bluuebunny/crossref_metadata_2025 huggingface dataset:
Identidades e subjetividades
Authors: Soares Rosana De Lima
Published: January 2020

O artigo tem como objetivo refletir sobre as formas de comunicação presentes nas mídias digitais, especialmente em narrativas audiovisuais e jornalísticas. Por meio da análise de visualidades e visibilidades juvenis, o estudo busca problematizar estigmas, estereótipo e preconceitos em relação às juventudes. Além disso, observa os modos como os jovens se tornam produtores de representações divergentes, interferindo no imaginário social a eles relacionado e instaurando novas subjetividades e práticas de resistência. Para isso, serão observadas produções de coletivos de comunicação audiovisual ou jornalística formados por mulheres ativistas na cidade de São Paulo e voltados para as periferias ou nelas situados.
O exemplo de Sócrates
Authors: Pimenta Olímpio
Published: January 2020

Um tópico de interesse permanente em relação a Sócrates é a determinação dos melhores termos para o entendimento da articulação entre sua vida e sua prática filosófica. O presente artigo busca ensaiar uma discussão introdutória desta questão. Nesse sentido, parte-se de uma restituição, em largos traços, do testemunho das três principais fontes diretas, avança-se daí até algumas formulações atuais centradas no tema do exame para, por último, considerar a matéria à luz da morte de Sócrates e dos desdobramentos que seu exemplo quanto a isso ensejou, já no âmbito das escolas helenísticas.
Cardiac Rehabilitation Dose Around the World
Authors: Chaves Gabriela , Turk-Adawi Karam , Supervia Marta , Santiago de Araújo Pio Carolina , Abu-Jeish Abdel-hadi , Mamataz Taslima , Tarima Sergey , Lopez Jimenez Francisco , Grace Sherry L.
Published: January 2020

Background:

Cardiac rehabilitation (CR) is recommended in clinical practice guidelines, but dose prescribed varies highly by country. This study characterized the dose offered in supervised CR programs and alternative models worldwide and their potential correlates.

Methods and Results:

In this cross-sectional study, an online survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Countries were classified based on region and income categories. Dose was operationalized as program duration×sessions per week. Generalized linear mixed models were performed to assess correlates. Of 203 countries in the world, 111 (54.7%) offered CR; data were collected in 93 (83.8% country response rate; n=1082 surveys, 32.1% program response rate). Globally, supervised CR programs were a median of 24 sessions (n=619, 57.3% programs ≥12 sessions); home-based and community-based programs offered 6 and 20 sessions, respectively. There was significant variation in supervised CR dose by region (
P
≤0.001), with the Americas (median, 36 sessions) offering a significantly greater dose than several other regions; there was also a trend for variation by country income classification. There was no difference in home-based dose by region (
P
=0.43) but there was for community-based programs (
P
<0.05; Americas offering greater dose). There was a significant dose variation in both home- and community-based programs by income classification (
P
=0.002 and
P
<0.001, respectively), with higher doses offered by upper-middle-income than high-income countries. Correlates of supervised CR dose included more involvement of physicians (
P
=0.026), proximity to other programs (
P
=0.002), and accepting patients with noncardiac indications (
P
=0.037).

Conclusions:

CR programs in many countries may need to increase their dose, which could be supported through physician champions.
Morphological and molecular characterisation of three known species of Criconematoidea from Iran
Authors: Hosseinvand Manouchehr , Eskandari Ali , Ghaderi Reza
Published: January 2020

In this study, we provide morphological and molecular characterisation of three known species of the Criconematoidea, namely Criconema cylindraceum, Paratylenchus alleni and P. steineri, recovered from Iran. Descriptions, morphometric data, drawings and photomicrographs are provided, and comparisons are made with closely related species. Phylogenetic analysis using the D2-D3 expansion segments of the 28S rRNA gene revealed that C. cylindraceum formed a cluster with Ogma decalineatus, a species with a similar head structure, but with differences in cuticle ornamentation, tail shape and morphometric characters. Moreover, P. alleni grouped with species of Paratylenchus having four lateral lines and a short stylet (< 40 μm), exceptionally including the unresolved P. straeleni, while P. steineri formed a clade with long stylet species, including P. teres and P. wuae. The taxonomic placement of C. cylindraceum in Criconema, rather than in Criconemoides, is justified, and P. teres is molecularly differentiated from P. steineri, the two species differing in having or lacking a stylet in the fourth-stage juvenile.
Streams of Latin American Protestant Theology
Authors: Gladwin Ryan R.
Published: January 2020

