bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGARUH MINAT DAN KEBIASAAN MEMBACA SISWA TERHADAP HASIL BELAJAR GEOGRAFI SMA
Authors: Ni'matullah Onik Farida
Published: August 2019

Membaca adalah salah satu cara untuk mendapatkan informasi dan pengetahuan. Seseorang akan lebih kaya informasi dan wacana apabila ia memiliki minat dan kebiasaan membaca yang baik. Begitu pula pada seorang pelajar atau siswa. Intensitas dan kualitas mereka dalam membaca bisa menjadi penyebab kesuksesan saat pembelajaran di sekolah. Minat membaca yang ada pada diri siswa sangat berkaitan dengan kebiasaan mereka dalam kehidupan sehari-hari. Misalnya pada mata pelajaran geografi yang banyak memuat fakta dan konsep sehingga sangat memerlukan aktivitas membaca untuk memahaminya. Prestasi yang maksimal pada mata pelajaran geografi bergantung pada tinggi rendahnya minat dan kebiasaan mereka dalam membaca buku atau tulisan ilmiah yang berkaitan dengan materi pelajaran. Oleh karena itu guru di sekolah diharapkan dapat memilih strategi pembelajaran yang dapat memacu motivasi agar siswa tertarik dengan membaca sehingga akan mendapatkan pencapaian hasil belajar yang optimal.
ANALISIS PENGEMBANGAN OBJEK WISATA ASAM SATU BEACH KABUPATEN FLORES TIMUR NUSA TENGGARA TIMUR
Authors: Payong Fransiskus Laga , Wardani Nila Restu
Published: August 2019

Asam Satu Beach merupakan salah satu pantai di Larantuka,  berada di ujung timur Pulau Flores yang terletak di Kelurahan Weri  Kecamatan Larantuka Kabupaten Flores Timur. Pantai ini berada di pusat kota. Asam Satu Beach memiliki daya tarik wisata berupa sunset. Tujuan penelitian ini adalah untuk mengetahui bagaimana pengembangan wisata yang telah dilakukan oleh pengelola objek wisata Asam Satu Beach. Jenis penelitian yang digunakan adalah penelitian deskriptif dengan pendekatan kualitatif. Peneliti hadir selama penelitian  berlangsung untuk mengumpulkan data baik data primer maupun data sekunder. Pengumpulan data dilakukan dengan 3 teknik yaitu:  wawancara,  observasi, dan  dokumentasi. Analisis datanya dengan  analisis deskriptif kualitatif dan analisis SWOT. Berdasarkan hasil penelitian dan analisis yang dilakukan tentang pegembangan Objek Wisata Asam Satu Beach berdasarkan analisi SWOT sebagai berikut: Sampai saat ini Pantai Asam Satu Beach meliliki keindahan alam pantai yang masih alami, lokasi yang strategis, aksesbilitas yang dilalui jalan arteri, dan memiliki daya tarik tambahan seperti spot foto. Selain itu Pantai Asam Satu Beach memiliki beberapa kelemahan diantaranya, kurangnya promosi dan pungutan biaya masuk, kurangnya sarana dan prasarana seperti kamar ganti semua ini  juga dikarenakan tanpa campur tangan pemerintah dalam mengolahnya. Pantai Asam Satu Beach yang merupakan wisata populer di Kota Larantuka, memberikan dampak posostif bagi masyarakat sekitar karena dapat menunjang lapangan pekerjaan dan menurunkan tingkat pengangguran.
Faktor-Faktor yang Mempengaruhi Pola Keruangan Belanja Wanita dalam Pemberdayaan Ekonomi di Urban Fringe Kecamatan Sukun Kota Malang
Authors: Septina Riska , Hamdani Akhmad Faruq , Jamil Achmad Maulana Malik
Published: August 2019

Kecamatan Sukun merupakan salah satu kecamatan di Kota Malang, sebagai wilayah urban fringe. Perkembangan kota yang terus menerus akan berpengaruh terhadap kegiatan masyarakat yang ada di wilayah urban fringe. Kebiasaan belanja wanita mempunyai pengaruh terhadap pemberdayaan ekonomi dan masyarakat. Pemberdayaan ekonomi berarti memampukan masyarakat sekitar agar mandiri secara ekonomi atau setidaknya memberikan pemacu agar terjadi perkembangan ekonomi di daerah. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi pola keruangan belanja wanita di urban fringe Kecamatan Sukun Kota Malang.  Penelitian ini bersifat deskriptif kuantitatif, dengan teknik pengumpulan data yaitu kuesioner dan dokumentasi. Objek penelitian adalah wanita rumah tangga di urban fringe Kecamatan Sukun Kota Malang. Penentuan sampel didasarkan pada stratified random sampling, dengan jumlah yaitu 100  wanita rumah tangga yang tersebar di enam kelurahan sebagai sampel wilayah. Teknik analisis data yang digunakan yaitu deskriptif persentase, Chi Square dan regresi linear berganda. Hasil penelitian menunjukkan bahwa karakteristik sosial ekonomi wanita di urban fringe Kecamatan Sukun memiliki potensi bagi pemberdayaan ekonomi, ditandai dengan umur yang produktif, tingkat pendidikan, pendapatan  dan pengeluaran keluarga. Pola keruangan terutama pada jarak menunjukkan adanya hubungan dengan wilayah urban fringe. Faktor-faktor yang mempengaruhi pola keruangan belanja wanita adalah kepribadian wanita sebagai faktor internal dan sebagai faktor eksternal adalah kualitas serta pilihan produk. Berdasarkan hasil penelitian, maka saran yang diberikan adalah pengembangan sarana dan prasarana di urban fringe Kecamatan Sukun dengan memperhatikan daya saing kualitas dan jumlah produk. Pengembangan fasilitas pelayanan ekonomi terutama pasar tradisional di urban Fringe karena wanita cenderung memilih jarak yang dekat dari tempat tinggalnya untuk belanja.
Acxiom, Red Hat, Actifio, & IBM: A Strategic Partnership on Virtualization and Marketing
Authors: Gutiérrez B. Wilson H.
Published: August 2019

