bluuebunny/crossref_metadata_2025 huggingface dataset:
Garp’s Ascension Through the Diegetic “World According to Garp” by John Irving
Authors: PUŞKİN Mikail , DAĞABAKAN Davut
Published: March 2020

The main focus of analysis in the article is the evolution of the protagonist in relation to the complex system of characters in the diegetic world of John Irving’s “The World According to Garp”. Throughout the essay, Garp’s maturation and evolution is being continuously analytically measured against the other characters masterfully aligned within the story by author to support the protagonist’s growth, contrast and elucidate him. A typology of characters by their diegetic function is introduced, separating them into three main groups: people, creations, symbols. The linking reciprocal element between them is the protagonist, not only connecting all the characters, but also traversing through their roles on the way to his own posthumous ascension. Starting the novel as a regular human being, the protagonist is gradually transformed into a writer – creator of worlds and characters, to finally ascend into a symbol for the new world upon his death.
Debate sobre juventudes, violência e invisibilidade
Authors: Arruda Daniel Péricles
Published: March 2020

O debate sobre as juventudes é uma questão emergente e importante para tornar conhecidos os modos de vida e as demandas desses sujeitos. O objetivo deste artigo é refletir sobre alguns aspectos das relações entre as juventudes com os processos de formação da violência e invisibilidade. A partir do apoio teórico interdisciplinar e da metodologia qualitativa para a análise de documentos, de dados estatísticos e experiência profissional, observa-se a importância de investimento em políticas públicas que reconheçam as singularidades e diversidades desse público e da elaboração de estratégias de aproximação e leitura das expressões juvenis.
Contrarreforma psiquiátrica e o trabalho profissional dos/as assistentes sociais nos Centros de Atenção Psicossocial-CAPS´s em Belém-Pará
Authors: Silva Rosiane Silva da , Gomes Vera Lúcia Batista
Published: March 2020

Este artigo objetiva analisar as repercussões da contrarreforma psiquiátrica em curso, no Brasil, para o trabalho profissional das/os assistentes sociais que atuam nos CAPS´S em Belém-Pará. Tem por base teve por base, os dados obtidos com a realização de uma pesquisa em nível regional, com recorte para os mencionados CAPS’s, cujos sujeitos forma 09 (nove) assistentes sociais de um universo de 34 (trinta e quatro) que atuam nesses espaços sócio ocupacionais. A luz da teoria marxista, o artigo evidencia que o/a assistente social é chamado de forma mais significativa para compor as equipes multidisciplinares nos serviços substitutivos de saúde mental, para intervir sobre os determinantes sociais do processo saúde-doença mental. Mas, as condições de trabalho nos mencionados CAPS’s, têm dificultado o trabalho desse/a profissional no que concerne ao acesso dos usuários ao atendimento, devido as medidas de  retrocesso ao acesso aos direitos sociais, provocados pelo momento político e econômico vivenciado, no País, pois até a infraestrutura física dos CAPS´s limita e, muitas vezes, impede que os atendimentos sejam efetuados com qualidade e preservem a privacidade das/os usuários/as. Desta forma, o Estado neoliberal não investe na qualidade dos serviços públicos prestados precarizando suas estruturas; nos serviços como o CAPS´s esta situação se agrava devido possuir uma demanda com uma carga de sofrimento muito densa – ao se deparar com os entraves no acesso aos serviços prestados na RAPS, em geral.
Pembelaan Terpaksa yang Melampaui Batas (Noodweer Exces) Pada Pasal 49 Ayat (2)
Authors: Marselino Rendy
Published: March 2020

