bluuebunny/crossref_metadata_2025 huggingface dataset:
Percepção dos gerentes de instituição financeira brasileira sobre a importância e o domínio das competências gerenciais
Authors: Costa Carlos , Pessotto Ana Paula , Laimer Claudionor Guedes , Santos André De Oliveira , Laimer Viviane Rossato
Published: May 2020

As percepções dos gestores de instituição financeira brasileira sobre a importância e domínio de competências gerenciais foram investigadas por meio de um estudo quantitativo, descritivo e transversal empregando-se questionários abertos e fechados. Os dados foram coletados em escala nacional de gerentes de filiais de uma das maiores instituições financeiras do Brasil. A liderança, a capacidade de formar relações interpessoais e trabalho em equipe, atributos sociais, foram consideradas as competências gerenciais mais importantes dentro desse ambiente de trabalho. Essas descobertas apóiam a noção de que uma política de treinamento e desenvolvimento gerencial é fundamental para o sucesso das instituições financeiras.
Penerapan Model Pembelajaran Kooperatif Berbasis Hands on Activity untuk Meningkatkan Keterampilan Proses Sains
Authors: Avisya Nanda , Miriam Sarah , Suyidno Suyidno
Published: May 2020

Keterampilan proses sains peserta didik khususnya dalam hal memprediksi, menyimpulkan dan mengomunikasikan data hasil percobaan masih rendah. Oleh karena itu, diterapkan model pembelajaran kooperatif berbasis hands on activity untuk meningkatkan keterampilan proses sains peserta didik. Tujuan penelitian ini adalah untuk mendeskripsikan peningkatan keterampilan proses sains peserta didik setelah diterapkan model pembelajaran kooperatif berbasis hands on activity. Adapun tujuan secara khusus, yaitu untuk mendeskripsikan: 1) keterlaksanaan rencana pelaksanaan pembelajaran, 2) keterampilan proses sains dan, 3) hasil belajar siswa. Jenis penelitian ini adalah penelitian tindakan kelas model Hopkins yang terdiri atas 3 siklus. Teknik pengumpulan data diperoleh melalui observasi dan tes. Hasil penelitian menunjukkan: 1) keterlaksanaan RPP pada siklus I, II, dan III terlaksana dengan baik, 2) keterampilan proses sains pada siklus I dengan kriteria baik (mengobservasi), kriteria cukup (menyimpulkan dan mengomunikasikan) dan kriteria kurang baik (memprediksi) mengalami peningkatan pada siklus II dan III menjadi kriteria baik dan sangat baik, 3) hasil belajar siswa meningkat dari siklus I (18,75%) dan siklus II (56,25%) dengan kategori tidak tuntas menjadi (87,50%) dengan kategori tuntas pada siklus III. Diperoleh simpulan bahwa keterampilan proses sains siswa di kelas VIII-E SMPN 25 Banjarmasin meningkat setelah penerapan model pembelajaran kooperatif berbasis hands on activity Science process skills of students, especially in terms of predicting, concluding and communicating experimental results data is still low. Therefore, a hands-on-based cooperative learning model is applied to improve students' science process skills. The purpose of this study is to describe the improvement of science process skills of students after applying a cooperative learning model based on hands on activity. The specific objectives, namely to describe: 1) the implementation of the learning implementation plan, 2) science process skills and, 3) student learning outcomes. This type of research is a Hopkins model action research consisting of 3 cycles. Data collection techniques obtained through observation and tests. The results showed: 1) the implementation of lesson plans in cycles I, II, and III were carried out well, 2) science process skills in cycle I with good criteria (observing), sufficient criteria (inferring and communicating) and unfavorable criteria (predicting ) experienced an increase in the second and third cycles into good and very good criteria, 3) student learning outcomes improved from cycle I (18.75%) and cycle II (56.25%) with the incomplete category being (87.50%) with complete category in cycle III. It was concluded that the science process skills of students in class VIII-E SMPN 25 Banjarmasin increased after the application of hands-on-based cooperative learning models.
Validitas dan Kepraktisan Perangkat Pembelajaran dengan Metode Problem Solving melalui Model Pengajaran Langsung pada Materi Usaha Energi
Authors: Qalbi Nor Alfi , Zainuddin Zainuddin , Miriam Sarah
Published: May 2020

