bluuebunny/crossref_metadata_2025 huggingface dataset:
Requirements for multispectral remote sensing data used for the detection of arable land colonization by tree and shrubbery vegetation
Authors:   Samara National Research University, Denisova A.Y. , Egorova A.A. ,   Samara National Research University, Sergeyev V.V. ,   Samara National Research University,   IPSI RAS – Branch of the FSRC “Crystallography and Photonics” RAS, Kavelenova L.M. ,   Samara National Research University
Published: November 2019

We discuss requirements for the multispectral remote sensing (RS) data utilized in the author's technique for estimating plant species concentration to detect arable land colonization by tree and shrubbery vegetation. The study is carried out using available high-resolution remote sensing data of two arable land plots. The paper considers the influence of resolution, combinations of spectral channels of RS data, as well as the season RS data is acquired on the quality of identification of elementary vegetation classes that form the basis of the plant community – a fallow land. A fallow land represents a piece of arable land that has not been cultivated for a long time. The study was conducted using a technology that is based on image superpixel segmentation. We found out that for determining tree and shrub vegetation, it is preferable to use RS data acquired in autumn, namely, in late September. The combination of red and blue spectral channels turned out to be the best for the analysis of tree-shrub vegetation against the background of grassy plant communities, and the presence of a near-infrared channel is necessary to range the various grassy plant communities in different classes. RS data with a spatial resolution of 2.5 m can be used to define tree-shrub plant communities with a high closeness of crowns (90 % or more), but cannot be used to classify isolated trees. Trees and shrubs (with a height of 8 m) can be classified in images with a spatial resolution of 0.8 m. An increase in spatial resolution does not improve the quality of the classification. The highest accuracies achieved for the land areas studied are 90 % and 83 %. Therefore, the suggested technology can be used in arable land expertise.
Scene distortion detection algorithm using multitemporal remote sensing images
Authors:   Samara National Research University, Belov A.M. , Denisova A.Y. ,   Samara National Research University
Published: November 2019

Multitemporal remote sensing images of a particular territory might include accidental scene distortions. Scene distortion is a significant local brightness change caused by the scene overlap with some opaque object or a natural phenomenon coincident with the moment of image capture, for example, clouds and shadows. The fact that different images of the scene are obtained at different instants of time makes the appearance, location and shape of scene distortions accidental. In this article we propose an algorithm for detecting accidental scene distortions using a dataset of multitemporal remote sensing images. The algorithm applies superpixel segmentation and anomaly detection methods to get binary images of scene distortion location for each image in the dataset. The algorithm is adapted to handle images with different spectral and spatial sampling parameters, which makes it more multipurpose than the existing solutions. The algorithm's quality was assessed using model images with scene distortions for two remote sensing systems. The experiments showed that the proposed algorithm with the optimal settings can reach a detection accuracy of about 90% and a false detection error of about 10%.
Number systems in modular rings and their applications to "error-free" computations
Authors:   IPSI RAS – Branch of the FSRC “Crystallography and Photonics” RAS, Chernov V.M. ,   Samara National Research University
Published: November 2019

The article introduces and explores new systems of parallel machine arithmetic associated with the representation of data in the redundant number system with the basis, the formative sequences of degrees of roots of the characteristic polynomial of the second order recurrence. Such number systems are modular reductions of generalizations of Bergman's number system with the base equal to the "Golden ratio". The associated Residue Number Systems is described. In particular, a new "error-free" algorithm for calculating discrete cyclic convolution is proposed as an application to the problems of digital signal processing. The algorithm is based on the application of a new class of discrete orthogonal transformations, for which there are effective “multipication-free” implementations.
Evaluation of Seismic Performance Based on A Direct Displacement-based Method
Authors: Wijaya Usman , Soegiarso Roesdiman , Tavio
Published: November 2019

Commonly, in the design of the seismic-resistant building, the force-based method has been popularly adopted to distribute the effect of earthquake forces to the building structure. This concept uses forces as an approach to simulate the impact of the earthquake on a building. To predict lateral forces of a building structure due to earthquake, Direct Displacement-Based Method (DDBM) can be introduced as an alternative solution. The performance level of a building structure can be categorized based on its damage level. In this paper, the performance-based evaluations were carried out according to ATC-40, FEMA 356, FEMA 440, and nonlinear time history analysis with seven ground motion (Denali, Imperial Valley, Kobe, Loma Prieta, Northridge, San Fernando, and Superstition Hills). The expected performances of the building structures were checked from the results obtained by the pushover time-history analyses compare to nonlinear time history analysis. The structural response parameters obtained from the force-based approach were found different from those obtained from the performance-based approach of the same building structures. The target displacements almost approach the results of DDBM. This means that the overall structure is in the category of performance criteria for Damage Control. The design level of performance is Life Safety, then the structure has not yet reached the target performance but approaching the design performance at a higher performance level. The actual structural response parameters obtained based on the DDBM were found slightly different from those stated in the ASCE 7-16. Therefore, the DDBM can be used as a promising alternative approach for the design engineers in evaluating the structural performance level of a building structure.
Al6061 Reinforced Al2O3 Metal Matrix Composite Produced by Double Blade Stir Casting
Authors: Zulfia Anne , Raga Krista , Narottama Wahyuaji , Yunus Salahuddin
Published: November 2019