This document contains an analysis of strategic alliances between «big» players in information technology (IT) and software applications in server virtualization (SV) and marketing alliances. The main objective is to analyze the commercial advantages, benefits, and challenges of business partners, using the SV for information management, data storage, and collaboration in marketing programs. We analyze cases of alliances in companies like IBM, Acxiom, Red Hat, and Actifio, who have identified the competitive advantages of having a main «partner», which has the ideal product or service to complement one or several secondary brands as a commercial strategy and brand positioning.

The SV brings positive transformations such as the reduction of hardware costs, the improvement of the provisioning and implementation of the server, disaster recovery solutions, efficient and economical use of energy, and increased productivity. This strategy invites to change the way in which data centers are being formed, and becomes a preferred solution not only for the reduction of IT costs, but at the same time it makes a company more flexible, productive, and efficient, generating better results.

The ability to capture and store more and more detailed information about customer needs and behavior, taking advantage of the technology and intelligence of business partners, creates better opportunities in services, products, and more effective marketing campaigns, attracting new customers and positioning brands.
Emerging pesticides responsible for suicide in rural Sri Lanka following the 2008-2014 pesticide bans
Authors: Weerasinghe Manjula , Pearson Melissa , Konradsen Flemming , Agampodi Suneth , Sumith J.A. , Jayamanne Shaluka , Senanayake S.M.H.M.K. , Rajapaksha Sandamali , Eddleston Michael
Published: August 2019

Background

Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through regulation of a series of agricultural pesticides. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation.

Methods

We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011-16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners’ records, and the person’s family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides.

Results

We identified 337 suicidal deaths. Among them, 193 (57.3%) were due to ingestion of pesticides and 82 (24.3%) to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos was statistically significant (R square 0.846, F 16.541, p 0.027).

Conclusion

Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka.
Systematic analysis of JmjC gene family of Brassica napus and KDM5 subfamily involved in abiotic stress response
Authors: He Xinghui , Pan Jiao , Liu Boyu , Tan Chengfang , Ruan Ying , Huang Yong
Published: August 2019

Background: Jumonji C (JmjC) proteins play an important role in plant development and stress response through the removal of lysine methylation from histones. Brassica napus, which originated from spontaneous hybridization between Brassica rapa and Brassica oleracea, is the most important oilseed crop after soybean, but evolutionary relationships and functions of JmjC proteins remain unclear.
Results: 65 JmjC genes were identified from B. napus genome, 29 from B. rapa, and 23 from B. oleracea. These genes were grouped into seven clades according to conserved sequences, and their catalytic activities of demethylation were predicted. Group-KDM4/JHDM3 for H3K4/9/27/36, Group-KDM5A/B for H3K4, Group-JmjC domain-only A/B for H3K27/36, Group-KDM3/JHDM2 for H3K9, and Group-JMJD6 may be for arginine demethylases. B. napus inherited most of its JmjC genes from its parents. The average retention rate of B. napus JmjC gene from B. rapa (93.1%) and B. oleracea (82.6%) exceeded that of all homologous gene pairs (83.7%) across the whole B. napus genome. Thirteen new or duplicated JmjC genes have emerged in B. napus. Sequence similarity and domain organization analyses suggest that the functions of these genes might be diversified. Furthermore, KDM5 genes were examined under stress conditions due to H3K4 demethylation. Expression profiles indicated that the genes from B. napus are possibly involved in various stress responses.
Conclusion: This study provides the first genome-wide characterization of JmjC genes in Brassica species. Its JmjC genes potentially have diverse functions, and its KDM5 genes might be involved in stress response. The results of this study facilitate the future functional characterization of the demethylation of JmjC family in Brassica crops.
Transcriptome and phytochemical analyses provide new insights into long non-coding RNAs and characteristic secondary metabolites of oolong tea (Camellia sinensis) in solar-withering
Authors: Zhu Chen , Zhang Shuting , Fu Haifeng , Zhou Chengzhe , Chen Lan , Chang Xiaojun , Li Xiaozhen , Lin Yuling , Lai Zhongxiong , Guo Yuqiong
Published: August 2019

Background

Oolong tea, a semi-fermented tea, was deeply loved by consumers. Among tea processing, withering is the first indispensable process for improving the unique flavor. However, the roles of long non-coding RNAs (lncRNAs) and characteristic secondary metabolites in withering of oolong tea remain unknown.