Keterampilan pemecahan masalah penting untuk dikembangkan pada proses belajar mengajar agar peserta didik mampu memecahkan masalah yang  dihadapi secara realistis. Adapun fokus dari penelitian ini adalah untuk mendeskripsikan validitas dan kepraktisan perangkat pembelajaran dengan metode problem solving melalui model pengajaran langsung pada materi usaha energi. Validitas perangkat dapat ditinjau dari hasil lembar validasi perangkat yang dinilai oleh dua validator. Kepraktisan perangkat pembelajaran yang digunakan dapat dilihat dari lembar pengamatan keterlaksanaan RPP ketika diterapkan pada 22 peserta didik kelas X MIPA 2 di SMA Negeri 12 Banjarmasin yang diamati oleh dua orang pengamat. Data selanjutnya dianalisis secara deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa perangkat pembelajaran yang dikembangkan 1) valid berdasarkan hasil penilaian validator dengan kategori baik; dan 2) praktis berdasarkan keterlaksanaan RPP dengan kategori sangat baik. Disimpulkan bahwa perangkat pembalajaran dengan metode problem solving melalui model pengajaran langsung pada topik usaha dan energi yang dikembangkan berkategori valid dan praktis untuk diimplementasikan dalam proses pembelajaran. Problem solving skills are important to be developed in the teaching and learning process so that students are able to solve problems realistically. The focus of this research is to describe the validity and practicality of learning materials with problem solving methods through direct teaching models on work and energy. The validity of the learning materials can be reviewed from the results of the learning materials validation sheets which are assessed by two validators. The practicality of the learning materials used can be seen from the observation sheet of the implementation of the lesson plan when it is applied to 22 students of Class X MIPA 2 in SMA Negeri 12 Banjarmasin observed by two observers. Data were analyzed descriptively quantitatively. The results showed that the learning materials developed 1) were valid, this was based on the results of the validator assessment in both categories; and 2) were practical, this is based on the implementation of the lesson plan in the very good category. It was concluded that the learning tools with problem solving methods through direct teaching models on the topic of work and energy were developed in valid and practical categories to be implemented in the learning process.
Role of CDK1 in Translational Regulation in the M-Phase
Authors: Kalous Jaroslav , Jansova Denisa , Susor Andrej
Published: May 2020

Cyclin dependent kinase 1 (CDK1) has been primarily identified as a key cell cycle regulator in both mitosis and meiosis. Recently, an extramitotic function of CDK1 emerged when evidence was found that CDK1 is involved in many cellular events that are essential for cell proliferation and survival. In this review we summarize the involvement of active CDK1 in the initiation and elongation steps of protein synthesis in eukaryotes. During its activation CDK1 influences the initiation of protein synthesis, promotes the activity of specific translational initiation factors and affects the functioning of a subset of elongation factors. Our review provides insights into gene expression regulation during the transcriptionally silent cell cycle/M-phase and describes quantitative and qualitative translational changes based on the extramitotic role of the cell cycle master regulator CDK1, to optimize temporal synthesis of proteins to sustain division-related processes: mitosis and cytokinesis.
Numerical Analysis of Bicycle Helmet under Blunt Behavior
Authors: Sepulveda-Lopez David , Antona-Makoshi Jacobo , Rubio Ignacio , Rodríguez-Millán Marcos
Published: May 2020

This study evaluates various safety aspects of standardized impacts that cyclists may suffer while wearing a bicycle helmet, by combining a partially validated finite element model of the cranio-cervical region and a newly developed bicycle helmet model. Under EN 1078 standardized impact conditions, the results of simulated impact tests show that the helmet can absorb 40% to 50 % of the total impact energy at impact velocities above 4 m/s. Further, based on a relationship between Head Injury Criterion and the risk of injury from field data, the results of the simulations suggest that minor injuries may occur at impact velocities of 10 km/h, serious injuries at 15 km/h, and severe injuries at 20 km/h. Fatal injuries will likely occur at impact velocities of 30 km/h and higher.
The New Coronavirus Disease (COVID-19): What Do We Know So Far?
Authors: Tang Sammer , Brady Mike , Mildenhall Jo , Rolfe Ursula , Bowles Alex , Morgan Kirsty
Published: May 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes the new Coronavirus disease (COVID-19). The symptoms range from mild to severe with a higher incidence of severe cases seen in patients with risk factors such as older age and comorbidities. COVID-19 is mainly spread through the inhalation of respiratory droplets from coughing or sneezing or via contact with droplet-contaminated surfaces. Paramedics should be aware that some aerosol generating procedures (AGPs) may put them at a higher risk of contracting the virus via possible airborne transmission. The use of remote triage clinical assessment is likely to increase as a result of the pandemic. There is no curative drug treatment for the virus and some medications may exacerbate its effects or make patients more susceptible to it. Paramedics should accept that feeling stressed by the pandemic is a natural response. Official guidelines and advice are evolving continually as the evidence on SARS-CoV-2 and COVID-19 grows. Paramedics should keep up to date with the latest clinical guidance from their employers.
Assessment of Cost and Benefit Associated with Ecological Restoration in Ghana: A Case Study in Bekwai Municipal Area
Authors: Owusu Emmanuel , Afuubi Nelly Ataawomba , Li Fanglin
Published: May 2020

