bluuebunny/crossref_metadata_2025 huggingface dataset:
North–South–South collaboration as a context for collaborative learning and thinking with alternative knowledges
Authors: Riitaoja Anna-Leena , Posti-Ahokas Hanna , Janhonen-Abruquah Hille
Published: December 2019

This article discusses North–South–South higher education collaboration as a context for development education. We analyse an intensive course on qualitative research methods and culturally responsive education organized by a network of five universities from global South
and global North. The course aimed to enhance qualitative understanding of quality learning and educational practices through approaches of contextual and cultural relevance, in line with Sustainable Development Goal 4 (SDG4). The course initiated a research-focused learning dialogue among
students and researchers and encouraged participants to reflect and critique their views and to engage with alternative knowledges. Analysis of participants' course feedback highlights the opportunities and limits of North– South–South collaboration for enhancing contextual, cultural
and epistemological awareness for a better understanding of quality education.
Agonistic possibilities for global unlearning: Constraints to learning within global citizenship education and social movements
Authors: Underhill Helen
Published: December 2019

The continued rise of populisms and divisions alongside widening inequalities nationally and globally give increasing urgency to the question of how educators and activists can respond. This article examines the possibilities that emerge from the connections between global citizenship
education (GCE) and learning in social movements, both spaces where people seek to engage others in ideas of how the world is, could and should be. Drawing on Mouffe's (2005) theory of agonistic pluralism to engage conflict and emotion with possibilities for learning and unlearning, the case
study reveals the significance of recognizing constraints created by histories and narrations of the 'other'. The article calls for more work on the intersections of unlearning and agonism in order to create agonistic pedagogies for activism and GCE.
Enhanced oil recovery from high-viscosity oil deposits by acid systems based on surfactants, coordining solvents and complex compounds
Authors: Altunina Lyubov K. , Kuvshinov Vladimir A. , Stasyeva Lyubov A. , Kuvshinov Ivan V.
Published: December 2019

Physicochemical aspects of enhanced oil recovery (EOR) from heavy high-viscosity deposits, developed in natural mode and combined with thermal methods, using systems based on surface-active substances (surfactants), coordinating solvents and complex compounds are considered, which chemically evolve in situ to acquire colloidal-chemical properties that are optimal for oil displacement. Thermobaric reservoir conditions, interactions with reservoir rock and fluids are the factors causing the chemical evolution of the systems.
To enhance oil recovery and intensify the development of high-viscosity deposits, acid oil-displacing systems of prolonged action based on surfactants, inorganic acid adduct and polyatomic alcohol have been created. As a result of experimental studies of acid-base equilibrium in the systems with donor-acceptor interactions – polybasic inorganic acid and polyol, the influence of electrolytes, non-electrolytes and surfactants, the optimal compositions of the systems were selected, as well as concentration ranges of the components in the acid systems. When the initially acid system interacts with the carbonate reservoir to release CO2, the oil viscosity decreases 1.2-2.7 times, the pH of the system rises and this system evolves chemically turning into an alkaline oil-displacing system. As a result it provides effective oil displacement and prolonged reservoir stimulation. The system is compatible with saline reservoir waters, has a low freezing point (minus 20 ÷ minus 60 oC), low interfacial tension at the oil boundary and is applicable in a wide temperature range, from 10 to 200 oC.
In 2014-2018 field tests of EOR technologies were successfully carried out to intensify oil production in the test areas of the Permian-Carboniferous deposit of high-viscosity oil in the Usinsk oil field, developed in natural mode and combined with thermal-steam stimulation, using the acid oil-displacing system based on surfactants, coordinating solvents and complex compounds. The pilot tests proved high efficiency of EOR technologies, as far as the oil production rate significantly increased, water cut decreased to intensify the development. The EOR technologies are environmentally safe and technologically effective. Commercial use of the EOR is promising for high-viscosity oil deposits.
Los rituales de la libertad en la poesía de Rosario Castellanos: de las redes perversas del poder a la autoafirmación
Authors: García-Peña Lilia Leticia
Published: December 2019

Este trabajo analiza la representación simbólica de la dinámica del poder en la poesía completa de Rosario Castellanos, una de las escritoras mexicanas contemporáneas más importantes. Se estudia cómo Rosario Castellanos vincula los efectos de las redes de poder con una dimensión del mal metafísico y se aborda el proceso ritual liberador que la escritora construye en su vida y en su obra para aproximarse a la autoafirmación.
L'aggiornamento dei docenti di italiano L2. Una ricerca sulle necessità formative degli insegnanti
Authors: Facchetti Giulio , Grosso Micaela , Nitti Paolo
Published: December 2019

In questo contributo sono discussi i risultati di un questionario relativo alle necessità formative del personale docente, che si occupa di insegnamento dell’italiano L2. A partire dalla valutazione della letteratura scientifica di riferimento, è stato strutturato un questionario per rilevare i bisogni formativi e gli aspetti critici in merito alla dimensione della didattica dell’italiano L2. Dall’analisi dei dati emerge con chiarezza il desiderio di formazione di carattere linguistico e la necessità di ulteriori raccordi fra mondo accademico e professionale.
Mafarka il futurista come romanzo italiano dell’avvenire. F.T. Marinetti e il grande concorso di Poesia
Authors: Pernice Vincenzo
Published: December 2019