Demand for materials with excellent mechanical properties and lightweight increase in a recent year especially for high-performance applications. Aluminum reinforced Al2O3 composite (AMC) provide this superior property. Therefore in this research, aluminum alloy 6061 was used as a matrix and Al2O3 with 10 and 15 Vf-%  as a reinforced for making metal matrix composites while magnesium as a wetting agent was used various from 8, 10  to 15 wt-% to improve the wettability between Al and Al2O3 since aluminum was poor wetting with ceramic.  Al alloy 6061 was melted at 800 oC and magnesium was added into Al molten, then Al2O3 particles were poured into the melt. The process using double stirrer with a rotational speed of 1000 rpm for 3 minutes to distribute all Al2O3 particles in the Al melt and all the gas bubble formed was removed by flushing an Argon for 2 minutes. The composites produced then characterized both mechanical properties and microstructural analysis.  The focus of this research is to investigate the effect of Al2O3 and Mg on the mechanical properties of composites. The result showed that the optimum tensile strength was 202 MPa which was obtained in composite with 10% Vf-% Al2O3 and 10 wt-% Mg. Moreover, hardness and wear resistant to composite increased with the addition of Al2O3 and Mg content due to good wetting in composites with 10 wt-% Mg.  The double blade stirrer has contributed to the random distribution of Al2O3 particles in the molten Al. The microstructure observations showed that the composites yield pores and impaired the mechanical properties of composites.
Why we need to talk about lifelong learning and intercultural universities
Authors: Sanchez Tyson Lorena , Watson Vega Valerie
Published: November 2019

This article explores whether and how contemporary discourses in lifelong learning (LLL) can support intercultural universities in Latin America. Since the late twentieth century, LLL has primarily been seen through a Eurocentric lens, with a strong focus on the development of skills
for knowledge-based economies and societies. As this discourse has been promoted and adopted by so-called developing countries, the focus has shifted from an identified need for continuous learning in a global society to mainly targeting the promotion of basic education, as is evidenced by
the United Nations Sustainable Development Goals. In this context, we have identified a need for further discussion and research on intercultural universities, many of which are becoming increasingly vulnerable in current neoliberal times. This article looks at two intercultural universities
in Mexico and Ecuador and suggests that a more indigenized approach to LLL could provide a stronger sense of ownership and participation in decision-making. Thus, LLL can be an ally for a new and decolonized conceptual framework that further legitimizes intercultural universities and provides
a long-term strategy for the future.
A pilot study of MBA programmes in South Africa
Authors: Muposhi Asphat , Dhurup Manilall , Martin Robert L. , Bhadury Joyendu
Published: November 2019

In recent years, Master of Business Administration (MBA) programmes and their curricula have been subjected to substantial scrutiny. However, the majority of studies have been confined to business schools in Western countries. By comparison, much less research is available on MBA programmes
in developing countries, particularly those in Africa. In an effort to address this gap, this article examines MBA programmes in South Africa by first situating them within the global MBA curriculum debate. It then notes the need to move away from a generalist MBA programme to a specialized
MBA in line with emerging global trends. Finally, it suggests a multidisciplinary approach to the redesign of the MBA curriculum.
The end of powerful knowledge?
Authors: White John
Published: November 2019

This is a response to two discussions of my article 'The Weakness of "Powerful Knowledge"' featuring in 2018 in the London Review of Education 16 (2), the first by Johan Muller and Michael Young and the second by Jim Hordern. It also makes brief comments on pieces on powerful knowledge
in the London Review of Education Special Issue 16 (3). The question I focus on here, as in 2018, is 'What is powerful knowledge?' I raise doubts about Muller and Young's new answer to this question as well as about Hordern's defence of Young's position more generally. I suggest in conclusion
that it would be helpful to abandon the term 'powerful knowledge' and use language more suitable to impartial scholarly investigations.
Serum cytokine profile in early and established rheumatoid arthritis
Authors: Novikov A. A. , Aleksandrova Е. N. , Lukina G. V.
Published: November 2019

Background:An important characteristic of immune pathology in rheumatoid arthritis (RA) is a B-cell tolerance defect, associated with autoantibodies production, and antigen-specific activation of Th-1 CD4+ T lymphocytes with an excess production of pro-inflammatory cytokines compared to anti-inflammatory ones. Pro-inflammatory cytokines contribute to the development of local inflammatory effects, induce bone destruction and pannus formation, and contribute to the development of autoimmune abnormalities and systemic manifestations. Anti-inflammatory cytokines are able to reduce the rate of joint destruction. There is evidence of the involvement of Th2 cytokines in the development of early RA. These facts suggest the need for a thorough investigation into the balance between the Th1 and Th2 types of immune response at different stages of the disease.