Results

Using phytochemical analyses, the total flavonoid, total catechins, EGC, CG, GCG, ECG, and EGCG were all present at significantly lower levels in solar-withered leaves (SW) than in fresh leaves (FL) and indoor-withered leaves (IW). However, terpenoid, JA, and MeJA were present at a higher level in SW than FL and IW. By analyzing the transcriptome data, we obtained a total of 32,036 lncRNAs. On the basis of Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, flavonoid metabolic pathway, terpenoid metabolic pathway, and JA/MeJA biosynthesis and signal transduction pathway were the representative pathways in this study. And a total of 63 differentially expressed-lncRNAs (DE-lncRNAs) and 23 target genes were identified in the 3 pathways. Analysis of the expression profiles of DE-lncRNAs and their target genes in SW compared with IW, we found that 4 up-regulated genes (FLS, CCR, CAD, and HCT), 7 up-regulated lncRNAs, 4 down-regulated genes (4CL, CHI, F3H, and F3'H), and 3 down-regulated lncRNAs in flavonoid metabolism; 9 up-regulated genes (DXS, CMK, HDS, HDR, AACT, MVK, PMK, GGPPS, and TPS), 3 up-regulated lncRNAs, 6 down-regulated lncRNAs in terpenoid metabolism; 6 up-regulated genes (LOX, AOS, AOC, OPR, ACX, and MFP2), 4 up-regulated lncRNAs, and 3 down-regulated lncRNAs in JA/MeJA biosynthesis and signal transduction pathway.

Conclusions

These results suggested that the expression of DE-lncRNAs and their targets involved in the 3 pathways maybe related to the low content of total flavonoid, total catechins, EGC, CG, GCG, ECG, and EGCG, and high content of terpenoid in SW. Moreover, solar light, high content of JA and MeJA, and the endogenous target mimics (eTMs) regulatory mechanism in SW were also crucial factors in increasing the terpenoid. These findings provide new insights into the view of "Kàn qīng shài qīng" that the solar-withering is more contribute to the high quality flavor of oolong tea compared to the indoor-withering.
Comparative study of GenePOC GBS LB Assay and GeneXpert GBS LB Assay for the detection of Group B Streptococcus in prenatal screening samples
Authors: Choera Tsokyi , Jung-Hynes Brittney , Chen Derrick J.
Published: August 2019

Group B Streptococcal (GBS) infections in the United States are a leading cause of meningitis and sepsis in newborns. The CDC, therefore recommends GBS screening for all pregnant women at 35–37 weeks of gestation and administration of intrapartum prophylaxis (in those that tested positive) as an effective means of controlling disease transmission. Several FDA approved molecular diagnostic tests are available for rapid and accurate detection of GBS in antepartum women. In this study, we report a clinical comparison of the Xpert GBS LB assay and a novel FDA-cleared test, GenePOC GBS LB assay. A total of 250 vaginal-rectal swabs from women undergoing prenatal screening were submitted to the University of Wisconsin’s clinical microbiology laboratory for GBS testing. We found 96.8% of samples were concordant between the two tests, while 3.2% were discordant with higher sensitivity observed for the GenePOC GBS LB assay, and higher specificity for the GeneXpert GBS LB assay.
Early rehabilitation for children with visual processing dysfunctions from 1 year of age: a Randomized Controlled Trial protocol
Authors: Kooiker Marlou , Linden Yoni van der , Dijk Jenneke van , Zee Ymie J van der , Swarte Renate MC , Smit Liesbeth S , Steen-Kant Sanny van der , Loudon Sjoukje E , Reiss Irwin KM , Kuyper Kees , Pel Johan JM , Steen Johannes van der
Published: August 2019

Background

An increasing amount of children suffer from brain damage-related visual processing dysfunctions (VPD). At present, there is a lack of evidence-based rehabilitation methods that can be used early in development. We developed a visual rehabilitation protocol suitable from 1 year of age. The protocol contains objective, quantitative outcomes and is structured, comprehensive and individually-adaptive. Our aim is to investigate effectiveness of this first visual rehabilitation program for young children with (a risk of) VPD.

Methods

We conduct a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (<30 weeks) of 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care: an ophthalmic and visual function assessment and a (newly developed) visual rehabilitation program. This program consist of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to specific needs of the child), and employs quantitative parameters of visual outcome. Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA), or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual rehabilitation will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention).

Discussion

Through this RCT we will establish the effectiveness of a new and early visual rehabilitation program. Combining a general and supplement protocol enables structured comparisons between participants and groups, and custom rehabilitation that is tailored to the children’s specific needs. The design ensures that all included children will benefit from participation by advancing the age at which they start receiving rehabilitation. We expect results to be applicable to all children with (a risk of) VPD early in life.
Socio-demographic characteristics and co-occurrence of depressive symptoms with chronic diseases among older adults in China: the China Longitudinal Ageing Social Survey
Authors: Wang Zhenjie , Yang Hanmo , Guo Zhanyuan , Liu Bei , Geng Shen
Published: August 2019

Background

The aim of the current study is to assess the cross-sectional association of chronic non-communicable diseases (hypertension, diabetes mellitus, arthritis, and cerebrovascular) with depression among older adults in China.

Methods

Data was obtained from the China Longitudinal Ageing Social Survey (CLASS) conducted in 2014. A total of 7505 participants were included. Depression status was assessed by 9-item Center for Epidemiological Studies Depression Scale (CES-D) Associations between depression and chronic diseases, adjusting for so, demographics and chronic diseases risk factors were assessed.