Although church historians often call the 19th century the Great Century of Protestant mission, for Latin America it was the 20th century that was the great century of Protestant growth and expansion. The 20th century witnessed vast societal changes and the realization of systemic poverty and injustice as well as the exponential growth, pentecostalization, and diversification of Latin American Protestantism. Latin American Protestant Theology emerged during this century of change. This text provides an introduction to Latin American Protestant Theology by engaging its dominant theological streams (Liberal, Evangelical, and Pentecostal) and how they understand themselves through the lens of mission. The text offers both a critique of the Christendom cartography that is dominant in Latin American Protestant Theology as well as suggestions for how to move towards a transformative theology of mission. The primary intention of this text is to offer an informed outline and analysis of the theological landscape of Latin American Protestantism. The secondary intention of this book is to note the contributions as well as deficiencies of the streams of LAPT in the hope to signal a possible path towards the development of an integral, transformative, contextual, and decolonial theological voice.
Four new species of free-living nematodes from shallow continental shelf
of Portugal
Authors: PINTO TACIANA KRAMER , NERES PATRICIA FERNANDES
Published: January 2020

Free-living marine nematodes of continental shelf of Portugal were studied through the goals of the Marine Biodiversity Information System Project (M@rbis 2015). Four species unknown to science and belonging to the families Axonolaimidae, Chromadoridae, Desmodoridae and Xyalidae are described. Besides Hypodontolaimus golikovy, Hypodontolaimus portuguese sp. n. is the only species in this genus which lacks precloacal supplements and gubernaculum but differs from the former mainly in cephalic setae length and amphidial fovea features. Metachromadora aliusa sp. n. doesn’t have a unique diagnostic character, differing in many aspects from the other species of the genus instead, mainly teeth number in the buccal cavity, size of the cephalic setae and the amphidial fovea, velum presence in the spicules, number and shape of the precloacal supplements. The main character of Odontophora sinapophysis sp. n. is the absence of apophysis in the gubernaculum. Stylotheristus multipapillatus sp. n. is characterized by the presence of precloacal supplements (papilliform) and the gubernaculum formed by only a piece.
A new species of Osteobrama (Teleostei: Cyprinidae) from the Mahanadi River, India with a note on the validity of O. dayi
Authors: SHANGNINGAM BUNGDON , RATH SHIBANANDA , TUDU ASHA KIRAN , KOSYGIN LAISHRAM
Published: January 2020

A new species of the genus Osteobrama is described from the Mahanadi River, Tikarpada, Angul District, Odisha state, India. Osteobrama tikarpadaensis, new species, differs from its congeners in having two pairs of minute barbels; iii–iv unbranched dorsal-fin rays with 25–33 serrae on the last unbranched ray; 15–16 branched pectoral-fin rays, and 25–27 branched anal-fin rays. The status of Osteobrama dayi is discussed and shown to be a valid species. A key to the species of the genus is provided.
The Tiberian Pronunciation Tradition of Biblical Hebrew, Volume 1
Authors: Khan Geoffrey
Published: January 2020

The form of Biblical Hebrew that is presented in printed editions, with vocalization and accent signs, has its origin in medieval manuscripts of the Bible. The vocalization and accent signs are notation systems that were created in Tiberias in the early Islamic period by scholars known as the Tiberian Masoretes, but the oral tradition they represent has roots in antiquity. The grammatical textbooks and reference grammars of Biblical Hebrew in use today are heirs to centuries of tradition of grammatical works on Biblical Hebrew in Europe. The paradox is that this European tradition of Biblical Hebrew grammar did not have direct access to the way the Tiberian Masoretes were pronouncing Biblical Hebrew.

In the last few decades, research of manuscript sources from the medieval Middle East has made it possible to reconstruct with considerable accuracy the pronunciation of the Tiberian Masoretes, which has come to be known as the ‘Tiberian pronunciation tradition’. This book presents the current state of knowledge of the Tiberian pronunciation tradition of Biblical Hebrew and a full edition of one of the key medieval sources, Hidāyat al-Qāriʾ ‘The Guide for the Reader’, by ʾAbū al-Faraj Hārūn. There is also an accompanying oral performance of samples of the reconstructed pronunciation by Alex Foreman. It is hoped that the book will help to break the mould of current grammatical descriptions of Biblical Hebrew and form a bridge between modern traditions of grammar and the school of the Masoretes of Tiberias.
Characterizing and Predicting Marine Fog Offshore Newfoundland and Labrador
Authors: Isaac George A. , Bullock Terry , Beale Jennifer , Beale Steven
Published: January 2020

As several review papers have concluded, marine fog is imperfectly characterized, and quantitative visibility forecasts are difficult to produce accurately. Some unique measurements have been made offshore Newfoundland and Labrador of the climatology of occurrence and the microphysical characteristics of marine, or open-ocean, fog. Based on measurements made at an offshore installation over 21 years, the percent of time with visibilities less than 0.5 n mi or approximately 1 km (1 n mi ≈ 1.85 km) reaches 45% in July, with a low of about 5% during the winter. The occurrence of fog is mainly due to warm air advection, with the highest frequency occurring with wind directions from over the warm Gulf Stream, and with air temperatures about 2°C warmer than the sea surface temperature. There is no diurnal variation in the frequency of occurrence of fog. The microphysical properties of the fog have been documented in the summer time frame, with over 550 h of in situ measurements made offshore with fog liquid water content greater than 0.005 g m−3. The fog droplet number concentration spectra peaks near 6 μm, with a secondary peak near 25–40 μm, which typically contains most of the liquid water content. The median droplet concentration is approximately 70–100 cm−3. The microphysical spectra have been used to develop a new NWP visibility parameterization scheme, and this scheme is compared with other parameterizations currently in use.
Prominence in French Dual Focus
Authors: Destruel Emilie , Féry Caroline
Published: January 2020

