper (Nilaparvata lugens, BPH) and small brown planthopper (Laodelphax striatellus, SBPH) are the most destructive insect pests belonging to Delphacidae. These two species differ in the host range (SBPH can well colonize on rice and wheat plants, while BPH survive on rice plants only), but the underlying mechanism still remains unknown. High-throughput sequencing technology provides a powerful approach for analyzing the association between gene expression changes and physiological responses of insects. Therefore, the gut transcriptomes were performed to elucidate the genes associated with host adaptation in planthoppers. Comparative analysis of planthoppers’ responses to different diets would improve our knowledge of host adaptation regarding herbivores insects.Results: In the present study, we analyzed the gene expression change of SBPH that transferred from rice plants to wheat plants in a short term (rSBPH vs tSBPH) and colonized on wheat plants for a long term (rSBPH vs wSBPH). The results showed that the majority of differentially expressed genes in SBPH showed similar expression change between short-term transfer and long-term colonization. Based on the comparative analysis of BPH and SBPH after transferring, genes associated with sugar transporters and heat shock proteins varied similarly. However, most of genes were differentially regulated between two species. The detoxification-related genes were upregulated in SBPH after transferring while downregulated in BPH under the same condition. Ribosomal-related genes were downregulated in SBPH after transferring while upregulated in BPH under the same condition.Conclusion: The results of this study provided evidence that host plants played dominant roles in shaping the gene expression, and unfitness of BPH on wheat plants might be determined within 24 hours after transferring. This study deepens our understanding of different host ranges regarding two planthopper species, which may provide a potential strategy for pest management.
An exploration of evidence-based practice work files for occupational therapy students during clinical placements: a descriptive cross-sectional study
Authors: Johnson Susanne , Bruset Else Britt , Hjelle Kari Margrete , Mongs Malin , Sveen Unni
Published: June 2020

Background: Bachelor students of occupational therapy are expected to work in accordance with evidence-based practice (EBP). The EBP work file, a learning tool in a Word document format, covering all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine the attitudes and behaviours of occupational therapy students’ in relation to applying evidence-based practice during their second-year clinical placement. We compared cohorts who received training in EBP work files with those who did not receive such training.Methods: A descriptive, cross-sectional comparative study was conducted. Five cohorts of second-year occupational therapy students took part in the study. The students answered two questionnaires, the EBP Beliefs Scale and the EBP Implementation Scale, after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, mean and standard deviations of all participating students’ scores across both questionnaires. ANOVA with Bonferroni correction was conducted to analyse the differences between the mean totals of the questionnaires. Results: In this study, 126 occupational therapy students participated (response rate = 57.3%). The students reacted positively to EBP, although few were practicing EBP. The students believed that EBP resulted in the best clinical care for patients, but they lacked confidence in their own ability to apply EBP. The students in Cohort 5, who received extra instruction and assignments via the EBP work file, rated their EBP behaviour statistically lower than the students in Cohort 1, who did not receive extra training on the EBP work file. Conclusions: Additional EBP work file assignments were insufficient in terms of supporting students in the implementation of EBP during clinical placements. It is, therefore, important to facilitate the learning strategies of EBP skills and demonstrate how students can practise this competency during clinical placements. Including clinical instructors in EBP teaching and learning seems essential.
Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa
Authors: Chen Tao , Xu Ye , Xu Wenya , Liao Wenli , Xu Chunquan , Zhang Xiucai , Cao Jianming , Zhou Tieli
Published: June 2020

Background: Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections, such as diabetic foot infections, and further exacerbates the treatment options and cost of such conditions. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear. In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant P. aeruginosa strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by P. aeruginosa. Results: Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the model P. aeruginosa PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in P. aeruginosa. The expression of major quorum sensing genes (lasI, lasR, rhlI, and rhlR) in P. aeruginosa were all downregulated in response to hypertonic glucose treatment. In a Galleria mellonella larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by P. aeruginosa strains (3/5).Conclusions: Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa, as well as reduced the production of virulence factors and quorum sensing gene expression. Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.
Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor
Authors: Maeda Naoaki , Shirakawa Yasuhiro , Tanabe Shunsuke , Sakurama Kazufumi , Noma Kazuhiro , Fujiwara Toshiyoshi
Published: June 2020