Tindak pidana merupakan suatu pelanggaran norma yang dengan sengaja atau tidak sengaja dilakukan oleh seorang pelaku tindak pidana. Unsur-unsur tindak pidana meliputi: perbuatan dan akibat, perbuatan pidana hanya menunjuk kepada dilarang dan diancamnya perbuatan dengan suatu pidana. Apakah orang yang melakukan perbuatan kemudian juga dijatuhi pidana? sebagaimana telah diancamkan, ini tergantung dari soal apakah dalam melakukan perbuatan ini dia mempunyai kesalahan. Sebab dalam pertanggungjawaban pidana ialah tidak dipidana jika tidak ada kesalahan, pembelaan terpaksa merupakan pembelaan hak terhadap ketidakadilan, sehingga seseorang yang melakukan perbuatan dan memenuhi unsur-unsur tindak pidana oleh undang-undang dimaafkan karena pembelaan terpaksa.Yang melatarbelakangi permasalahan dalam penulisan ini ialah apa saja yang menjadi alasan penghapus pidana menurut Kitab Undangundang Hukum Pidana, serta bagaimana sifat pembelaan terpidana yang menjadi alasan penghapus pidana. pengaturan pembelaan terpaksa menurut Pasal 49 ayat (1) dan ayat (2) KUHP menyebutkan: Barang siapa melakukan perbuatan yang terpaksa dilakukannya untuk mempertahankan dirinya atau diri orang lain mempertahankan kehormatan atau harta benda sendiri atau kepunyaan orang lain dari kepada seorang yang melawan hak dan merancang dengan segera pada saat itu juga tidak boleh dihukum.
Study of Poisoning Cases Presenting in Emergency Department of Medical Teaching Hospital in Libya
Authors: Zubaeda. M. Mohamed Alsayeh  , Ahmed Ali EBshena
Published: March 2020

Poisoning is the emergence of unfavourable signs and symptoms in the body after exposure to harmful chemical, physical or drugs substances, the current study, we evaluated risk factors and treatments that help to decrease the incidence in adult patients admitted to the emergency department in Al Gmail government public hospital in Libya. In this retrospective revaluation study, a total of 101 cases attended to the emergency department during the study period from January 2010 to January 2015. Data were collected by studying records from the hospital emergency Center, were studied for gender, age, types of poisons, poisoning route, patient status (conscious, unconscious and semiconscious), treatment and antidote of poisoning, duration of hospital stay. There was significantly more common in females than males (M/F) ratio was (0.4/0.61), Amongst the type of poison, bleach (sodium hypochlorite) poisoning founds the commonest cause (20.7%) and Alcohol accounted for (17.8%) and Food poisoning (14.8%) and benzene (13.9%) ware significantly more common than any other types of poisoning in this study. In our study, not all cases of intoxication were intended for self-harm, but the poisoning was accidental.
Modulation of Pharmaceutical and Pharmacokinetic Attributes of Curcumin Encapsulated in Chitosan Using Spray Drying Technique
Authors: Roopa G  , Venkatesh, Jayanthi C  , Hanumanthachar Joshi
Published: March 2020

The present study is designed to formulate and characterize Curcumin (CUR) loaded Chitosan nanoparticles by ionic cross linking using TPP by employing spray drying technique to enhance the aqueous solubility, hence oral bio availability of Curcumin. Curcumin is very sparingly aqueous soluble, unstable in alkaline conditions and gets eliminated faster, resulting in poor bio availability. Curcumin in alcohol was used as drug loading solution. Tween 80 served as nano emulsifier and stabilizer. EE of optimized formulation F6 was found to be 98.5 ± 0.16 %. This formulation has an average particle size of 25 ± 0.1 nm. The Zeta potential of the formulation is -200 mV.  FTIR results revealed the absence of characteristic CUR peak in Curcumin Chitosan nanoparticles implying the successful incorporation of CUR into the Chitosan matrix. DSC thermograms witnessed that the crystalline form of CUR is transformed into amorphous form, having better dissolution and stability profile. SEM imaging of the nanosuspension formulation showed the topological features of the prepared nanoparticles. The nanoparticles were more spherical, discrete and homogeneous. % cumulative drug release studies exhibited very less drug release in Simulated Gastric Fluid (SGF- 3.97 %) and Simulated Intestinal Fluid (SIF - 4.2 %) exhibiting sustained release. Pure Curcumin showed burst release of approximately 95 % in 2 h in SGF with a decline in the concentration after 2 h in SIF due to significantly increased degradation in the alkaline conditions. The oral bioavailability (AUC) of Curcumin in female wistar rats increased 11-times following ingestion of Curcumin nanosuspension in comparison with conventional Curcumin suspension. The maximum concentration Cmax of 1034 ± 96 ng / ml for nanosuspension and 94 ± 9.4 ng / ml for Curcumin suspension and was observed at tmax of 2 h for both nanosuspension and suspension.
Artificial Intelligence, Machine Learning and Real-time Probabilistic Data for Cyber Risk (Super) -forecasting: Red Teaming the Connected World (RETCON)
Authors: Radanliev Petar
Published: March 2020