Ghana has had a long-standing problem of illegal gold mining that has led to the destruction of the environment. The government of Ghana is taking steps to not only curb illegal mining but also to restore destroyed lands that resulted from illegal mining. The government intends to spend financially in the area of ecological restoration to returned disturbed lands to their natural states possible, but the question remains whether restoring those disturbed lands will be beneficial to the country. The study was undertaken in Bekwai Municipal Area in the Ashanti region of Ghana where most locals are farmers. The research studies whether the benefits of ecological restoration outweigh the cost of ecological restoration? The research deployed a quantitative data collection. The data collected was analyzed using benefit-Cost ratio. The result shows that the benefit of ecological restoration outweighs the cost incurred as dependent on the land use as a carbon sequestration project. In conclusion, investment in ecological restoration is a step in the right direction for a country endowed with gold resources. This will spur growth and at the same time improve and protect the country’s natural resources and environment.
Getting Rid of Contextuality from Quantum Physics
Authors: Khrennikov Andrei
Published: May 2020

This brief note is aimed to dissociate from quantum physics contextuality, where the latter is standardly defined on the basis of families of compatible observables. In quantum physics, contextuality is just an exhibition of incompatibility of observables and, hence, Bohr's principle of complementarity. At the same time we recognize that contextuality can play the important role outside of physics.
Discovering Business Processes from Email Logs Using fastText and Process Mining
Authors: Rashnavadi Yaghoub , Behzadifard Sina , Farzadnia Reza , Zamani Sina
Published: May 2020

Communication has never been more accessible than today. With the help of Instant messengers and Email Services, millions of people can transfer information with ease, and this trend has affected organizations as well. There are billions of organizational emails sent or received daily, and their main goal is to facilitate the daily operation of organizations. Behind this vast corpus of human-generated content, there is much implicit information that can be mined and used to improve or optimize the organizations’ operations. Business processes are one of those implicit knowledge areas that can be discovered from Email logs of an Organization, as most of the communications are followed inside Emails. The purpose of this research is to propose an approach to discover the process models in the Email log. In this approach, we combine two tools, supervised machine learning and process mining. With the help of supervised machine learning, fastText classifier, we classify the body text of emails to the activity-related. Then the generated log will be mined with process mining techniques to find process models. We illustrate the approach with a case study company from the oil and gas sector.
Collapse Mechanism of Single-Layer Cylindrical Latticed Shell Under Severe Earthquake
Authors: Zhou Haitao , Zhang Yigang , Fu Feng , Wu Jinzhi
Published: May 2020

In this paper, the results of finite element analyses of a single-layer cylindrical latticed shell under severe earthquake is presented. A 3D Finite Element model using fiber beam elements were used to investigate the collapse mechanism of this type of shell. The failure criteria of structural members are simulated based on the theory of damage accumulation. Severe earthquake of peak ground acceleration (PGA) of 500 gal was applied to the shell. The stress and defeomation of the shell were studied in detail. A three-stages collapse mechanism “double-diagonal -members-failure-belt” of this type of structure was discovered. Based on the analysis results, the measures to mitigate collapse of this type of structure is recomanded.
Coronavirus (2019-nCoV) Deactivation via Spike Glycoprotein Shielding by Old Drugs, Bioinformatic Study
Authors: Dayer Mohammad Reza
Published: May 2020

The disease of COVID-19 comprises the most serious against human health worldwide with a high rate of virulence and mortality. The disease is caused by the 2019-nCoV virus from the beta coronavirus family. The virus makes use of its surface glycoprotein named S protein or spike to enter the human cells. The virus attached to its receptor named angiotensin-converting enzyme 2 on host cells surface via its receptor-binding domain and its fusion is mediated by cleavage at S2' site that is carried out by surface protease. Vaccines or drugs interfering with S protein binding or cleavage sites could be considered as drugs to get rid of the infection. In the current work and though docking and molecular dynamic experiments we have checked more than 100 drugs with high enough molecular weights for their shielding potency toward S protein binding sites and processing S2' sites. Our results indicate the shielding potency of: fidaxomicin > ivermectin > heparin > azithromycin > clarithromycin > eryhthromycin > niclosamide > ritonavir. Considering affluent reports regarding the complex disturbance in the immune system and multi-organ involvement in the disease there is no single or binary drug regime for cure expectedly and instead, we claim the multi-drug regime should be the choice in this context. Accordingly, we suggest our extracted drugs as an adjuvant for clinical trials.
Anti Iglon5 Syndrome: What We Know So Far? A Non-Systematic Review
Authors: Figueiredo da Silva Caroline , Figueiredo da Silva Gustavo , Gomes de Medeiros Junior Washigton Luiz , Magno Gonçalves Marcus Vinícius
Published: May 2020