This paper investigates how French signals prominence in prosody in the post-verbal domain of sentences with two objects or two adjuncts that vary in information status and prosodic length. The information status of particular interest here is dual focus, defined as the presence of two foci in a mono-clausal sentence, but other information states are investigated as well. The controlled production experiment we report on allows for a detailed examination of prosodic prominence. High boundary tones at the end of non-final prosodic phrases are pervasive, as has been documented in many studies before the present one. An important but less documented result is the variation in different prosodic curs, in particular in the number and position of high tones, as well as the particular scaling relationship between them, providing a powerful tool for the expression of (dual) focus. We also report on a perception experiment with our data, showing a clear tendency for French listeners to select the intended context question, recognizing dual focus better than other information states. Overall, this article provides elements of answers as to why French prosody is so difficult to pin down, and why contradictory results and analyses have been proposed for this language.
Strategies of a transnational intellectual: Tariq Ramadan and the project of a European Islam
Authors: Brahimi Mohamed Amine , Brisson Thomas
Published: January 2020

This article offers an analysis of the ‘European Islam Project’ developed by Tariq Ramadan since the 1990s. It highlights the tension that exists between the transnational dimension of this project and its application at national levels. There has been the case in two European countries where Islam is well represented – France and the UK – and on which this article focuses. In these different locations, intellectual and political interventions by Ramadan in order to formulate his project for a European Islam have had different outcomes, ranging from distrust towards exclusion from official political circles in France to recognition as a Muslim modernist thinker in the UK. To account for this discrepancy, we analyse the transnational realms in which Ramadan has built his career. We then examine the parallel evolution of his position in France and the UK by linking his academic and political recognition to the differing structures of politics and academia in these two countries.
Associations Between Teacher–Student Racial/Ethnic Congruence and Public School Teachers’ Risk for Stress
Authors: McCarthy Christopher J. , Dillard Jendayi , Fitchett Paul G. , Boyle Lauren , Lambert Richard G.
Published: January 2020

Using national data from the National Center for Education Statistics 2011–2012 Schools and Staffing Survey and Common Core of Data, we examined the relationship between K–12 practitioners’ risk for stress and the teacher-to-student racial/ethnic congruence. Analyses indicated significant variation in risk for stress by school racial composition and suggested that the likelihood of being categorized as most at-risk for stress is associated with the teacher-to-student racial/ethnic congruence. Findings point to substantial differences in how teachers appraise their environments depending on school context, which has implications for how education stakeholders recruit and prepare classroom practitioners.
Deschooling from above
Authors: Sukarieh Mayssoun , Tannock Stuart
Published: January 2020

The concept of deschooling has been making a comeback, after having been largely written off by the mainstream education research community in the 1980s and early 1990s. However, it is not just anti-capitalist radicals who are rediscovering the appeal of deschooling, but political and economic elites as well. This article traces some of the central claims and practices of this elite-led movement – that we call ‘deschooling from above’ – in current attacks on universal higher education, projects to deschool professional and technical training and an abandonment of past commitments to universal compulsory schooling. The authors argue that all of these trends need to be situated within the broader context of the unravelling of the education fix of the previous era of global (neoliberal) capitalist restructuring.
Biohydrometallurgy as an environmentally friendly approach in metals recovery from electrical waste: A review
Authors: Habibi Alireza , Shamshiri Kourdestani Shatav , Hadadi Malihe
Published: January 2020

Nowadays, large amount of municipal solid waste is because of electrical scraps (i.e. waste electrical and electronic equipment) that contain large quantities of electrical conductive metals like copper and gold. Recovery of these metals decreases the environmental effects of waste electrical and electronic equipment (also called E-waste) disposal, and as a result, the extracted metals can be used for future industrial purposes. Several studies reported in this review, demonstrated that the biohydrometallurgical processes were successful in efficient extraction of metals from electrical and electronic wastes. The main advantages of biohydrometallurgy are lower operation cost, less energy input, skilled labour, and also less environmental effect in comparison with pyro-metallurgical and hydrometallurgical processes. This study concentrated on fundamentals and technical aspects of biohydrometallurgy. Some points of drawbacks and research directions to develop the process in the future are highlighted in brief.
How the ideology of ‘quality’ protects civil society in Xi Jinping’s China
Authors: Hsu Carolyn L.
Published: January 2020

