bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study
Authors: Gad Ahmed Ibrahim , Elmedames Mohamed Rezk , Abdelhai Ayman Ramadan , Marei Ayman Mohamed
Published: June 2020

Background

The association between vitamin D levels and non-alcoholic fatty liver disease (NAFLD) has been increasingly determined in recent researches. The aim of this study was to determine the association between vitamin D levels, measured as serum 25-hydroxy vitamin D (25(OH)D) and NAFLD. Serum 25(OH)D was prospectively determined in 80 patients. Of them, 40 subjects had NAFLD, whereas 40 subjects served as healthy control. Vitamin D deficiency was defined as serum 25(OH)D level < 20 ng/ml. Receiver operating characteristic (ROC) and regression analysis methods were used in our analysis.

Results

About 70% of patients with NAFLD had vitamin D deficiency, but only 35% in the control group had. The mean serum 25 (OH)D was significantly lower in patients with NAFLD than the healthy control group (16.13 ± 10.23 versus 27.35 ± 10.58 ng/mL; P < 0.001). ROC curve analysis revealed that serum 25(OH)D level of less than 11.2 ng/ml increases the risk of NAFLD with 45% sensitivity and 97.5% specificity (Serum 25(OH)D level ≤ 18.1 ng/ml in males and ≤ 9.4 ng/ml in females increase the risk of NAFLD). Multivariate regression analysis showed that vitamin D deficiency, high age, and high BMI were associated with a significant high risk of NAFLD.

Conclusion

NAFLD patients have low serum vitamin D concentrations, suggesting that vitamin D may have a role in the development of NAFLD. Future studies are recommended to determine the important therapeutic implications of vitamin D for the prophylaxis or the treatment of NAFLD.
Value-based healthcare in mental health services
Authors: Baggaley Martin Roger
Published: June 2020

In value-based healthcare (VBHC) value is defined as outcomes that matter to patients divided by the cost of achieving these outcomes. Value is measured for discrete medical conditions across the whole cycle of care. Data on the value achieved by different providers is openly shared. Providers increase value using quality improvement (QI) techniques to improve outcomes, reduce costs or both. Patients or commissioners choose the provider achieving the greatest value. Units should compete regionally or nationally. There are challenges to implementing such ideas in the mental health services in the UK. However, measuring outcomes, understanding costs and using QI to drive up value may be possible without adopting the complete model that has developed in the context of a North American and acute hospital healthcare system.
Volumising value: value-based healthcare and its coming of age
Authors: Wallang Paul
Published: June 2020

Value-based healthcare holds great potential to transform healthcare globally. This commentary reviews the historical milestones in its evolution and raises critical questions regarding how it should proceed.
Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed
Authors: Shamsi Uzma , Khan Shaista , Azam Iqbal , Usman Shaheryar , Maqbool Amir , Gill Tiffany , Iqbal Romaina , Callen David
Published: June 2020

PURPOSE

Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them.

METHODS

Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review.

RESULTS

The mean (standard deviation) age of patients with breast cancer was 48.0 (12.3) years. The mean (standard deviation) patient delay was 15.7 (25.9) months, with 55.2% of women detecting a breast lump but not seeking a medical consultation because of a lack of awareness about the significance of the lump. A total of 9.4% of the women decided to seek treatment initially using complementary and alternative medicine and traditional treatment; 9.4% of the women presented to a health care provider with a breast lump but no action was taken, and they were wrongly reassured about the lump without mammography or biopsy. For 26% of the women, the delay in presentation was caused by anxiety, fears and misconceptions regarding diagnosis and treatment, and other social factors including possible adverse effects on their relationship with their husband. Multivariable analysis showed a strong association of lower socioeconomic status (odds ratio [OR], 8.11 [95% CI, 2.46 to 26.69]) and late stage of breast cancer (OR, 4.83 [95% CI, 1.74 to 13.39]) with a patient delay of ≥ 3 months.

CONCLUSION

Patient delay is a serious problem in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education that addresses the myths and misconceptions related to breast cancer.
Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial
Authors: Abbas Syed Tatheer , Raza Ahmad , Ch Ihtasham Muhammad , Hameed Tahira , Hasham Nausheen , Arshad Naveed
Published: June 2020

Background and Objectives: Milligan Morgan Hemorrhoidectomy is one of the most commonly performed surgeries. Post-operative pain is the major cause of morbidity in post hemorrhoidectomy patients. Metronidazole has an established role in relieving post hemorrhoidectomy pain. The objective was to evaluate the pain score by using topical and oral metronidazole in post Milligan Morgan hemorrhoidectomy patients.

Methods: A prospective randomized controlled trail was done in surgical departments of Akbar Niazi Teaching Hospital, Islamabad. A total of 166 consecutive patients with 3rd and 4th degree hemorrhoids were presenting in surgical OPD and who underwent Milligan Morgan hemorrhoidectomy between July 2018 and December 2018 were included in the study. Patients allocated in two groups, Group-A received topical metronidazole 10% post hemorrhoidectomy for seven days and Group-B were given oral metronidazole 400mg for 07 days. Analgesics were given on patient’s requirement. Patients post hemorrhoidectomy pain was recorded by using VSA scale at baseline (1st day) and on 7th post-operative day. Data analysis was done by using SPSS 21. Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Association between demographic details like gender and ages of the patients with pain scale on 7th day was measured and chi-square distribution was used.

