bluuebunny/crossref_metadata_2025 huggingface dataset:
Los rasgos de la educación mediática en el nivel secundario: un estudio del caso argentino
Authors: Saez Virginia
Published: November 2019

This paper presents a qualitative analysis of secondary level curriculum designs from the Province of Buenos Aires, Argentina. The material was studied from the perspective of socio-educational discourse analysis. The results show that, in different subjects, media literacy education is proposed as a curricular content, while identifying different ways of including it in teaching proposals: linking school contents to topics that circulate in the media, using them as a source of information, problematizing discourses that circulate in the media, and using them as a tool for youth empowerment. It leaves for further research the characteristics of the media field (such as the concentration and convergence of property and forms of financing) that impact information that circulates in the media
Civismo e questão nacional em debate no monumento à Revolución de Mayo (Buenos Aires, Argentina)
Authors: Alves Ana Carolina Oliveira
Published: November 2019

Desde que se tornou capital da Argentina, a cidade de Buenos Aires foi alvo de ações que transformaram seu espaço urbano buscando expressar a nação. A Plaza de Mayo foi envolvida nesse processo de articulação entre narrativas nacionalistas e estratégias de base simbólica, do final do século XIX até início do XX, quando se aproximava o centenário da independência. Na primeira década da virada, foi lançado um concurso para o monumento à Revolución de Mayo a ser colocado na praça, substituindo o anterior monumento pátrio. Do concurso emergiram propostas de intervenção no espaço da Plaza – evidenciando concepções sobre a nação, seus principais “heróis” ou protagonistas e uma leitura da História argentina bastante específica, que buscava consolidar na memória coletiva os eventos relacionados à Revolución. Atentaremos aqui às análises feitas na Revista Técnica sobre os projetos, para tangenciar embates em torno da cidade e da compreensão de monumentos como forma de pedagogia cívica.
A cidade, o progresso e o espelho quebrado de Narciso
Authors: Costa Ricardo Felipe Santos da
Published: November 2019

Com o advento da República e o desenvolvimento da economia ligada ao café, verificam-se nas sessões da Câmara Municipal de São Paulo, de forma quase regular, referências orgulhosas ao progresso da cidade. Inspirando-se no método do historiador Michel de Certeau, porém, este artigo busca os desvios das falas, entre a cidade que se pretende, normatizada, e a cidade que se vive. A miséria que desfila nas ruas entre novos viadutos, praças arborizadas e o Theatro, não espelhava os ideais civilizatórios acalentados em uníssono pelos legisladores. Relativizando o bom ou mau gosto, frente às contradições de uma cidade narcisista, este estudo pretende colocar os seus esforços em analisar uma realidade urbana complexa, com os seus conflitos e representações.    Para tal, propõe-se trabalhar com a série documental constituída pelas Actas e Annaes da Câmara Municipal de São Paulo, além de jornais da época. O período cronológico contempla dois marcos legais: o Código Penal (1890) e o Código de Menores (1927). Assim, entre a compaixão e o amor de si próprio, com relação ao escândalo da miséria e a agonia dos que a vivem nas ruas, por fim, este artigo investiga o tratamento dado pela municipalidade à filantropia, bem como as suas intenções.
A experimentação fotográfica inventiva de Cássio Vasconcellos
Authors: Simão Selma Machado
Published: November 2019

Este artigo apresenta análises de um conjunto de fotografias pertencentes à obra   de Cássio Vasconcellos. O estudo foi desenvolvido através da abordagem fenomenológica e análise documental, além de entrevistas realizadas com o artista. Este artista brasileiro, nascido em São Paulo e reconhecido a nível nacional e internacional realiza em seu trabalho interfaces com propriedades das Artes Visuais que vão além da linguagem inicialmente escolhida por ele. São possibilidades perceptivas e processuais que adentram o campo pictórico e escultórico. Assim, através das aparições das obras verifica-se a confluência de linguagens atuantes de experiências estendidas. O estudo também se volta ao contexto contemporâneo dos procedimentos técnicos e expressivos do fazer artístico valendo-se da pesquisa que desvela manipulações artesanais e tecnológicas capazes de reunir: teoria, domínio técnico e sensibilidade estética.
O corpo-câmera
Authors: Delpeux Sophie
Published: November 2019

Neste texto que introduz sua obra, Le corps-caméra: le performer et son image, Sophie Delpeux se pergunta qual o lugar que as imagens de performance ocupam no contexto das artes corporais. Neste sentido, a autora nos conduz por um caminho reflexivo que nos faz ver nestes documentos de época, não um substituto da performance, mas uma outra instância legítima de experiência. Para este dossiê, Delpeux  acrescentou algumas linhas iniciais para nos dar conta do estado atual de sua pesquisa.
La Investigación sobre Biomedicina de Altura
Authors: García Cueva Roger Guerra
Published: November 2019