Aim:To assess the importance of сytokine profiling in the evaluation of immune abnormalities in RA.

Materials and methods:In this descriptive, controlled, retrospective study, we examined 118 patients with RA and 33 healthy donors as a control group. Serum IgM rheumatoid factor (RF) and C-reactive protein (CRP) levels were measured by immunonephelometry; anti-cyclic citrullinated peptide antibodies (anti-CCP) and anti-mutated citrullinated vimentin antibodies (anti-MCV) were determined by an enzyme immunoassay, cytokines levels with "xMAP" technique.

Results:Serum cytokine levels vary depending on RA duration. The cytokine profile in early RA, unlike that in established RA with a duration of more than 6 months, is characterized by higher levels of pro-inflammatory (MIP-1α), Th1 (IFN-γ), and Th17 (IL-17) cytokines, colony-stimulating factors (IL-7, G-CSF), and chemokines (IL-8, IP-10) (p < 0.05 for all parameters). In established RA, the levels of pro-inflammatory (IL-1β, -6, -15, TNF-α), anti-inflammatory (IL-1ra, IL-10, IL-13, IL-5), Th1 (IL-2, IL-12), Th2 (IL-9) cytokines and colony-stimulating factors (G-CSF, GM-CSF) correlate with the concentrations of IgM RF and antibodies to citrullinated proteins (antiCCP, anti-MCV) (all p < 0.05). There was also а correlation between CRP and pro-inflammatory (IL-1β, IL-6, TNF-α), Th1 (IL-12), Th2 (IL-5, IL-9) cytokine levels and between DAS28 and pro-inflammatory cytokine (IL-6) and colony-stimulating factor (G-CSF) levels (all p < 0.05).Conclusion:In RA, cytokines, chemokines and colony-stimulating factors mirror the inflammatory activity of the disease. Changes in blood concentrations of cytokines enable to get an insight into the complex interplay of numerous mediators of innate and acquired immunity
WHAT KIND OF HEALING DOES PSYCHEDELIC-ASSISTED PSYCHOTHERAPY FOSTER?
Authors:   Professor of Philosophy, University of Colorado Denver, Denver, Colorado, United States of America, Shelby Candice L
Published: November 2019

World-wide, researchers and practitioners in psychiatry are increasingly interested in the effectiveness of such substances as MDMA, LSA, and psylocibin in treating such disorders as addiction, post-traumatic stress disorder, and other types of depressive and anxiety. Although most of these substances were declared illegal in most countries during the 1970s, research into their use was widespread during the mid-20th century, and has recently returned to the spotlight. Psychotherapy enhanced by some of these substances has been demonstrated to be highly effective where pharmaceuticals have not. People undergoing these therapies appear to be truly healed, rather than merely treated. This, though, raises the philosophical question of what the nature is of the healing that therapy utilizing these substances fosters. Unlike pharmaceutical treatments, these treatments are not based on a biological model, chronically altering brain chemistry; and unlike traditional talk therapies, psychedelic-assisted psychotherapy does not require extended periods of time, or any of the elements associated with Freudian, cognitive behavior, or other psychological models. Using traditional philosophical methods, this paper argues that objections to the use of psychedelics in psychotherapy are unwarranted, and that, in fact, the kind of healing that they bring about is just what our competitive, isolating, and alienating contemporary world needs.
The Impact of Fiscal Subsidies on the Sustainability of China’s Rural Pension Program
Authors: Zhang Yu Yvette , Lin Benxi
Published: November 2019

This paper studies the impact of fiscal subsidies on the sustainability of China’s rural pension system. We first provides an overview of China’s rural pension system and explains the formulas used to calculate the pension payments. We then examines how fiscal subsidies, in forms of basic pension, incentive pension, and matching subsidy, affect participation rates and individual contributions. Our study shows that the rural residents’ participation rates can be improved significantly by increasing basic pension or by providing incentive pension, but not by matching subsidy. However, none of these fiscal subsidies has significant effects on the amount of individual contributions. Overall, our results imply that incentive pension is an effective mechanism in encouraging rural residents to participate in the pension programs, but current level of matching subsidies are not sufficient enough to improve participation or increase contributions. Our study suggests the needs to increase the fiscal subsides in China’s rural pension system, and can provide useful implications in designing the effective pension system for rural residents.
A regulação da saúde no Brasil: o controle externo do Tribunal de Contas da União nas unidades do SUS geridas por instituições privadas
Authors: Nóbrega Theresa C. Albuquerque
Published: November 2019