Il presente contributo intende collegare la stesura di Mafarka il futurista di F.T. Marinetti al “grande concorso di Poesia per un romanzo italiano inedito”. L’esito negativo della competizione fa emergere una serie di considerazioni estetiche, paragonabili a quelle che avrebbero guidato il padre del futurismo nella scrittura del suo primo romanzo. Viene così confermata la precoce attenzione dell’avanguardia italiana nei confronti di questo genere letterario.
EAL IN VOCATIONAL EDUCATION: NEEDS ANALYSIS AND COURSE SYLLABUS DESIGN
Authors: Kampmark Nataša V.
Published: December 2019

After examining the role of a needs analysis approach in ESL/EAL[1] and most common tools of varied efficiency and reliability used to conduct it, the paper explicates a development of a needs analysis tool for the purpose of designing a syllabus for an English language course for a group of international students and bringing their language competency to the level required for enrolment into a VET/TAFE course in Australia. Furthermore, the paper gives an overview of a five-lesson programme designed to address the perceived needs of overseas students and in its final section offers possible ways of evaluating the programme.

[1] Because the term ESL (English as a Second Language) presumes that English is a student’s second language, which in most instances is not the case with ELICOS students in Australia, the term EAL (English as an Additional Language) is used.
TABU I INTERKULTURNA KOMPETENCIJA U NASTAVI STRANOG JEZIKA: TEMA SMRTI U NASTAVI ŠPANSKOG KAO L2
Authors: Georgijev Ivana Z. , Maričić Mesarović Sanja M.
Published: December 2019

Autorke se u ovom radu bave temom smrti u nastavi španskog kao stranog jezika. Cilj rada je da, u skladu sa savremenim tendencijama u nastavi stranih jezika koje fokus stavljaju na razvoj interkulturne kompetencije kod učenika, skrenu pažnju na temu smrti i mogućnost uključivanja ove teme u nastavu španskog kao stranog jezika. Polazi se od ideje da obrada fenomena smrti iz perspektive različitih kultura omogućava da gradimo interkulturni dijalog i, posledično, interkulturnu kompetenciju. Hipoteza rada je da će ova tema, imajući u vidu činjenicu da smrt predstavlja univerzalni fenomen, ali i jedan od dominantnijih tabua u savremenim zapadnim društvima – biti veoma malo zastupljena u udžbenicima za španski kao strani jezik, i da će uglavnom biti obrađena kroz praznik el Día de Muertos, najmanje na početnim nivoima učenja zbog kompleksnosti i specifičnosti leksike. Autorke najpre nude sažet prikaz prisustva i obrade teme smrti u udžbenicima za španski kao L2 koje izdaju neke od najznačajnijih španskih izdavačkih kuća. Zatim sledi predlog didaktičke jedinice koji predstavlja težište rada. Rezultati korpusnog istraživanja potvrdili su početnu hipotezu jer je tema smrti veoma malo zastupljena u didaktičkom materijalu i uvek se obrađuje kroz poznatu hispansku svetkovinu el Día de Muertos koju karakteriše nesvakidašnje poimanje smrti. Analiza je opovrgla jednu od polaznih hipoteza da će ova tema biti obrađena na višim nivoima učenja pokazavši njeno prisustvo na nižim nivoima (A1–B1). Predlog didaktičke jedinice o pomenutoj hispanskoj svetkovini obrađuje temu smrti kroz različite tipove aktivnosti predviđenih za nivo B1, sa ciljem razvijanja interkulturne kompetencije kod učenika španskog jezika.
Os índios Xipaya
Authors: Toledo Beatriz Furlan
Published: December 2019

Resenha do livro Os índios Xipaya: Cultura e língua, organizado e traduzido por Peter Schröder. O livro reúne textos de Curt Nimuendajú sobre aspectos culturais e linguísticos do povo Xipaya, registrados no período em que o autor esteve entre eles.
Modelagem 3D e geovisualização aplicada a desastres naturais. Uma proposta de laboratório de ensino e pesquisa para monitoramento e previsão de escorregamentos
Authors: Simoes Silvio Jorge Coelho , Andrade Márcio Roberto Magalhães , Mendes Tatiana Sussel Gonçalves , Mendes Rodolfo Moreda , Gomes Luciene , Bortolozo Cassiano Antonio
Published: December 2019