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Authorities of Preparation and Hospitality of Applications for Post-Conditions Post-Decision of Constitutional Court
Authors: Minarno Nur Basuki
Published: November 2019

The objective of Pre-Trial is basically to provide justice rights protection from abuse of power and the arbitrary actions of law enforcement officers. Pre-Trial is as the guard for the realization of due process of law. Hence, its authority is not limited to Article 77 of the Criminal Law Procedural Code and the decision of Constitutional Court No.21/PUU-XII/2014. The dismissal of Pre-Trial appeal as provided for in article 82 paragraph (1) sub-paragraph d of the Criminal Law Procedural Code and the decision of the Constitutional Court No.102/PUU-XII/2015 do not have a sufficient rational basis. Pre-Trial and principal case examination should not terminate each other. Conversely, the result of Pre-Trial will be used as a reference to analyze whether evidence used in the principal case examination is conducted properly or not. Thus, when a Pre-Trial examination is underway, the chief of a judge of the district court must adjourn the principal review of his case.
Application of Al-Ijarah Al-Maushufah Fi Al-Dzimmah for Infrastructure Project Financing in Indonesia
Authors: Felix Rega , Abubakar Lastuti
Published: November 2019

Islamic bank has a huge potential to involve in large project financing such as infrastructure. The demand for infrastructure provision in Indonesia is growing rapidly, so the Islamic bank should become one of the financial institutions for a financing infrastructure project. One of the products of Islamic bank is lease based contract or ijarah. In 2016, the Indonesian Islamic Scholars Council (MUI) enacted Fatwa that allowed ijarah contract for a forward obligation or called al-ijarah al-maushufah fi al-dzimmah (IMFD). IMFD has some characteristics that equitable for infrastructure project needs, such as for long term financing. The main issues in this research are to drawn a model for infrastructure project financing by applying IMFD and observe the readiness of Indonesian regulation to support the implementation of IMFD on infrastructure project financing. The type of research is the normative study, and the approach of this research having four methods approach among others are statute approach, conceptual approach, cases approach, and comparative approach. The results of this research are model for infrastructure project financing by applying IMFD is by combining musharakah-istishna’-ijarah (IMFD) and regulation in Indonesia is not ready enough to support the implementation of IMFD on infrastructure project financing because combination of three contracts like musharakah-istishna’-IMFD, implementation of liquidated damages in istishna’ contract, and allowance IMFD in infrastructure project are not regulated in Indonesia.
Regression Model for Bike-Sharing Service by Using Machine Learning
Authors: Wang Zhifeng
Published: November 2019

The bike sharing system has brought wide convenience to residents in the city and serves as important tools to transport from one place to another place. For the bike sharing companies, they need to know the total users of bike, so they can release suitable number of bikes into the market. This paper uses visualization technology to visualize data and figure out the possible factors which can impact the total number of users. After completing the data analyzing, this paper figures out the season, weather sit, feeling temperature, humanity and wind speed are the main factors which can have impacts on the total number of users. In the second stages, this paper uses regression model, NN model, ELM model and DELM model to predict the possible number of bike users. The input factors are season, weather sit, feeling temperature, humanity and wind speed. By analyzing regression model results, the ELM model has the best prediction, which can be used for real practice.
Unrelated Parallel-Machine Scheduling with Maintenance Activities and Rejection Penalties for Minimizing Total Cost
Authors: Yang Xiaona , Peng Can , Jin Lei , Li Qiangyi ,   College of Economics and Management, Nanjing University of Aeronautics and Astronautics 29 Jiangjun Road, Jiangning District, Nanjing City, Jiangsu 211106, China,   Management School, Henan University of Science and Technology, Henan, China,   College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
Published: November 2019

During the production process, regular maintenance is necessary and important to maintain high efficiency, because machines inevitably fail with increasing use. However, certain tasks are often neglected due to time and budget constraints, and other factors. In this regard, we propose the unrelated parallel-machine scheduling problem with maintenance and rejection penalties, wherein the ultimate objective is to minimize total cost while identifying the optimal maintenance frequencies, optimal maintenance positions, set of rejected jobs, and optimal scheduled job sequence. Considering resource constraints, the maintenance cost is controlled by the upper bound of the total maintenance frequency. Based on these factors, the optimal polynomial-time solution and its computational complexity with a fixed number of machines are presented. As an illustrative example, it was determined that the scheduling method proposed in this report is effective and practical.
Gap Detection Using Convolutional Neural Network and Adaptive Control in Robotic Plasma Welding
Authors: Yamane Satoshi ,   Department of Environmental Science and Technology, Saitama University 255 Shimo-okubo, Sakura-ku, Saitama-shi, Saitama 338-8570, Japan, Matsuo Kouki
Published: November 2019

