bluuebunny/crossref_metadata_2025 huggingface dataset:
Psikolojik Esneklik Ölçeği: Uyarlama, Geçerlik ve Güvenirlik Çalışması
Authors: KARAKUŞ Sena , AKBAY Sinem Evin
Published: April 2020

Bu çalışmanın amacı bireylerin psikolojik esnekliklerini ölçen Psikolojik Esneklik Ölçeğinin Türkçe forumunun psikometrik özelliklerini incelemektir. Psikolojik Esneklik Ölçeği, Francis, Dawson ve Golijani-Moghaddam (2016) tarafından geliştirilmiştir. Çalışma, 310 yetişkin bireyin katılımıyla yürütülmüştür. SPSS 22.0 paket programı ile yapılan açımlayıcı faktör analizine göre 28maddeden ve beş boyuttan oluşan modelin iyi uyum değerlerine sahip olduğu değerlendirilmiştir (KMO=0.789; X2= 3096.080; p= 0.00). Ölçeğin faktör yükleri .47 ile .81 arasında sıralanmaktadır. Ölçek varyansın %60’ını açıklamaktadır. Ölçeğin Cronbach Alfa iç tutarlılık güvenirlik katsayısı .79 olarak bulunmuştur. Elde edilen veriler, uyarlaması yapılan Psikolojik Esneklik Ölçeği’nin Türkiye’deki yetişkin bireylerin psikolojik esnekliklerinin ölçülmesinde geçerli ve güvenilir bir ölçme aracı olduğunu göstermiştir.
Effects of Topology Optimization in Multimaterial 3D Bioprinting of Soft Actuators
Authors: Zolfagharian Ali , Denk Martin , Z. Kouzani Abbas , Bodaghi Mahdi , Nahavandi Saeid , Kaynak Akif
Published: April 2020

Recently, there has been a proliferation of soft robots and actuators that exhibit improved capabilities and adaptability through three-dimensional (3D) bioprinting. Flexibility and shape recovery attributes of stimuli-responsive polymers as the main components in the production of these dynamic structures enable soft manipulations in fragile environments, with potential applications in biomedical and food sectors. Topology optimization (TO), when used in conjunction with 3D bioprinting with optimal design features, offers new capabilities for efficient performance in compliant mechanisms. In this paper, multimaterial TO analysis is used to improve and control the bending performance of a bioprinted soft actuator with electrolytic stimulation. The multimaterial actuator performance is evaluated by the amplitude and rate of bending motion and compared with the single material printed actuator. The results demonstrated the efficacy of multimaterial 3D bioprinting optimization for the rate of actuation and bending.
A PARTICIPAÇÃO DAS MISSÕES RELIGIOSAS NA FORMAÇÃO DOS PROFESSORES KARITIANA
Authors: Medeiros Adriana Francisca de
Published: April 2020

O objetivo deste texto é descrever a trajetória educacional do povo karitiana a partir da percepção dos professores indígenas da citada etnia, analisando a influência das missões religiosas do Summer Institute of Linguistics - SIL e do Conselho Indigenista Missionário - CIMI na formação dos professores indígenas. Os dados foram construídos a partir da análise de três trabalhos de conclusão de curso de professores karitiana, alunos do curso de licenciatura em educação intercultural da Universidade Federal de Rondônia. Os textos monográficos retratam a trajetória educacional de cada concluinte e as suas percepções a respeito da educação escolar oferecida ao seu povo durante as últimas décadas.
Questioning the Islam of Abu Thalib: Critical Study to the Sunni’s Hadith and the Shiite’s Hadith
Authors: Jumadil Kubro Achmad Darojat , Nyarminingsih Nyarminingsih , Faizah Isti
Published: April 2020

Sunnis and Shiites place the Hadith as a source of law, but both have different methods of examining Hadith.  The most prominent difference is how both of them accept the Prophet companions as a hadith narrator. Sunnis believe that all companions were just. But this examination was rejected by the Shiites. The second difference is the reception about the ma’sum. Sunnis reject the concept of ma'sum other than the Prophet, while Shiites believe imams of ahlu al-bait are ma’sum. The implication of these differences is the different narratives of Islamic history, which are based on the hadith. In this issue is the case of the Islam of Abu Thalibwhich is narrated from each different tradition. Therefore, this research is trying to examine the validity of their narrations and its historicity. The result of this paper is that al-Musayyab bin Hazn, the Prophet companion who narrate the hadith about the death of Abu Thalib, is judged differently by each traditions. Sunnis judged him with Siqah, while Shiites said that he only became Islam after fathu makkah and he was not at the scene when Abu Thalib died.
GERINDO A TRANSIÇÃO: ESTRATÉGIAS DE EXPLORAÇÃO NO PROCESSO PARA SER LIDER
Authors: Almeida Bernardo , Brandão Catarina
Published: April 2020