Landslides have a high degree of uncertainty requiring new methods for their analysis, monitoring and forecasting. In Brazil, Cemaden is responsible for actions related to the natural disasters and, recently, has started with partner institutions, a project sponsored by FINEP in order to monitor ten prone-landslides areas situated  in different regions of the country. This paper presents the proposal of REDEGEO to implant a laboratory of modeling and geovisualization to study landslide processes in urbanized areas. The laboratory consists of three parts: A) Field surveys to obtain high resolution images from unmanned aerial vehicles and to obtain the internal geometry of outcrops from geophysics methods (Resistivity and Radar Soil Penetration - GPR); B) 3D modeling using the software Geovisionary® which allows the analysis of image and geophysical dataset from different formats considering their volumetric properties; C) Geovisualization and Virtual Reality (VR) where the images obtained in the fieldwork can be observed from a human-machine interface which allows that the researchers have a full immersion  in the selected areas. The creation of a laboratory related to the natural disasters, which include geovisualization and VR, stimulates the active participation of the researcher team and creates mechanisms for the participation of technologies developers, managers, civil defense agents and even the population that lives in the risk prone-areas.
Insegurança Alimentar, consumo de alimentos e estado nutricional de mulheres de Campo Grande, Mato Grosso do Sul
Authors: Santos Lídia Viegas Tenório da Silva , Cáceres Larissa de Azevedo , Pegolo Giovana Eliza
Published: December 2019

Objetivou-se avaliar a Insegurança Alimentar de famílias, tendo a figura materna como representante, e fatores associados. Trata-se de estudo transversal com mulheres de Campo Grande (MS). Constatou-se 52,4% de Insegurança Alimentar, consumo de alimentos inadequado e 50,8% de excesso de peso. A inadequação do consumo de alimentos pode favorecer a instalação de doenças crônicas e agravar o estado nutricional já evidenciado pelo expressivo percentual de excesso de peso.
Proposta de indicador de eficiência da gestão pública municipal em promover desenvolvimento local
Authors: Oliveira Bruno Garcia , Liboni Lara Bartocci
Published: December 2019

O objetivo deste artigo foi avaliar a eficiência dos munícipios do estado de São Paulo em promover desenvolvimento local. Os municípios foram agrupados em quatro clusters conforme perfil tributário e por meio da Análise Envoltória de Dados foi elaborado um indicador de eficiência. Somente 29 municípios foram considerados benchmarking, sendo que 28% destes estão na mesorregião de Campinas. Além disso, a presença de municípios benchmarking limítrofes pode indicar que a escala local ultrapassa o limite geopolítico municipal.
Avaliação da qualidade ambiental de corpos hídricos urbanos utilizando análise multivariada
Authors: Silva César de Oliveira Ferreira , Goveia Danielle
Published: December 2019

O presente trabalho avaliou a qualidade da água em corpos hídricos urbanos utilizando técnicas estatísticas multivariadas. Na cidade de Sorocaba, SP, Brasil, foram selecionados dez corpos hídricos e determinou-se nove variáveis limnológicas. Os resultados indicaram impactos devido ao descarte irregular de resíduos sólidos e esgoto doméstico. Diante dos resultados, são apresentadas diretrizes de gestão ambiental.
Reflexões acerca da Política Nacional de Saúde Integral LGBT nas regiões de fronteiras
Authors: Preuss Lislei Teresinha , Martins Dilermando Aparecido Borges
Published: December 2019

Este artigo tem por objetivo correlacionar as regiões de fronteiras e população LGBT, em uma pesquisa exploratória de viés crítico-dialético, para estabelecer as pontes entre estas duas categorias de análise. Para tanto, a discussão parte das políticas de saúde, especialmente através da Política Nacional de Saúde Integral LGBT. São poucas as discussões sobre a temática, tampouco as ações voltadas para a saúde integral desta população nas regiões fronteiriças.
A humanização do cuidado na emergência na perspectiva de enfermeiros: enfoque no paciente politraumatizado
Authors: Perboni Jéssica Siqueira , Silva Renata Cunha da , Oliveira Stefanie Griebeler
Published: December 2019

O enfoque deste estudo esta relacionado ao cuidado ao paciente politraumatizado na unidade de Emergência. Trata-se de uma abordagem qualitativa, na qual foram utilizadas entrevistas semiestruturadas com 12 enfermeiros para a obtenção dos dados. Os principais achados versaram sobre a humanização do atendimento pelos enfermeiros, prioridades e os desafios do cuidado ao paciente politraumatizado.
Identidade territorial e visibilidade midiática: o artesanato no Caderno Quarta Colônia
Authors: Mello Carolina Iuva de , Froehlich José Marcos
Published: December 2019

Ancorada nas interações entre local e global, a projeção identitária passa a ser estratégica na busca de oportunidades em nome do desenvolvimento. O Caderno Quarta Colônia foi parte de uma estratégia de visibilidade midiática que visava promover uma imagem identitária territorial, porém, embora presente nas narrativas históricas da italianidade recorrentes no território, a visibilidade dada ao artesanato foi menos intensa do que a outros ativos, indiciando o caráter seletivo dos processos de projeção identitária tecidos em nome do desenvolvimento dos territórios.
Percepções de Aspectos Psicossociais no Cuidado em Saúde de Adolescente com Obesidade Grave
Authors: Müller Adriana Lobo , Lima Duarte da Silva Cláudia Regina , Vargas Deisi Maria
Published: December 2019