Results

We found negative associations between depression and several socioeconomic factors, including education attainment and economic level. Widowed/divorced/ unmarried individuals are more likely to suffer from depression. Hypertension (Odds ratio:1.29 [95%CI:1.16, 1.42]), diabetes (1.41 [95%CI:1.19,1.67]), arthritis (1.72 [1.52, 1.96]), and cerebrovascular disease (1.69 [1.41, 2.02]) were found to be associated with depression.

Conclusions

Most depression cases were found to be strongly associated with chronic diseases. Our findings has provided empirical evidence for clinicians to view co-morbid depression with chronic diseases, which could help them to evaluate, diagnose and manage depression promptly.
Exploring Pathways to Hospital Care for Patients with Alzheimer’s Disease and Related Dementias in Rural South Western Uganda
Authors: Kakongi Nathan , Rukundo Godfrey Zari , Galaye Bizu , Wakida Edith K. , Obua Celestino , Okello Elialilia S.
Published: August 2019

Background: In order to analyze use of health services and identify sources of delays in accessing the right care for patients with Alzheimer’s disease and related dementias (AD/ADRD), understanding of care seeking pathways is needed. The objectives of this study were: (i) to explore pathways to hospital care for patients with AD/ADRD and (ii) to describe challenges experienced by the patients and their families while seeking health care.
Methods: Using purposive sampling, 30-in-depth, semi-structured interviews were conducted among caregivers of elderly patients diagnosed with dementia from rural Southwestern, Uganda. Data was analyzed using ATLAS.Ti software.
Results: There was variability in pathways to care from individual to individual. The points of care varied from one to four including; hospitals, clinics, places of worship and traditional healers with one to six point of care visits. Two broad themes were identified: (1) points of care choice and perceived care outcomes; (2) challenges encountered at various points of care. Most of the respondents reported use of hospitals at first and second visit to the health care point (53.3% and 67.9% respectively), but reduced to none at 5th and 6th encounters. Places of worship, clinics and traditional healer’s shrine received few patients but places of worship became more common from third point of care encounter to the sixth. Major improvements (58.1%) were observed on hospital use but little or no help with prayers, clinics and traditional healers. The challenges experienced with formal points of care focused on cost of prescribed drugs, weakening effect of the drugs, health workers’ rudeness, lack of skills to manage the condition, and lack of improvement in quality of life.
Conclusions: Study findings indicate that caregivers and or families of patients with dementia go to different places both formal and informal care settings while seeking health care. However, hospital point of care was more frequent at first and second points of care visit while places of worship took the lead at subsequent visits. Although no specific pathway reported, most of them begin with hospital (formal) and end with non-formal. We recommend that health systems carry out public awareness on dementia.
Title: Retrospective analysis of reported cases of intraoperative awareness in a large multi-hospital health system
Authors: Deis Amanda S. , Schnetz Michael P. , Ibinson James W. , Vogt Keith M
Published: August 2019

Background: Awareness with recall under general anesthesia remains a rare but important issue that warrants further study.

Methods: We present a series of seven cases of awareness that were identified from provider-reported adverse event data from the electronic anesthesia records of 647,000 general anesthetics.

Results: The low number of identified cases suggests an under-reporting bias. Nonetheless, some important themes emerge from this small series that can serve as important reminders to anesthesia providers to ensure delivery of an adequate anesthetic for each patient. Commonalities between a majority of our identified anesthetic awareness cases include: obesity, use of total intravenous anesthesia, use of neuromuscular blockade, and either a lack of processed electroencephalogram (EEG) monitoring or documented high depth of consciousness index values. An interesting phenomenon was observed in one case, where adequately-dosed anesthesia was delivered without technical issue, processed EEG monitoring was employed, and the index value suggested an adequate depth of consciousness throughout the case.

Conclusions: Provider-reported adverse event data in the immediate post-operative period is likely insensitive for detecting cases of intraoperative awareness. Themes identified in this series of cases of awareness under general anesthesia provide important reminders for anesthesia providers for maintain vigilance in monitoring depth and dose of anesthesia, particularly with total intravenous anesthesia.
Preoperative risk factors for delirium in hip-fracture surgery under regional anesthesia: A nationwide population-based study
Authors: Ahn Eun-Jin , Bang Si Ra
Published: August 2019

Background

Delirium is common, but is frequently undetected by clinicians, despite the fact that it can be life-threatening. The objective of this study was to identify the incidence of delirium and the preoperative factors associated with postoperative delirium in elderly patients who underwent hip fracture surgery under regional anesthesia.

Methods

We retrospectively reviewed records of all patients ≥65 years who underwent hip fracture surgery under regional anesthesia, covered by the Korean National Health Insurance, between January 1, 2009 and December 31, 2015. A univariate and stepwise logistic regression model with the occurrence of delirium as the dependent variable was used to identify perioperative factors for this sample of patients.