Results: Total 166 patients were included in this study. The mean ages of the patients were 44.07±10.62 years with minimum 20 and maximum 60 years. Out of 166 patients, female were 55 (33.1%) and male were 111 (66.9%). Results showed significantly lower pain in patients using topical metronidazole as compared to oral metronidazole (p=0.001). Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028).

Conclusion: These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids.

doi: https://doi.org/10.12669/pjms.36.5.1796

How to cite this:Abbas ST, Raza A, Chaudhry I, Hameed T, Hasham N, Arshad N. Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. Pak J Med Sci. 2020;36(5):867-871.  doi: https://doi.org/10.12669/pjms.36.5.1796

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
H μεταναστευτική αισθητική ως πολιτική στρατηγική στο πεδίο της τέχνης: Διεθνικότητα, υβριδισμός και διαπολιτισμικότητα στη Διαρκή αναχώρηση της Πέτρα Γκόινγκ (Τσαγγάρη, 2000)
Authors: Petsa Vasiliki
Published: June 2020

Το παρόν άρθρο διερευνά τους όρους και τις προϋποθέσεις διαμόρφωσης μιας αισθητικής με πολιτικά δραστικό περιεχόμενο στην παρούσα συγκυρία της αυξανόμενης παγκόσμιας διασυνδεσιμότητας. Εστιάζοντας στο πεδίο της κινηματογραφικής δημιουργίας, και μέσα από το πρίσμα του «διαπολιτισμικού κινηματογράφου» και του «ανεξάρτητου διεθνικού είδους», πραγματοποιείται μια αναλυτική προσέγγιση της ταινίας Η διαρκής αναχώρηση της Πέτρα Γκόινγκ [The Slow Business of Going] της Αθηνάς-Ραχήλ Τσαγγάρη (2000), η οποία προάγει τη «μεταναστευτική αισθητική», καθώς ενεργοποιεί τον υβριδισμό και τη διαπολιτισμικότητα στο πλαίσιο μιας αγωνιστικής πολιτικής στρατηγικής.
Πολιτισμός και οικονομία: διαμορφώνοντας ένα πλαίσιο πολιτιστικής διαχείρισης της μουσικής παραγωγής στην οικονομική κρίση
Authors: Papanikolaou Dimitris
Published: June 2020

Το παρόν άρθρο είναι αποτέλεσμα μεταδιδακτορικής έρευνας που διενεργήθηκε σε συνεργασία με το Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης την περίοδο 2016-2018. Παρουσιάζει ποιοτικά συμπεράσματα για τους κλάδους της δισκογραφίας και των συναυλιών την περίοδο της οικονομικής κρίσης καθώς και ποσοτικά ευρήματα διαδικτυακής έρευνας κοινού σχετικά με τη μουσική κατανάλωση. Με βάση αυτά, το άρθρο θεμελιώνει ως βασική του θέση ότι η διαμόρφωση πολιτικής με αναπτυξιακό πρόσημο για τη μουσική παραγωγή στο τρέχον περιβάλλον της οικονομικής ύφεσης χρειάζεται να στηριχθεί στη φιλοσοφία που διέπει ένα πολιτιστικό οικοσύστημα παρά μια δημιουργική βιομηχανία.
Η αξιοποίηση των Τεχνολογιών Πληροφορικής και Επικοινωνιών από την τοπική αυτοδιοίκηση στις εφαρμογές της κοινωνικής πολιτικής. Το παράδειγμα εφαρμογής σε δήμους της Περιφέρειας Ηπείρου.
Authors: Daflou Ekaterini
Published: June 2020

Η διδακτορική διατριβή που παρουσιάζεται εκπονήθηκε στο Τμήμα Κοινωνικής Πολιτικής, της Σχολής Πολιτικών Επιστημών του Παντείου Πανεπιστημίου και υποστηρίχθηκε τον Οκτώβρη του 2016. Η τριμελής συμβουλευτική επιτροπή στελεχώθηκε από τον Καθηγητή του Παντείου Πανεπιστημίου κ. Α. Μωυσίδη (επιβλέπων), τον Καθηγητή του Εθνικού Μετσόβιου Πολυτεχνείου κ. Ι. Καλογήρου (μέλος της συμβουλευτικής επιτροπής) και τον Επίκουρο Καθηγητή του Παντείου Πανεπιστημίου κ. Κ. Δημουλά (μέλος της συμβουλευτικής επιτροπής). Η διατριβή εξετάζει το πρόβλημα του τόπου στην άσκηση της κοινωνικής πολιτικής.
Η πανδημία Covid-19: Επιταχυντής των ανισοτήτων και εγκαταστάτης νέων μορφών ανισοτήτων
Authors: Zissi Anastasia , Chtouris Sotiris
Published: June 2020