This paper surveys deep learning algorithms, IoT cyber security and risk models, and established mathematical formulas to identify the best approach for developing a dynamic and self-adapting system for predictive cyber risk analytics supported with Artificial Intelligence and Machine Learning and real-time intelligence in edge computing. The paper presents a new mathematical approach for integrating concepts for cognition engine design, edge computing and Artificial Intelligence and Machine Learning to automate anomaly detection. This engine instigates a step change by applying Artificial Intelligence and Machine Learning embedded at the edge of IoT networks, to deliver safe and functional real-time intelligence for predictive cyber risk analytics. This will enhance capacities for risk analytics and assists in the creation of a comprehensive and systematic understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when Artificial Intelligence and Machine Learning technologies are migrated to the periphery of the internet and into local IoT networks.
Aridity Trend in the Middle East and the Adjacent Areas
Authors: Sahour Hossein , Vazifehdan Mehdi , Alshehri Fahad
Published: March 2020

Available water resources in the Middle East, as one of the most water-scarce regions of the world, have undergone extra pressure due to climatic change, population growth, and economic development during the past decades. The objective of this study is to detect the trends and quantify the changes in aridity with respect to precipitation and potential evapotranspiration in 20 countries of the Middle East and the adjacent area. A Pixel-wised trend analysis was conducted on precipitation, potential evapotranspiration, and aridity index for 71 years from 1948 to 2018. A nonparametric Mann-Kendall test was used over 14106 points in the study area to detect the trends at monthly and annual time scales. Results showed statistically significant (|Z| >1.96) upward trends in aridity (a downward trend in aridity index) up to 96 percent from December through September in most parts of the region. Aridity in October and November had a downward tendency in most parts of the study area. At the annual time scale, 62.5 percent of the statistically significant trends in aridity were found to be upward (up to 96 percent increase in aridity) due to the combined effects of the decrease in precipitation and the increase in potential evapotranspiration and 37.5 percent of the detected trends were downward (up to 61 percent decrease in aridity). The highest and the lowest trends in aridity were found in the north of Sudan (96 percent increase in aridity) and Eastern Arabia (61 percent decrease in aridity), respectively.
Marketing Constraints among Smallholder Farmers in South Africa: An Overview of Potato Market Outlets in Lusikisiki Township
Authors: Nwafor Christopher Ugochukwu
Published: March 2020

Recent studies of the difficulties faced by smallholder farmers in many developing countries have echoed their disconnection with formal markets. These limitations have been attributed to a number of factors including stringent quality and volume requirements, among others. While smallholder farmers seek access to formal markets, the existing alternatives through which they sell their produce remain obscure. Using an interview of market outlets and selected smallholder farmers in the area, the study applied a crop marketing index to examine the outlets currently used by farmers and the volume of potatoes sold in each. Findings indicate that smallholder farmers on average sold sixty-eight percent of their produce. The outlet mostly used by farmers was street vendors because the large supermarkets sold potatoes supplied from external sources. It would be helpful for smallholder farmers to aggregate their produce through producer and marketing cooperatives, to better engage with these formal market outlets.
Vitamin D Supplementation Could Prevent and Treat Influenza, Coronavirus, and Pneumonia Infections
Authors: Grant William B. , Lahore Henry , McDonnell Sharon L. , Baggerly Carole A. , French Christine B. , Aliano Jennifer L. , Bhattoa Harjit Pal
Published: March 2020