A pesquisa que apresentamos diz respeito a discussão contemporânea do direito administrativo brasileiro que refere o controle da administração pública, observando a produção do plenário do TCU no exercício 2018. A estrutura do trabalho se apropria da regulação para fixar seu eixo teórico e tem o SUS como recorte do objeto delimitado em relação ao órgão de controle. O método hipotético-dedutivo é a raiz do processo analítico que resguarda conclusões de uma incursão qualitativa na observação dos acórdãos relativos à atuação de instituições privadas contratadas pelo Poder Público para gestão de unidades de saúde, as quais se ocupam da condução de sua infraestrutura e/ou da prestação do serviço de saúde.
Evidence for Large Holocene Earthquakes along the Denali Fault in Southwest Yukon, Canada
Authors: Blais-Stevens AndréE , Clague John J. , Brahney Janice , Lipovsky Panya , Haeussler Peter J. , Menounos Brian
Published: November 2019

The Yukon–Alaska Highway corridor in southern Yukon is subject to geohazards ranging from landslides to floods and earthquakes on faults in the St. Elias Mountains and Shakwak Valley. Here we discuss the late Holocene seismic history of the Denali fault, located at the eastern front of the St. Elias Mountains and one of only a few known seismically active terrestrial faults in Canada. Holocene faulting is indicated by scarps and mounds on late Pleistocene drift and by tectonically deformed Pleistocene and Holocene sediments. Previous work on trenches excavated against the fault scarp near the Duke River reveals paleoseismic sediment disturbance dated to ∼300–1,200, 1,200–1,900, and 3,000 years ago. Re-excavation of the trenches indicates a fourth event dated to 6,000 years ago. The trenches are interpreted to show a negative flower structure produced by extension of sediments by dextral strike-slip fault movement. Nearby Crescent Lake is ponded against the fault scarp. Sediment cores reveal four abrupt sediment and diatom changes reflecting seismic shaking at ∼1,200–1,900, 1,900–5,900, 5,900–6,200, and 6,500–6,800 years ago. At the Duke River, the fault offsets sediments, including two White River tephra layers (∼1,900 and 1,200 years old). Late Pleistocene outwash gravel and overlying Holocene aeolian sediments show in cross section a positive flower structure indicative of post-glacial contraction of the sediments by dextral strike-slip movement. Based on the number of events reflecting ∼M6, we estimate the average recurrence of large earthquakes on the Yukon part of the Denali fault to be about 1,300 years in the past 6,500–6,800 years.
Regulations Concerning Naturally Occurring Asbestos (NOA) in Germany—Testing Procedures for Asbestos
Authors: Pierdzig Stefan
Published: November 2019

In Germany, potential asbestos-containing rocks are used as raw materials for a number of engineering applications. These rocks are ultrabasites (dunite, harzburgite), igneous rocks (basalt, gabbro, norite), and metasomatic or metamorphic rocks like talcum, greenschist and amphibolite. Based on the German Gefahrstoffverordung (Hazardous Substances Ordinance), regulatory statutes exist for operations using these rocks and resultant composites and products. The authorities state that in Germany no natural rocks exist with more than 0.1 mass-% of one of the six regulated asbestos minerals. But it is well known that there are rocks with a high modal concentration of these minerals with a non-asbestiform, columnar to prismatic habitus. Under mechanical stress during handling, they can lead to fibrous cleavage fragments, which conform to the World Health Organization (WHO) “respirable asbestos fiber” definition. In view of this fact, the regulations changed in 2009, with revision of the Technical Rules for Hazardous Substances (TRGS) 517: any fibrous asbestos particles, regardless of whether or not they represent naturally occurring asbestos or are of cleavage origin, are evaluated for potential hazards associated with handling of these rocks. If the WHO fiber concentration is <0.1 mass-%, rocks and products can be used and re-used under protective measures. At concentrations >0.1 mass-%, the material is considered hazardous waste. These regulations apply to many industrial sectors that exploit and process rocks, using them in road building and track construction and when they are recycled. Analysis (by scanning electron microscopy, SEM/energy dispersive x-ray spectroscopy, EDS) to determine the asbestos concentration of rocks, gravels, or dusts is carried out in the <100-µm, grain-size fraction produced by sieving or grinding. The results provide a representation of a worst-case examination of the air quality during mechanical treatment of these materials. Workplace monitoring is done by air sampling to survey an exposure limit of 10,000 fibers/m3 of air (0.01 f/cc).
Comprehensive analysis of codon usage pattern of whole genome in protozoa, Stylonychia lemnae
Authors: wang ying , Yao Lin , Fan Jinfeng , Zhang Xueying , Guo Changhong , Chen Ying
Published: November 2019