N/A
Προλογικό σημείωμα: συνομιλώντας για την πανδημία
Authors: Afouxenidis Alex , Chtouris Sotiris
Published: June 2020

Στο παρόν –ένθετο– τεύχος της Επιθεώρησης, θα βρείτε κείμενα (μικρά ή μεγαλύτερα) σχετικά με την πανδημία και τις κοινωνικές επιπτώσεις αυτής λόγω της βαθιάς κρίσης που προκλήθηκε. Το τεύχος θα παραμείνει ανοικτό για όσο καιρό διαρκεί αυτή η κρίση έτσι ώστε κοινωνικοί και πολιτικοί επιστήμονες να μπορούν να γράψουν και να εκφράσουν την άποψη τους. Όλες και όλοι, ανεξάρτητα από την ειδικότητα τους, μπορούν να συνεισφέρουν στο διάλογο. Να σημειώσουμε εδώ ότι πολλά από τα κείμενα του τεύχους έχουν δοθεί σε τελική μορφή κατά τη περίοδο της καραντίνας και, συνεπώς, εκφράζουν μια (φωτογραφική) στιγμή της απώλειας της κανονικότητας.    Η κρίση φυσικά αφορά τη χώρα μας, την Ευρώπη και τον υπόλοιπο κόσμο και, ακριβώς, λόγω της παγκοσμιοποιημένης φύσης της έχει πολλαπλά χαρακτηριστικά (που εκφράζονται σε συλλογικό ή ατομικό επίπεδο) και αμέτρητες δυσκολίες ως προς το πώς αντιμετωπίζεται. Με αναφορά σε αυτό το ζήτημα, στο ακόλουθο κείμενο αποτυπώνονται ορισμένες σκέψεις –υπό τη μορφή διαλόγου– των συγγραφέων, καταλήγoντας σε μια (νέα;) πρόταση δέκα βασικών σημείων για την κοινωνιολογία και την έρευνα.
Career development for infection and immunity research in Uganda: a decade of experience from the Makerere University – Uganda Virus Research Institute research and training programme
Authors: Nakanjako Damalie , Zalwango Flavia , Wairagala Pamela , Luboga Fiona , Andia Biraro Irene , Bukirwa Victoria Diana , Mboowa Mary Gorrethy , Cose Steve , Seeley Janet , Elliott Alison
Published: June 2020

Background:The Makerere University/Uganda Virus Research Institute (UVRI) Centre of Excellence for Infection & Immunity Research and Training (MUII) is a collaborative programme supporting excellence in Infection and Immunity (I&I) research in Uganda. Set up in 2008, MUII aims to produce internationally competitive Ugandan and East African I&I research leaders, and develop human and infrastructural resources to support research and training excellence. We undertook an internal evaluation of MUII’s achievements, challenges and lessons learned between August 2008 and December 2019, to inform programmes seeking to build Africa’s health research expertise.

Methods:Quantitative data were abstracted from programme annual reports. Qualitative data were obtained in March and April 2019: a cross-sectional evaluation was undertaken among a purposefully selected representative sample of 27 trainees and two programme staff. Qualitative data was analysed according to pre-determined themes of achievements, challenges, lessons learned and recommendations for improvement.

Results:By December 2019, MUII had supported 68 fellowships at master’s-level and above (50% female: 23 Masters, 27 PhD, 15 post-doctoral, three group-leader fellows) and over 1,000 internships. Fellows reported career advancement, mentorship by experts, and improved research skills and outputs. Fellows have published over 300 papers, secured grants worth over £20m, established over 40 international collaborations, and taken on research and academic leadership positions in the country. Key lessons for success include the following: efficient administration provides an enabling environment; institutions need supportive policies for procurement, including provisions for purchases of specific biological research reagents from international manufacturers; strong international, multi-disciplinary collaboration provides a critical mass of expertise to mentor researchers in development; and mentorship catalyses young scientists to progress from graduate trainees to productive academic researchers, relevant to society’s most pressing health challenges.

Conclusions:Sustainable academic productivity can be achieved through efficient operational support, global collaboration and mentorship to provide solutions to Africa’s health challenges.
Association of food environment and cardiovascular mortality
Authors: Jhaveri Khushali , Krishnan Anand , Kir Devika , Chen Kai , Angraal Suveen
Published: June 2020

Background: The association between healthy dietary habits and cardiovascular health is well established; however, it is unknown whether access to healthy and sustainable food sources correlates with better cardiovascular mortality.

Methods: County-level data on Food Environment Index (FEI) for 2014 was retrieved from the County Health Rankings dataset. County-level data on cardiovascular diseases (CVD) mortality was obtained from the death registry files of the National Vital Statistics System. We used a linear regression model to assess the association between FEI and CVD mortality after adjusting for sex and race distributions, urban-rural distribution and median household income.

Results: Data were available for 3069 counties. The mean FEI was 7.0 (SD, 1.2) and mean CVD mortality (per 100,000 population) was 252.7 (95% CI, 247.1-258.3) across the United States in 2014. There was a significant inverse association between FEI and adjusted CVD mortality (P <0.001). Every unit increase in FEI corresponded to a decline in CVD mortality of 19.1 per 100,000 population.