Este estudo tem por objetivo conhecer a vivência do processo de transição para um posto de liderança, explorando e descrevendo as estratégias que os indivíduos adotam para manter ativo o seu comportamento exploratório durante o processo. A investigação tem por base uma metodologia qualitativa, com recurso a entrevistas de história de vida, operacionalizadas em dois momentos. Os dados revelam as seguintes estratégias para manter ativo o comportamento exploratório: desenvolver competências; atividades de relaxamento; autorreflexão; estar próximo dos colaboradores; e suporte de familiares, amigos e pares. Baseado na Theory of Attachment Based Exploratory Interest Sharing, o estudo assume a importância de se investir na análise das dinâmicas exploratórias e desenvolvimentais dos líderes e dos seus contextos com vista a potenciar a qualidade e a eficácia da liderança nas organizações.
Relación entre los síntomas musculoesqueléticos y la funcionalidad en personas con enfermedad de Parkinson
Authors: Ortiz-Rubio Araceli , Cabrera-Martos Irene , Torres-Sánchez Irene , López-López Laura , Rodríguez-Torres Janet , Valenza Marie Carmen
Published: April 2020

Introducción: La enfermedad de Parkinson (EP) es una de las enfermedades más frecuentes del sistema nervioso central, y además de los síntomas motores clásicos, ahora se sabe que los pacientes también sufren una variedad de síntomas no motores que afectan negativamente a la independencia funcional. Objetivo: El objetivo de este estudio fue evaluar la relación entre los síntomas musculoesqueléticos y la funcionalilidad en personas con EP. Materiales y Métodos: Este estudio es un estudio observacional transversal que involucra a pacientes con enfermedad de Parkinson utilizando los siguientes instrumentos: Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS- UPDRS), Fahn-Tolosa-Marín Tremor Rating Scale (TRS), Manual Ability Measure-16 (MAM-16), Evaluative Frailty Index for Physical Activity (EFIP), Coin Rotation Task (CRT), Fatigue Severity Scale (FSS), Brief Pain Inventory (BPI). Resultados: Se incluyeron 24 pacientes, con una edad media de 72,54 ± 9,4 años.  Se encontró relación (p < 0,05) entre las variables severidad del Parkinson, temblor, destreza, fatiga y dolor con las variables de funcionalidad. Conclusiones: Puntuaciones altas en las afecciones musculoesqueléticas se asocian con discapacidad. El enfoque de la gestión en la EP debe cambiar a una estrategia integral que incorpore el cuidado de síntomas motores como el temblor o la destreza y síntomas no motores como la fatiga y el dolor.
Influencia del volumen y la carga total del entrenamiento contra resistencia sobre la presión arterial post ejercicio: una investigación meta analítica
Authors: Quesada-Valle Engell , Carpio-Rivera Elizabeth , Solera-Herrera Andrea
Published: April 2020

Introducción: La hipertensión arterial es una enfermedad que se ha incrementado en jóvenes y adultos; el ejercicio contra resistencia (ECR) ha mostrado reducirla. No obstante, aún existe controversia acerca de cuál es la mejor prescripción del ECR para producir una disminución beneficiosa de la presión arterial (PA) en las horas posteriores al entrenamiento. Objetivo: Evaluar la influencia del volumen y la carga total del ECR sobre la reducción de la PA post-ejercicio. Materiales y Métodos: Se realizaron dos búsqueda sistemáticas de artículos escritos en inglés o español que evaluaran la presión arterial post-ejercicio contra resistencia, publicados hasta el 2016 en las bases de datos: MEDLINE, SciELO, SPORTDiscus, Google Scholar, ProQuest, Springer Link y Pubmed. La primera de agosto 2012 a marzo 2013, y la segunda de noviembre 2013 a julio 2016. Se utilizó el modelo de efectos aleatorios para calcular tamaños del efecto (TE), prueba Z e intervalos de confianza, Prueba Q de Cochran e inconsistencia mediante I2. Se evaluó el sesgo a través de la prueba de Egger y el efecto gaveta. Se realizaron ANOVAS y correlaciones para determinar la influencia de las variables moderadoras sobre la hipotensión post-ejercicio. Resultados: Se meta-analizaron 12 estudios, se extrajeron 342 TE. Los TE global para las condiciones de ejercicio fueron -0,86 (-6,3 mmHg) y -0,51 (-3,3 mmHg) para la PA sistólica (PAs) y diastólica (PAd), respectivamente. Los ANOVA evidenciaron que la reducción de la presión arterial (PA) fue mayor cuando los participantes eran normotensos, físicamente activos y la prescripción de la intensidad del ejercicio se hizo con base en pruebas submáximas. Las correlaciones evidenciaron que a mayor volumen total y carga total de trabajo existe mayor efecto hipotensor en la PAs (r=-0,36; p=0,0001) y en la PAd (r=-0,23, p=0,005), respectivamente. Conclusión: A mayor volumen y carga de entrenamiento mayor reducción de la PA post sesión de ECR.
Génétique de la qualité de l’œuf
Authors: BEAUMONT C. , CALENGE F. , CHAPUIS H. , FABLET J. , MINVIELLE F. , TIXIER-BOICHARD M.
Published: April 2020