O objetivo deste estudo foi desvelar percepções de aspectos psicossociais no cuidado de adolescentes com obesidade grave na atenção básica. Trata-se de um estudo qualitativo – descritivo que utilizou a entrevista com roteiro semiestruturado para coleta de dados. Os dados foram processados e analisados através de análise temática de conteúdo. Foram entrevistados seis profissionais de saúde, cinco adolescentes com obesidade grave e seis familiares de adolescentes com obesidade grave. Foram identificadas três categorias temáticas: concepção de obesidade, concepção de cuidado e obesidade na vida. Os dados encontrados evidenciaram que a concepção de obesidade dos profissionais de saúde, adolescentes e familiares é multifatorial, incluindo os fatores genéticos e orgânicos, o modo de vida contemporâneo e os aspectos psicológicos. A concepção de cuidado envolveu dieta, atividade física e cirurgia bariátrica. Nessa perspectiva foram realizadas reflexões acerca das políticas públicas de nutrição, saúde mental e saúde do adolescente permeadas pela proposta emergente da integralidade em saúde.
Capacidades e Dificuldades Socioemocionais de Crianças Antes e Após a Participação no Método FRIENDS
Authors: Ignachewski Cynthia Lais , Batista Ana Priscila , Toni Caroline Guisantes de Salvo , Pavoski Giulia Tatiana Tkaczyk
Published: December 2019

Atualmente, milhões de pessoas sofrem de algum transtorno mental, sendo as crianças uma considerável parcela dessa população. Nesse sentido, intervenções precoces para prevenir e intervir sobre distúrbios na infância são muito importantes. Uma possibilidade de intervenção precoce é o Método FRIENDS, que busca desenvolver habilidades socioemocionais e resiliência. O presente estudo buscou investigar se o Método FRIENDS promoveu melhorias em comportamentos relacionados a capacidades e dificuldades socioemocionais de crianças, relacionadas a comportamento pró-social, hiperatividade, sintomas emocionais, problemas de conduta e de relacionamento com os colegas. Participaram do estudo dez crianças de uma cidade do interior do Paraná com idade entre 6 e 7 anos. Os pais responderam o Strengths and Difficulties Questionnaire (versão em português), antes e depois do método e dois meses após sua finalização. O resultado indicou uma diminuição nas dificuldades dos participantes, demonstrando que o FRIENDS foi eficaz para a melhoria dos comportamentos das crianças.
Otimismo, Autoeficácia e Lócus de Controle na Adesão ao Tratamento de Pessoas Hipertensas
Authors: Santos Lucila Moraes Chaves , Almeida Laís Gabriela Rocha , Faro André
Published: December 2019

Este estudo analisou a relação do otimismo, da autoeficácia e do lócus de controle na adesão ao tratamento de pessoas hipertensas, bem como os principais preditores da adesão na amostra selecionada, considerando-se as variáveis sociodemográficas e os construtos psicológicos avaliados. A amostra foi composta de 100 hipertensos, e foram utilizados cinco instrumentos: questionário sociodemográfico e clínico, a Escala de Adesão Terapêutica de Morisky, o Teste de Orientação na Vida, a Escala de Autoeficácia Geral Percebida e a Escala de Lócus de Controle da Saúde. Por meio da técnica de regressão logística, verificou-se que praticar atividade física, não consumir álcool, ter maiores pontuação no lócus de controle acaso e na autoeficácia foram preditores de média e alta adesão ao tratamento. Finalmente, os resultados demonstraram a necessidade de mais investigações acerca da relação entre variáveis psicológicas e aderência ao tratamento hipertensivo, especialmente no que se refere ao lócus de controle acaso e sua influência sobre os comportamentos de saúde.
Directional Modulation Technique Using a Polarization Sensitive Array for Physical Layer Security Enhancement
Authors: Zhang Wei , Li Bin , Le Mingnan , Wang Jun , Peng Jinye
Published: December 2019

Directional modulation (DM), as an emerging promising physical layer security (PLS) technique at the transmitter side with the help of an antenna array, has developed rapidly over decades. In this study, a DM technique using a polarization sensitive array (PSA) to produce the modulation with different polarization states (PSs) at different directions is investigated. A PSA, as a vector sensor, can be employed for more effective DM for an additional degree of freedom (DOF) provided in the polarization domain. The polarization information can be exploited to transmit different data streams simultaneously at the same directions, same frequency, but with different PSs in the desired directions to increase the channel capacity, and with random PSs off the desired directions to enhance PLS. The proposed method has the capability of concurrently projecting independent signals into different speciﬁed spatial directions while simultaneously distorting signal constellation in all other directions. The symbol error rate (SER), secrecy rate, and the robustness of the proposed DM scheme are analyzed. Design examples for single- and multi-beam DM systems are also presented. Simulations corroborate that 1) the proposed method is more effective for PLS; 2) the proposed DM scheme is more power-efﬁcient than the traditional artiﬁcial noise aided DM schemes; and 3) the channel capacity is signiﬁcantly improved compared with conventional scalar antenna arrays.
Seasonal and Yearly Variation in Photosynthetic Capacity of Short- and Long-shoot Needles of the Canopy of Japanese Larch Trees as a Basis for Determining for O3 Sensitivity
Authors: Kitaoka Satoshi , Qu Laiye , Mao QiaoZhi , Watanabe Yoko , Watanabe Makoto , Koike Takayoshi
Published: December 2019