Results

Among the 70696 patients who underwent hip fracture surgery, 58972 patients were who received regional anesthesia during surgery were included in our study. Delirium was detected in 8680 (14.7%) patients. Performing stepwise logistic regression, preoperative variables including female gender, included age ≥85 years, hospital type (medical center), ICU and ventilator care, neurodegenerative disorders, uncomplicated diabetes mellitus, peptic ulcer disease, psychoses, and depression (OR=1.49[1.42-1.58], 4.7[4.15-5.37], 13.3[7.57-23.8], 1.52[1.43-1.60], 1.19[1.01-1.40], 1.20[1.14-1.27], 1.09[1.04-1.14], 0.87[0.96-0.00], 2.23[1.48-3.37], and 1.38[1.32-1.46], respectively) were identified to be associated with delirium.

Conclusion

Delirium could occur in approximately 15% of elderly hip fracture surgery cases in which regional anesthesia is used. Multiple preoperative risk factors were found to be associated with delirium.
Neutrophil extracellular trap formation and nuclease activity in septic patients
Authors: Cox Linda , Walstein Kai , Völlger Lena , Reuner Friederike , Bick Alexandra , Dötsch Annika , Engler Andrea , Peters Jürgen , von Köckritz-Blickwede Maren , Schäfer Simon T.
Published: August 2019

Background: There is little knowledge, whether in patients with sepsis neutrophil extracellular trap (NET) formation and NET degrading nuclease activity are altered. Thus, we tested the hypotheses that 1) NET formation from neutrophils of septic patients is increased compared to healthy volunteers, both without stimulation and following incubation with mitochondrial DNA (mtDNA), a damage-associated molecular pattern, or phorbol 12-myristate 13-acetate (PMA; positive control); and 2) serum nuclease activities are increased as well.
Methods: We included 18 septic patients and 27 volunteers in this prospective observational trial while study was registered retrospectively. Blood was withdrawn and NET formation from neutrophils in vitro was quantified (average percentage of neutrophils showing NET formation on an image) without stimulation and following incubation with mtDNA (10µg/well) or PMA (25nmol). Serum nuclease activity was assessed using gel electrophoresis.
Results: In contrast to our hypothesis, compared to healthy volunteers unstimulated NET release from neutrophils in septic patients was decreased by 46.3% (4.3%±1.8 SD vs. 8.2%±2.9, p≤0.0001) and 48.1% (4.9%±2.5 vs. 9.4%±5.2, p=0.002) after 2 and 4 hours of incubation. mtDNA further decreased NET formation in neutrophils from septic patients (4.7%±1.2 to 2.8%±0,8; p=0.03) but did not alter NET formation in neutrophils from volun-teers. As expected, PMA, as positive control, increased NET formation to 73.2% (±29.6) in septic patients and to 91.7% (±7.1) in volunteers after 4 hours of incubation (p=0.22). Serum nuclease activity (range: 0-6) was decreased in septic patients by 39.6% (3±2 vs 5±0; median and ICR, p=0.0001) compared to volunteers.
Conclusions: Unstimulated NET formation and nuclease activity are decreased in septic patients and mtDNA can further reduce NET formation. Thus, neutrophils from septic patients show decreased NET formation in vitro despite diminished nuclease activity in vivo.
Trail registration DRKS00007694, German Clinical Trials database (DRKS). Registered retrospectively 06.02.2015.
Preference of Traditional Bone setting and associated factors among trauma patients with fracture at Black Lion Hospital in Addis Ababa, Ethiopia: Institution Based cross sectional study
Authors: Worku Nardos , Tewelde Tsegaye , Abdissa Biru , Merga Hailu
Published: August 2019

Objective
Despite the access and availability of modern health care, traditional bone setting (TBS) has a big place as alternative health care. Hence, this study was aimed to assess the preference of traditional bone setting and associated factors among patients with a fracture.
Results
A total of 224 patients known to have fractured at Black Lion Hospital, Addis Ababa was included in the study. This study revealed that 29.9% of the study participants had a preference for the traditional bone setting. Hospital admission (AOR=8.158, 95% CI: 1.179, 56.439), TBS center as first port of call after injury (AOR=0.004, 95% CI: 0.001, 0.090), knowledge (AOR=9.448, 95% CI: 1.481, 60.251) and perception (AOR=0.026, 95% CI: 0.003, 0.215) were statistically significant. The preference for the traditional bone setting is high. Hospital admission, traditional bone setting center as a first port of call after injury, knowledge, and perception were significantly associated with the preference of traditional bone setting. In addition to deployment of trained in trauma professionals, working more on awareness creation and training are recommended.
Mediators of effective organizational capacity training: lessons from a training programme on health workforce development with participants from three African Countries
Authors: Amde Woldekidan Kifle , Marchal Bruno , Sanders David , Lehmann Uta
Published: August 2019

Background

Health systems in sub-Saharan Africa face multifaceted capacity challenges to fulfil their mandates of service provision and governance of their resources. Four academic institutions in Africa implemented a WHO-funded collaborative project encompassing training, curriculum development, and partnership to strengthen national leadership and training capacity for health workforce development. This paper looks into the training component of the project, a blended Masters programme in public health that sought to improve the capacity of personnel involved in teaching or management/development of human resources for health. With a focus on the training participants, the paper aims to explore factors mediating contribution of training to organisational capacity development.

Methods

We chose a case study design. Semi-structured interviews were held with 18 trainees that were enrolled in the training programme, and who were affiliated to health ministries or public health training institutions. We gathered additional data through document reviews, observation, and interviews with representatives of the collaborating institutions. The evidence gathered were analysed thematically.