La sélection des pondeuses commerciales repose sur un ensemble de critères où les paramètres de qualité de l’œuf prennent une importance croissante. Les caractères tels que le poids de l’œuf, la solidité de coquille (mesurée directement ou indirectement) la proportion de jaune et la qualité du blanc (unités Haugh) présentent une assez forte variabilité génétique (héritabilité de 0,30 à 0,60). Malgré une corrélation négative entre le poids d’œuf et le nombre d’œufs, la combinaison de la sélection en lignée pure et du croisement a permis d’améliorer le nombre d’œufs tout en stabilisant le poids d’œuf à un niveau élevé (62 g en moyenne). La variabilité génétique de la couleur de coquille, de la proportion de jaune et de la composition en lipides du jaune a été explorée, chez la poule comme chez la caille, par la sélection expérimentale et l’étude de races locales. Cependant, les gènes contrôlant les caractères de ponte et de la qualité technologique de l’œuf sont encore mal connus. Quelques protocoles de détection de QTL ont permis d’identifier des régions chromosomiques contrôlant une part significative de la variabilité de ces caractères, chez la poule et la caille. Récemment des gènes majeurs ont été identifiés comme l’enzyme FMO3 responsable de l’odeur de poisson d’œufs de poule nourries au tourteau de soja. De nombreuses études portent sur la la qualité bactériologique des oeufs, avec une priorité donnée au portage de salmonelles, pour laquelle plusieurs gènes ont été identifiés (SLC11A1, TLR4). Ces perspectives sont encourageantes pour répondre aux demandes croissantes du consommateur en matière de qualité des produits.
Système d’élevage et qualité microbienne de l’œuf
Authors: MALLET S. , HUNEAU-SALAÜN A. , HERMAN L. , DE REU K.
Published: April 2020

Suite à la suppression programmée pour 2012 des cages conventionnelles pour l’élevage des poules pondeuses, de nouveaux systèmes d’élevages se sont développés (cages aménagées ou systèmes hors cage). L’impact de ces systèmes sur la qualité hygiénique des œufs de consommation a été évalué.
La contamination de la coquille des œufs par des bactéries aérobies mésophiles est significativement plus élevée pour les œufs pondus dans les élevages hors cage (volières et pondeuses au sol) que dans les cages aménagées ou les cages conventionnelles. Ces différences sont moins marquées dans les élevages commerciaux que dans les études en station expérimentale ce qui pourrait s’expliquer par des différences au niveau de la conduite des différents élevages étudiés. Entre les cages aménagées et les cages conventionnelles, les différences observées sont plus faibles et moins constantes. Le pourcentage d’œufs pondus au nid mais aussi le type de cage utilisé et l’agencement des aménagements (nid, perchoirs et bac à poussière) peuvent influencer fortement la charge bactérienne des œufs. De nombreux autres facteurs tels que la présence de souillures ou de fêlures sur les œufs, le taux de poussières dans l’air ou la saison peuvent également influencer la contamination bactérienne des œufs.
Les résultats disponibles laissent supposer qu’il y a très peu de risque que le remplacement des cages conventionnelles par des cages aménagées ou par les systèmes alternatifs hors cage pour les poules pondeuses n’induise une quelconque augmentation de l’infection par Salmonella ou de leur diffusion. C’est même le contraire qui est suggéré.
Contaminants chimiques organiques des œufs de poule pondeuse : aspects réglementaires, modalités et risques de transfert
Authors: JONDREVILLE C. , FOURNIER A. , TRAVEL A. , FEIDT C. , ROUDAUT B.
Published: April 2020