Ground-level ozone (O3) increases in the northeastern part of Eurasia, where larch species are dominant trees and have been planted intensively. The Japanese larch (Larix kaempferi; hereafter larch) is classified as the tree species most of its sensitive to O3 based on data from long-shoot needles of seedlings. This criterion should be reconsidered based on O3 uptake, which is strongly depended on stomatal conductance (Gs) of adult trees through the difference in relevant needle traits. Because Gs is closely correlated with photosynthetic activity, we measured the in situ seasonal and yearly change in photosynthetic function, needle mass per area (LMA) and nitrogen (N) content of both short- and long-shoot needles of the canopy of larch trees over successive 3 years. No difference was observed in the in light saturated photosynthetic rate at ambient CO2 (Psat) between needles of hetero types of shoot in the latter part of the growing season, but clear differences were found within a specific year, indicating that seasonal changes in climatic factors determine Psat in the long term. The Psat-N relations differed significantly between the needle types. However, Psat at saturated CO2 (Pmax)-N was quite similar, implying that the CO2 diffusion difference between short- and long-shoots is responsible for the differing Psat -N. In conclusion, seasonal and yearly variations in photosynthetic capacity are mainly determined mainly by climatic variations, whereas shoot type determined the traits of photosynthetic N utilization as well as Gs regulation.
Evaluation of Oral Supplementation with a Casein Hydrolysate-based Formula to Favor the Clearance of HR-HPV Infections and their Derived Lesions
Authors: Pingarrón Carmen , Duque Alfonso , López Ana Isabel , Ferragud Juan
Published: December 2019

Cervical cancer screening systems aim to detect established HPV infections early. However, if there are no high-grade lesions, the intervention choice is basically limited to observational follow-up with recommendations on life habits like diet, to favor infection control. Therefore, it is important to establish specific feeding guidelines that provide clear evidence about the benefit they may bring against HPV infections. The present study evaluates the benefits of nutritional supplementation with a casein hydrolysate-based formula in patients with HR-HPV infection, compared with a non-supplemented control group. A total of 118 patients completed 6 months of follow-up. Significant differences between supplemented and control groups were observed for total or partial HR-HPV clearance at 6 months (74.6% vs 35.6%). Supplemented patients also suffered a lower occurrence of new intracervical lesions (0% vs 28.6%), a significantly greater resolution (67.4% vs 41.9%) and less progression of pre-existing lesions (4.7% vs 9.7%) at 6 months. An increase in the effectors of cellular immunity that could be responsible for their effect was also observed in supplemented patients. We conclude that nutritional supplementation with this casein hydrolysate-based formula could improve the outcomes of observational management of HPV infection.
Weak Gravitational Lensing by Stringy Black Holes
Authors: Javed Wajiha , Bilal Khadim Muhammad , Abbas Jameela , Övgün Ali
Published: December 2019

In this paper, we discuss the weak gravitational lensing in the context of stringy black holes. Initially, we examine the deflection angle of photon by charged stringy black hole. For this desire, we compute the Gaussian optical curvature and implement the Gauss-Bonnet theorem to investigate the deflection angle for spherically balanced spacetime of stringy black hole. We also analyze the influence of plasma medium in the weak gravitational lensing for stringy black hole. Moreover, the graphical impact of coupling constant $\alpha$, impact parameter $b$ , black hole charge $Q$ on deflection angle by charged stringy black hole has been studied in plasma as well as non-plasma medium.
A Review Paper on Decision Making using AHP (Analytical Hierarchy Process) Techniques in Different Types of Project Management
Authors: Sirshar Mehreen , Hanif Iqra , Shahzad Sidra
Published: December 2019

Today project management in every field of life is prerequisite for the success of project by increasing quality reduces cost and schedule. But selecting tools and techniques to achieve our objectives and implement our plan fully is very difficult task because choice creates complexity. So, we discuss AHP to make decision simple. Ranking critical success factor, cloud computing services, risk prioritization, selection of right ETL software and many other systems AHP plays its important role. For the improvement of today’s complex systems it is very important to prioritize and select projects to remove the root cause of the problem. To attain the right selection of construction equipment for carrying out schedule tasks with high efficiency, production and financial capability is the main purpose of procurement of construction equipment process. Certain conflicts can occur due to the construction of UML models in a collaborative way. AHP is used to remove these conflicts and for establishing and evaluating modelers judgments. Nowadays it is very important and critical decision to choose the best option from multiple alternatives for a successful career after passing 12th standard and also it affects our future. “AHP and TOPSIS” methods are used for this purpose. In this paper, an “AHP and Fuzzy AHP” based hierarchical trust model has been used to rate the service providers and their various plans for infrastructure as a service.
Combined Targeting of Mutant p53 and Jumonji Family Histone Demethylase Augments Therapeutic Efficacy of Radiation in H3K27M DIPG
Authors: Nikolaev Anatoly , Fiveash John B. , Yang Eddy S.
Published: December 2019