Background: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery.Methods: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and June 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and three days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model.Results: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The three-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group.Conclusion: skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.
Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study
Authors: Redmond Patrick , Munir Khalid , Alabi Oludare , Grimes Tamasine , Clyne Barbara , Hughes Carmel , Fahey Tom
Published: June 2020

Background: Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process.Methods: Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Thematic analysis was undertaken using an adaptation of a combined theoretical framework of Grol, Cabana and Sluisveld to classify the barriers and facilitators to implementation of medicines reconciliation.Results : Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review).Conclusions: Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.
Assessing and coping with the financial burden of Computed Tomography utilization in Limbe, Cameroon: a sequential explanatory mixed-methods study.
Authors: Tambe Joshua , Mbuagbaw Lawrence , Ongolo-Zogo Pierre , Nguefack-Tsague Georges , Edjua Andrew , Mbome-Njie Victor , Minkande Jacqueline Ze
Published: June 2020

Background: Out-of-pocket (OOP) payments for healthcare services leads to unequal access to care with many not able to seek care or suffer catastrophic health expenditure and impoverishment. The cost of healthcare is on the rise and technological innovations in medical imaging are partly responsible. In this study we assess the risk of financial hardship after Computed Tomography (CT) utilization in a health facility in Cameroon and elaborate on how users adapt and cope.Methods: We carried out a sequential explanatory mixed methods study with a quantitative hospital-based survey of CT users followed by an in-depth interview of some purposively selected participants who reported risk of financial hardship after CT utilization. Data was summarized using frequencies, percentages and 95% confidence intervals. Logistic regression was used in multivariable analysis to determine predictors of risk of financial hardship. Identified themes from in-depth interviews were categorized. Quantitative and qualitative data were integrated.Results: A total of 372 participants were surveyed with a male to female sex ratio of 1:1.2. The mean age (standard deviation) was 52(17) years. CT scans of the head and facial bones accounted for 63% (95%CI: 59%, 68%) and the top three indications were suspected stroke (27% [95%CI: 22%, 32%]), trauma (14% [95%CI: 10%, 18%]) and persistent headaches with blurred vision (14% [95%CI: 10%, 18%]). Seventy-two percent (95%CI: 67%, 76%) of respondents declared being at risk of financial hardship after CT utilization and predictors in the multivariable analysis were low socioeconomic status (aOR: 0.19 [95%CI: 0.10, 0.38]; p<0.001) and not having any form of financial risk protection (aOR: 3.59 [95%CI: 1.31, 9.85]; p=0.013). Coping strategies included relying on family members and friends for financial assistance, lobbying hospital administration, social services and healthcare staff for a reduction of the direct cost, and borrowing of money.Conclusion: Lack of financial risk protection and a low socioeconomic status are associated with risk of financial hardship after CT utilization and diverse coping strategies are engaged to minimize the financial burden. Reducing OOP payments for CT scans and/or the direct cost will reduce this hardship and improve access to CT.
Fairness evaluation for the elder population in China
Authors: Wang Guan , Shen Qing
Published: June 2020

Background: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare.Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.
Exploring the Consequences of Teachers’ Self-efficacy: A Case of Teachers of English as a Foreign Language
Authors: Alibakhshi Goudarz , Nikdel Fariborz , Labafi Akram
Published: June 2020

Teacher self-efficacy has been abundantly studied. However, it seems that the consequences of teachers' self-efficacy have not been appropriately explored yet. The research objective was to investigate the consequences of teachers' teaching self-efficacy. The researchers used a qualitative research method. They collected the data through semi-structured interviews with 20 EFL teachers who were selected through purposive sampling. The interviews were content analyzed thematically. Findings showed that self-efficacy has different consequences: pedagogical, learner-related, and psychological. Each consequence has several sub-categories. It is concluded that high self-efficacy affects teachers’ teaching practices, learners’ motivation, and achievement. It also affects teachers’ burn-out status, psychological being, as well as their job satisfaction. The findings can be theoretically and pedagogically important to EFL teachers, teacher-trainers, and administrators of educational settings.
Burn Injuries Related to E-Cigarettes Reported to Poison Control Centers in the United States, 2010-2019
Authors: WANG BAOGUANG , Liu Sherry T. , Rostron Brian , Hayslett Camille
Published: June 2020