Le présent article fait le point sur les contaminants chimiques organiques potentiellement présents dans les œufs de poules pondeuses. Ils ont pour origine soit des médicaments vétérinaires, des additifs introduits dans les aliments, des pesticides utilisés pour la production des matières premières entrant dans l’alimentation des animaux ou encore des polluants rémanents de l’environnement. Les médicaments vétérinaires et additifs alimentaires font l’objet d’études strictes de transfert avant d’être autorisés et les résultats d’enquêtes ou de contrôles officiels montrent que les limites maximales de résidus sont très rarement dépassées dans les œufs. Les non conformités ont en général pour origine une utilisation inadéquate de la molécule, ou des contaminations croisées lors de la fabrication des aliments, notamment pour les anticoccidiens. Les pesticides utilisés pour la production de matières premières entrant dans l’alimentation des animaux font également l’objet d’une étude d’évaluation du risque de transfert avant leur autorisation. L’exposition des animaux aux contaminants de l’environnement est plus difficilement contrôlable, notamment dans les élevages en plein air, et des dépassements importants des teneurs maximales autorisées pour les dioxines, furanes ou polychlorobiphényles sont parfois rencontrés dans ce type d’élevage. Les cas les plus préoccupants émanent d’élevages de particuliers, dans lesquels certaines pratiques semblent favoriser l’ingestion de matrices, notamment de sol, en quantités importantes. Afin de prévenir le risque de transfert de ces contaminants, il est important d’évaluer l’impact de ces pratiques sur l’exposition des animaux et de quantifier l’impact de la matrice sol sur le transfert des contaminants ingérés vers l’œuf.
Les ovoproduits : des ingrédients fonctionnels pour des matrices complexes
Authors: ANTON M. , NAU F. , LECHEVALIER V. , GUERIN-DUBIARD C. , CROGUENNEC T.
Published: April 2020

L’œuf de poule est un ingrédient polyfonctionnel, c’est-à-dire qu’il peut remplir simultanément plusieurs fonctions technologiques dans un produit alimentaire formulé. Ses propriétés émulsifiantes, foisonnantes, gélifiantes, épaississantes, colorantes et aromatiques en font un ingrédient de base de la cuisine domestique et de l’agroalimentaire. Plus spécifiquement, le jaune d’œuf est l’agent émulsifiant par excellence, alors que le blanc d’œuf est une référence en termes de foisonnement. A l’échelle industrielle, l’œuf est transformé en ovoproduits dits de première transformation (œuf entier, jaune ou blanc, à l’état liquide, congelé ou poudre), ou dans certains cas cuit et/ou cuisiné, de manière à reproduire certaines recettes ménagères classiques ; on parle alors d’ovoproduits de deuxième transformation. Cette industrie relativement récente connaît depuis plusieurs années une croissance importante. Les connaissances sur les constituants, la structure de l’œuf et la compréhension des mécanismes mis en jeu au cours des traitements thermomécaniques, issues de la recherche développée depuis plus d’une vingtaine d’années, ont permis d’une part de mieux maîtriser les fonctionnalités des constituants de l’œuf et d’autre part d’adapter les procédés de transformation utilisés dans le secteur des ovoproduits. De même, les progrès réalisés dans l’extraction et la connaissance des constituants mineurs de l’œuf et de leurs propriétés biologiques ouvrent des perspectives de développement pour des applications hors du secteur de l’agroalimentaire (biologie, médecine, pharmacie). Cet article, a pour objectif de décrire les différentes étapes de fabrication des ovoproduits, après avoir abordé succinctement la structure, les constituants, et les principales applications de l’œuf et de certains de ses constituants.
Atmospheric Variables and Additional Urgent Solutions for Combating COVID-19
Authors: Roy Indrani
Published: April 2020

This article investigates whether the weather has any role in terms of spread and vulnerability of COVID-19 and how that knowledge can be used to arrest this fast spreading disease. It highlights that temperature and humidity both are important for transmitting the virus- temperature being the stronger factor. A dry, cool environment is the most favourable state for the spread of the virus. In fact, high temperature environment significantly reduces the risk from the virus. Warm places and countries are likely to be less vulnerable. Only regulating temperature level can provide drastic results to stop and arrest the outbreak. Some urgent solutions are proposed based on that knowledge. The novelty of such approach is- it can be applied overnight and implemented immediately across the globe. It is very cost effective and practically without side effects. No vast amount of funding is required to adopt these solutions. Apart from existing guidelines, these additional measures are likely to reduce the spread of the disease dramatically. Following the scientific discussion, such solutions may be thought of implementing worldwide, especially to vulnerable countries, as an emergency basis.
Reliability and Validity in Cranial Osteopathy Experience: A Cross-Sectional Study
Authors: Requena García Jesús , García Nieto Evelyn , Varillas Delgado David
Published: April 2020

Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of study is to assess the reliability and validity of osteopathic treatment depending on experience. Materials and Methods: A cross-sectional study of reliability and validity was conducted. For measurements, a strain gauge was placed on the sphenobasilar synchondrosis of the skull base, and three maneuvers (lateral compression, anteroposterior compression and compression maneuver of the mastoids) were repeated 25 times each by osteopaths with different time of experience (5-10 years, 1-5 years, <1 year). Measurement averages were computed for each of the three maneuvers to verify the average effect of each group in comparison to that of the Gold Standard (GS) (>10 years of experience). Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability and validity in 5-10 experience of observer 1 and observer 2 in the tree maneuvers was excellent (p<0.001) against GS. Poor or enough reproducibility and concordance were observed in osteopaths with less experience. Conclusion: Experience of osteopaths determines the efficacy of cranial maneuvers in osteopathic treatment for patients’ rehabilitation.
Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: A prospective observational study in a primary care setting in Japan
Authors: Akimoto Takashi , Kobayashi Tadashi , Maita Hiroki , Osawa Hiroshi , Kato Hiroyuki
Published: April 2020