Background: Codon usage pattern is an important evolutionary feature in genomes widely observed in many organisms. Stylonychia lemnae is a classical model single-celled eukaryote, and a quintessential ciliate typified by dimorphic nuclei: a germline micronucleus and a vegetative macronucleus. Analysis of codon usage pattern of S. lemnae macronucleus genome helps in understanding evolution at molecular level and acquires signiﬁcance in mRNA translation, design of transgenic and new gene discovery. Results: The codons of the macronucleus genome sequence of S. lemnae were analyzed and 20,750 coding sequences (CDS) were screened. The overall codon usage of S. lemnae is similar and slightly biased. The value of effective number of codons (ENC) showed that the overall extent of codon usage bias in S. lemnae is relatively high. Nucleotide analysis showed that the overall codon usage is biased toward A- and U-ending codons. The phylogenetic analysis indicated that ciliate is independent evolutionary origins from a common ancestor. The RSCU analysis showed that the codon usage pattern of S. lemnae is more similar to that of Thtrahymana thermophila and Paramecium caudatum . Correlation analysis, ENC-GC 3S plot, and PR2 plot indicated that the codon usage patterns of S. lemnae are influenced by both mutational pressure and natural selection, neutrality plot analysis showed that those two factors play major roles. C onclusions : Codon usage patterns in eukaryotes are not determined by translational efficiency, but also are determined by the genome. Our study is the ﬁrst attempt to evaluate the codon usage pattern of S.lemnae macronucleus genome to better understand the evolutionary changes. These results built the base for further research on the molecular evolution of S. lemnae .
Antioxidants and oxidative damage markers response to visceral fat loss in obese female subjects.
Authors: Gariballa Salah , Alkaabi Juma , Yasin Javed , Essa Awad Al
Published: November 2019

Objective

Visceral obesity and related diabetes is reaching epidemic proportions in the United Arab Emirates (UAE). Inflammation and oxidative damage are possible mechanisms linking visceral obesity to diabetes and other related complications. We have recently reported that levels of oxidative stress and inflammatory markers increase with increasing waist circumference (WC) in obese female subjects. The aim of this study was to measure antioxidants and oxidative damage markers response to visceral fat loss.

Results

Overall 293 females who received structured dietary education for obesity management were included in the study. Over a follow-up period of 427±223 days, obese subjects had a mean (±SD) of 13±5 education sessions. At the end of the follow up period we found decreased visceral fat, inflammatory and oxidative damage markers and increased antioxidant enzymes and vitamins, however, no significant differences were found between obese subjects who lost visceral fat compared to those who gained visceral fat. Both increased fruits and vegetables and decreased calorie intake had significant independent positive effects on WC decrease [odd ratio (95% CI): 1.04 (1.01, 1.08); p=0.045 and 1.0 (1.0, 1.01); p=0.048 respectively].
Improving Practice of Institutional Delivery in Southern Ethiopia
Authors: Kassa Dejene , Tadele Henok , Tadesse Birkneh Tilahun , Alemayehu Akalewold , Abuka Teshome , Woldegebriel Fistum , Ethiopia Hawassa University , Mengesha Selamawit , Haji Yusuf
Published: November 2019

Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.
High Dose and Low Dose Oxytocin Regimen as Determinants of Successful Induction: A multicenter comparative study
Authors: TESEMMA MELESE GEZAHEGN , Sori Demisew Amenu , Gemeda Desta Hiko
Published: November 2019

Background Induction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study is aimed at comparing the effect of high dose versus low dose oxytocin regimen on success of induction.Methods Hospital based comparative cross-sectional study was conducted in four selected hospitals in Ethiopia from October 1, 2017 to May 30, 2018. A total of 216 pregnant women who undergo induction of labor at gestational age of 37 weeks and above were included. Data was entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to look for determinants of successful induction. The result is presented using 95% confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance.Result Mean “Induction to delivery time” was 5.9 hours and 6.3 hours for participants who received high dose Oxytocin and low dose Oxytocin respectively. Higher successful induction (72.2% versus 61.1%) and lower Cesarean Section rate (27.8% vs. 38.9) was observed among participants who received low dose Oxytocin compared to high dose. Favourable bishop score [AOR 4.0 95% CI 1.9, 8.5], elective induction [AOR 0.2 95% CI 0.1, 0.4], performing artificial rupture of membrane [AOR 10.1 95% CI 3.2, 32.2], neonatal birth weight of < 4Kg [AOR 4.3, 95% CI 1.6, 11.6] and being parous [AOR 2.1 95% CI 1.1, 4.0] were significantly associated with success of induction. Conclusions : In this study, oxytocin regimen didn’t show significant association with success of induction. But, high dose oxytocin regimen is significantly associated with slightly shorter induction to delivery time. Favourable bishop score, emergency induction, performing artificial rupture of membrane and delivery to non-macrosomic neonate are positive determinants of successful induction. Thus, we recommend ripening cervix when condition allows, estimating fetal weight and performing artificial rupture of membrane. We also recommend researchers to conduct more strong research that controls confounders to see the real effect of different oxytocin regimen on induction success.
A case report of asymptomatic long-segmental aortic dissection diagnosed by transthoracic echocardiography
Authors: Wang Jiwei , Lai Bin , Yao Cai , Wu Yongbing , Liu Yanna
Published: November 2019