Background: United States (U.S.) national data indicate that 2,035 individuals with burn injuries from e-cigarette explosions presented to U.S. hospital emergency departments (EDs) in 2015-2017. This national estimate is valuable for understanding the burden of burn injuries from e-cigarette explosions among individuals who presented to EDs. However, little is known about individuals who experienced e-cigarette-related burns but may not present to EDs or health care facilities.Findings: We analyzed data from the National Poison Data System (NPDS) to describe frequency and characteristics of e-cigarette-related burn cases in the U.S. in 2010-2019. NPDS contains information collected during telephone calls to poison control centers (PCCs) across the U.S., including e-cigarette-related burns and other unintended events. During 2010-2019, 19,306 exposure cases involving e-cigarettes were documented in NPDS. Of those, 69 were burn cases. The number of burn cases increased from one in 2011 to a peak of 26 in 2016, then decreased to three in 2019. The majority of the burn cases occurred among young adults aged 18-24 years (29.0%; n=20) and adults aged 25 years or older (43.5%; n=30); 14.4% occurred among individuals ≤ 17 years old. Of the 69 burn cases, 5.8% (n=4) were admitted to a hospital; 65.2% (n=45) were treated and released; 15.9 % (n=11) were not referred to a health care facility (HCF); 4.4% (n=3) refused referral or did not arrive at an HCF; and 8.7% (n=6) were lost to follow-up or left the HCF against medical advice. Nearly one-third (30.4%; n=21) of the cases had a minor effect (symptoms resolved quickly), 47.8% (n=33) had a moderate effect (symptoms were more pronounced and prolonged than in minor cases, but not life-threatening), and 2.9% (n=2) had a major effect (life-threatening symptoms).Conclusions: Approximately one-fifth of e-cigarette-related burn cases reported to PCCs were not referred to or did not arrive at an HCF. Some burn cases had serious medical outcomes. The burn cases mostly affected young adults and adults aged 25 years or older. The number of burn cases in NPDS represents a small portion of e-cigarette-related burn cases but it can serve as a complementary data source to traditional injury surveillance systems.
The judgment grounds in surrogate decision-making in Japanese clinical practice: A qualitative survey
Authors: Tanaka Masashi , Ohnishi Kayoko , Enzo Aya , Okita Taketoshi , Asai Atsushi
Published: June 2020

Background Surrogate decision-making is expected to become more prevalent in Japanese clinical practice. In recent years, activities to promote advanced care planning (ACP) have gathered momentum ,which may potentially affect the ways in which judgments are made in surrogate decision-making. The purpose of this study is to clarify the current judgment grounds on which surrogate decisions are made in Japan. Methods We adopted a qualitative research method that was based on semi-structured interviews to reveal the judgement grounds in surrogate decision-making involving critical, life-related choices in acute hospitals. Results We interviewed 15 participants. We analyzed the content of the 14 transcribed texts, eliminating one text that does not meet the inclusion criteria. We extracted a total of 4 core categories, 17 categories, 35 subcategories, and 55 codes as an analysis results of interviews regarding the judgment grounds in surrogate decision-making. The four categories are as follows: type 1“Patient preference-oriented factor”, type2“Patient interest-oriented factor”, type3“Family preference-oriented factor”,and type4 “Balanced patient/family preference-oriented factor”. Conclusions This study revealed the current status of surrogate decision-making in Japan: when making decisions about important matters related to a patient’s life, surrogate decision-makers base their decisions not only on the preferences and best interests of the patient, but on their own preferences as well. Included in the preferences of surrogate decision-makers were their own views of life and death, their values, and care burden. Given the cultural and social backgrounds in Japan, it remains unclear whether ACP can be properly reflected in judgment grounds in surrogate decision-making. It would be undesirable to base judgments solely on the principle of respect for autonomy or the principles of surrogate decision-making. In the future, we believe that surrogate decisions-makers will be required to consider the judgment grounds from a more diverse perspective and that such attitudes should be ethically accepted.
Patterns of Fish and Whale Consumption in Relation to Methylmercury in Hair among Residents of Western Canadian Arctic Communities
Authors: Walker Emily Victoria , Yuan Yuan , Girgis Safwat , Goodman Karen J.
Published: June 2020