Background Acute hip pain caused by femoral proximal fractures or acute hip arthritis requires imaging for accurate diagnosis. Although pocket-sized ultrasound (PsUS) offers several advantages over other imaging modalities, there is limited information regarding its use in diagnosing femoral proximal fractures or acute hip arthritis. Thus, we aimed to validate the diagnostic accuracy of PsUS for both disorders. Methods In this prospective observational study, outpatients with acute hip pain were diagnosed according to a fixed procedure of the PsUS probe handling. We verified the diagnostic accuracy of PsUS findings (cortical discontinuity and joint fluid retention) and compared it with that of radiography, computed tomography, and magnetic resonance imaging. Results Our study included 52 outpatients (mean age, 78.0 years; female, 88.5%). Of 26 patients diagnosed with femoral proximal fractures, 14 had femoral neck fractures and 12 had femoral trochanteric fractures. The sensitivity and specificity for identifying cortical discontinuity in femoral proximal fractures were 0.96 and 0.92, respectively. The sensitivity for identifying either cortical discontinuity or joint fluid retention in femoral proximal fractures or acute hip arthritis was 0.97. Conclusions Negative PsUS findings of cortical discontinuity and joint fluid retention in the hip are useful for ruling out femoral proximal fractures and acute hip arthritis. PsUS and radiography have comparable diagnostic accuracies, and PsUS could aid in the initial assessment of acute hip pain among the elderly in primary care settings.
Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases
Authors: Kalinauskaite Goda , Tinhofer Ingeborg , Kufeld Marcus , Kluge Anne Kathrin , Grün Arne , Budach Volker , Senger Carolin , Stromberger Carmen
Published: April 2020

Background: Patients with oligometastatic disease can potentially be cured by using an ablative therapy for all active lesions. Stereotactic body radiotherapy (SBRT) is a non-invasive treatment option that lately proved to be as effective and safe as surgery in treating lung metastases (LM). However, it is not clear which patients benefit most and what are the most suitable fractionation regimes. The aim of this study was to analyze treatment outcomes after single fraction radiosurgery (SFRS) and fractionated SBRT (fSBRT) in patients with lung oligometastases and identify prognostic clinical features for better survival outcomes. Methods: Fifty-two patients with 94 LM treated with SFRS or fSBRT between 2010 and 2016 were analyzed. The characteristics of primary tumor, LM, treatment, toxicity profiles and outcomes were assessed. Kaplan-Meier and Cox regression analyses were used for estimation of local control (LC), overall survival (OS), progression-free survival and distant metastases-free survival (DMFS). Results: Ninety-four LM in 52 patients were treated using SFRS/fSBRT with a median of 2 lesions per patient (range: 1–5). The median planning target volume (PTV)-encompassing dose for SFRS was 24 Gy (range: 17-26) compared to 45 Gy (range: 20-60) in 2-12 fractions in fSBRT. The median follow-up time was 21 months (range: 3-68). LC rates at 1 and 2 years for SFSR vs. fSBRT were 89% and 83% vs. 75% and 59%, respectively (p=0.026). LM treated with SFSR were significantly smaller (p=0.001). The 1 and 2-year OS rates for all patients were 84% and 71%, respectively. In univariate analysis treatment with SFRS, an interval of ≥ 12 months between diagnosis of LM and treatment, non-colorectal cancer histology and BED <100 Gy were significantly associated with better LC. However, none of these parameters remained significant in the multivariate Cox regression model. OS was significantly better in patients with negative lymph nodes (N0), Karnofsky performance status (KPS) >70% and time to first metastasis ≥12 months. There was no grade 3 acute or late toxicity. Conclusions: Longer time to first metastasis, good KPS and N0 predicted better OS. Good LC and low toxicity rates were achieved after short SBRT schedules.
The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: A randomized trial
Authors: Aboulghar Mona , El-Faissal Yahia , Kamel Ahmed , Mansour Ragaa , Aboulserour Gamal , Aboulghar Mohamed , Islam Yomna
Published: April 2020