Under Xi Jinping, the Chinese state has asserted authoritarian control over many aspects of civil society. Yet there is evidence that Chinese citizens are continuing to mobilize and organize with relative levels of success. This article examines one mechanism that prevents the Chinese state from eliminating civil society: the political ideology of suzhi (素质), translated as ‘quality’ in English. In the post-Mao era, the Chinese Communist Party (CCP) has increasingly invested its political legitimacy in its ability to deliver a rising quality of life to its citizens. This dynamic means that it is possible for Chinese citizens to mobilize and organize to achieve their goals. Suzhi ideology gives citizens one set of means to effectively limit undesirable behaviour by the state. It also provides citizens with leverage to make the state respond robustly to their needs and desires. It opens up possibilities for citizens to solve social problems on their own, without recourse to state actors. This article will examine four arenas of Chinese civil society which suzhi ideology protects under the Xi regime: media-inspired public outrage; public protests and demonstrations; NGOs as state consultants; and the increased accessibility of litigation.
A Systematic Review of Network Meta-Analyses and Real-World Evidence Comparing Apixaban and Rivaroxaban in Nonvalvular Atrial Fibrillation
Authors: Hill Nathan R. , Sandler Belinda , Bergrath Evelien , Milenković Dušan , Ashaye Ajibade O. , Farooqui Usman , Cohen Alexander T.
Published: January 2020

There is no direct evidence comparing the 2 most commonly prescribed direct oral anticoagulants, apixaban and rivaroxaban, used for stroke prevention in nonvalvular atrial fibrillation (NVAF). A number of network meta-analyses (NMAs) of randomized control trials and real-world evidence (RWE) studies comparing the efficacy, effectiveness, and safety of apixaban and rivaroxaban have been published; however, a comprehensive evidence review across the available body of evidence is lacking. In this study, we aimed to systematically review and evaluate the clinical outcomes of apixaban and rivaroxaban using a combination of data gleaned from both NMAs and RWE studies. The review identified 21 NMAs and 5 RWE studies. The data demonstrated that apixaban was associated with fewer major bleeding events compared to rivaroxaban. There was no difference in the efficacy/effectiveness profiles between these treatments. Bleeding is a serious complication of anticoagulation therapy for the management of NVAF, and is associated with increased rates of hospitalization, morbidity, mortality, and health-care expenditure. The majority of studies in this comprehensive evidence review suggests that apixaban has a lower risk of major bleeding events compared to rivaroxaban in patients with NVAF.
The migration–terrorism nexus: An analysis of German and Italian press coverage of the ‘refugee crisis’
Authors: Galantino Maria Grazia
Published: January 2020

Over the last few years, terrorist attacks in European cities, together with the so-called ‘refugee crisis’, have (re)ignited a debate on whether there is an association between the two issues. Drawing on sociological approaches to risk and uncertainty, I claim that the discursive construction of causal linkages connecting refugees and migrants to terrorist activities is a fundamental passage in the process of social construction of migration as a threat. To identify the terrorism–migration linkages constructed in/through the media, this article examines the coverage of migration issues in two Italian and two German newspapers in 2015 and 2016, combining computer-assisted and qualitative content analysis. My findings reveal, firstly, how and in what circumstances the discourse on the terrorism threat is conflated with the discourse on migration. Then, the in-depth analysis of causal links in the coverage of four main terror attacks in Europe shows the predominance of a chain of causation linking terrorism to new migrants and refugees. Given the limited empirical research informing the debate over the migration–terrorism nexus, this study contributes to a better understanding of the process of social construction of migrants as threat objects.
Robotic Transanal Minimally Invasive Surgery for Rectal Lesions
Authors: Yao Hong-Liang , Ngu James Chi-Yong , Lin Yen‑Kuang , Chen Chia‑Che , Chang Sheng-Wei , Kuo Li-Jen
Published: January 2020

Background. Transanal minimally invasive surgery (TAMIS) was developed as a less aggressive alternative treatment for rectal lesions. The purpose of this study was to report the results of robotic TAMIS for such patients. Methods. Patients eligible for TAMIS were operated on using the da Vinci robotic surgical system and GelPOINT Path Transanal Access Platform. Patient demographics, lesion characteristics, perioperative data, complications, and follow-up of all patients were recorded retrospectively. Results. Between March 2015 and August 2018, 24 patients underwent robotic TAMIS by using the da Vinci Si or Xi. The median operative time was 129.6 minutes, and the estimated blood loss was minimal. The mean length of hospital stay was 4.6 days, with no operative complications and no 30-day mortality. There were no statistically significant differences in clinical results and pathological outcomes between the 2 generations of da Vinci systems. Conclusions. With the use of robotic technology, transanal local excision for rectal lesions can be performed with relative ease and safety and can be potentially decreasing the morbidity associated with more aggressive surgical techniques.
Personal electronic healthcare records: What influences consumers to engage with their clinical data online? A literature review
Authors: Crameri Kellie-Anne , Maher Lynne , Van Dam Pieter , Prior Sarah
Published: January 2020

Background:

Online electronic records such as patient portals and personally controlled electronic health records (PEHRs) have been widely viewed as a key component to modernising the delivery of healthcare but the uptake of such systems has been slow.

Objective:

The purpose of this literature review was to determine what influences consumers to engage and interact with their clinical data online.