Background. Methylmercury contamination of the environment represents a substantial environmental health concern. Human exposure to methylmercury occurs primarily through consumption of fish and marine mammals. Heavily exposed subgroups include sport or subsistence fishers residing in Arctic communities. We aimed to estimate the association of fish/whale consumption patterns of Canadian Arctic subsistence fishers with the internal dose of methylmercury as measured in hair. Methods. This research was conducted within ongoing community projects led by the CANHelp Working Group in Aklavik and Fort McPherson, Northwest Territories and Old Crow, Yukon. We interviewed each participant using a fish-focused food-frequency questionnaire during September-November 2016 and collected hair samples concurrently. Methylmercury was measured in the full-length of each hair sample using gas chromatography inductively-coupled plasma-mass spectrometry. Multivariable linear regression estimated beta-coefficients and 95% confidence intervals (CIs) for the effect of fish/whale consumption on hair-methylmercury concentrations. Results. Among 101 participants who provided hair samples and diet data, the mean number of fish/whale species eaten was 3.5 (SD:1.9). The mean hair-methylmercury concentration was 0.60μg/g (SD:0.47). Fish/whale consumption was positively associated with hair-methylmercury concentration, after adjusting for sex, hair length and use of permanent hair treatments. Hair-methylmercury concentrations among participants who consumed the most fish/whale in each season ranged from 0.30- 0.50μg/g higher than those who consumed <1 meal/week.Conclusions. In this population of Canadian Arctic subsistence fishers, hair-methylmercury concentration increased with fish/whale consumption, but the maximum concentrations were below Health Canada’s 6.0μg/g threshold for safe exposure.
Effect of preoperative carbohydrate intake on inflammatory factors and clinical outcomes in elderly patients undergoing radical prostatectomy: a single-center, double-blind randomized controlled trial
Authors: Hu Zhen , Liu Ji , Ma Wenchao , Wang Fen
Published: June 2020

BACKGROUND

To investigate the advantages of Carbohydrate (CHO) in inflammatory factors, comfort and clinical outcomes in elderly patients with open radical prostatectomy.
METHODS

Patients of ≥ 65 years old with radical prostatectomy who underwent open radical prostatectomy were randomized to the CHO group, placebo group, and conventional water-blocking group. Patients in the CHO group and placebo group received oral CHO, 800 ml of placebo water before surgery,and oral CHO and placebo water 400 ml 2 to 3 hours before surgery; the water-free group did not drink any liquid. The main test indicators are inflammatory factors, comfort and clinical outcomes.
RESULTS

28 patients in the CHO group, 30 in the placebo group, and 32 in the conventional water-blocking group were included in the study. The three groups matched well in age, body mass index, the grade of (American Society of Anesthesiologists)ASA, operation time, blood loss, and fluid volume.CHO reduces IL-6 of Day1 and Day7 (P = 0.009, 0.005, respectively), IL-8 (P = 0.005) of Day1, Day1, Day 3, and Day 7 TNF (P = 0.001, 0.006, 0.003 respectively) compared with the water-stopping group ; placebo water reduced Day 1 and Day 7 TNF (P = 0.005, 0.038, respectively), Day 1of IL-8 (P = 0.045). CHO reduced Day3 of TNF (P = 0.026) compared to placebo. In the CHO group and the placebo group, the morning thirst scores (0.68, 1.26, respectively) and starvation (0.24, 0.47, respectively)were decreased. The first time to leave bed in the conventional water-blocking group (39.21 (15–93) h) was much later than in the CHO group (28.57 (10–100) h) and the placebo group (28.71 (12–70) h).
Conclusion

Compared with routine water ban, preoperative CHO and placebo water can reduce the levels of IL-6, IL-8 and TNF in elderly patients undergoing radical prostatectomy, which can improve the patient's preoperative comfort and shorten the patient's first time to leave bed. Compared with placebo water, CHO has no significant advantage in improving inflammatory factors and clinical outcomes.
Changes in malaria patterns in Brazil over 28 years (1990-2017): results from the Global Burden of Disease Study 2017
Authors: Bezerra Juliana Maria Trindade , Barbosa David Soeiro , Martins-Melo Francisco Rogerlândio , Werneck Guilherme Loureiro , Braga Érika Martins , Tauil Pedro Luiz , Carneiro Mariângela
Published: June 2020