Welding is an essential technology for joining metal plates. In general, gas metal arc welding (GMAW) generates a large amount of fumes in the welding of thick metal plates. In contrast, the butt joining of thick metal plates can be achieved using plasma arc welding (PAW) with a lower amount of fumes. Further, the improvement of the welding environment is critical in welding. In particular, if there are gaps between the base metals, the welding conditions are adjusted based on the gap. A visual sensor, such as a complementary metal-oxide-semiconductor (CMOS) camera, is useful for observing the welding situation. In this study, such a camera was attached to a plasma torch. During welding, we obtained weld pool images using the camera and detected the gaps by processing the images. As the arc light is very intense, it is difficult to obtain a clear image of the weld pool in PAW. In conventional welding, a constant current is used; however, pulsed welding current is used herein to obtain a clear image. The frequency of the current is 20 Hz, which indicates that the interval time is 50 ms. Moreover, the welding current was reduced to 30 A to minimize the effect of the intense arc light while the shutter of the CMOS camera was opened. The exposure time of the CMOS camera is 1 ms. Furthermore, gaps can be detected through image processing. It is necessary to identify the base metals with or without a gap. It was observed that the gap is darker than the solid area of the base metal. Moreover, a gap can be detected through the binarization method. The center area is not dark in the image of the weld pool without the gap. As the image of the weld pool is uneven without a gap, the binarization method can provide a detection result with some errors. Hence, it is challenging to identify whether there is a gap. A convolutional neural network (CNN) is useful for analyzing images. Thus, we applied a CNN to the weld pool image. If the gap is identified using the CNN, the binarization method is used to obtain the gap width. Hence, in PAW, welding conditions are adjusted based on the gap.
Links of the Supplemental Nutrition Assistance Program With Food Insecurity, Poverty, and Health: Evidence and Potential
Authors: Keith-Jennings Brynne , Llobrera Joseph , Dean Stacy
Published: November 2019

The Supplemental Nutrition Assistance Program (SNAP) is a highly effective program, vital to our nation’s health and well-being. SNAP’s entitlement funding structure allows it to provide benefits to anyone who meets the program’s eligibility requirements, and this structure also enables SNAP to respond quickly when need increases. Research shows that SNAP reduces poverty for millions, improves food security, and is linked with improved health.

Despite SNAP’s successes, there is room to build on its considerable accomplishments. Evidence suggests that current benefit levels are not adequate for many households. Some vulnerable groups have limited SNAP eligibility, and some eligible individuals face barriers to SNAP participation.

Policymakers should address these shortcomings by increasing SNAP benefits and expanding SNAP eligibility to underserved groups. The federal government and states should also continue improving policies and procedures to improve access for eligible individuals.
Diversity in Orthopaedic Surgery: International Perspectives
Authors:   The Carousel Presidents
Published: November 2019

Orthopaedic surgery in the United States is one of the few medical specialties that has consistently lacked diversity in its training programs and workforce for decades, despite increasing awareness of this issue. Is this the case in other English-language speaking countries? Are there inherent national differences, or does orthopaedics as a profession dictate the diversity landscape around the globe?

The Carousel group includes the presidents of the major English-language-speaking orthopaedic organizations around the globe—Australia, Canada, New Zealand, South Africa, the United Kingdom, and the United States. Established in 1952, members of this group attend each other’s annual scientific meetings during the year of their presidency, learning about our profession in each country and building international relationships. In this article, 13 Carousel presidents from different countries explore diversity in orthopaedics in their training programs and the workforce, with an assessment of the current state and ideas for improvement.
Oblique Lateral Closing-Wedge Osteotomy for Cubitus Varus in Skeletally Immature Patients
Authors: Greenhill Dustin A. , Kozin Scott H. , Kwon Michael , Herman Martin J.
Published: November 2019

Background:

We perform an oblique lateral closing-wedge osteotomy of the distal end of the humerus to correct cubitus varus deformity in children. This deformity is often the consequence of undertreatment, malreduction, or malunion of supracondylar humeral fractures
1
. Although standard arcs of motion may be altered, cosmesis was traditionally considered a primary surgical indication. However, uncorrected cubitus varus leads to posterolateral rotatory instability of the elbow (PLRI)
2
, lateral condylar fractures
3
, snapping medial triceps, and ulnar nerve instability
4
. A contemporary understanding of these delayed sequelae has expanded our current indications. Detailed parameters predictive of late sequelae are needed to further specify surgical indications.

Description:

We remove an oblique lateral closing wedge from the distal end of the humerus via a standard lateral approach. The osteotomy is angled away from the varus joint line such that lateral cortices after reduction lack prominence. Kirschner wires provide adequate fixation in young patients. In older children, extension is simultaneously corrected, and fragments are stabilized via plate osteosynthesis.