Conclusions: Higher FEI correlates with reduced CVD mortality. Improving access to healthy sustainable food sources may help decrease cardiovascular mortality.
Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins
Authors: Abu Hasna Amjad , Pereira Da Silva Laiana , Pelegrini Fernanda Carvalho , Ferreira Cláudia Luísa Ribeiro , de Oliveira Luciane Dias , Carvalho Cláudio Antonio Talge
Published: June 2020

Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics. The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA).

Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05.

Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI.

Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.
Feasibility of informing syndrome-level empiric antibiotic recommendations using publicly available antibiotic resistance datasets
Authors: Leclerc Quentin J. , Naylor Nichola R. , Aiken Alexander M. , Coll Francesc , Knight Gwenan M.
Published: June 2020

Background:Antibiotics are often prescribed empirically to treat infection syndromes before causative bacteria and their susceptibility to antibiotics are identified. Guidelines on empiric antibiotic prescribing are key to effective treatment of infection syndromes, and need to be informed by likely bacterial aetiology and antibiotic resistance patterns. We aimed to create a clinically-relevant composite index of antibiotic resistance for common infection syndromes to inform recommendations at the national level.

Methods:To create our index, we used open-access antimicrobial resistance (AMR) surveillance datasets, including the ECDC Surveillance Atlas, CDDEP ResistanceMap, WHO GLASS and the newly-available Pfizer ATLAS dataset. We integrated these with data on aetiology of common infection syndromes, existing empiric prescribing guidelines, and pricing and availability of antibiotics.

Results: The ATLAS dataset covered many more bacterial species (287) and antibiotics (52) than other datasets (ranges = 8-11 and 16-32 respectively), but had a similar number of samples per country per year. Using these data, we were able to make empiric prescribing recommendations for bloodstream infection, pneumonia and cellulitis/skin abscess in up to 44 countries. There was insufficient data to make national-level recommendations for the other six syndromes investigated. Results are presented in an interactive web app, where users can visualise underlying resistance proportions to first-line empiric antibiotics for infection syndromes and countries of interest.

Conclusions:We found that whilst the creation of a composite resistance index for empiric antibiotic therapy was technically feasible, the ATLAS dataset in its current form can only inform on a limited number of infection syndromes. Other open-access AMR surveillance datasets are largely limited to bloodstream infection specimens and cannot directly inform treatment of other syndromes. With improving availability of international AMR data and better understanding of infection aetiology, this approach may prove useful for informing empiric prescribing decisions in settings with limited local AMR surveillance data
Low lung function in the developing world is analogous to stunting: a review of the evidence
Authors: Mishra Navya , Salvi Sundeep , Lyngdoh Tanica , Agrawal Anurag
Published: June 2020

Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world.

Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies.  The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines.

Results: Early life influences operate in synergism with environmental and nutritional factors to influence lung growth and development in children.  Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates and shared chronic inflammatory pathways indicated that the two conditions were analogous.

Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, where malnutrition lies at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. The common pathological mechanisms governing stunting and lung function deficits counter the idea of redefining the normal for lung function measurements.
The genome sequence of the channel bull blenny, Cottoperca gobio (Günther, 1861)
Authors: Bista Iliana , McCarthy Shane A. , Wood Jonathan , Ning Zemin , Detrich III H. William , Desvignes Thomas , Postlethwait John , Chow William , Howe Kerstin , Torrance James , Smith Michelle , Oliver Karen ,   Vertebrate Genomes Project Consortium, Miska Eric A. , Durbin Richard
Published: June 2020

We present a genome assembly for Cottoperca gobio (channel bull blenny, (Günther, 1861)); Chordata; Actinopterygii (ray-finned fishes), a temperate water outgroup for Antarctic Notothenioids. The size of the genome assembly is 609 megabases, with the majority of the assembly scaffolded into 24 chromosomal pseudomolecules. Gene annotation on Ensembl of this assembly has identified 21,662 coding genes.
Financial Reporting for Pollution Reduction Programs
Authors: Ertimur Yonca , Francis Jennifer , Gonzales Amanda , Schipper Katherine
Published: June 2020

We develop a conceptually grounded approach, based on the International Accounting Standards Board’s conceptual framework, to the accounting for the rights and obligations embodied in a cap-and-trade program. Under this approach, firms recognize allowances as intangible assets, initially measured at fair value with a credit to cash for purchased allowances and to a current period gain for allocated allowances; firms recognize current period expense and accrue liabilities, at fair value, as they emit; both asset and liability are remeasured at fair value at every reporting date. We apply our treatment and three alternative treatments, based on current practice and proposals considered by standard setters, to transaction-level data from the U.S. sulfur dioxide cap-and-trade program to calculate as-if financial statement outcomes using actual data. The alternative treatments result in noncomparable accounting for otherwise similar arrangements. To provide ex ante evidence on the effects of noncomparable accounting, we analyze reporting outcomes and show that alternative accounting treatments of the same arrangement result in meaningful differences in reported assets and liabilities, income volatility, and commonly used performance and leverage metrics. Because the financial reporting effects of noncomparable accounting are exacerbated by business combinations and plant-level purchases of allocated allowances that may have been initially recorded at zero, our analysis explicitly accounts for the effects of these transactions. Finally, we find that among the four accounting treatments we consider, reporting outcomes under our proposed approach are most aligned with investor perceptions, as indicated by the associations between the market value of equity and assets, liabilities, and income.