The objective of this review is to do an overview about the current knowledge of Anti Iglon5 Syndrome, a disease that was first described in 2014. The IgLON proteins are a family of cell adhesion molecules and the presence of antibodies against IgLON5 are crucial for diagnosis of Anti IgLON5 Syndrome. This syndrome has an expanded clinical spectrum that involves prominent sleep disorder, progressive bulbar dysfunction, gait instability with abnormal eye movements reminiscent and cognitive deterioration sometimes associated with chorea. The main neuropathological finding is the neuronal loss with hyperphosphorylated tau (p-Tau) protein accumulation at hypothalamus, brainstem tegmentum, hippocampus, periaqueductal gray matter, medulla oblongata and upper cervical cord. The exact pathogenesis is still unclear and involves a neurodegenerative process and autoimmune response. The early diagnosis is important to avoid unnecessary tests and prevent complications. Important resources for diagnosis are the antibody testing of serum and CSF for IgLON5-IgG. The mortality of anti IgLON5 syndrome is high and new studies published described a good response to immune therapy. However, the response to immune therapy depends of some clinical and analytical characteristic. In addition, future studies are needed to thoroughly study the aspects of pathogenesis and treatment of this important pathological syndrome.
Structural and Genetic Analysis of Coronaviruses Spike Proteins Suggest Pangolin as a Proximate Intermediate Host of SARS-CoV-2 (COVID-19)
Authors: Raza Sohail , Rasheed Muhammad Asif , Zahir Wajeeha , Navid Muhammad Tariq , Diwan Rana Aamir , Awais Muhammad , Yaqub Tahir , Rabbani Masood , Rashid Muhammad
Published: May 2020

During December 2019, a novel coronavirus named SARS-CoV-2 has emerged in Wuhan, China. The human to human transmission of this virus has also been established. The virus has so far infected more than 2 million people and spread over 200 countries. The World Health Organization (WHO) has declared COVID-19 a global health emergency due to its spread well beyond China. It has been established that this virus originates from bats and uses an intermediate host for transfer to humans. The knowledge about the intermediate host is important to find the virus shuttle mechanism to stop future outbreaks. For this, the genetic and structural analysis of coronaviruses spike proteins was performed using a computer-assisted approach.To conduct the In silico analysis, 43 sequences of spike protein belong to different species were retrieved from the NCBI nucleotide database. Pairwise and multiple sequence alignments were performed to check the similarities and differences of the retrieved sequences. Moreover, to highlight relationships among different species, phylogenetics analysis was performed using the MEGA software tool. In the end, protein structure alignment (superimposition) was performed against the reference structure by UCSF Chimera software. The results highlighted that the maximum similarity of human protein was found against Bat and Pangolinsequences. Moreover, among Bat and Pangolin, the highest similarity was found against pangolin based on phylogenetics analysis. These results suggest that SARS-CoV-2 transfers from bats to humans through pangolins.
Characterization of Relationships Between the Domains of Two Linear Matrix-Valued Functions with Applications
Authors: Tian Yongge
Published: May 2020

One of the typical forms of linear matrix expressions (linear matrix-valued functions) is given by $A + B_1X_1C_1 + \cdots + B_kX_kC_k$, where $X_1, \ldots, X_k$ are independent variable matrices of appropriate sizes, which include almost all matrices with unknown entries as its special cases. The domain of the matrix expression is defined to be all possible values of the matrix expressions with respect to $X_1, \ldots, X_k$. I this article, we approach some problems on the relationships between the domains of two linear matrix expressions by means of the block matrix method (BMM), the matrix rank method (MRM), and the matrix equation method (MEM). As application, we discuss some topics on the relationships among general solutions of some linear matrix equations and their reduced equations.
The Forrest Gump Approach to Prevent Severe COVID-19 – Reverse the Predisposing Pro-Inflammatory State with Exercise
Authors: Kenyon Chris
Published: May 2020

We hypothesize that the reason severe COVID-19 is closely linked to a limited number of conditions such as obesity, hypertension, older age and diabetes is that these conditions are characterized by a pro-inflammatory state in general and an angiotensin converting enzyme-1-bias in particular. We review recent evidence that this pro-inflammatory state can be reversed via regular exercise and a healthy diet. Studies are suggested that could test this hypothesis.
Ar flow-rate effect for low-resistivity Al/Ti/Al Ohmic contact to n-ZnO thin films
Authors: Adriyanto Feri
Published: May 2020

The Ar flow rate effect on the electrical and optical properties of the sputtered Al-doped ZnO thins films were investigated. It was shown that a strong X-ray peak from (002) and (004) planes is dominant, suggesting that most grains have c-axis perpendicular to the substrate surface. The (002)-ZnO and (004)-ZnO peaks were measured at 2q = 34.120, and 71.850, respectively. It was also found that the growth rate of the Al-doped ZnO thin films increases when the sputtering power is increased. The transmittance of these film are strongly dependent on the sputtering power with the maximum transmittance of 92% was obtained at the sputtering power of 150 W and 50 sccm of Ar flow rate. The resistivity of the films is decreases as the Ar flow rate is increased. The lowest resistivity of 9.74 x 10-4 W.cm was obtained at the films with Ar flow rate of 80 sccm. The mobility increases with the Ar flow rate increases. The carrier concentration also indicates the same pattern as the mobility. The transmittance of Al-doped ZnO thin films is also strongly dependent on the Ar flow rate. It was also observed the variation of contact resistivity of Al/Ti/Al to Al-doped n-ZnO thin films. The speciﬁc contact resistivity rc of 1.8x10−5 W.cm2 was obtained at 150 nm-thick Al.
Respons Benih Kakao Terhadap Amelioran, Mikrob Pelarut Fosfat, dan Pupuk Fosfat pada Tanah Masam
Authors: Sasmita Kurnia Dewi , Anas Iswandi , Anwar Syaiful , Yahya Sudirman , Djajakirana Gunawan
Published: May 2020