Results

Many training participants stayed in the target institutions and contributed to improved capacity of their institutions in the fields of management, policy, planning, research, training, or curriculum development. Some of the training participants, however, left the target institutions for private and international agencies due to dissatisfaction with payment, work conditions, or career prospect.

Clusters of interacting factors, which were related to the training, trainees, and the institutional and broader context, mediate contribution of training to organisational capacity development. These include relevance of newly acquired knowledge and skills set of trainees to the role/position they assume in the organisation; recognition of trainees by employing organisations in terms of promotion or assignment of challenging tasks; and motivation and retention of trained staff.

Conclusion

Training, even if relevant and applicable, makes no more than a ‘latent’ contribution, one which is activated and realised through alignment of clusters of interacting contextual and relational factors related to the target institutions and trained personnel. While not predictable, implementers need to focus more deliberately on the likely interaction and best possible alignments between training relevance, student selection for potential to contribute, recognition and career advancement potential.
A training manual for event history analysis using longitudinal data
Authors: Bocquier Philippe , Ginsburg Carren , Collinson Mark A.
Published: August 2019

Objective: This research note reports on the activities of the Multi-centre Analysis of the Dynamics of Internal Migration And Health (MADIMAH) project aimed at collating and testing of a set of tools to conduct longitudinal event history analyses applied to standardised Health and Demographic Surveillance System (HDSS) datasets. The methods are illustrated using an example of longitudinal micro-data from the Agincourt HDSS, one of a number of open access datasets available through the INDEPTH iShare2 data repository. The research note documents the experience of the MADIMAH group in analysing HDSS data and demonstrates how complex analyses can be streamlined and conducted in an accessible way. These tools are aimed at aiding analysts and researchers wishing to conduct longitudinal data analysis of demographic events.

Results: The methods demonstrated in this research note may successfully be applied by practitioners to longitudinal micro-data from HDSS, as well as retrospective surveys or register data. The illustrations provided are accompanied by detailed, tested computer programs, which demonstrate the full potential of longitudinal data to generate both cross-sectional and longitudinal standard descriptive estimates as well as more complex regression estimates.
Autotransplantation of mature impacted tooth to a fresh molar socket using a 3D replica and guided bone regeneration: a one year retrospective study
Authors: Wu Ye , Chen Jiaming , Xie Fuping , Liu Huanhuan , Niu Gang , Zhou Lin
Published: August 2019

Objective

The aim of this study was to evaluate the performance of autotransplantation of a mature third molar to a fresh molar extraction socket using a 3D replica.

Materials and Methods

Ten patients underwent autotransplantation of teeth. We observed the mobility, percussion, radiography examination, the probing depth and the masticatory function of the transplanted teeth during one year following up, which were transplanted into fresh molar sockets by using a 3D replica, and GBR when it is necessary.

Results

The average extra-oral time of donor tooth had been shortened to 1.65 min. The clinical examination of the autotransplantation teeth during one year follow-up showed no sign of failure. Expect one patient feel slight sensitive when chewing with soft food at 4 weeks, and 3 points of probing depth deeper at different patients than 3mm and 1 points of probing depth deeper than 4mm at 4 weeks among them, and 1 points of probing depth deeper than 3mm at 5 weeks at the same patient.

Conclusions

The autotransplantation of teeth using 3D replica is an effective method which can reduce the extra-oral time of the donor teeth and the demand for the experience of a surgeon, and had a high success rate.

Clinical Relevance

The new 3D replica of donor tooth can make the surgery of tooth autotransplantation much easier, and improve it success rate.
Retained primary teeth in STAT3 hyper-IgE syndrome: Early intervention in childhood is essential
Authors: Meixner Iris , Hagl Beate , Kröner Carolin I. , Spielberger Benedikt D , Paschos Ekaterini , Dückers Gregor , Niehues Tim , Hesse Ronny , Renner Ellen D
Published: August 2019

Objectives: To optimize dental management we evaluated development of the dentition and long-term outcome of dental treatment in STAT3 hyper-IgE syndrome (STAT3-HIES), a rare primary immunodeficiency clinically overlapping with atopic dermatitis. Next to eczema, elevated serum-IgE, and recurrent infections, STAT3-HIES patients present with characteristic facies, midline defects, and retained primary teeth.
Materials and Methods: We assessed dental histories of 13 molecularly defined STAT3-HIES patients by questionnaires, radiographs, and dental investigations.
Results: Primary tooth eruption was unremarkable in all STAT3-HIES patients. Primary tooth exfoliation and permanent tooth eruption was delayed in 83% of patients due to unresorbed tooth roots. Permanent teeth erupted spontaneously in all patients receiving primary teeth extraction of retained primary teeth during average physiologic exfoliation time. A complex orthodontic treatment was needed in one patient receiving delayed extraction of primary molars and canines.
Conclusion: To enable spontaneous eruption of permanent teeth in children with STAT3-HIES, we recommend extracting retained primary incisors not later than 9 years of age and retained primary canines and molars not later than 13 years of age after having confirmed the presence of the successor permanent teeth by radiograph.
Clinical Relevance: The association of STAT3-HIES with retained primary teeth is important knowledge for dentists in any field as timely extraction of retained primary teeth avoids dental complications.
A CROSS SECTIONAL ANALYSIS OF DIETARY PRACTICES AND NUTRITION STATUS OF FEMALE UNDERGRADUATE STUDENTS AT KENYATTA UNIVERSITY, KENYA
Authors: Waweru Grace , Chege Peter , Njogu Eunice
Published: August 2019

Background

The rapid changes in eating habits and lifestyles in Kenya have resulted to the overweight/obesity transition. Students are likely to make poor food choices which may affect their nutrition status during the beginning of college and this may continue throughout their life. This study aimed to establish the dietary practices, assess nutrition status based on body mass index and the relationship between selected dietary practices and nutrition status of female undergraduate students at Kenyatta University, Kenya.