Diffuse intrinsic pontine glioma (DIPG) is an aggressive pediatric brainstem tumor with a 5-year survival of <1%. Up to 80% of DIPG tumors contain a specific K27M mutation in one of two genes encoding histone H3 (H3K27M). Furthermore, p53 mutations found in >70-80% of H3K27M DIPG, and mutant p53 status is associated with a decreased response to radiation treatment and worse overall prognosis. Recent evidence indicates that H3K27M mutation disrupts tri-methylation at H3K27 leading to aberrant gene expression. Jumonji family histone demethylases collaborates with H3K27 mutation in DIPG by erasing H3K27 trimethylation and thus contributing to derepression of genes involved in tumorigenesis. Since the first line treatment for pediatric DIPG is fractionated radiation, we investigated the effects of Jumonji demethylase inhibition with GSK-J4, and mutant p53 targeting/oxidative stress induction with APR-246, on radio-sensitization of human H3K27M DIPG cells. Both APR-246 and GSK-J4 displayed growth inhibitory effects as single agents in H3K27M DIPG cells. Furthermore, both of these agents elicited mild radiosensitizing effects in human DIPG cells (sensitizer enhancement ratios (SERs) of 1.12 and 1.35, respectively; p<0.05). Strikingly, a combination of APR-246 and GSK-J4 displayed a significant enhancement of radiosensitization, with SER of 1.50 (p<0.05) at sub-micro-molar concentrations of the drugs (0.5 μM). The molecular mechanism of the observed radiosensitization appears to involve DNA damage repair deficiency triggered by APR-246/GSK-J4, leading to the induction of apoptotic cell death. Thus, a therapeutic approach of combined targeting of mutant p53, oxidative stress induction, and Jumonji demethylase inhibition with radiation in DIPG warrants further investigation.
Total Hip Arthroplasty in a Low-Income Country
Authors: Graham Simon Matthew , Howard Nicholas , Moffat Chipiliro , Lubega Nicholas , Mkandawire Nyengo , Harrison William J.
Published: December 2019

Background:

We describe our 10-year experience performing total hip arthroplasty (THA) in patients enrolled in the National Joint Registry of the Malawi Orthopaedic Association.

Methods:

Eighty-three THAs were performed in 70 patients (40 male and 30 female) with a mean age of 52 years (range, 18 to 77 years). The cohort included 24 patients (14 male and 10 female; mean age, 52 years [range, 35 to 78 years]) who were human immunodeficiency virus (HIV)-positive.

Results:

The main indications for surgery were osteonecrosis (n = 41 hips) and osteoarthritis (n = 26 hips). There were no deaths perioperatively and no early complications at 6 weeks. Forty-six patients (59 THAs) were seen at 10 years postoperatively, with a mean Harris hip score (HHS) of 88 (range, 41 to 91) and a mean Oxford Hip Score (OHS) of 46 (range, 25 to 48). Five hips (8% of 59) were revised due to loosening (n = 4) and fracture (n = 1). There were no infections or dislocations. Fourteen patients died, including 4 HIV-positive patients, of unknown causes in the follow-up period, and 10 patients were lost to follow-up. In the group of 24 HIV-positive patients, there were no early complications, and the mean HHS was 88 (range, 76 to 91) at >10 years.

Conclusions:

Our 10-year experience and long-term outcomes after primary THA in a low-income setting show that good results can be achieved within a controlled hospital environment, thereby establishing a benchmark against which other hospitals and registries in similar low-income countries can compare their results.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice
Authors: Faber Suzanne J , Scherpbier Nynke , Peters Hans , Uijen Annemarie
Published: December 2019

Background Elderly, patients with chronic kidney disease (CKD) and patients with heart failure who continue using renin-angiotensin-aldosterone-system (RAAS) inhibitors, diuretics, or non-steroidal-anti-inflammatory drugs (NSAIDs) during times of fluid loss have a high risk of developing complications like acute kidney injury (AKI). The aim of this study was to assess how often advice to discontinue high-risk medication was offered to high-risk patients consulting the general practitioner (GP) with increased fluid loss. Furthermore, we assessed the number and nature of the complications that occurred after GP consultation. Methods We performed a cross-sectional study with patients from seven Dutch general practices participating in the Family Medicine Network between 1-6-2013 and 1-7-2018. We included patients who used RAAS-inhibitors, diuretics, or NSAIDs, and had at least one of the following risk factors: age ≥70 years, CKD, or heart failure. From this population, we selected patients with a ‘dehydration-risk’ episode (vomiting, diarrhoea, fever, chills, or gastrointestinal infection). We manually checked their electronic patient files and assessed the percentage of episodes in which advice to discontinue the high-risk medication was offered and whether a complication occurred in three months after the ‘dehydration-risk’ episode. Results We included 3607 high-risk patients from a total of 44.675 patients (8.1%). We found that patients were advised to discontinue the high-risk medication in 38 (4.6%) of 816 ‘dehydration-risk’ episodes. In 59 of 816 episodes (7.1%) complications (mainly AKI) occurred. Conclusions Dutch GPs do not frequently advise high-risk patients to discontinue high-risk medication during ‘dehydration-risk’ episodes. Complications occur frequently. Timely discontinuation of high-risk medication needs attention.
Does intimate partner violence influence the utilization of maternal health services?
Authors: Acharya Devaraj , Adhikari Ramesh , Ranabhat Chhabilal , Paudel Radha , Thapa Purna Bahadur , Kreps Gary L.
Published: December 2019