Method:

A scoping literature review following PRISMA guidelines was completed. Electronic patient record research published between January 2009 and December 2018 was included. Following screening and full-text reviews, a total of 64 records were included in this review.

Results:

Three key areas of influence on consumer engagement with their clinical data online emerged: demographic factors affecting consumer interaction with PEHRs; consumers’ perceived benefits and detriments of PEHR use; and the influence of PEHR use on consumer empowerment and responsibility.

Discussion:

Consumer motivation and readiness for engaging with their clinical data online and their long-term ongoing use of these systems requires further exploration.

Conclusion:

As worldwide rates of consumer interactions with individual online clinical data remain low, what influences consumer engagement with a PEHR remains unknown. Further research into the consumer perspective of, and interaction with, a PEHR, needs to be undertaken to determine if factors such as frequent usage of the system by consumers leads to improved clinical outcomes.
Accounting Curricula in Universities and Market Needs: The Jordanian Case
Authors: Maali Bassam , Al-Attar Ali M.
Published: January 2020

The objectives of this study are to examine whether the current accounting curricula of Jordanian universities fit the Jordanian market demand, in addition to determining the skills and competences that Jordanian businesses require from accounting graduates. To achieve these objectives, an analysis of current accounting curricula of Jordanian universities took place, interviews with professionals and academics were conducted, and a questionnaire survey was administrated to a large sample of academics and professionals. The study found the presence of a significant gap between the courses covered in the accounting curricula of Jordanian universities and the skills acquired by the students versus the market’s requirements and needs. This is mainly due to the fact that the accounting curricula of Jordanian universities are structured based on specific requirements set by the Accreditation and Quality Assurance Commission for Higher Education Institutions (AQACHEI), leaving no freedom for universities to develop curriculums that meet the market’s need. It is also argued that that current exam-based assessment methodology adopted by Jordanian universities largely contributes to expanding the gap. The study recommends giving Jordanian universities more freedom in setting the curriculum for accounting programs, and that they should start revising their accounting curriculums to take into account current market needs.
Women’s Decision-Making about PrEP for HIV Prevention in Drug Treatment Contexts
Authors: Qin Yilu , Price Carolina , Rutledge Ronnye , Puglisi Lisa , Madden Lynn M. , Meyer Jaimie P.
Published: January 2020

Despite pre-exposure prophylaxis’s (PrEP) efficacy for HIV prevention, uptake has been low among women with substance use disorders (SUDs) and attributed to women’s lack of awareness. In semistructured interviews with 20 women with SUD and 15 key stakeholders at drug treatment centers, we assessed PrEP awareness and health-related decision-making. Women often misestimated their own HIV risk and were not aware of PrEP as a personally relevant option. Although women possessed key decision-making skills, behavior was ultimately shaped by their level of motivation to engage in HIV prevention. Motivation was challenged by competing priorities, minimization of perceived risk, and anticipated stigma. Providers were familiar but lacked experience with PrEP and were concerned about women’s abilities to action plan in early recovery. HIV prevention for women with SUD should focus on immediately intervenable targets such as making PrEP meaningful to women and pursuing long-term systemic changes in policy and culture. Efforts can be facilitated by partnering with drug treatment centers to reach women and implement PrEP interventions.
High prevalent human papillomavirus infections of the oral cavity of asymptomatic HIV-positive men
Authors: Méndez-Martínez Rocío , Maldonado-Frías Silvia , Vázquez-Vega Salvador , Caro-Vega Yanink , Rendón-Maldonado José Guadalupe , Guido-Jiménez Miriam , Crabtree-Ramírez Brenda , Sierra-Madero Juan G. , García-Carrancá Alejandro
Published: January 2020

Background

Incidence of anal and oral infections with Human Papillomavirus (HPV) is increasing, particularly among Human Immunodeficiency Virus-positive (HIV+) men. HPV type 16 has exhibited the highest incidence and only limited data is available on other prevalent types, variants of HPV16, as well as associated factors. We were interested in identifying prevalent HPV types, variants of type 16, as well as factors associated with HPV16 infections in the oral cavity of HIV+ men who have sex with men (MSM).

Methods

A cross-sectional study of oral cavity samples from HIV+ MSM, that in a previous study were identified as positive for HPV16 in the anal canal. Cells from the oral cavity (102 samples, paired with 102 from the anal canal of same patient) were used to extract DNA and detect HPV infections using INNO-LiPA HPV Genotyping Extra II, and PCR. From these, 80 samples (paired, 40 anal and 40 oral) were used to identify variants of type 16 by sequencing. Statistical differences were estimated by the X2 test, and p values equal to or less than 0.05 were considered significant. SPSS ver. Twenty-four statistical software (IBM Corp) was used.

Results

We found a high prevalence of High-Risk HPV (HR-HPV) and Low-Risk HPV (LR-HPV). Patients were positive in the oral cavity for HR types; 16, 39 and 18 (80.4, 61.8 and 52.9% respectively) and LR types 11 and 6 (53.9 and 34.3% respectively). Surprisingly, only European variants of type 16 were found in the oral cavity, although American Asian (22.5%) and African (2.5%) variants were identified in the anal canal. The analysis showed that CD4 counts could be the most important risk factor associated with HR-HPV infections in the oral cavity, anal canal or both anatomical regions. The risk of infection of the oral cavity with type 18 increased in men diagnosed with HIV for more than 6 years.