Alternatives:

Patients who decline surgery are counseled regarding risks of delaying treatment until symptoms are present. PLRI manifests as lateral elbow pain or instability while rising from a chair. Once symptomatic, the lateral ulnar collateral ligament (LUCL) is irreversibly attenuated and morphologic changes in the ulnohumeral joint necessitate more extensive surgery to include distal humeral osteotomy, LUCL reconstruction, and possibly ulnar nerve transposition
5
. Alternative osteotomy techniques are described and categorized as simple lateral closing wedge, step-cut
6–9
, dome, 3-dimensional
10
, or distraction osteogenesis. Simple closing-wedge osteotomies include a distal cut parallel to the joint line and retain a problematic lateral prominence (if the medial cortex is intact or the distal end of the humerus is not translated medially)
11,12
. Step-cut osteotomies theoretically minimize this lateral prominence while enhancing inherent stability. However, these additional cuts mandate wide surgical exposure despite similar outcomes
13
. Three-dimensional planning employs computed tomography to create expensive anatomic cutting guides that address varus, extension, and internal rotation. However, residual internal rotation is generally well tolerated, derotation is associated with loss of fixation, and the extension deformity will successfully remodel in patients who are <10 years old
14
. We employ 3-dimensional planning in skeletally mature patients with complex deformity and no remodeling potential.

Rationale:

The oblique lateral closing wedge is ideal for skeletally immature patients because it is simple, reproducible, and efficient. It avoids the lateral prominence without increasing complexity or complications.
Mini-Open Access for Lateral Lumbar Interbody Fusion
Authors: Salzmann Stephan N. , Fantini Gary A. , Okano Ichiro , Sama Andrew A. , Hughes Alexander P. , Girardi Federico P.
Published: November 2019

Background:

Lateral lumbar interbody fusion (LLIF) is a relatively new procedure. It was established as a minimally invasive alternative to traditional open interbody fusion. LLIF allows the surgeon to access the disc space via a retroperitoneal transpsoas muscle approach. Theoretical advantages of the LLIF technique include preservation of the longitudinal ligaments, augmentation of disc height with indirect decompression of neural elements, and insertion of large footprint cages spanning the dense apophyseal ring bilaterally
1,2
. The original 2-incision LLIF technique described by Ozgur et al., in 2006, had some inherent limitations
3
. First, it substantially limited direct visualization of the surgical field and may have endangered nerve and vascular structures. Additionally, it often required multiple separated incisions for multilevel pathologies. Finally, for surgeons with experience in traditional open retroperitoneal surgery, utilization of their previously acquired skills may have been difficult with this approach. To overcome these limitations, we adopted the mini-open lateral approach, which allows for visualization, palpation, and electrophysiologic neurologic confirmation during the procedure
4
.

Description:

As detailed below, the patient is positioned in the lateral decubitus position and a single incision is carried out centered between the target discs. For single-level LLIF, the incision spans approximately 3 cm and can be lengthened in small increments for multilevel procedures. After blunt dissection, the retroperitoneal space is entered. The psoas muscle is split under direct visualization, carefully avoiding the traversing nerves with neurosurveillance
5
. A self-retaining retractor is used, and after thorough discectomy, the disc space is sized with trial components. The implant is filled with bone graft materials and is introduced using intraoperative fluoroscopy.

Alternatives:

The 2-incision LLIF technique or traditional anterior or posterior lumbar spine interbody fusion techniques might be used instead.

Rationale:

LLIF offers the reported advantages of minimally invasive surgery, such as reduced tissue trauma during the approach, low blood loss, shorter length of stay, decreased recovery time, and less postoperative pain. LLIF allows for the placement of a relatively larger interbody cage spanning the dense apophyseal ring bilaterally. The lateral approach preserves the anterior longitudinal ligament and posterior longitudinal ligament. These structures allow for powerful ligamentotaxis and provide extra stability for the construct. Compared with other approaches, LLIF has a reduced risk of visceral and vascular injuries, incidental dural tears, and perioperative infections. Although associated with approach-related complications such as motor and sensory deficits, LLIF can be a safe and versatile procedure
1,2
.
Arthroscopic Reconstruction of Multifragmented Anteroinferior Glenoid Rim Fractures
Authors: Maziak Nina , Minkus Marvin , Krüger David , Scheibel Markus
Published: November 2019

Background:

The optimal treatment of anteroinferior glenoid rim fractures remains a matter of debate. Surgical repair aims to prevent persistent instability and osteoarthritic changes of the glenohumeral joint
1–3
and is recommended in patients with a subluxated humeral head and substantial displacement of the fracture fragment(s)
3–5
. Arthroscopic reconstruction with suture anchors was described by Sugaya et al. for large solitary glenoid rim fractures using an indirect reduction and fixation via labral repair
6
. We present the arthroscopic reconstruction of a multifragmented anteroinferior glenoid rim fracture using a modified knotless anchor technique and bioabsorbable pins. The additional fixation and compression may improve reduction and consolidation of the fracture.