Background: Intimate partner violence [IPV] is a public health problem globally and most common in developing countries that affects more than one fourth of women of reproductive age [WRA]. It is more critical during pregnancy. IPV not only affects physical and mental well-being but also leads to negative consequences in with birth outcomes.
Methods: We conducted a secondary data analysis of the Nepal Demographic and Health Survey 2016 to assess the association between IPV and maternal service utilization: ANC visits and institutional delivery. Altogether 1374 WRA were randomly selected. Background characteristics of WRA and IPV were the independent variables and ANC visits and institutional delivery were the dependent variables.
Results: Data showed that 26 percent of WRA had faced at least one form of IPV, 68 percent had visited health facilities at least four times for ANC check-ups during pregnancy, and the rate of institutional delivery was 61 percent. There were associations among IPV with ANC visits and institutional delivery (p<0.001). Age group, educational level, ethnicity, number of children, residence setting, and wealth status of WRA were significantly associated with ANC visits and institutional delivery (p<0.001).
Conclusion: IPV, educational level, and wealth status of WRA were significant predictors for maternal health service utilization. Policy makers should incorporate these significant predictors during planning and interventions as well.
Comparative Genomics of Multidrug-Resistant Enterococcus spp. isolated from Wastewater Treatment Plants
Authors: Sanderson Haley , Ortega-Polo Rodrigo , Zaheer Rahat , Goji Noriko , Amoako Kingsley K. , Brown R. Stephen , Majury Anna , Liss Steven N. , Mcallister Tim
Published: December 2019

Background Wastewater treatment plants (WWTPs) are considered hotspots for the environmental dissemination of antimicrobial resistance (AMR) determinants. Vancomycin-Resistant Enterococcus (VRE) are candidates for gauging the degree of AMR bacteria in wastewater. Enterococcus faecalis and Entercoccus faecium are recognized indicators of fecal contamination in water. Comparative genomics of enterococci isolated from conventional activated sludge (CAS) and biological aerated filter (BAF) WWTPs was conducted. Results VRE isolates, including E. faecalis (n=24), E. faecium (n=11), E. casseliflavus (n=2) and E. gallinarum (n=2), were selected for sequencing based on WWTP source, species and AMR phenotype. The pangenomes of E. faecium and E. faecalis were both open. The genomic fraction related to the mobilome was positively correlated with genome size in E. faecium ( p < 0.001) and E. faecalis ( p < 0.001) and with the number of AMR genes in E. faecium ( p = 0.005). Genes conferring vancomycin resistance, including van A and van M ( E. faecium ), van G ( E. faecalis ), and van C ( E. casseliflavus / E. gallinarum ), were detected in 20 genomes. The most prominent functional AMR genes were efflux pumps and transporters. A minimum of 16, 6, 5 and 3 virulence genes were detected in E. faecium , E. faecalis , E. casseliflavus and E. gallinarum, respectively. Virulence genes were more common in E. faecalis and E. faecium , than E. casseliflavus and E. gallinarum . A number of mobile genetic elements were shared among species. Functional CRISPR/Cas arrays were detected in 13 E. faecalis genomes, with all but one also containing a prophage. The lack of a functional CRISPR/Cas arrays was associated with multi-drug resistance in E. faecium . Phylogenetic analysis demonstrated differential clustering of isolates based on source but not based on WWTP. Genes related to phage and CRISPR/Cas arrays could potentially serve as environmental biomarkers. Conclusions There was no discernible difference between enterococcal genomes from the CAS and BAF WWTPs. E. faecalis and E. faecium have smaller genomes and harbor more virulence, AMR, and mobile genetic elements than other Enterococcus spp .
What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018
Authors: Inns Thomas , Wilson Deb , Manley Petra , Harris John P , O’Brien Sarah J , Vivancos Roberto
Published: December 2019

Background
Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings.
Methods
We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression.
Results
From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 50% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01-1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60-0.91), compared to outbreaks caused by other viral pathogens.
Conclusions
These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.
WITHDRAWN: Evaluation of PAX8 Expression Promotes the Proliferation of Stomach Cancer cells
Authors: Bie Liang-Yu , Li Ning , Deng Wen-Ying , Lu Xiao-Yu , Guo Ping , Luo Su-Xia
Published: December 2019