The growth of cacao in acid soils is commonly limited by some problems such as low available P and pH, and high Al saturation. Therefore, research is needed to solve the problem of coffee cultivation in acid soil. This study aimed to determine the effect of ameliorant, phosphate solubilizing microbes (PSM), and phosphate fertilizers (P) on the growth and nutrient uptake of cacao seedlings, and some acid soil properties. The study used a randomized block design with 3 factors and 3 replications. The first factor was ameliorant applications (without ameliorant, 10% organic fertilizer, 4% rice husk biochar, 4% rice husk biochar + 10% organic fertilizer). The second factor was PSM applications: without PSM, Burkholderia ambifaria (BPF) inoculants, and Aspergillus niger (FPF) inoculants. The third factor was P fertilizers applications (without Phosphate Rock (PR), 100, 200, and 400 mg P/kg of PR, and 400 mg P/kg of SP-36). The results showed that the applications of 4% rice husk biochar + 10% organic fertilizer + BPF or FPF inoculants increase the number of leaves by 77.9% and 69.2%, respectively, and increase the dry weight of shoot by 93.6 % and 101.9%, respectively. Phosphate rock application in media without organic fertilizer increases dry weight of shoots and roots of cacao seedlings, and the uptake of P, Ca, and Mg in shoots linearly in line with the increase of PR dose to 400 mg P/kg. Application of rice husk biochar significantly increased the acid phosphatase activity of growing media. Meanwhile, organic fertilizer increased the soil pH, acid phosphatase and available P activity, and decreased Al-dd growing media.
A Chat with Émile Zola, The Globe, Toronto, 1892
Authors: De Viveiros Geneviève
Published: May 2020

Un entretien d'Emile Zola publié dans le quotidien canadien The Globe (l’ancêtre du Globe and Mail) en date du 12 novembre 1892 réalisé par Carl Sadakichi-Hartman (1867-1944), poète symboliste et critique d’art américain.
Terapia de Ai chi para el tratamiento del equilibrio y la prevención de las caídas
Authors: De la Llave Pérez Miriam , Marín Hernández María Isabel , Flores Gandolfo Laura
Published: May 2020

Antecedentes: Las alteraciones en el equilibrio reducen la actividad física de las personas y su autonomía en las actividades de la vida diaria, provocando un aumento del riesgo de caídas. El Ai Chi es una técnica de terapia acuática que se presenta como una herramienta útil en la mejora del equilibrio, por las características específicas de los movimientos que conforman la técnica y por beneficiarse de los principios físicos que ofrece el agua.Objetivos: Valorar los efectos de la técnica Ai Chi en el equilibrio de las personas mayores.Método: Hemos realizado una revisión sistemática consultando las fuentes de información PubMed, Isi Web of Knowledge, OVID, EBSCOHost y Teseo. Los términos utilizados en la estrategia de búsqueda fueron “ai chi” y “balance”, solos o combinados con el operador booleano AND. Además, efectuamos una búsqueda manual en la bibliografía de los artículos seleccionados. El análisis cualitativo del nivel de evidencia científica se llevó a cabo con la escala Jadad.Resultados: Tras eliminar los artículos duplicados y aplicar los criterios de selección se obtuvieron ocho resultados. El nivel de evidencia metodológica de los estudios fue generalmente bajo.Conclusiones: El tratamiento mediante la técnica Ai Chi mejora el equilibrio en las personas que lo practican. Además, produce cambios terapéuticos positivos en el dolor, la calidad de vida y la capacidad funcional.Palabras clave: Ai Chi, equilibrio, hidroterapia y caídas.
¿Qué aporta realmente la terapia acuática a la esclerosis múltiple? Una visión desde la terapia ocupacional
Authors: Marín Hernández María Isabel , De la Llave Pérez Miriam , Flores Gandolfo Laura
Published: May 2020