Description:

The patient is placed in the lateral decubitus position with the affected arm fixed in a traction device. A standard posterior, an anterosuperior (suprabicipital), and a deep anteroinferior portal are required for this minimally invasive technique. A posterolateral portal may be required additionally. First, a diagnostic arthroscopy is performed to identify possible concomitant lesions. Labral repair enables an indirect reduction of the attached fracture fragments and is achieved by the aid of knotless suture anchors. Temporary reduction using Kirschner wires can be applied. Bioabsorbable pins can be used for additional ultimate fixation and compression of the fracture fragments.

Alternatives:

A variety of surgical techniques for the reconstruction of glenoid rim fractures have been described in the literature, including open or arthroscopic screw osteosynthesis using either metallic or bioabsorbable screws
3,6–10
. Screw osteosynthesis, however, is not a feasible option for fractures with multiple small fragments
3
. Isolated suture anchor reconstruction represents another alternative
6
. Good clinical results and a high subjective satisfaction rate, however, can also be achieved by nonoperative treatment, depending on the patient and fracture characteristics
3,10–12
.

Rationale:

This minimally invasive technique enables an almost anatomical reconstruction of the glenoid rim with a minor risk of hardware impingement compared with screw osteosynthesis.
What influenced people with chronic breathlessness and advanced disease to take part and remain in a drug trial? A qualitative study.
Authors: Lovell Natasha , Etkind Simon N , Bajwah Sabrina , Maddocks Matthew , Higginson Irene J
Published: November 2019

Background Recruitment and retention in clinical trials remains an important challenge, particularly in the context of advanced disease. It is important to understand what affects retention to improve trial quality, minimise attrition and reduce missing data. We conducted a qualitative study embedded within a randomised feasibility trial and explored what influenced people to take part and remain in the trial. Methods Qualitative study embedded within a double blind randomised trial designed using a person-centred approach. Participants with cancer, Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), or Chronic Heart Failure (CHF), with a Modified Medical Research Council Dyspnoea Scale grade 3/4 were recruited from three UK sites. A convenience subsample completed qualitative interviews after the trial. Interviews were analysed using thematic analysis. Results were considered in relation to the core elements of person-centred care and our model of the person-centred trial. Results In the feasibility trial 409 people were screened for eligibility and 64 randomised. No participant was lost to follow up. 22 participants provided qualitative interviews. 11 had a diagnosis of COPD, 8 ILD, 2 CHF, and 1 lung cancer. Median age was 71 years (56-84). 16 were male. 20 had completed the trial, 2 withdrew due to adverse effects. The relationship between patient and professional, potential for benefit, trial processes and the intervention all influenced the decision to participate in the trial. The relationship with the research team and continuity, perceived benefit, and aspects relating to trial processes and the intervention influenced the decision to remain in the trial. Conclusions In this feasibility trial recruitment targets were met, attrition levels were low, and aspects of the person-centred approach were viewed positively by trial participants. Prioritisation of the relationship between the patient and professional, ensuring a person-centred trial design, and enabling people to participate by having processes in line with individual capabilities may support recruitment and retention in clinical trials in advanced disease. We would recommend the integration of a person-centred approach in all clinical trials.
“Being in good hands”: Next of kin’s perceptions of continuity of care in patients with heart failure
Authors: Östman Malin , Bäck-Pettersson Siv , Sandvik Ann-Helén , Sundler Annelie J
Published: November 2019

Background Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF. Methods This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n=15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon. Results The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities. Conclusions Next of kin perceive continuity of care, when having access to care and treatment, when the caregivers collaborate, regardless of who is currently responsible for the care. A feeling of “being in good hands” summarise the need for continuous support and seamless transitions between caregivers in the care process. Consequently, to improve the development of evidence-based HF care, there is a call for collaboration models where caregivers from primary care, hospital, and home health care as well as patients and next of kin participate. Keywords Continuity of care, Heart failure, Next of kin, Phenomenography, Qualitative research
Failure patterns after curative resection for intrahepatic cholangiocarcinoma: Possible implications for postoperative radiotherapy
Authors: Yu Wei , Hu Chunxiu , Shui Yongjie , Wu Kui , Zhang Lili , Chen Ying , Li Chao , Xu Jing , Wei Qichun
Published: November 2019