Background: The rate of multiple pregnancies in IVF/ICSI ranges from 20-30% . The incidence of preterm birth in multiple pregnancies is as high as 60% and is even higher in pregnancies conceived after IVF & ICSI. The effect of progesterone on prevention of preterm birth in twins is controversial . Our group has proven a positive effect in reduction of preterm birth ,by starting progesterone from the mid-trimester ,in exclusively IVF/ICSI singleton pregnancies but not twins. The purpose of our current study was to explore the effect of earlier administration of natural progesterone, in IVF/ICSI twin pregnancies starting at 11-14 weeks for prevention of preterm birth. Methods: This is a double-blind, placebo controlled, single center, randomized clinical trial. Women with dichorionic twin gestations, following an IVF/ICSI trial were randomized to receive natural rectal progesterone (800 mg daily ) vs placebo, starting early from 11-14 weeks. They were randomized regardless of cervical length and had no previous history of preterm birth or known Mullerian anomalies. The primary outcome was, spontaneous preterm birth rate <37 weeks. The secondary Outcome was; spontaneous preterm birth <34,32,28 weeks and neonatal outcome. Results: A total of 203 women were randomized to both groups, final analysis included 199 women as 4 were lost to follow up. The base line characteristics as well as gestational age at delivery were not significantly different between the study and the placebo group (34.7±3.6 vs 34.5±4.5, P=0.626). Progesterone administration was not associated with a significant decrease in the spontaneous preterm birth rates <37 weeks (73.5% vs 68%, P = 0.551), <34 (20.6% vs 21.6%, P = 0.649), <32 (8.8% vs 12.4%, P = 0.46) & <28 (4.9 % vs 3.1 %, P = 0.555). Conclusions: Rectal natural progesterone starting from the first trimester in IVF/ICSI twin pregnancies did not reduce spontaneous preterm birth.The trial was registered on 31 January 2014 at www.ISRCTN.com, 69810120.
Explicating Practice Norms and Tensions Between Values in Resident Training in Family Medicine
Authors: Achkar Morhaf Al
Published: April 2020

Background. Residency programs have the intricate and complex role of training health care providers. But little is known about what residents and attendings consider norms of practice or the tensions among different values residents are expected to uphold. Thus, dialogical and reflective frameworks are being explored for resident learning.Methods. This study examined the use of facilitated conversations with groups of residents and attending physicians while reviewing video-recorded resident–patient interactions. The conversations were recorded, transcribed, and qualitatively analyzed.Results. A total of 24 residents and 10 attendings participated in conversations while separately and in parallel groups reviewing 15 resident sessions. Residents explicated the norms of practice and evaluated their performance, which often agreed with those of attending physicians in calling out important learning opportunities. When disagreement occurred, residents’ explications of their reasoning were often relevant and, via reflection and dialogue, helped clarify intentions that were not apparent in the videos. Residents and attendings often judged actions on more than one domain of value. For instance, if a resident addressed problems, built relationships in a timely manner, and acted autonomously without jeopardizing the quality of care, she satisfactorily performed her duty.Conclusions. Practice norms and value struggles were addressed by participants during reviews, which provided a promising framework for learning and assessment. Also, the non-hierarchical structure opened space to acknowledge a diversity of positions and for tensions among values to be explicated.
Resources Utilisation and Economic Burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue
Published: April 2020

Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate. Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city. Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.
Application of Loop-Mediated Isothermal Amplification combined with colorimetric and lateral flow dipstick visualization as the potential point-of-care testing for Corynebacterium diphtheriae
Authors: Zasada Aleksandra Anna , Wiatrzyk Aldona , Czajka Urszula , Brodzik Klaudia , Formińska Kamila , Mosiej Ewa , Prygiel Marta , Krysztopa-Grzybowska Katarzyna , Wdowiak Karol
Published: April 2020

Background Diphtheria outbreaks occurred in endemic areas and imported and indigenous cases are reported in UE/EEA. Because of the high infectiveness and severity of the disease, early and accurate diagnosis of each suspected case is essential for the treatment and management of the case and close contacts.The aim of the study was to establish simple and rapid testing methods based on Loop-Mediated Isothermal Amplification (LAMP) assay for the detection of Corynebacterium diphtheriae and differentiation between toxigenic and non-toxigenic strains.Methods Corynebacterium diphtheriae and Corynebacterium ulcerans isolates from the National Institute of Public Health-National Institute of Hygiene collection were used for the development of LAMP assay for the diagnosis of diphtheria and nontoxigenic C. diphtheriae infections. Various colorimetric methods for visualization of results were investigated. Sensitivity and specificity of the assay were examined using a collection of DNA samples from various gram-positive and gram-negative bacteria.Results The LAMP assay for tox and dtxR genes was developed. The sensitivity and specificity of the assay were calculated as 100%. The detection limit was estimated as 1.42 pg/µl concentration of DNA template when the reaction was conducted for 60 min. However, the detection limit was lowered 10 times for every 10 minutes of reduction in the time of incubation during the reaction. Positive results were successfully detected colorimetrically using hydroxynaphthol blue, calcein, QuantiFluor, and lateral flow Milenia HybriDetect dipsticks.Conclusion The assay developed in the study might be applied for point-of-care testing of diphtheria and other C. diphtheriae infections as well as for other infections caused by diphtheria-toxin producing Corynebacterium species. It is highly sensitive, specific, inexpensive, easy to use, and suitable for low-resource settings.
Glistening formation in a new hydrophobic acrylic intraocular lens
Authors: Yildirim Timur M. , Fang Hui , Schickhardt Sonja K. , Wang Qiang , Merz Patrick R. , Auffarth Gerd U.
Published: April 2020