Background: Aortic dissection (AD) is a life-threatening disease with high mortality rate. Severe pain in chest, back or abdomen is the most common symptom. Painless, but with a variety of other symptoms, also happened in some AD patients. Asymptomatic AD is exceptionally rare and often under-recognized. Case presentation: A 51-year-old man presented to cardiovascular department accompanied with an exaggerated low DBP and widened PP when measuring routine BP. Blood pressure was 124/36 mmHg (PP 88mmHg) in his right arm and 108/32 mmHg (PP 76mmHg) in his left arm. Transthoracic echocardiography was scheduled and showed that dissection intimal flaps are visualized in the aortic root, aortic arch and descending aorta. Subsequent CT angiography (CTA) was performed and demonstrated that a long-segmental AD occurred from aortic root to left common iliac artery. The patient underwent replacement of the aortic root, ascending aorta, and aortic arch with endovascular stent-graft placement into the descending aorta. At three months of follow-up, he was asymptomatic and with no signs of target organ damage. Conclusions: A careful TTE scan is particularly important for asymptomatic AD patient because it most likely as a routine imaging technique used for cardiovascular evaluation. If miss-diagnosed and under-recognized by clinician, untreated patients with prolonged dissection will become highly susceptible to an aortic rupture or ischemia to organs and leads to mortality.
Clients’ satisfaction with malaria in pregnancy preventive services in Anambra State, Nigeria
Authors: Obagha Chijioke Emmanuel , Ajayi IkwOluwakpo , Abdullahi Gobir A. , Umeokonkwo Chukwuma David
Published: November 2019

Background: Burden of Malaria in pregnancy (MIP) is still high despite deployment of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with malaria in pregnancy services delivered at antenatal clinics (ANC) in Anambra State Nigeria. Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of MIP preventive services, but 64.8% and 57.8% were not satisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of MIP preventive services. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare domain. Conclusion: A fair proportion of respondents were satisfied with the MIP services provided even though most were unsatisfied with the cost of assessing care and interpersonal relationship with health workers. To achieve satisfaction with services, the state government should subsidize the cost of services and encourage HWs to build good relationships with their clients especially at public secondary health facilities.
Metagenomic Next-generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Central Nervous System Infections: A Multicentre Cohort Study
Authors: Fan Siyuan , Wang Xiaojuan , Hu Yafang , Shi Jingping , Zou Yueli , Zhao Weili , Qiao Xiaodong , Wang Chunjuan , Chin Jerome H. , Liu Lei , Qin Lingzhi , Wang Shengnan , Li Hongfang , Yue Wei , Zhang Weihe , Li Xiaohua , Ge Ying , Wu Honglong , Chen Weijun , Li Yongjun , Li Shiying , Wu Yihan , Zhou Gaoya , Liu Zheng , Piao Yushun , Zhang Jianzhao , Ren Changhong , Cui Li , Liu Caiyun , Ren Haitao , Zhao Yanhuan , Feng Shuo , Jiang Haishan , Wang Jiawei , Bu Hui , Guo Shougang , Peng Bin , Cui Liying , Li Wei , Guan Hongzhi
Published: November 2019

Background: Infectious encephalitis and meningitis are often treated empirically without identification of the causative pathogen, even if comprehensive conventional diagnostic technologies are applied. Metagenomic next-generation sequencing (mNGS) is a high throughput technology that enables the detection of pathogens independent of prior clinical or laboratory information.Methods: The present study was a multicentre prospective evaluation of mNGS of cerebrospinal fluid (CSF) for the diagnosis of suspected central nervous system infections in China, where routine PCR was not widely used. Results: A total of 276 patients were enrolled in this study between Jan 1, 2017 and Jan 1, 2018. Identification of an aetiologic pathogen in CSF by mNGS was achieved in 101 patients (36.6%). mNGS detected 11 bacterial species, 7 viral species, 2 fungal species, and 2 parasitic species. The leading positive detections were Mycobacterium tuberculosis (14), Listeria monocytogenes (8), Brucella (7), varicella-zoster virus (17), herpes simplex virus 1 (12), Epstein-Barr virus (12), and Cryptococcus neoformans (7). False positives occurred in 12 (4.3%) patients with bacterial infections known to be widespread in hospital environments. False negatives occurred in 16 (5.8%) patients and included bacterial, viral and fungal aetiologies. Conclusions: This study shows that mNGS of CSF is a powerful diagnostic method to identify the pathogen for many central nervous system infections. The result of mNGS should be interpreted with clinical information sometimes.
A comparative study of laminoplasty with short segment transpedicular screw fixation versus laminoplasty with anterior fusion in treating extensional cervical spinal cord injury without radio graphic abnormality in adults
Authors: Zhang Bi , Zhou Zhenhai , Yu Honggui , Pan Zhimin , Zhou Rongping , Wan Wenbing , Chen Lu , Zeng Zhaoxun , Cao Kai
Published: November 2019