Conclusions

Prevalence of both HR and LR HPV’s in the oral cavity of Mexican HIV+ MSM is very high. The fact that only European variants of HPV16 were found in the oral cavity suggest a possible tropism not previously described.
Disseminated Cryptococcosis revealed by transverse myelitis in Immunocompetent patient: a case report and review of the literature
Authors: Qu Fangfang , Qu Zhenzhen , Lv Yingqian , Song Bo , Wu Bailin
Published: January 2020

Background

Transverse myelitis (TM) is due to inflammatory spinal cord injury with bilateral neurologic involvement, which is sensory, motor, or autonomic in nature. It may be associated with autoimmune disease, vaccination, intoxication and infections. The most common infection cause of TM is Coxsackie virus and Mycoplasma pneumoniae. The cryptococcosis is rare. We present the case of disseminated cryptococcosis revealed by transverse myelitis in an immunocompetent 55-year-old male patient. The literature review is also stated.

Case presentation

The 55-year-old man suffered from gradual numbness, weakness in both lower limbs and finally paralyzed in the bed. The thoracic spine Computed tomography (CT) was normal, but multiple nodules in the lung were accidentally discovered. Thoracic Magnetic Resonance Imaging (MRI) showed diffused thoracic spinal cord thickening and extensively intramedullary T2 hyper intensity areas. Gadolinium contrast enhanced T1WI showed an intramedullary circle-enhanced nodule at 9th thoracic level. Diagnosis was made by histological examination of the bilateral lung biopsy. The patient was treated successfully with systemic amphotericin B liposome and fluconazole and intrathecal dexamethasone and amphotericin B liposome.

Conclusions

This is a patient with disseminated cryptococcosis involving the lung, spinal cord and adrenal glands, which is rare in the absence of immunodeficiency.
Childhood cancer incidence and survival trends in Estonia (1970–2016): a nationwide population-based study
Authors: Paapsi Keiu , Baburin Aleksei , Mikkel Sirje , Mägi Margit , Saks Kadri , Innos Kaire
Published: January 2020

Background

Childhood cancers represent a small proportion of all cancers but are still a major public health problem. The study analysed long-term trends in childhood cancer incidence and survival in Estonia in relation to societal and health care transition.

Methods

Data on all malignant tumours, diagnosed in children aged 0–14 during 1970–2016, were derived from the Estonian Cancer Registry. Age-standardised (World standard) incidence rates were calculated by ICCC-3 site groups and joinpoint regression was used to estimate annual percentage change (APC) for incidence trends. Cohort and period approach were used to estimate 5-year survival. Internal age standardisation was applied.

Results

A total of 1628 incident cancer cases were diagnosed during the study period and overall incidence increased significantly at a rate of 0.5% per year. Significant increases were seen for neuroblastoma and germ cell tumours, for lymphoid leukemias and some CNS sub-sites. At the same time, decline in incidence was seen in almost all subgroups of unspecified neoplasms. The overall 5-year survival improved from 24% in 1970–1979 to 73% in 2010–2016, with the largest changes occurring in the 1990s and 2000s. For many sites, survival increase thereafter has been marginal.

Conclusion

In this first comprehensive population-based study of childhood cancer incidence and survival in Estonia, long-term trends are shown in the context of societal and health care changes. Even though the increasing incidence of some sites may, at least partially, be explained by improved diagnostics reflected in the decreased incidence of unspecified neoplasms, the overall cancer incidence in children seems to be rising. Rapid progress in diagnosis and care have improved childhood cancer survival immensely, but deficit in Estonia persists compared to other European countries. Results of the study accentuate the need for a more in-depth analysis of clinical data, but also for the prioritization of childhood cancer in Estonia, to ensure access to standard care and innovative treatments.
Comparison of intraocular pressure measured by ocular response analyzer and Goldmann applanation tonometer after corneal refractive surgery: a systematic review and meta-analysis
Authors: Zhang Hui , Sun Zhengtao , Li Lin , Sun Ran , Zhang Haixia
Published: January 2020

Background

Accurate measurement of intraocular pressure (IOP) after corneal refractive surgery is of great significance to clinic, and comparisons among various IOP measuring instruments are not rare, but there is a lack of unified analysis. Although Goldmann Applanation Tonometer (GAT) is currently the internationally recognized gold standard for IOP measurement, its results are severely affected by central corneal thickness (CCT). Ocular Response Analyzer (ORA) takes certain biomechanical properties of cornea into account and is supposed to be less dependent of CCT. In this study, we conducted the meta-analysis to systematically assess the differences and similarities of IOP values measured by ORA and GAT in patients after corneal refractive surgery from the perspective of evidence-based medicine.