Background: To document the patterns of failure, identify sites at highest risk of recurrence following curative resection of intrahepatic cholangiocarcinoma (IHCC), in order to guide adjuvant postoperative radiotherapy (PORT). Methods: Patients with IHCC who had undergone radical surgery at our institution from July 2010 to August 2017 were retrospectively analyzed. The survival and prognostic factors were evaluated using univariate and multivariate analysis. All sites of recurrence were recorded and classified including the surgical margin, regional lymph nodes, liver remnant and distant metastasis. The sites at highest risk of recurrence form the basis of the target volume of potential adjuvant radiotherapy. Results: The median follow-up time was 23.5 months (2-85 months). The median recurrence free survival (RFS) and overall survival (OS) were 12.1 months and 24.8 months, respectively. Seventy-three (73/127, 57.5%) IHCC patients developed tumor recurrence. The number of initial recurrences occurring in the potential PORT volume, remnant liver and distant sits were 46 (46/73, 63.0%), 36 (36/73, 49.3%) and 22 (22/73, 30.1%) cases, respectively. Of the 46 patients whose initial recurrence were inside the potential PORT volume, 29 (29/73, 39.7%) developed recurrence confined to the potential PORT volume, including 13 tumor bed recurrences, 7 lymph node metastases, and 9 with both tumor bed recurrences and lymph node metastases. The most common lymph node metastases were nodes around the abdominal aorta, followed by lymph nodes along the celiac artery, the common hepatic artery, and in the hepatoduodenal ligament. Conclusions: A high proportion of the recurrences occurred only within the potential PORT volume, implying that adjuvant radiotherapy might improve local-regional control. It seems reasonable to include surgical margins and lymph node stations No.16a2, 9, 8, 12, 13, and 14 in the radiation treatment volume.
Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy
Authors: Zhang Guodong , Li Jijun , Tang Jun , Zhang Lei , Wang Dechao , Sun Zengtao
Published: November 2019

Background: The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP). Methods: A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. The 24 patients were divided into two groups based on whether they underwent technically successful collateral embolization (UAE-SCE group) or failed collateral embolization (UAE-FCE group) in addition to UAE. The baseline characteristics and clinical outcomes including time for serum β-human chorionic gonadotropin (β-hCG) levels normalization, blood loss, secondary anemia, and pelvic pain were compared between the two groups. The paired t test and Man Whitney test were used for comparisons of discrete and numerical variables, respectively. Results: Collateral embolization was techinically successful in 16 (66.7%, 16/24) patients and failed in the other 8 (33.3%, 8/24) patients. There were no significant differences between the two groups in baseline characteristics. The mean blood loss and secondary anemia in the UAE-SCE group were significantly less than UAE-FCE group. No significant difference was found between the two groups in the mean time for β-hCG levels normalization and pelvic pain. Conclusions: During the management of UAE combined with hysteroscopic curettage for CSP, additional embolization of non-gonadal collateral supplying GS during UAE is feasible and safe in patients with non-gonadal collateral supplying GS, and the additional embolization of the collateral may reduce blood bloss related to hysteroscopic curettage.
Associations of serum low-density lipoprotein and systolic blood pressure levels with type 2 diabetic patients with and without peripheral neuropathy: Systemic review, meta-analysis and meta-regression analysis of observational studies
Authors: Naqvi Syed Shah Zaman Haider , imani Saber , Hosseinifard Hossein , Wen QingLian , Shahzad M. Naveed , Ijaz Iqra , Deng Youcai , Guo Man , Xu Yong
Published: November 2019

Background: Compositional abnormalities in lipoproteins and cardiovascular risk factors play an important role in the progression of diabetic peripheral neuropathy (DPN). This systematic review aimed to estimate the predicting value of low-density lipoprotein (LDL) and systolic blood pressure (SBP) level in type-2 diabetes mellitus (T2DM) patients with and without peripheral neuropathy. We also tried to determine whether LDL and SBP are associated with an increased collision risk of DPN. Materials: A systematic search was conducted for eligible publications which explored the LDL and SBP level in T2DM patients with and without peripheral neuropathy. The quality of the included studies was assessed by the QUADAS-2 tool. The standardized mean difference (SMD) with 95% CI of LDL and SBP level were pooled to assess the correlation between LDL and SBP level with DPN. We performed random effects meta-regression analyses to investigate factors associated with an increased collision risk of DPN. Results: There was a significant association between LDL and SBP with poor prognosis of DPN in those included studies (I 2 = 88.1% and I 2 = 84.9%, respectively, Both P < 0.001 ). European T2DM patients have higher serum level of LDL in compare with the European DPN patients (SMD = 0.16, 95 % CI: -0.06 - 0.38; P < 0.001). SBP level was associated with a 2.6-fold decrease in non-DPN patients of T2DM (SMD = -2.63, 95% CI: -4.00 - -1.27, P < 0.001). Old age European T2DM patients have significantly high risk for diabetes drivers. Furthermore, the results of the case-control study design model are more precise to show the accuracy of SBP in Asian T2DM patients. Conclusion: Our finding supports the LDL and SBP status could be associated with increased risk of peripheral neuropathy in T2DM patients.
A model for predicting carotid instability plaque in high risk group of stroke individuals
Authors: Yin Junxiong , Yu Chuanyong , Liu Hongxing , Du Mingyang , Sun Feng , Yu Cheng , Wei Lixia , Wang Chongjun , Wang Xiaoshan
Published: November 2019