Methods
The study adopted a cross-sectional analytical design involving sample of 422 female undergraduate students randomly selected from Kenyatta University. Food Frequency Questionnaire and the Minimum Dietary Diversity – Women were used to assess dietary practices. Weight and height were measured to assess the nutrition status of the female students.

Results

The results showed that 64.0% of the participants had consumed ≥ 5 food groups while 36% had consumed <5 food groups over a period of 24 hours. In terms of nutrition status, 68.4% of the participants had normal BMI while 23.9% were overweight, 5.55% were underweight and 2.3% were obese. MDDS-W was significantly associated with nutrition status (p=0.044).

Conclusion

The results illustrated unhealthy eating habits and sub-optimal nutrition status among a significant number of the female students. Policy makers should scale up interventions that would help improve dietary practices of women of reproductive age particularly university students.
Staff expectations for the implementation of an electronic patient record system: A qualitative study
Authors: mccrorie carolyn , Benn Jonathan , Johnson Owen , Scantlebury Arabella
Published: August 2019

Background

Global evidence suggests benefits of introducing electronic patient record (EPR) systems to improve patient care. However, implementing EPR into healthcare organisations is complex and in the United Kingdom (UK), uptake has been slow. More research is needed to explore factors influencing successful implementation. This study explored staff expectations for change and outcome following procurement of an EPR system in a large academic acute NHS trust in the UK.

Methods

Qualitative interviews were conducted with 14 members of hospital staff who represented a variety of user groups across different specialities within an NHS hospital in England. The four components of Normalisation Process Theory (Coherence, Cognitive participation, Collective action and Reflexive monitoring) provided a theoretical framework to interpret and report study findings.

Results

Health professionals had a common understanding for the rationale for EPR implementation (Coherence). There was variation in willingness to engage with and invest time into EPR (Cognitive participation) at an individual, professional and organisational level. Collective action (whether staff feel able to use EPR) was influenced by context and perceived user-involvement in EPR design and planning of the implementation strategy. When appraising EPR (Reflexive monitoring), staff anticipated short and long-term benefits. Staff perceived that quality and safety of patient care would be improved with EPR implementation, but that these benefits may not be immediate. Some staff perceived use of the system during early implementation to negatively impact patient care. The findings indicate that preparedness for EPR use could mitigate perceived threats to the quality and safety of care.

Conclusions

Health professionals looked forward to reaping the benefits from EPR use. Variations in level of engagement suggest early components of the implementation strategy were effective, and that more work was needed to involve users in preparing them for use. A clearer understanding as to how staff groups and services differentially interact with EPR as they go about their daily work was required. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EPR implementation to reduce concerns for quality and safety of patient care and improve the chance of successful implementation.
Predicting Hospitalization following Psychiatric Crisis Care using Machine Learning
Authors: Blankers Matthijs , Post Louk F. M. van der , Dekker Jack J. M.
Published: August 2019

Background: It is difficult to accurately predict whether a patient on the verge of a potential psychiatric crisis will need to be hospitalized. Machine learning may be helpful to improve the accuracy of psychiatric hospitalization prediction models. In this paper we evaluate and compare the accuracy of ten machine learning algorithms including the commonly used generalized linear model (GLM/logistic regression) to predict psychiatric hospitalization in the first 12 months after a psychiatric crisis care contact, and explore the most important predictor variables of hospitalization.

Methods: Data from 2,084 patients with at least one reported psychiatric crisis care contact included in the longitudinal Amsterdam Study of Acute Psychiatry were used. The accuracy and area under the receiver operating characteristic curve (AUC) of the machine learning algorithms were compared. We also estimated the relative importance of each predictor variable. The best and least performing algorithms were compared with GLM/logistic regression using net reclassification improvement analysis. Target variable for the prediction models was whether or not the patient was hospitalized in the 12 months following inclusion in the study. The 39 predictor variables were related to patients’ socio-demographics, clinical characteristics and previous mental health care contacts.

Results: We found Gradient Boosting to perform the best (AUC=0.774) and K-Nearest Neighbors performing the least (AUC=0.702). The performance of GLM/logistic regression (AUC=0.76) was above average among the tested algorithms. Gradient Boosting outperformed GLM/logistic regression and K-Nearest Neighbors, and GLM outperformed K-Nearest Neighbors in a Net Reclassification Improvement analysis, although the differences between Gradient Boosting and GLM/logistic regression were small. Nine of the top-10 most important predictor variables were related to previous mental health care use.