Background: Cervical spinal cord injury(CSCI) without major fracture or dislocation is often described as cervical SCI without radiographic abnormality (SCIWORA). Majority of this injury could be without radiographic abnormality but with disrupted anterior longitudinal ligament or intervertebral disc unless examined by MRI. The optimal surgical management of this cervical spinal cord injury remains controversial. This study is to evaluate the clinical advantages of laminoplasty combined with short-segment transpedicular screw fixation for managing this issue. Methods: SCIWORA patients were collected into two groups according to different surgical methods. Patients in group A received laminoplasty combined with transpedicular screw fixation, and patients in group B received anterior cervical fusion combined with laminoplasty. All cervical spine were assessed by X-ray, CT, MRI preoperatively and postoperatively to evaluate the decompression range, bonegraft fusion and instruments location. ASIA grade and JOA score were recorded to assess the neurological function recovery. Complications, surgery time, intraoperative blood loss and hospital stay were compared between two groups. Mean follow-up was at least 2 years. Results: In this study, Forty eight patients were in group A and 54 ones were in group B. All cases were decompressed fully and obtained fusion 6-month postoperatively. The ASIA grade was improved postoperatively, but no significantly different between two groups (p=0.907). The JOA was 6.12±1.76 preoperatively and improved to 11.98±2.98 postoperatively with the 53.13% neurofunction recovery rate in group A, with no significantly different compared with group B(vs 6.63±2.45, p=0.235; vs 12.62±3.59, p=0.303; vs 57.76%, p=0.590)respectively. Total 18 complications occurred but the occurrence was significant lower in group A(p=0.020). The average surgery time was 2.2±0.32 hours, intraoperative blood loss was 304±56ml and hospital stay was 8.2±3.1 days, significantly decreased compared with group B(vs 3.1±0.29, p=0.000; vs 388±61ml, p=0.000; vs 12±2.8days, p=0.000)respectively. Conclusions: Cervical laminoplasty combined with short-segment transpedicular screw fixation is a reliable option to treat SCIWORA patients with CSS. The advantages include achieving sufficient cervical decompression, maintaining cervical stability and avoiding extra anterior cervical fusion which increases surgery time, intraoperative blood loss, postoperative complications and hospital stay.
Topping-off surgery vs posterior lumbar interbody fusion for degenerative lumbar disease: a finite element analysis
Authors: Fan Yunpeng , Zhu Liulong
Published: November 2019

Background Adjacent segment disease (ASD) is a common complication after posterior lumbar interbody fusion (PLIF). Recently, a topping-off surgery (non-fusion with Coflex) has been developed to reduce the risk of ASD, yet whether and how the topping-off surgery can relieve ASD remains unclear. The purpose of this study was to explore the biomechanical effect of PLIF and Coflex on the adjacent segments via finite element (FE) analysis and discuss the efficacy of Coflex in preventing ASD.Methods A FE model of L3-5 segments was generated from the CT of a healthy volunteer via three commercially available software. Coflex and PLIF devices were modeled and implanted with the segment model in the FE software. In the FE model, a pre-compressive load of 500 N, which was equal to two thirds of the human body mass, was applied to the top surface of the L3. In addition, four types of moments (anteﬂexion, rear protraction, bending and axial rotation) set as 10 Nm were successively applied to the FE model combined with this pre-compressive load. Then the range of motion (ROM), the torsional rigidity and the maximum von Mises equivalent stress on L3-L4 disc and the implant were analyzed.Results Both Coflex and PLIF reduced ROM. However, no significant difference was found in the maximum von Mises equivalent stress of adjacent segment disc between the two devices. Interestingly enough, both systems increased the torsional rigidity at the adjacent lumbar segment, and PLIF had a more significant increase. The Coflex implant had a larger maximum von Mises equivalent stress.Conclusions Both Coflex and PLIF reduced ROM at L3-L4, and thus improved the lumbar stability. Under the same load, both devices had almost the same maximum von Mises equivalent stress as the normal model on the adjacent intervertebral disc. But it is worthy to notice the torsional rigidity of PLIF was higher than that of Coflex. It indicated that the lumbar treated with PLIF would undertake a larger load to reach ROM of Coflex. Therefore, we presumed that ADS was related to higher torsional rigidity.
Changes in Inflammatory Cytokines, Antioxidants and Liver Stiffness after Chelation Therapy in Individuals with Chronic Lead Poisoning
Authors: Teerasarntipan Tongluk , Chaiteerakij Roongruedee , Prueksapanich Piyapan , Werawatganon Duangporn
Published: November 2019