Methods

The authors searched electronic databases (MEDLINE, EMBASE, Web of science, Cochrane library and Chinese electronic databases of CNKI and Wanfang) from Jan. 2005 to Jan. 2019, studies describing IOP comparisons measured by GAT and ORA after corneal refractive surgery were included. Quality assessment, subgroup analysis, meta-regression analysis and publication bias analysis were applied in succession.

Results

Among the 273 literatures initially retrieved, 8 literatures (13 groups of data) with a total of 724 eyes were included in the meta-analysis, and all of which were English literatures. In the pooled analysis, the weighted mean difference (WMD) between IOPcc and IOPGAT was 2.67 mmHg (95% CI: 2.20~3.14 mmHg, p < 0.0001), the WMD between IOPg and IOPGAT was − 0.27 mmHg (95% CI: − 0.70~0.16 mmHg, p = 0.2174). In the subgroup analysis of postoperative IOPcc and IOPGAT, the heterogeneity among the data on surgical procedure was zero, while the heterogeneity of other subgroups was still more than 50%. The comparison of the mean difference of pre- and post-operative IOP (∆IOP) was: mean-∆IOPg > mean-∆IOPGAT > mean-∆IOPcc.

Conclusions

IOPcc, which is less dependent on CCT, may be more close to the true IOP after corneal refractive surgery compared with IOPg and IOPGAT, and the recovery of IOPcc after corneal surface refractive surgery may be more stable than that after lamellar refractive surgery.
Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis
Authors: Tolossa Tadesse , Mengist Belayneh , Mulisa Diriba , Fetensa Getahun , Turi Ebisa , Abajobir Amanuel
Published: January 2020

Background

Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it.

Methods

We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity.

Results

The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81–18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84–4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47–24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58–4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25–1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22–0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11–0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21–0.92)).

Conclusion

The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.
Prevalence and predictors of overweight and obesity in Brazilian immigrants in Massachusetts
Authors: Klabunde Rachel A. , Lazar Neto Felippe , Louzada Andressa , de Moura Ricardo Faé , Calixto Fernando Morelli , Danaei Goodarz , Castro Marcia C.
Published: January 2020

Background

Overweight and obesity are important risk factors for chronic non-communicable diseases, and their prevalence is on the rise worldwide. This study seeks to describe the prevalence and predictors of overweight and obesity in Brazilian immigrants living in Massachusetts, United States of America (USA).

Methods

Modeled after a survey on behavioral risk factors for chronic disease conducted annually in Brazil (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico: Vigitel), Brazilian immigrants aged 18+ (n = 361) were surveyed between December 2013 and March 2014. Information was obtained from consenting participants regarding their demographic characteristics, physical activity, dietary and lifestyle habits, and other behavioral risk factors. Weight status was estimated from body mass index (BMI), calculated from self-reported height and weight data. Participants were categorized as overweight/obese if their BMI was ≥25; overweight and obese categories were combined to ensure appropriate sample size. Prevalence of overweight/obesity was estimated using STATA, and significant predictors were identified via multi-variable logistic regression. Odds ratio (OR), 95% confidence intervals (95% CI) and p-values were determined.

Results

The overall prevalence of overweight/obesity in the sample was 47.6%. Significant predictors of overweight and obesity were gender (men OR 2.30, 95% CI: 1.10, 3.78; women are comparison group), working in the 3 months prior to the survey (OR 2.90, 95% CI: 1.01, 8.30), and longer duration living in the USA (OR per additional year 1.06, 95% CI: 1.02, 1.11). Significant dietary predictors of overweight/obesity included 5 or more days per week of consumption of red meat (OR red meat 3.70, 95% CI: 1.47, 9.26) or of sweetened beverages, like soft drinks also known as soda (OR soda 2.40, 95% CI: 1.00, 5.78) compared with less frequent consumption of these foods.

Conclusions

This study suggests that long duration of time lived in the USA increases odds of overweight and obesity for Brazilian immigrants living in Massachusetts. Efforts to curb increases in overweight and obesity in this population should focus not only on the men and those who work but also the women. Possible intervention measures should target soda (soft drink) and red meat consumption in Brazilian immigrants.
Cervical esophageal perforation caused by the use of bougie during laparoscopic sleeve gastrectomy: a case report and review of the literature
Authors: Lovece Andrea , Rouvelas Ioannis , Hayami Masaru , Lindblad Mats , Tsekrekos Andrianos
Published: January 2020

Background

Obesity is considered a chronic disease with an increasing prevalence worldwide during the last decades. Laparoscopic sleeve gastrectomy is the most commonly performed bariatric procedure, due to its relative safety and long-term efficacy. The use of bougie to ensure correct size of the gastric tube is part of the standard operation, usually placed by the anesthesiologist and with a very low rate of complications. We report the first case, to our knowledge, of a cervical esophageal perforation caused by the use of bougie during laparoscopic sleeve gastrectomy.