Background
This study presents the malaria burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), by analyzing disease burden indicators in federated units of the Legal Amazon and Extra Amazon regions, as well as describing malaria cases according to Plasmodium species occurring in the country.
Methods
We used estimates from the GBD 2017 to report years of life lost due to premature death (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for malaria in Brazil, grouped by gender, age group, and Brazilian federated unit, from 1990 to 2017. Results are presented as absolute numbers and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UI).
Results
At the national level, the age-standardized DALYs rate due to malaria decreased by 92.0%, from 42.5 DALYs per 100,000 inhabitants (95% UI 16.6–56.9) in 1990 to 3.4 DALYs per 100,000 inhabitants (95% UI 2.7–4.7) in 2017. The YLLs were the main component of the total DALYs rate for malaria in 1990 (67.3%), and the YLDs were the main component of the metric in 2017 (61.8%). In 2017, the highest sex-age DALYs rate was found among females in the “<1 year old” age group, with a 6.4 DALYs per 100,000 inhabitants (95% UI 1.8–14.7) and among males in the age group of “20 to 24 years old”, with a 4.7 DALYs per 100,000 inhabitants (95% UI 3.3–9.9). Within the Brazilian Amazon region, the three federated units with the highest age-standardized DALYs rates in 2017 were Acre [28.4 (95% UI 14.2–39.1)], Roraima [28.3 (95% UI 13.5–40.2)], and Rondônia [24.7 (95% UI 11.4–34.8)]. Concerning the parasite species that caused malaria, 73.5% of the total of cases registered in the period had Plasmodium vivax as the etiological agent.
Conclusions
The results of the GBD 2017 show that despite the considerable reduction in the DALYs rates between 1990 and 2017, malaria remains a relevant and preventable disease, which in recent years has generated more years of life lost due to disability than deaths. The states endemic for malaria in the Amazon region require constant evaluation of preventive and control measures. The present study will contribute to the direction of current health policies aimed at reducing the burden of malaria in Brazil, as knowing the geographical and temporal distribution of the risk of death and disability of this disease can facilitate the planning, implementation and improvement of control strategies aimed at eliminating the disease.
Indian vaccine decision-makers’ conceptualization and fostering of ‘community engagement’: A qualitative analysis of elite interviews
Authors: Dutta Tapati , Meyerson Beth , Agley Jon , Barnes Priscilla , Sherwood-Laughlin Catherine , Nicholson-Crotty Jill
Published: June 2020

Background: Vaccination literature highlights programmatic and ethical pertinence of ‘community engagement’ in ensuring efficacious vaccines becoming effective vaccinations. However, lack of consensual definition of community engagement, recurring evidence of community backlashes especially during vaccine introductions, and paucity of literature on community engagement’s effectiveness in achieving vaccination outcomes is problematic because assuming a shared understanding of community engagement will only lead to erroneous assumptions about its value, or lack thereof. This study examines conceptualization of community engagement by vaccine decisionmakers in India and efforts to foster it during the Decade of Vaccines.Methods: Elite interviews were carried out (December 2017 to February 2018) with 25 national-level vaccine decisionmakers in India. Study participants included policymakers, immunization program heads, and vaccine technical committee leads representing Government, international non-profits, and donors. Using Schutz’ Social Phenomenological theory, an a priori framework guided coding decisionmakers’ conceptualizations of ‘communities’, ‘community engagement’, and fostering the same. NVivo12 was used for data analysis placing exemplar community engagement interventions on a low to high spectrum. Findings were validated in a one-day member check-in meeting with study participants and teams. Results: Barring themselves, decisionmakers defined ‘communities’ as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers namely- religious leaders, and members of local youth clubs and non-profits. ‘Community engagement’ was variously defined as vaccine outreach, capacity-building of healthcare workers, and information dissemination to guardians of vaccine-eligible children. There was no explicit policy guideline defining community engagement, and no metrics assessing its effectiveness in vaccination uptake. Participants agreed that ‘community engagement’ though evolving is a complex and under-researched area. Community engagement spectrum exemplified seven intersecting layers, with ‘low’ as ‘vaccine impositions’, and ‘high’ as ‘community’s vaccination decision-making’. Participants in the member check-in meeting proposed an operational definition of community engagement and discussed gaps/concerns related to defining/implementing it.Conclusions: It is critical to build-in the operational definition of community engagement in vaccine guidelines, develop its performance and outcome indicators, and advocate their incorporation in immunization surveillance instruments in India. Acknowledging relational gains of community engagement is pertinent to improve vaccination outcomes in India and is relevant for consideration by other countries too.
Psychological Distress among Iranian Health-Care Providers Exposed to Coronavirus Disease 2019 (COVID-19): A Qualitative Study
Authors: Alizadeh Azizeh , Khankeh Hamid Reza , Barati Mohammad , Ahmadi Yazdan , Hadian Arash , Azizi Maryam
Published: June 2020