This paper was accepted by Shiva Rajgopal, accounting.
Preregistration adult nursing students' experiences of online learning: a qualitative study
Authors: Bramer Clare
Published: June 2020

Background:

Online learning (OL) is widely used in UK preregistration nursing programmes and the latest Nursing and Midwifery Council professional education standards state digital technology must be embedded in the curriculum. An exploration of preregistration adult nursing students' experiences of OL considers how technology supports learning theory and practice, and assists in designing and delivering effective OL in future programmes.

Aim:

This study aimed to explore preregistration adult nursing students' OL experiences.

Method:

Two focus groups with students were held and thematic analysis carried out.

Findings:

Three main themes emerged regarding OL: advantages, disadvantages and preferences. The main advantages included time, accessibility and convenience, being able to revisit learning and the variety of approaches. Disadvantages included inadequate communication, support and interaction. Students preferred an adequate balance of OL with traditional teaching, more communication, synchronous OL, preparation and support.

Conclusion:

OL is valuable to adult nursing students, providing convenience and flexibility. While it has advantages, the disadvantages and preferences require addressing to ensure future programmes are effective and meet nursing students' requirements.
Caring for older people with dementia in the emergency department
Authors: Watkins Sarah , Murphy Fiona , Kennedy Catriona , Graham Margaret , Dewar Belinda
Published: June 2020

Background:

Admission to an emergency department (ED) may expose the older person with dementia to a range of negative consequences, including a deterioration in their behavioural symptoms. The authors conducted a review of primary research relating to the experiences of older people with dementia, their carers and ED nurses, to understand how these experiences might inform nursing practice.

Methods:

Integrative review with a search of the electronic databases of Medline, CINAHL and PSYCHINFO using specified inclusion and exclusion criteria.

Results:

Three themes were identified: carers and older people with dementia—waiting and worrying; nurses juggling priorities; and strategies for improvement—taking a partnership approach.

Conclusion:

Older people with dementia may be exposed to disparities in treatment in the ED. A practice partnership between carers and ED nurses may help to prevent this. ED nurses need support to blend technical- and relationship-centred care. Participatory research exploring the experiences of older people with dementia, their carers and ED nurses is needed.
Burnout: a continuing problem
Authors: Foster Sam
Published: June 2020

Sam Foster, Chief Nurse, Oxford University Hospitals, considers how clinical supervision can be used to support staff during the COVID-19 pandemic to help prevent burnout
Chronic enterocutaneous fistula: management in the community setting
Authors: Evans Moira , Anders Tessa
Published: June 2020

Despite being aggravating and potentially embarrassing, enterocutaneous fistulas can be successfully managed, with patients being able to resume many of their normal daily activities while the fistula continues to drain. Nevertheless, the management of enterocutaneous fistulas in the community can pose many challenges to nurses, the most common being peri-fistula moisture-associated skin damage. This article presents fistula management plans, which can facilitate the long-term support of these patients, promoting patient comfort and adherence to treatment.
A Metrics Framework for Evaluating Microservices Architecture Designs
Authors: Al-Debagy Omar , Martinek P.
Published: June 2020

Microservices are becoming a more popular software architecture among companies and developers. Therefore, there is a need to develop methods for quantifying the process of measuring the quality of microservices design. This paper has created a novel set of metrics for microservices architecture applications. The proposed metrics are the Service Granularity Metric “SGM”, the Lack of Cohesion Metric “LCOM”, and the Number of Operations “NOO”. The proposed metrics measure the granularity, cohesion, and complexity of individual microservices through analyzing the application programming interface “API”. Using these metrics, it is possible to evaluate the overall quality of the design of microservices applications. The proposed metrics were measured on 5 applications with different sizes and business cases. This research found that the value for the SGM metric needs to be between 0.2 and 0.6. Besides, the value of LCOM metric for a microservice needs to be between 0 and 0.8 with less than ten operations per microservice. These findings can be applied in the decomposition process of monolithic applications as well.
GenDE: A CRF-Based Data Extractor
Authors: Kayed Mohammed , Shalaan Khaled
Published: June 2020