Background: Atherosclerosis is the main risk factor of cerebral vascular disease. Previous studies published several predictive models of asymptomatic carotid stenosis , yet they were ignored that people with lower levels of stenosis (＜50% or carotid instability plaque) who may benefit from early risk reducing medications, such as statins, antiplatelet drugs. Thus, this study determined to establish a predictive model of carotid vulnerable plaque through systematic screening of high-risk population for stroke. Methods: All community residents who participated in the screening of stroke high-risk population by the China National Stroke Screening and Prevention Project(CNSSPP). A total of 19 risk factors were analyzed. Individuals were randomly divided into Derivation-Set group and Validation-Set group. According to carotid ultrasonography, the derivation set group patients were divided into instability plaque group and non-instability plaque group. Univariate and multivariable logistic regression were taken for risk factors. A predictive model scoring system were established by the coefficient. The Area under curve (AUC) value of both derivation and validation set group were used to verify the effectiveness of the model. Results: A total of 2841 high risk stroke patients were enrolled in this study, 266(9.4%) patients were found instability plaque. According to the results of Doppler ultrasound, Derivation Set group were divided into instability plaque group (174 cases) and non-instability plaque group (1720 cases). The independent risk factors for carotid instability plaque were: male (OR 1.966, 95%CI 1.406-2.749)，older age (50-59, OR 6.012, 95%CI 1.410-25.629; 60-69, OR 13.915, 95%CI 3.381-57.267;≥70, OR 31.267, 95%CI 7.472-130.83) , married(OR 1.780, 95%CI 1.186-2.672)，LDL-c(OR 2.015, 95%CI 1.443-2.814), and HDL-C(OR 2.130, 95%CI 1.360-3.338). A predictive scoring system was created, range 0-10. The cut-off value of prediction model score is 6.5. The AUC value of derivation and validation set group were 0.738 and 0.737. Conclusions:For a high risk group of stroke individual, We provide a model that could distinguishing those who have a high probability of having carotid instability plaque. When resident’s predictive model score exceeds 6.5, the incidence of carotid instability plaque is high, carotid artery Doppler ultrasound would be checked immediately. This model can be helpful in the primary prevention of stroke.
HDAC4 regulates GR signaling Contributes to Stress-Induced Hyperalgesia in the Medial Prefrontal Cortex
Authors: Zhang Li , Chen Chen , Qi Jian
Published: November 2019

“Stress-induced hyperalgesia (SIH)” is a phenomenon that stress can lead to an increase in pain sensitivity. Recent findings showed that epigenetic mechanisms have been known to play fundamental roles in stress and pain. Histone acetylation is an outstanding epigenetic feature that is changed in numerous stress-related disease situations. However, epigenetic mechanism for the control of SIH is not well known. We investigated the effect of histone acetylationon pain hypersensitivity on SPS (single-prolonged stress) + CFA (complete Freund’s adjuvant) model. Here, we show that the glucocorticoid receptor (GR) is regulated by histone deacetylases 4 (HDAC4) on stress-induced hyperalgesia and the paw withdrawal threshold in the SPS+CFA group dropped significantly compared with the control group. HDAC4-expressing neurons in the medial prefrontal cortex (mPFC) were increased in the SPS+CFA-exposed group compared with CFA-exposed group. Inhibiting HDAC4 by microinjection of sodium butyrate into the mPFC could disrupting glucocorticoid receptor (GR) signaling pathway, lowered SPS+CFA-caused mechanical allodynia and alleviated anxiety-like behavior. Together, our studies suggest that HDAC inhibitors may involve in the process of stress-induced anxiety-like behavior, amplifying the sensitivity to pain.
Transcriptomic analysis among sub-clinically ill cattle following Bovine Respiratory Disease vaccine protocol and challenge with Bovine Viral Diarrhea Virus
Authors: Fleming Damarius S , Herring Andy D. , Miller Laura C , Gill Clare A.
Published: November 2019