Background: The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistening formation.Methods: An in-vitro stress test for glistening induction was performed on twenty samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm2) was evaluated in five sections of each IOL. The results for each model were compared and rated on the Miyata Scale for grading glistening severity.Results: In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm². The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm². Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero.Conclusion: In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.
The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation
Authors: Wang Hongwei , Qin Xiuhong , Ji Jiali , Lu Yang , Xu Li , Guo Tao , Xiao Caiwen , Zhang Zhenzhen
Published: April 2020

Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular laceration were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and the complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid laceration with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.
Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital
Authors: Lyra Divaldo Pereira de , Alcântara Thaciana dos Santos , Neto Fernando Castro de Araújo , Lima Helena Ferreira , Araújo Dyego Carlos S. Anacleto de , Sanchez Júlia Mirão , Junior Divaldo P. de Lyra
Published: April 2020

The authors have withdrawn this preprint due to author disagreement.
Phosphate starvation enhances phagocytosis of Mycobacterium bovis/BCG by macrophages.
Authors: Espinosa-Cueto Patricia , Magallanes-Puebla Alejandro , Mancilla Raul
Published: April 2020

Background:Tuberculosis is an important health problem worldwide. The only available vaccine isM. bovis/BCG, an attenuated mycobacterium that activates the innate and the acquired immune system after being phagocytosed by macrophages and dendritic cells. Vaccination fails to prevent adult pulmonary tuberculosis although it may have a protective effect in childhood infection. Understanding how BCG interacts with macrophages and other immunocompetent cells is crucial to develop new vaccines.Results:In this study we showed that macrophages phagocytoseM. bovis/BCG bacilli with higher efficiency when they are cultured without phosphate. We isolated mycobacterial membranes to search for mycobacterial molecules that could be involved in these processes; by immunoblot, it was found that the plasma membranes of phosphate-deprived bacilli express the adhesins PstS-1, LpqH, LprG, and the APA antigen. These proteins are not detected in membranes of bacilli grown with usual amounts of phosphate.Conclusions:The interest of our observations is to show that under the metabolic stress implied in phosphate deprivation, mycobacteria respond upregulating adhesins that could improve their capacity to infect macrophages. These observations are relevant to understand howM. bovis/BCGinduces protective immunity.
WITHDRAWN: High Failure Rate after Beta-tricalcium Phosphate Grafting for the Treatment of Femoral Head Osteonecrosis: a Retrospective Analysis
Authors: Liu Pei , Mu Xiao-hong , Yu Hua-chen , Jian-lei Guan , Liu Zhao-hui , Wang Wei-guo , Zhang Qi-dong , Guo Wanshou
Published: April 2020

Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, “light-bulb” procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH. Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes. Results: The 5-years survival rate of using β-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed ( P < 0.05). 2 hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative. Conclusions: Our results suggest that “light-bulb” procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.
Effect of acupuncture and its influence on cerebral activity in patients with persistent asthma: study protocol for a randomized controlled clinical trial
Authors: Yu Siyi , Dong Xiaohui , Sun Ruirui , He Zhaoxuan , Zhang Chuantao , Chen Mei , Hong Xiaojuan , Lan Lei , Zeng Fang
Published: April 2020