Antecedentes: La Esclerosis Múltiple es una enfermedad desmielinizante que afecta al Sistema Nervioso Central sobre todo al cerebro, tronco del encéfalo y medula espinal, presentando síntomas motores en un 90-95% de las personas, sensitivos en un 77% y cerebelosos un 75%. 
Objetivos: Describir las posibles modificaciones que produce la rehabilitación con terapia acuática en pacientes con Esclerosis Múltiple en sus destrezas y habilidades motoras: fuerza y equilibrio; Analizar la repercusión de la terapia acuática sobre la fatiga en este tipo de pacientes.
Método: Se llevó a cabo una revisión sistemática cuyas bases de datos consultadas fueron: Cochrane plus, Pubmed y Ebsco Host entre otras. De un total de 252 referencias encontradas, fueron seleccionados 11 artículos para un análisis, evaluando su calidad metodológica con la escala Jadad.
Resultados: De los 11 artículos encontrados cinco analizaron la variable fuerza y cuatro de ellos obtuvieron una mejorar significativa, seis evaluaron equilibrio, de los cuales cinco de ellos arrojaron una mejora significativa, y por último la fatiga fue estudiada en siete ensayos obteniendo una mejora significativa en cinco. 
Conclusiones:  Los usuarios con EM tras realizar terapia acuática sufren modificaciones positivas en sus habilidades y destrezas motoras: fuerza y equilibrio, mejorando también en la variable fatiga.
Palabras clave: Esclerosis Múltiple, Hidroterapia, Control motor y Fatiga.
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain
Authors: SNG Ban Leong , Tan Daryl Jian'an , TAN Chin Wen , HAN Nian-Lin Reena , SULTANA Rehena , SIA Alex Tiong Heng
Published: May 2020

Background: We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodied in a novel algorithm that took into account patients’ vital signs (oxygen saturation, heart rate). The system aimed to allow responsive titration of personalized pain relief to optimize pain relief and reduce the risk of respiratory depression. Moreover, the system would be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods: Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for at least 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results: The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The median percentage time during treatment that oxygen saturation fell below 95% was 1.9%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median [IQR] pain scores at rest and at movement after post-op 24 hours were 0.0 [2.0] and 3.0 [2.0], respectively. The average morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump. Conclusions: The use of VPIA analgesic infusion pump, when integrated with continuous vital sign monitor and variable lockout algorithm, was able to provide pain relief with good patient satisfaction.Trial registration: This study was registered on clinicaltrials.gov registry (NCT02804022) on 28 Feb 2016.
Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria
Authors: Okereke Ekechi , Unumeri Godwin , Akinola Akinwumi , Eluwa George , Adebajo Sylvia
Published: May 2020

Background In Nigeria, anecdotes abound that female clients, particularly within northern Nigeria, have gender-based preferences for frontline health workers (FLHWs) who provide healthcare services. This may adversely affect uptake of maternal newborn and child health services, especially at primary healthcare level in Nigeria, where a huge proportion of the Nigerian population and rural community members in particular, access healthcare services. This study explored female clients’ gender preferences for frontline health workers who provide maternal, newborn and child healthcare (MNCH) services at primary healthcare level in Nigeria. Methods The study adopted a cross-sectional quantitative design with 256 female clients’ exit interviews from selected primary health facilities within two States - Bauchi (northern Nigeria) and Cross-River (southern Nigeria). Data was collected using Personal Digital Assistants and data analysis was done using SPSS software. Descriptive analysis was carried out using percentage frequency distribution tables. Bivariate analysis was also carried out to examine possible relationships between key characteristic variables and the gender preferences of female clients involved in the study. Results Out of 256 women who accessed maternal, newborn and child health services within the sampled health facilities, 44.1% stated preference for female FLHWs, 2.3% preferred male FLHWs while 53.5% were indifferent about the gender of the health worker. However only 26.6% of female clients were attended to by male FLHWs. Bivariate analysis suggests a relationship between a female client’s health worker gender preference and her pregnancy status, the specific reason for which a female client visits a primary healthcare facility, a female client’s location in Nigeria as well as the gender of the health worker(s) working within the primary healthcare facility which she visits to access maternal, newborn and child health services. Conclusions The study findings suggest that female clients at primary healthcare level in Nigeria possibly have gender preferences for the frontline health workers who provide services to them. There should be sustained advocacy and increased efforts at community engagement to promote the acceptability of healthcare services from male frontline health workers in order to have a significant impact on the uptake of MNCH services, particularly within northern Nigeria.
Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up
Authors: Maldonado David R. , Yelton Mitchell J. , Rosinsky Philip J. , Shapira Jacob , Meghpara Mitchell , Lall Ajay C , Domb Benjamin
Published: May 2020

Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players.Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS.Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved by players with a continued interest in playing. The severity of cartilage damage was shown to not influence rate of returned to sport nor PROs in this population. The data here may be useful in counseling tennis players of various levels who are considering arthroscopic treatment of a hip injury. Level of Evidence: IV
Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin
Authors: Sullivan Gentiane Perrault , Guédou Fernand Aimé , Batona Georges , Kintin Frédéric , Béhanzin Luc , Avery Lisa , Bédard Emmanuelle , Gagnon Marie-Pierre , Zannou Djimon Marcel , Kpatchavi Adolphe , Alary Michel
Published: May 2020