Background: PAX8 was identified as a mitosis-related regulator involved in the pathogenesis of human tumors and an indicator of the prognosis for patients. However, the function of PAX8 -in stomach cancer have not been studied. Aim: This study was aimed to explore the expression pattern of PAX8 in stomach cancer, and investigate the effect of PAX8 on the proliferation of stomach cancer cells. Methods: PAX8 expression pattern in stomach cancer was investigated in the “TCGA” database and compared in cancer and adjacent tissues of 36 clinical samples, in which the co-expression of SOX13 and PAX8 was confirmed by qRT-PCR. Based on the clinical record and IHC staining results, the survival curve was also mapped. Western blotting and qRT-PCR was used to analyze the effect of SOX13 on PAX8 and its downstream effector Aurora B and Cyclin B1 expression in AGS and MGC803 cells-. ChIP and luciferase assay were performed to explore SOX13 locate on the promoter of PAX8. Furthermore, CCK8, clone formation, EdU incorporation assay, and flow cytometry were used to detect the proliferative ability of AGS and MGC803 cell lines stably silenced PAX8. Results: PAX8 and SOX13 were identified to be synchronously upregulated in primary stomach cancer tissues and the TCGA stomach cancer datasets, and combined high PAX8 and SOX13 expression induced- worse prognosis. Furthermore, SOX13 can mediate PAX8 and its targeted genes expression, including Aurora B and Cyclin B1, in AGS and MGC803-. Flow cytometry and EdU incorporation assays showed that silencing PAX8 can block the cell cycle of stomach cancer cell in G1 phase and SOX13 expression can rescue the arrested proliferative process induced by PAX8 silence in CCK8 and colony formation assays. Conclusion: SOX13 participated in the elevated expression of PAX8,which promote the proliferation of stomach cancer cells, and both SOX13 and PAX8 act as an oncogene- in stomach cancer.
Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.
Authors: Parker Belinda , Achilles Melinda Rose , Subotic-Kerry Mirjana , O'Dea Bridianne
Published: December 2019

Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.
Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness
Authors: Owen-Smith Ashli , Stewart Christine , Sesay Musu M. , Strasser Sheryl M. , Yarborough Bobbi Jo , Ahmedani Brian , Miller-Matero Lisa R. , Waring Stephen C. , Haller Irina V. , Waitzfelder Beth E. , Sterling Stacy A. , Campbell Cynthia I. , Hechter Rulin C. , Zeber John E. , Copeland Laurel A. , Scherrer Jeffrey F. , Rossom Rebecca , Simon Greg
Published: December 2019

Background Individuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia.Methods Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N=65,750), BD (N=38,117) or schizophrenia or schizoaffective disorder (N=12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses.Results Multivariable models indicated that having a MDD (OR=1.90; 95% CI=1.85–1.95) or BD (OR=1.71; 95% CI=1.66–1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR=0.86; 95% CI=0.82– 0.90). Having a MDD (OR=2.59; 95% CI=2.44–2.75) or BD (OR=2.12; 95% CI=1.97–2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications.Conclusions Individuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients. Future research is needed to evaluate the effectiveness of involving mental health clinicians in these efforts.
Does the Use of a Closed-Suction Drain Reduce the Effectiveness of an Antibiotic-loaded Spacer in Two-Stage Exchange Arthroplasty for Periprosthetic Hip Infection? A Prospective, Randomized, Controlled Study
Authors: Xu Chi , Jia Cheng-Qi , Kuo Feng-Chih , Chai Wei , Zhang Ming-Hua , Chen Ji-Ying
Published: December 2019

Background: There is a concern regarding the use of a closed-suction drain (CSD) in two-stage exchange arthroplasty for periprosthetic joint infection as it may decrease the antibiotic concentrations in the joint fluids. The purpose of this study was to identify whether the use of a CSD could reduce local antibiotic concentrations following spacer implantation. Methods: A prospective, randomized, controlled trial was conducted at our institution between January 2018 and November 2018. We enrolled 32 patients undergoing two-stage exchange arthroplasty for periprosthetic hip infection with an interim cement spacer containing 4-g vancomycin and 2-g meropenem per 40-g methyl-methacrylate cement polymer. Patients were randomized and evenly divided into the study group (non-CSD) and control group (CSD group) by sealed envelopes. Drainage samples of joint fluids (n=160) were collected every 24 hours for the first five days following spacer implantation. The antibiotic concentrations of drainage samples were measured by high-performance liquid chromatography, and the bioactivities of the drainage samples against methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) and E. coli were assessed. Results: There was no significant difference in the decrease of vancomycin (study group vs. control group: 163.20 ± 77.05 vs. 162.39 ± 36.31; p=0.917) and meropenem concentration (123.78 ± 21.04 vs. 117.27 ± 19.38; P=0.548) between the two groups during the first five days following spacer implantation. All joint drainage samples in each group exhibited antibacterial activity against MSSA, MRSA and E. Coli . Conclusions: The use of CSD following the implantation of an antibiotic-loaded cement spacer does not reduce the effectiveness of such a spacer in two-stage exchange arthroplasty.