Case presentation

The complication occurred in a previously healthy 42-year old female patient who underwent laparoscopic sleeve gastrectomy for class 1 obesity (BMI 31 kg/m2) and was diagnosed the first post-operative day. She was subsequently treated with an emergency thoracoscopy and evacuation of a mediastinal fluid collection, with additional neck incision for primary closure of the esophageal defect which was reinforced with a sternocleidomastoid muscle flap. The post-operative course was uneventful.

Conclusions

We made a literature review to better understand the options considering the diagnosis and treatment in case of very proximal iatrogenic esophageal perforations. The risks related to the use of bougie during surgery should not be underestimated, and its insertion must be done with extreme caution. Esophageal perforation is still a challenging, life threatening complication where prompt diagnosis and adequate treatment are essential.
Have medical students’ attitudes towards clinical communication skills changed over a 12- year period? A comparative long-term study
Authors: Gude Tore , Tyssen Reidar , Anvik Tor , Grimstad Hilde , Holen Are , Baerheim Anders , Vaglum Per , Løvseth Lise
Published: January 2020

Background

Attitudes towards learning clinical communication skills at the end of medical school are likely to reflect the students’ training and motivation for the continued development of their skills as doctors. Students from two Norwegian medical schools, one with a traditional, and the other with an integrated curriculum, were approached in 2003 and 2015; with regard to changes in students’ attitudes towards acquiring communication skills in two diverse learning environments. This comparison might reveal the effects of the training programs from a long-term perspective, as neither of the medical schools made any major curriculum changes within the study period.

Methods

The samples comprised final-year medical students. Two separate cross-sectional surveys performed 12 years apart (2003 and 2015) used items from the Communication Skills Attitude Scale in addition to age and gender. The traditional curriculum included only theoretical teaching and no contact with patients was made during the first 2 to 2.5 years of medical school. However, the integrated curriculum combined training in theoretical and clinical communication skills with early patient contact from the beginning.

Results

Attitudes improved from the first to the second survey at both schools, however, students from the integrated school reported more positive attitudes than those from the traditional school. Female students from the integrated school contributed the most to the difference in attitudes in both surveys.

Conclusions

Students in both traditional and integrated curricula improved their attitudes from the first to the second assessment. However, compared with the traditional curriculum, the integrated one fostered even higher levels of positive attitudes towards acquiring communication skills, and a pronounced influence was observed on female students. These findings suggest that an educational program with greater emphasis on improving attitudes among male students may be required.
TEAD4 modulated LncRNA MNX1-AS1 contributes to gastric cancer progression partly through suppressing BTG2 and activating BCL2
Authors: Shuai You , Ma Zhonghua , Liu Weitao , Yu Tao , Yan Changsheng , Jiang Hua , Tian Shengwang , Xu Tongpeng , Shu Yongqian
Published: January 2020

Background

Gastric cancer (GC) is the third leading cause of cancer-related mortality globally. Long noncoding RNAs (lncRNAs) are dysregulated in obvious malignancies including GC and exploring the regulatory mechanisms underlying their expression is an attractive research area. However, these molecular mechanisms require further clarification, especially upstream mechanisms.

Methods

LncRNA MNX1-AS1 expression in GC tissue samples was investigated via microarray analysis and further determined in a cohort of GC tissues via quantitative reverse transcription polymerase chain reaction (qRT-PCR) assays. Cell proliferation and flow cytometry assays were performed to confirm the roles of MNX1-AS1 in GC proliferation, cell cycle regulation, and apoptosis. The influence of MNX1-AS1 on GC cell migration and invasion was explored with Transwell assays. A xenograft tumour model was established to verify the effects of MNX1-AS1 on in vivo tumourigenesis. The TEAD4-involved upstream regulatory mechanism of MNX1-AS1 was explored through ChIP and luciferase reporter assays. The mechanistic model of MNX1-AS1 in regulating gene expression was further detected by subcellular fractionation, FISH, RIP, ChIP and luciferase reporter assays.

Results

It was found that MNX1-AS1 displayed obvious upregulation in GC tissue samples and cell lines, and ectopic expression of MNX1-AS1 predicted poor clinical outcomes for patients with GC. Overexpressed MNX1-AS1 expression promoted proliferation, migration and invasion of GC cells markedly, whereas decreased MNX1-AS1 expression elicited the opposite effects. Consistent with the in vitro results, MNX1-AS1 depletion effectively inhibited the growth of xenograft tumour in vivo. Mechanistically, TEAD4 directly bound the promoter region of MNX1-AS1 and stimulated the transcription of MNX1-AS1. Furthermore, MNX1-AS1 can sponge miR-6785-5p to upregulate the expression of BCL2 in GC cells. Meanwhile, MNX1-AS1 suppressed the transcription of BTG2 by recruiting polycomb repressive complex 2 to BTG2 promoter regions.

Conclusions

Our findings demonstrate that MNX1-AS1 may be able to serve as a prognostic indicator in GC patients and that TEAD4-activatd MNX1-AS1 can promote GC progression through EZH2/BTG2 and miR-6785-5p/BCL2 axes, implicating it as a novel and potent target for the treatment of GC.