Background
Novel corona virus pneumonia, named COVID-19, has spread rapidly to other countries like Italy, Iran and South Korea and affected all people, especially health-care providers. Therefore, due to the rapid spread of the disease in Iran, the aim of the present study was to explore psychological distress experienced by Iranian health-care providers in the first few weeks of the corona virus outbreak.
Methods
The present qualitative study was conducted on 18 Iranian health-care providers exposed to COVID − 19 using a content analysis method. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis.
Results
By analyzing 236 primary codes, three main categories, including demands, job resources and individual resources were extracted from the experiences of health-care providers during corona virus outbreak. These categories each included several sub-categories, which were classified according to their significant characteristics.
Conclusions
.Psychological protection of health care workers is an important component in addressing the COVID-19 epidemic. Understanding the health care providers’ experiences and their mental health demands during public health emergency might help medical workers and managers to response better to a disaster.
Epitope‐based peptide vaccine design against spike protein (S) of novel coronavirus (2019-nCoV): an immunoinformatics approach
Authors: Awadelkareem Eman Ali , Mohammed Nisreen Osman , Gaafar Bothina Bakor Mohammed , Abdelmagid Zahra - , Ali Sumaia AwadElkariem
Published: June 2020

Background

Recently the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated a significant need on identifying drugs or vaccines to prevent or reduce clinical infection of Coronavirus disease – 2019 (COVID-19). In this study, immuno-informatics tools were utilized to design a potential multi-epitopes vaccine against SARS-CoV-2 spike S protein. Structural analysis for SARS-CoV-2 spike S protein was also conducted.
Method:

SARS-CoV-2 spike S protein sequences were retrieved from the GeneBank of National Central Biotechnology Information (NCBI). Immune Epitope Database (IEDB) tools were used to predict B and T cell epitopes, to evaluate their allergenicity, toxicity and cross- reactivity and to calculate population coverage. Protparm sever was applied to determine protein characterization of spike protein and predicted epitopes. Molecular docking for the proposed MHCI epitopes were also achieved against Tall like Receptor (TLR8) receptors and HLA-B7 allele.
Result

Immuno-informatics analysis of S protein using IEDB identified only one B cell epitope 1054QSAPH1058 as linear, surface and antigenic. Although 1054QSAPH1058 was estimated as non-allergic and non-toxic, it showed protein instability. Moreover, around 45 discontinuous epitopes were also recognized as different exposed surface area. In MHCI methods, six conserved stable and safe epitopes (898FAMQMAYRF906, 258WTAGAAAYY266 and 2FVFLVLLPL10, 202 KIYSKHTPI210, 712IAIPTNFTI720 and 1060VVFLHVTYV1068) were identified. These epitopes showed strong interaction when docked with TLR8 and HLA-B7 allele especially 1060VVFLHVTYV1068 and 2FVFLVLLPL10 epitopes. Three epitopes were also predicted (898FAMQMAYRF906, 888FGAGAALQI896 and 342FNATRFASV350) using MHCII methods. Furthermore, the potential multi-epitopes were acquired by assessing allergenicity, toxicity and cross-reactivity to prevent autoimmunity.
Conclusion

The multi-epitopes vaccine was predicted based on Bioinformatics tools that may provide reliable results in a shorter time and at a lower cost. However, further in vivo and in vitro studies are required to validate their effectiveness.