Web site schema detection and data extraction from the Deep Web have been studied a lot. Although, few researches have focused on the more challenging jobs: wrapper verification or extractor generation. A wrapper verifier would check whether a new page from a site complies with the detected schema, and so the extractor will use the wrapper to get instances of the schema types. If the wrapper failed to work with the new page, a new wrapper/schema would be re-generated by calling an unsupervised wrapper induction system. In this paper, a new data extractor called GenDE is proposed. It verifies the site schema and extracts data from the Web pages using Conditional Random Fields (CRFs). The problem is solved by breaking down an observation sequence (a Web page) into simpler subsequences that will be labeled using CRF. Moreover, the system solves the problem of automatic data extraction from modern JavaScript sites in which data/schema are attached (on the client side) in a JSON format. The experiments show an encouraging result as it outperforms the CSP-based extractor algorithm (95% and 96% of recall and precision, respectively). Moreover, it gives a high performance result when tested on the SWDE benchmark dataset (84.91%).
Optical transport for Industry 4.0 [Invited]
Authors: Sabella Roberto , Iovanna Paola , Bottari Giulio , Cavaliere Fabio
Published: June 2020

Industry 4.0 represents a new industrial revolution that will dramatically change the landscape in many sectors, including manufacturing and logistics. Robotics, machine intelligence, and new forms of connectivity are key ingredients of this paradigm. 5G mobile networks are expected to play a crucial role, supporting a lower cost per transported bit in air and a lower latency compared with 4G. 5G radio ensures different performance levels in very heterogeneous coverage situations, including a mix of indoor and outdoor contexts. Mobile network evolution requires new transport networks to address the new challenging requirements: increasing transmission capacity, compatibility with latency-critical applications, significantly reduced cost with respect to conventional metro network segments, lower energy consumption, and, in some cases, switching capabilities. Optical communications and networking will play a key role in these new transport scenarios, where tailored transmission techniques and network architectures are needed. This paper discusses the requirements and challenges that Industry 4.0 scenarios pose to optical communications and networking architectures. Performance of optical transmission schemes, tailored to support these new radio access networks, are detailed and benchmarked. A network test bed, focused on transport for vertical use cases, is described. Experimental results demonstrate the compliance of the proposed optical transport network with a latency-critical cloud robotics application, which presents industry-grade connectivity needs.
Self-heated fiber thermal lever sensor based on the temperature gradient inside a hermetic chamber
Authors: Gao Ran , Ye Jiansen , Lu Danfeng
Published: June 2020

A thermal convection-based fiber lever sensor is proposed and experimentally demonstrated. Instead of the solid or liquid mass found in a conventional lever sensor, a Co2+-doped microfiber is self-heated with a pump laser as the heat source, generating a symmetrical temperature profile inside a hermetic chamber due to thermal convection. The convection current generated by the temperature gradient remains in the opposite direction to gravity with different tilt angles, due to a natural convection effect acting as a “gas pendulum”. However, the locations of two micro-single mode fibers are asymmetric, corresponding to the central axis of the temperature gradient. Therefore, the tilt angle can be detected by interrogating the wavelength shift of the Michelson interferometer induced by the temperature difference. The experimental results show that a tilt-angle sensitivity of 95 pm/deg can be achieved. The proposed fiber-optic lever sensor possesses large dynamic range, low cost, and high sensitivity.
Terahertz magneto-optical effect of wafer-scale La: yttrium iron garnet single-crystal film with low loss and high permittivity
Authors: Li Yi-Lei , Li Teng-Fei , Wen Qi-Ye , Fan Fei , Yang Qing-Hui , Chang Sheng-Jiang
Published: June 2020

The wafer-scale La:YIG single crystal thick films were fabricated on a three-inch gadolinium gallium garnet (GGG) substrate by liquid phase epitaxy method. The terahertz (THz) optical and magneto-optical properties of La:YIG film were demonstrated by THz time domain spectroscopy (THz-TDS). The results show that a high refractive index of approximately 4.09 and a low absorption coefficient of 10–50 cm−1 from 0.1 to 1.6 THz for this La:YIG film. Moreover, the THz Faraday rotation effect of La:YIG film was measured by the orthogonal polarization detection method in THz-TDS system, which can be actively manipulated by a weak longitudinal magnetic field of up to 0.155 T. With 5 samples stacked together, the Faraday rotation angle varies linearly from −15° to 15°, and the Verdet constant of La:YIG is about 100 °/mm/T within the saturation magnetization. This magneto-optical single crystal thick film with large area shows low loss, high permittivity and strong magneto-optical effect in the THz regime, which will be widely used in magneto-optical polarization conversion, nonreciprocal phase shifter and isolator for THz waves.
Star sensor calibration with separation of intrinsic and extrinsic parameters
Authors: Fan Qiaoyun , He Kangkang , Wang Gangyi
Published: June 2020

The calibration method based on integrated modeling with intrinsic and extrinsic parameters is widely used for star sensors. However, the unified optimization of parameters results in the coupling between intrinsic and extrinsic parameters in this method, further influencing the calibration accuracy of the intrinsic parameters and causing certain limitations for the practical applications involving precise extrinsic parameters. A novel calibration method for star sensors with separation of intrinsic and extrinsic parameters is proposed in this paper to solve the issue. Firstly, the coupling form of intrinsic and extrinsic parameters in the integrated calibration model is analyzed, and the coupling degree is analyzed through the partial correlation coefficient (PCC). Then, on the basis of the analysis results, combined with the applications of star sensors in satellites and missiles, the extrinsic parameters coupled with the intrinsic parameters are separated individually, and the intrinsic and extrinsic parameters without coupling are optimized nonlinearly as a whole. The experimental results verify the validity of the proposed method.
224-Gbps single-photodiode PAM-4 transmission with extended transmitter bandwidth based on optical time-and-polarization interleaving
Authors: Zhang Xiaoling , Fu Yan , Kong Deming , Li Longsheng , Jia Shi , Wei Jin , Chen Chen , Zhang Chongfu , Qiu Kun , Hu Hao
Published: June 2020