Background: Bovine viral diarrhea (BVD) is a widespread immunosuppressive disease of cattle. Infection with bovine viral diarrhea virus (BVDV) can also be sub-clinical and persistent in herds, leading to high economic impact to cattle producers. Complicating this is BVD’s ability to predispose cattle to bovine respiratory disease (BRD) complex. Although many producers vaccinate for BRD to help protect herds from this predisposition, there are gaps in the knowledge of differences between the protection afforded by modified live (MLV) or killed (KV) vaccines, and the level of cross-protection they offer to BVDV. These knowledge gaps affect the economic impact of BVDV because, with more information on vaccine efficacy, cattle producers could possibly reduce treatment costs and disease spread. The study objective was to determine the level of BRD vaccine cross-protection by examining the underlying differential gene expression response to a sub-clinical BVDV challenge in Nellore-Angus cattle.
Results: Statistical analysis of clinical data showed that MLV had lower BVDVa, BVDV2, and BVDVb antibody titers (p < 0.001) compared to the KV vaccine. The three treatment groups (no vaccine (NON), KV, MLV; n = 5 per group) were also compared by RNA-seq analysis of buffy coats from cattle at 14 dpi. The BRD KV group displayed a higher antibody (AB) response, however transcriptomic analysis showed that the KV group still showed high innate gene expression at 14 dpi. The MLV showed displayed a higher number of adaptive and cell-mediated immune response genes being differentially expressed in reaction to challenge at 14 dpi. Analysis also showed the difference in vaccine cross-protection involved evidence of complement activation as part of the MLV bolstered immune response. Lack of detection of complement activation in the KV group could explain the higher titers, while complement activation in the MLV group could lead to less AB response due to better cell-mediated response. Upregulation of MHC molecules and T-cell related gene expression was also observed within the MLV group only.
Conclusions: Although both vaccines provide some level of cross-protection over non-vaccinated animals, the results point to MLV producing cross-protection that extends the adaptive immune response to BVDV.
Promoting rational antibiotics prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany
Authors: Poss-Doering Regina , Kamradt Martina , Glassen Katharina , Andres Edith , Kaufmann-Kolle Petra , Wensing Michel
Published: November 2019

Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. To foster understanding of the networks’ potential impact on antibiotics prescribing, data generated through surveys with physicians and non-physician health professionals were analyzed descriptively. Results : Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotics prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion: Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotics prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics. .
Serum metabolomics study of end-stage renal disease with depression: potential biomarkers for diagnosis and promising targets for therapy
Authors: Hu Jie , Yuan Dezhi , Tian Kuan , Feng Liping , Zhao Qiuye , Liao Xiaohui , Luo Huirong , Jiang Qihui , Wang Xuefei , Zhang Xiaotian , Hu Ling , Wang Hongkai , Zhou Peng , Guo Xingxian , Ran Jianhua , Li Jinfang
Published: November 2019

Background End-stage renal disease (ESRD) is the most severe stage during the development of the renal failure. And depression is the most common psychological disorder in patients with ESRD, which in turn aggravates the progression of renal failure and seriously reduce the quality of life in ESRD patients with depression, but its underlying mechanism remains unclear. This study aimed to reveal the pathogenesis and discover novel peripheral biomarkers for ESRD with depression through metabolomics analysis.Methods Ultra-high-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was used to explore changes of serum metabolites among healthy controls (n = 12), ESRD patients (n = 17), and ESRD patients with depression (n = 17). Also, the differential metabolites between groups were subjected to clustering analysis, pathway analysis, receiver operating characteristic (ROC) curve analysis.Results A total of 57 significant serum differential metabolites were identified between the ESRD without depression group and the ESRD with depression group, which were involved in 19 metabolic pathways, such as energy metabolism, glycerolipid metabolism and glutamate-centered metabolism. Moreover, the area under the ROC curve of Gentisic acid, Uric acid, 5-HT, 2-Phosphoglyceric acid, Leucyl-phenylalanine, Propenoyl carnitine, Malaoxon, Pregnenolone, 6-Thioxanthine 5'-monophosphate, Hydroxyl ansoprazole, Zileuton O-glucuronide, Cabergoline, PA (16:0/18:2(9Z,12Z)), PG (18:0/18:1(11Z)), probucol, etc. and their combination was greater than 0.90.Conclusions Inflammation, oxidative stress and metabolic abnormalities in energy metabolism, glycerolipid metabolism and glutamate-centered metabolism may be associated with the pathogenesis of ESRD with depression, which may be promising targets for therapy. Furthermore, the identified differential metabolites may serve as biomarkers for the diagnosis of ESRD patients with depression.
The Correlation among English Learning Anxiety, Speaking and Writing Achievements of Senior High School Students
Authors: Lestari Dian Eva , Loeneto Bambang , Ihsan Diemroh
Published: November 2019

The objectives of the study were to analyze whether or not there were a significant correlation among English learning anxiety, speaking, and writing achievements of the eleventh graders’. The sample of the study were 112 eleventh graders’. They were selected randomly. The study used quantitative research design. The questionnaire and the writing and speaking tests were done to analyze the data. The researcher used foreign language classroom anxiety scale  questionnaire to measure the students’ English learning anxiety with five-point likert scale, and speaking and writing tests were used to measure the students’ speaking and writing achievements. Pearson product moment correlation and regression were analyzed by using SPSS. The results of study were negative low correlation between English learning anxiety and speaking achievement (r=-.269 with p<0.01) and English learning anxiety and writing achievement (r=-.213 with p<0.05).