BACKGROUND: Behavioural and structural factors related to sex work, place female sex workers (FSWs) at high risk of maternal mortality and morbidity (MMM), with a large portion due to unintended pregnancies and abortions. In the African context where MMM is the highest in the world, understanding the frequency and determinants of pregnancy and abortion among FSWs is important in order to meet their sexual and reproductive health needs.METHODS: Data from two Beninese cross-sectional surveys among FSWs aged 18+ (2013, n=450; 2016, n=504) were merged. We first performed exploratory univariate analyses to identify factors associated with pregnancy and abortion (p<0.20) using Generalized Estimating Equations with Poisson regression and robust variance. Multivariate analyses first included all variables identified in the univariate models and backward selection (p≤0.05) was used to generate the final models.RESULTS: Median age was 39 years (N=866). The proportion of FSWs reporting at least one pregnancy during sex work practice was 16.4%, of whom 42.3% had more than one. Most pregnancies ended with an abortion (67.6%). In multivariate analyses, younger age, longer duration in sex work, previous HIV testing, having a boyfriend and not using condoms with him were significantly (p<0.05) associated with more pregnancies.CONCLUSION: One FSW out of five had at least one pregnancy during her sex work practice. Most of those pregnancies, regardless of their origin, ended with an abortion. Improving access to various forms of contraception and safe abortion is the key to reducing unintended pregnancies and consequently, MMM among FSWs in Benin.
Influence of China’s 2009 healthcare reform on the utilisation of continuum of care for maternal health services: Evidence from two cross-sectional household surveys in Shaanxi Province
Authors: Fan Xiaojing , Kumar Meghan Bruce , Zhou Zhongliang , Lee Ching-Hung , Wang Duolao , Liu Haixia , Dang Shaonong , Gao Jianmin
Published: May 2020

Background: Continuum of care for maternal health services (CMHS) is a proven approach to improve health and safety for mothers and newborns. This study aims to explore the influence of China’s 2009 healthcare reform on improving the CMHS utilisation.Methods: This population-based cross-sectional quantitative study included 2332 women drawn from the fourth and fifth National Health Service Surveys of Shaanxi Province, conducted in 2008 and 2013 respectively, before and after China’s 2009 healthcare reform. A generalised linear mixed model (GLMM) was applied to analyse the influence of this healthcare reform on utilisation of CMHS. Concentration curves, concentration indexes and its decomposition method were used to analyse the equity of changes in utilisation.Results: This study showed post-reform CMHS utilisation was higher in both rural and urban women than the CMHS utilisation pre-reform (according to China’s policy defining CMHS). The rate of CMHS utilisation increased from 24.66% to 41.55% for urban women and from 18.31% to 50.49% for rural women (urban: χ2=20.64, P<0.001; rural: χ2=131.38, P<0.001). This finding is consistent when the WHO’s definition of CMHS is applied for rural women after reform (12.13% vs 19.26%; χ2=10.99, P=0.001); for urban women, CMHS utilisation increased from 15.70% to 20.56% (χ2=2.57, P=0.109). The GLMM showed that the rate of CMHS utilisation for urban women post-reform was five times higher than pre-reform rates (OR=5.02, 95%CL: 1.90, 13.31); it was close to 15 times higher for rural women (OR=14.70, 95%CL: 5.43, 39.76). The concentration index for urban women decreased from 0.130 pre-reform (95%CI: -0.026, 0.411) to -0.041 post-reform (95%CI: -0.096, 0.007); it decreased from 0.104 (95%CI: -0.012, 0.222) to 0.019 (95%CI: -0.014, 0.060) for rural women. The horizontal inequity index for both groups of women also decreased (0.136 to -0.047 urban and 0.111 to 0.019 for rural).Conclusions: China’s 2009 healthcare reform has positively influenced utilisation rates and equity of CMHS’s utilisation among both urban and rural women in Shaanxi Province. Addressing economic and educational attainment gaps between the rich and the poor may be effective ways to improve the persistent health inequities for rural women.
Individualized Implant: A surgical advice for rotational stability and additional proximal locking of the Fassier-Duval telescoping nail
Authors: Schiedel Frank M
Published: May 2020

Background When stabilizing fractures and osteotomies in growing patients with special conditions of the long bones, the use of the Fassier-Duval nail as intended by the manufacturer (Pega Medical, Quebec, Canada) [1], shows that one problem with passive telescopic nails has not yet been solved. No stability in the rotation can be achieved. Postoperative to immobilize with plaster casts are obsolete in patients with osteogenesis imperfecta, as additional osteopenia due to immobilization must be feared. Especially with fractures and osteotomies in proximal femur long leg spica casts are a torture to patients and caregivers. Methods By experience in different surgical procedures in usage of the Fassier-Duval nailing system a technical solution for rotational stability of the nail as well as for locking of the nail in the proximal and distal physis could be developed. Results A transverse slot can be cutted in all available diameters of the female parts to make the FD nail rotationally stable. A proximal locking hole can be drilled individually by the surgeon on the operating table. The technical solution to the problems is presented in two exemplary cases in this article.Conclusions Rotational stability and additional proximal locking options can be achieved by additionally individualization of the Fassier-Duval telescoping nail during surgery.
Comparison of three different prophylactic treatments for postoperative nausea and vomiting after total joint arthroplasty under general anesthesia: a randomized clinical trial
Authors: Xie Jinwei , Cai Yingcun , Ma Jun , Huang Qiang , Zhou Zongke , Pei Fuxing
Published: May 2020