Background Chronic exposure to lead accumulates mainly in the liver. In vivo studies showed that lead toxicities are related to alterations of the inflammatory response. We aimed to evaluate the association between lead poisoning and liver fibrosis as well as the change in degree of liver fibrosis, levels of inflammatory mediators and glutathione (GSH) after chelation therapy.Methods Workers from a battery factory who were exposed to lead for > 12 months and had blood lead level (BLL) > 70 µg/dL were enrolled (n=86) into the study. They received chelation therapy with intravenous CaNa2EDTA for 2 days followed by oral D-penicillamine for 90 days. Primary outcome was the change in the degree of liver fibrosis, which was presented as liver stiffness (LS), measured by FibroScan®. Secondary outcomes were the change in the levels of serum GSH and inflammatory mediators such as tumor necrotic factor-alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) after chelation therapy.Results Of the 86 participants, there was a positive correlation between duration of lead exposure and LS (r=0.249, p=0.021). To avoid the confounder effect of obesity-related steatosis, only 70 individuals who had controlled attenuation parameters < 296 dB/m, BMI ≤ 25 kg/m2 and normal waist circumference were included in the interventional analysis. After chelation, the mean LS significantly decreased from 5.4 ± 0.9 to 4.8 ± 1.4 kPa (p=0.001). Similarly, all of the inflammatory cytokines studied significantly decreased after chelation (p<0.001); TNF-α dropped from 371.6 ± 211.3 to 215.8 ± 142.7; the levels of IL-1β dropped from 29.8 ± 1.7 to 25.9 ± 4.3 and the levels of IL-6 dropped from 46.8 ± 10.2 to 35.0 ± 11.9. On the other hand, the mean GSH level significantly increased from 3.3 ± 3.3 to 13.1 ± 3.7 (p<0.001) after chelation therapy.Conclusions Our findings suggest that long-term exposure of lead may cause liver fibrosis. Lead poisoning induces chronic inflammatory response and oxidative stress. Treatment by chelation decreases inflammation and replenishes antioxidants, and potentially reduces the degree of LS.
Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)
Authors: Nie Lan , Cheng Yi , Yao Fei , Wu Ru Shuo , Li Ming , Zhang Junjun , Wu Ming qing , Long Hui , Fang Ming Xiang
Published: November 2019

Background: In recent years,the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing.It is important for Clinical worker to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP.Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients.Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score.Results:There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC),Hospitalization days,Fatty liver,and Local complications between two groups,While no statistical differences in Gender, Age,Serum amylase,Alanine aminotransferase(ALT),Aspertate aminotransferase(AST),Hypertension,Type2 diabetes,and Hyperuricemia. Positive relevance was established between BISAP and TG with r of 0.55. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were0.89、0.78，sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%.In predictionig local complications,the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1%.Conclusion: BISAP score has a meaningful prognostic value for predicting the severity of HLAP and higher AUC than MCTSI.In particular,there are significant association between BISAP and TG.Keywords:Hyperlipidemic acute pancreatitis；Triglycerides;BISAP score；MCTSI score; Severe acute pancreatitis
Comparison of Two-Dimensional Shear Wave Elastography and Point Shear Wave Elastography for Assessing Liver Fibrosis
Authors: Zhou Xiaozhuan , Rao Jiawei , Wu Xukun , Deng Ronghai , Ma Yi
Published: November 2019

Background: Progressive liver fibrosis may result in cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC). We performed a meta-analysis to compare liver fibrosis staging in chronic liver disease patients using two-dimensional shear wave elastography (2D-SWE) and point shear wave elastography (pSWE). Methods: PubMed, Web of Science, and Cochrane Library databases were searched until September 30th 2019 for studies evaluating the diagnostic performance of 2D-SWE and pSWE for assessing liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristic curve (AUC) were estimated using the bivariate random effects model. Results: Eighteen studies with 3,082 patients were included in the analysis. The pooled sensitivities of 2D-SWE and pSWE were significantly different for the detection of significant fibrosis (0.83 vs. 0.70, P < 0.001) and advanced fibrosis (0.89 vs. 0.78, P < 0.05), but not for detection of cirrhosis (0.87 vs. 0.83, P > 0.05). The pooled specificities of 2D-SWE and pSWE were not significantly different for detection of significant fibrosis (0.83 vs. 0.83, P > 0.05), advanced fibrosis (0.80 vs. 0.85, P > 0.05), or cirrhosis (0.84 vs. 0.88, P > 0.05). Conclusions: Both 2D-SWE and pSWE have high sensitivity and specificity for detecting each stage of liver fibrosis. 2D-SWE has higher sensitivity than pSWE for detection of significant fibrosis and advanced fibrosis. Large-scale and multi-center studies are needed to directly compare 2D-SWE and pSWE.