Conclusions: Gradient Boosting led to the highest predictive accuracy and AUC while GLM/logistic regression performed average among the tested algorithms. Although statistically significant, the magnitude of the differences between the machine learning algorithms was modest. Future studies may consider to combine multiple algorithms in an ensemble model for optimal performance and to mitigate the risk of choosing suboptimal performing algorithms.
Genetic characterization of highly pathogenic avian influenza A (H5N8) virus isolated from domestic geese in Iraq, 2018
Authors: Saeed Nahla M. , Rashid Peshnyar M.A. , Dyary Hiewa Othman
Published: August 2019

After the circulation of H5N1 in 2006, 2015 and 2016 in Iraq, a new H5N8 influenza virus emerged in Iraq in 2018. In this study, a HPAI virus subtype H5N8 was identified from backyard domestic geese in Kurdistan region, Iraq. Phylogenic analyses of the hemagglutinin (HA) and neuraminidase (NA) genes indicated that Iraq H5N8 viruses belonged to clade 2.3.4.4 group B and clustered with isolates from Iran, Israel and Belgium. Genetic analysis of HA of the Iraq H5N8 indicated molecular markers for avian-type receptors. Characterization of the NA gene showed that the virus had sensitive molecular markers for antiviral drugs. This is the first study ever on H5N8 in Iraq and it is crucial to understand the epidemiology of the viruses in Iraq and the Middle East. The results are suggestive of a possible role of migratory birds in the introduction of HPAI subtype H5N8 into Iraq.
Carbapenems-resistant Pseudomonas aeruginosa bloodstream infection in Hematopoietic stem cell transplant patients: in vitro synergy and clinical outcome
Authors: Ramos Jessica Fernandes , Leite Gleice Cristina , Martins Roberta Cristina Ruedas , Rizek Camila , Sanabani Sabri Saeed Al , Guimarães Thais , Levin Anna Sara , Rocha Vanderson , Costa Silvia
Published: August 2019

Summary

Bloodstream infection (BSI) caused by Pseudomonas aeruginosa has high mortality in hematopoietic stem cell transplant (HSCT) recipients. Objectives: To evaluate clinical, in vitro synergy and molecular features of 30 BSI caused by carbapenems-resistant P. aeruginosa (CRPA) in HSCT patients. Methods: Demographic and clinical data including treatment were collected and a database was built using EPIINFO, bivariate and multivariate analysis were run to assess outcome using SPSS. In vitro synergy using time-kill assays, pulsed-field electrophoresis (PFGE) and PCR for carbapenemases and virulence genes were performed for all isolates. Whole genome sequence (WGS) of main clones was done by Nextera XT, using Illumina MiSeq technology. Results: Mortality was 71%; most patients who died were allogeneic HSCT (78%) (p=0.02). Clinical isolates showed a high resistance level to meropenem: 50% had a MIC of 512 µg/mL; two thirds were susceptible to amikacin (MIC 2-512 µg/mL) and 100% to colistin. Many (17/30) isolates achieved synergistic effect with meropenem plus colistin but not with amikacin. None antagonism was observed. The presence of synergy by time-kill between colistin and meropenem showed a tendency towards a better outcome (HR 0.68 95%CI 0.02-1.02; p=0.06). The most frequent carbapenemase gene identified was blaSPM, and six co-harboured both blaKPC and blaSPM. Isolates presented genes related with virulence factors such as toxA, exoS and more patients with BSI caused by P. aeruginosa harbouring gene lasB evolved to death. The WGS showed that all five clones harboured SPM-1, Tn4371 and belonged to ST277; however, the resistance and virulence genes differ among the clones. Conclusion: CRPA BSI showed high mortality in HSCT patients. All clones carried SPM-1, Tn4371 and belonged to ST277. Synergy by time-kill between colistin and meropenem showed a tendency towards a better outcome
Exploring the success of Brazilian endemic clone Pseudomonas aeruginosa ST277 and its association with the CRISPR-Cas system type I-C
Authors: Silveira Melise Chaves , Rocha-de-Souza Cláudio Marcos , Albano Rodolpho Mattos , Santos Ivson Cassiano de Oliveira , Carvalho-Assef Ana Paula D'Alincourt
Published: August 2019

Background

The Brazilian endemic clone Pseudomonas aeruginosa ST277 carry important antibiotic resistance determinants, highlighting the gene coding for SPM-1 carbapenamase. However, the resistance and persistence of this clone is apparently restricted to Brazilian territory. To completely understand the differences between strains from Brazil from the ones isolated in other countries, we phylogenetically examined 43 P. aeruginosa ST277 genomes as well as analyzed virulence and resistance genes, evaluated the distribution of genomic islands and assessed in detail the characteristics of the CRISPR-Cas immunity system in these isolates.

Results

The Brazilian genomes presented a typical set of resistance and virulence determinants, genomic islands and a high frequency of the CRISPR-Cas system type I-C. Upon phylogeny results, even if ST277 genomes are closely related we can see important differences among the strains isolated from China, Mexico and United States when compared to others, most of them from Brazil. We also observed a standard CRISPR spacers content for ST277, confirming a strong link between phylogeny and spacer acquisition.

Conclusions

Based on our findings, Pseudomonas aeruginosa ST277 strains circulating in Brazil have acquired a few distinctive genetic elements that contributing to their resistance, pathogenicity and success when compared to strains from other countries.