We have proposed and demonstrated the optical time-and-polarization interleaving (OTPI) technique, which can effectively extend the transmitter bandwidth for an intensity modulation and direct detection (IM/DD) optical system. The 224-Gbit/s line-rate OTPI-PAM-4 signal is successfully transmitted over a 500-m standard single-mode fiber (SSMF) in the C band, using the transmitter with a bandwidth of 25 GHz and the receiver with a single photodiode. By using a 33%-return-to-zero (RZ) pulse train, a bit-error ratio (BER) below 7% hard-decision forward error correction (HD-FEC) threshold is achieved. BER below 20% soft-decision forward error correction (SD-FEC) threshold is also realized using a carrier suppressed return-to-zero (CSRZ) pulse train. The OTPI technique can also be used for more higher-order pulse amplitude modulation (PAM) formats, making it a promising technique for next-generation high-speed optical interconnects.
Experimental investigation of chirped amplitude modulation heterodyne ghost imaging
Authors: Pan Long , Deng Chenjin , Bo Zunwang , Yuan Xin , Zhu Daming , Gong Wenlin , Han Shensheng
Published: June 2020

We have constructed a chirped amplitude modulation heterodyne ghost imaging (CAM-HGI) experimental system that demonstrates a robust ability against background light in experiments. In the experiments, the background light is simulated by irradiating a spatiotemporal random modulated light field onto the target. The effects of background light, modulation depth and modulation duration of the signal light source on CAM-HGI are investigated experimentally. The results show that the quality of CAM-HGI can be improved by increasing the modulation depth and the modulation duration of the signal light source, and more importantly, an image with a good signal-to-noise ratio (SNR) can be achieved even when the irradiation SNR is lower than −30 dB. This technique of CAM-HGI has an important application prospect for laser imaging in strong background light environments.
High security OFDM-PON with a physical layer encryption based on 4D-hyperchaos and dimension coordination optimization
Authors: Zhao Jianye , Liu Bo , Mao Yaya , Ullah Rahat , Ren Jianxin , Chen Shuaidong , Jiang Lei , Han Shun , Zhang Jingyi , Shen Jiajia
Published: June 2020

In this article we have enhanced the security of an orthogonal frequency division multiplexed passive optical network (OFDM-PON) based on four dimensional (4D) encryption, including constellation, subcarrier, symbol and time, which is proposed for the first time in this paper. 4D-hyperchaotic mapping is used to generate four masking factors to achieve ultra-high security encryption in four different dimensions. During the encryption, dimension coordination optimization is adopted, which effectively reduces the time cost of the system and improves the encryption efficiency by 3 times. At the same time, probabilistic shaping (PS) technology is used to further optimize the system that has effectively improved the bit error performance by about 1 dB. The proposed encryption technique for OFDM-PON has been demonstrated successfully with the help of experiments. The generated OFDM signal is modulated by the quadrature amplitude modulation (QAM) technique, which transmitted 16 Gb/s data rate across a 25 km fiber span of standard single-mode fiber. The values of bit error rate (BER) and peak-to-average-power ratio (PAPR) are analyzed during the experiments, and the obtained results show that the proposed security-enhanced OFDM-PON has high sensitivity and security and can be well compatible with PS and OFDM technologies. The proposed scheme has very reliable security performance and also has excellent benefit improvement, which is very promising in the future PS-OFDM-PON.
Nonlinear underwater propagation of picosecond ultraviolet laser beams
Authors: Chen Yu-Hsin , Peterson J. Ryan , Johnson Luke A. , Jones Theodore G. , Hafizi Bahman , Stamm Alexander B. , Ting Antonio C. , Palastro John P. , Helle Michael H. , Kaganovich Dmitri
Published: June 2020

Meter-scale nonlinear propagation of a picosecond ultraviolet laser beam in water, sufficiently intense to cause stimulated Raman scattering (SRS), nonlinear focusing, pump-Stokes nonlinear coupling, and photoexcitation, was characterized in experiments and simulations. Pump and SRS Stokes pulse energies were measured, and pump beam profiles were imaged at propagation distances up to 100 cm for a range of laser power below and above self-focusing critical power. Simulations with conduction band excitation energy

U

C
B

=
9.5

e
V

, effective electron mass

m

e
f
f

=
0.2

m
e

, Kerr nonlinear refractive index

n
2

=
5

×

10

−
16

c
m

2

/

W

, and index contribution due to SRS susceptibility

n
2
r

=
1.7
×

10

−
16

c
m

2

/

W

produced the best agreement with experimental data.
Profile of antibiotic-resistant and presence of methicillin-resistant Staphylococcus aureus from nasal swab of dogs from several animal clinics in Surabaya, Indonesia
Authors: Decline Vega , Effendi Mustofa Helmi , Rahmaniar Reina Puspita , Yanestria Sheila Marty , Harijani Nenny
Published: June 2020

Aim: The research was to investigate the antibiotic resistance profile and to screen for methicillin-resistant Staphylococcus aureus (MRSA) from nasal mucosa swab of dogs.