Background: Postoperative nausea and vomiting (PONV) after total joint arthroplasty is common and associated with delayed recovery. This study was performed to evaluate the efficacy of three different prophylactic regimens for PONV after total joint arthroplasty under general anesthesia. Methods: Patients undergoing primary total hip or knee arthroplasty were randomized to Group A (8 mg ondansetron, n= 108), Group B (10 mg dexamethasone plus mosapride, n= 108), or Group C (three doses of 10 mg dexamethasone plus mosapride, n=116). The primary outcome was the total incidence of PONV during postoperative 48 hours. The secondary outcomes were complete response, rescue antiemetic treatment, opioid consumption, time until first defecation, postoperative appetite score, satisfaction score, length of hospital stay, blood glucose level, and complications. Results: Patients in Group C experienced a lower incidence of total PONV (29.3%, p= 0.001), severe nausea (1.72%, p<0.001) and a higher incidence of complete response (70.69%, p=0.001) than did patients in Groups A and B. Moreover, less rescue antiemetic treatment and postoperative opioid consumption was needed in Group C (p<0.05). Additionally, a shorter time until first defecation, shorter length of stay, and better postoperative appetite scores and satisfaction scores were detected in patients in Group C. A slight increase in the fasting blood glucose level was observed in Group C, and the complications were comparable among the groups. Conclusion: Prophylactic use of mosapride and three doses of dexamethasone can provide better antiemetic effectiveness, postoperative appetite, bowel function recovery, and pain relief than a single dose or ondansetron only.
The Study of the Association between Immune Monitoring and Pneumonia in Kidney Transplant Recipients Through Machine Learning Models
Authors: Peng Bo , Gong Hang , Tian Han , Zhuang Quan , Li Junhui , Cheng Ke , Ming Yingzi
Published: May 2020

Background: Kidney transplantation is the optimal treatment to cure the patients with end-stage renal disease (ESRD). However, the infectious complication, especially pneumonia, is the main cause of mortality in the early stage. Immune monitoring by relevant biomarkers provides direct evidence of immune status. We aimed to study the association between immune monitoring and pneumonia in kidney transplant patients through machine learning models. Methods: A total of 146 patients receiving the immune monitoring panel in our center, including 46 pneumonia recipients and 100 stable recipients, were retrospectively reviewed to develop the models. All the models were validated by external data containing 10 pneumonia recipients and 32 stable recipients. The immune monitoring panel consisted of the percentages and absolute cell counts of CD3+CD4+ T cells, CD3+CD8+ T cells, CD19+ B cells and natural killer (NK) cells, and median fluorescence intensity (MFI) of human leukocyte antigen (HLA)-DR on monocytes and CD64 on neutrophils. The machine learning models of support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF) were applied for analysis.Results: The pneumonia and stable groups showed significant difference in cell counts of each subpopulation and MFI of monocyte HLA-DR and neutrophil CD64. The SVM model by monocyte HLA-DR (MFI), neutrophil CD64 (MFI), CD8+ T cells (cells/μl), NK cells (cell/μl) and TBNK (T cells, B cells and NK cells, cells/μl) had the best performance with the average area under the curve (AUC) of 0.940. The RF model best predicted the patients who would progress into severe pneumonia, with the average AUC of 0.760. All the models had good performance validated by external data.Conclusions: The immune monitoring panel was tightly associated with pneumonia in kidney transplant recipients. The models developed by machine learning techniques identified patients at risk and predicted the prognosis. Based on the results of immune monitoring, better individualized therapy might be achieved.
Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis
Authors: Fu Chun Wei , Chen Wei-Cheng , Lu Yung-Chang
Published: May 2020

Background To compare the clinical results of all-inside anterior cruciate ligament reconstruction (ACLR) using suspensory cortical button fixation and full tibial tunnel drillingMethods Systematic searches were conducted of published literature up to November 2019 on PubMed, Embase, and Cochrane for studies comparing all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. Two reviewers independently determined eligibility, extracted the outcome data, and assessed the risk of bias of the eligible studies. The clinical outcome and graft reruptures were pooled by using random effects with mean differences and risk ratios for continuous and dichotomous variables, respectively.Result A total of nine studies (five randomized controlled trials and four comparative studies) involving 613 patients were included in the meta-analysis. The postoperative functional outcome, knee laxity measured with arthrometer, and graft reruptures were comparable between patients with all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. However, a significantly greater thickness of autologous tendon was used and less change in drilling tunnel diameter was noted in patients with suspensory cortical button graft fixation.Conclusions All-inside ACLR with suspensory cortical button fixation was not clinically superior to full tibial tunnel ACLR with interference screw fixation in functional outcomes, knee laxity measured with arthrometer, or rerupture rate. However, the advantage of using suspensory cortical button fixation was that a thicker graft could be used for reconstruction, and brought less tibia tunnel widening compared with bioabsorbable interference screw fixation.