BackgroundPrevious studies suggested that acupuncture was a promising adjunct treatment for asthma. However, the underlying mechanism of acupuncture for asthma remains unclear. The present trial aimed to explore whether and how specific meridian acupuncture works in quality of life and symptomatic improvement by modulating brain function in asthma patients.Methods: A randomized controlled functional brain imaging trial is currently being conducted in Sichuan, China. In total 48 patients with mild to moderate, persistent asthma will be recruited randomly allocated to two acupuncture groups: acupuncturing at Lung Meridian and acupuncturing at Heart Meridian. The treatment period will last for 4 weeks. The Asthma quality of life questionnaire (AQLQ) is the primary outcome. Asthma control test (ACT), the rate of Peak expiratory flow (PEFR), Forced expiratory volume in 1 second (FEV1), Montreal cognitive assessment (MoCA), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) will also assess the clinical efficacy of different interventions. Functional magnetic resonance imaging (fMRI) scans will be performed to detect cerebral activity changes in each group. The clinical data and fMRI data will be analyzed, respectively. Pearson correlation analysis will be used to assess the association between the changes of cerebral activity features and the improvement of clinical outcomes in each group.Discussion: The present study has been established on the “meridians-viscera relationship” theory of traditional Chinese medicine and modern central mechanism of acupuncture. The results of this trial would be useful to identify the efficiency of the specific meridian acupuncture for asthma. The investigation of its central mechanism would further expand our knowledge of the acupuncture for asthma. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027478. Registered on 15 November 2019.
Is it necessary to use tobramycin-dexamethasone eye ointment prophylactically in eyes at the end of intraocular surgery?
Authors: Zhang Wei , Han Han , Feng Kang , Wang Xiaohong , Du Mei , Meng Xiangda , Liu Yuanyuan , Huang Bo , Brant Rodrigo , Yan Hua
Published: April 2020

Background: There are no data available regarding the complications associated with using antibiotic ointment at the end of intraocular surgery. This study aimed to explore the necessity of using ocular tobramycin-dexamethasone prophylactically at the end of intraocular surgery.Methods: This was a retrospective cohort study of patients who received intraocular surgery at Tianjin Medical University General Hospital from January 2015 to December 2017. The patients were grouped according to whether they received tobramycin-dexamethasone eye ointment or not after surgery. The Tobramycin dexamethasone eye ointment was sampled to observe bacterial contamination pathogens at 0.5, 1, 1.5, 2, 2.5, 3, 6, 8, 24, 36, 48, 72, and 168 h after being opened.Results: A total of 3811 eyes in 3811 patients (mean age of 63±12 years) were included: 2397 eyes that received prophylactic tobramycin-dexamethasone eye ointment and 1414 eyes that did not. The overall rate of endophthalmitis was 0.08% (3/3811) in our study, all in the eye ointment group (0.12%, 3/2397); no patients developed endophthalmitis in the non-ointment group (0%, 0/1414)(P=0.184). The anterior chamber reactions 1 day after surgery were more serious in the eye ointment group compared with the non-ointment group (all P<0.05), but there were no statistically significant differences at 1 month postoperatively (all P>0.05). The contamination rate was 0% at all time points over 7 days.Conclusion: We did not observe a statistically significant difference in the incidence of endophthalmitis in patients with or without prophylactic tobramycin-dexamethasone eye ointment. And tobramycin-dexamethasone eye ointment seemed to increase some side effects such as eye secretions increasing and foreign body feeling.
Radiographic and clinical outcome of lumbar lateral interbody fusion for extreme lumbar spinal stenosis of Schizas grade D: a retrospective study
Authors: Li Jun , Li Hao , Ning Zhang , Wang Zhi-wei , Zhao Teng-fei , Chen Lin-wei , Chen Gang , Chen Qi-xin , LI Fang-cai
Published: April 2020

Background: Extreme lumbar spinal stenosis was thought to be a relative contraindication for lumbar lateral interbody fusion (LLIF) and was excluded in most studies. This is a retrospective study to analyze the radiographic and clinical outcome of LLIF for extreme lumbar spinal stenosis of Schizas grade D. Methods: For radiographic analysis, we included 181 segments from 110 patients who underwent LLIF between June 2017 and December 2018. Lumbar spinal stenosis was graded according to Schizas’ classification. Anterior and posterior disc heights, disc angle, foramen height, spinal canal diameter and central canal area were measured on CT and MRI. For clinical analysis, 18 patients with at least one segment of grade D were included. Visual analogue scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate clinical outcome. Continuous variables were compared using Student's t-test, with P- values < 0.05 considered to indicate statistically significant differences. Results: Among the 181 segments included for radiological evaluation, there were 23 grade A segments, 37 grade B segments, 103 grade C segments and 18 grade D segments. Postoperatively, the average change of midsagittal canal diameter of grade D was significantly greater than that of grade A, and not significantly different compared to grades B and C. As to the average change of disc height, bilateral foraminal height, disc angle and central canal area (CCA), grade D was not significantly different from the others. The average postoperative CCA of grade D was significantly smaller than the average preoperative CCA of grade C. Eighteen patients with grade D stenosis were followed up for an average of 19.61 ± 6.32 months. Clinical evaluation revealed an average improvement in the ODI and VAS scores for back and leg pain by 20.77%, 3.67 and 4.15 points, respectively. Sixteen of 18 segments with grade D underwent posterior decompression. Conclusion: The radiographic decompression effect of LLIF for Schizas grade D segments was comparable with that of other grades. Posterior decompression was necessary for LLIF to achieve a satisfactory clinical outcome for extreme lumbar spinal stenosis of Schizas grade D.