Materials and Methods: The samples were collected from three pet clinics, three K9 units, one veterinary teaching hospital, and one kennel in Surabaya. Of the 50 total samples, 24 confirmed S. aureus strains, which were used for antibiotic sensitivity tests using a disk diffusion method and screening of MRSA used oxacillin resistance screening for base (ORSAB).

Results: This study showed that there were differences in antibiotic resistance patterns among different locations. Fourteen isolates were screened for MRSA by culture on ORSAB.

Conclusion: MRSA carriage was found on nasal swab of dogs, and dogs can act as reservoir of MRSA for spreading to human health.

Keywords: antibiotic-resistant, dogs, methicillin-resistant Staphylococcus aureus, Staphylococcus aureus.
IMMUNOPATHOLOGY AND IMMUNOPHARMACOTHERAPY OF CORONAVIRUS DISEASE 2019 (COVID-19): FOCUS ON INTERLEUKIN 6
Authors: Nasonov E. L.
Published: June 2020

The Coronavirus Disease 2019 (COVID-19) pandemic has drawn closer attention than ever before to the problems of the immunopathology of human diseases, many of which have been reflected when studying immune-mediated inflammatory rheumatic diseases (IIRDs). The hyperimmune response called a cytokine storm, the pathogenetic subtypes of which include hemophagocytic lymphohistiocytosis, macrophage activation syndrome, and cytokine release syndrome, is among the most serious complications of IIRDs or treatment for malignant neoplasms and may be a stage of COVID-19 progression. A premium is placed to interleukin-6 (IL-6) in the spectrum of cytokines involved in the pathogenesis of the cytokine storm syndrome. The clinical introduction of monoclonal antibodies (mAbs) that inhibit the activity of this cytokine (tocilizumab, sarilumab, etc.) is one of the major advances in the treatment of IIRDs and critical conditions within the cytokine storm syndrome in COVID-19. The review discusses data on the clinical and prognostic value of IL-6 and the effectiveness of anti-IL-6 receptor and anti-IL-6 mAbs, as well as prospects for personalized therapy of the cytokine storm syndrome in COVID-19.
RELATIONSHIP OF BONE MINERAL DENSITY AND VASCULAR WALL CONDITION WITH BIOCHEMICAL MARKERS OF INFLAMMATION IN POSTMENOPAUSAL WOMEN
Authors: Skripnikova I. A. , Alikhanova N. A. , Kolchina M. A. , Kosmatova O. V. , Novikov V. E. , Vygodin V. A. , Drapkina O. M.
Published: June 2020

Objective: to investigate the correlation of bone mass, the parameters of vascular stiffness and subclinical atherosclerosis with biochemical markers of inflammation in postmenopausal women. Subjects and methods. The cross-sectional investigation included 98 patients aged 45–82 years who were followed up in the outpatient setting and signed an informed consent. The investigation did not include patients with any clinical manifestations of atherosclerosis, malignant neoplasms, with diseases causing secondary osteoporosis, as well as with the presence of symptoms of acute bacterial or viral infections and an exacerbation of chronic diseases, who took drugs affecting bone metabolism and vascular stiffness. C-reactive protein (CRP) level was determined by a high-sensitive immunoturbidimetric assay using carboxylated polystyrene particles. interleukin (IL)-6 concentration was measured by an enzyme immunoassay. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (ASP) were studied with duplex scanning. Pulse wave velocity (PWV) and augmentation index (AI) were measured by applanation tonometry using a SphygmoCor device (AtCor Medical Pty. Ltd., Sydney, Australia). Lumbar spine and hip bone mineral density (BMD) was determined using dual energy X-ray absorptiometry. Results and discussion. There was an increase in the parameters of vascular stiffness, subclinical atherosclerosis, and CRP level and a decrease in bone mass with a longer length of menopause. The vascular stiffness parameters, including IMT (r=0.26; p<0.05), AI (r=0.25; p<0.05), the presence of ASP (r=0.24; p<0.05), and PWV (r=0.23; p<0.05), directly correlated with CRP level. A negative correlation was found between LI–IV BMD and CRP (r=-0.31; p<0.05). The probability of detecting increased IMT with a high CRP level was increased by 2.64 times, ASP by 3.18 times, and low BMD by 2.4 times. There was no association of bone mass, and the parameters of subclinical atherosclerosis and vascular stiffness with IL-6. Conclusion. Lower bone mass and the development of osteoporosis in postmenopausal women were associated with increased vascular stiffness and the presence of signs of subclinical atherosclerosis, and with a high level of CRP, which allows one to discuss the common mechanisms for development of osteoporosis and atherosclerosis, as well as the involvement of chronic inflammation in them.