Low vitamin D status in winter permits viral epidemics. During winter, people who do not take vitamin D supplements are likely to have low serum 25-hydroxyvitamin D [25(OH)D] concentrations. Vitamin D can reduce the risk of viral epidemics and pandemics in several ways. First, higher 25(OH)D concentrations reduce the risk of many chronic diseases, including cancers, cardiovascular disease, chronic respiratory tract infections (RTIs), diabetes mellitus, and hypertension. Patients with chronic diseases have significantly higher risk of death from RTIs than otherwise healthy people. Second, vitamin D reduces risk of RTIs through three mechanisms: maintaining tight junctions, killing enveloped viruses through induction of cathelicidin and defensins, and reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia. Observational and supplementation trials have reported higher 25(OH)D concentrations associated with reduced risk of dengue, hepatitis, herpesvirus, hepatitis B and C viruses, human immunodeficiency virus, influenza, respiratory syncytial virus infections, and pneumonia. Results of a community field trial reported herein indicated that 25(OH)D concentrations above 50 ng/ml (125 nmol/l) vs. <20 ng/ml were associated with a 27% reduction in influenza-like illnesses. From the available evidence, we hypothesize that raising serum 25(OH)D concentrations through vitamin D supplementation could reduce the incidence, severity, and risk of death from influenza, pneumonia, and the current COVID-19 epidemic.
A Feedback Loop Between Human Self-Domestication and Dog Domestication Contributing to Language Evolution?
Authors: Benítez-Burraco Antonio , Pörtl Daniela , Jung Christoph
Published: March 2020

Different factors seemingly account for the emergence of present-day languages in our species. Human self-domestication has been recently invoked as one important force favouring language complexity mostly via a cultural mechanism. As a consequence, evolutionary changes impacting on aggression levels are expected to have fostered this process. Here we hypothesise about a positive effect of dog-human interactions on aggression management and more generally, on our self-domestication, ultimately, contributing to aspects of language evolution. We review evidence of diverse sort (ethological mostly, but also archaeological, genetic, and physiological) supporting a positive feedback loop between dog domestication and human-self domestication that might have favoured the mechanisms promoting structural complexity in human languages.
Identification of Drought and Performance Evaluation of MODIS and TRMM through Remote Sensing: A Case Study in North and West Africa during 2002–2018
Authors: Henchiri Malak , Liu Qi , Essifi Bouajila , Ali Shahzad , Kalisa Wilson , Zhang Sha , Yun Bai , Zhang Jiahua
Published: March 2020

North and West Africa are the most vulnerable regions to drought, due to the high variation in monthly precipitation. An accurate and efficient monitoring of drought is essential. In this study, we use TRMM data with remote sensing tools for effective monitoring of drought. The Drought Severity Index (DSI), Temperature Vegetation Drought Index (TVDI), Normalized Difference Vegetation Index (NDVI), and Normalized Vegetation Supply Water Index (NVSWI) are more useful for monitoring the drought over North and West Africa. To classify the areas affected by drought, we used the TRMM spatial maps to verify the TVDI, DSI and NVSWI indexes derived from MODIS. The DSI, TVDI, NVSWI and Monthly Precipitation Anomaly (NPA) indexes with the employ of MODIS-derived ET/PET and NDVI were chosen for monitoring the drought in the study area. The seasonal spatial correlation between the DSI, NPA, NVWSI, NDVI, TVDI and TCI indicates that NVSWI, NDVI and DSI present an excellent monitor of drought indexes. The change trend of drought from 2002 to 2018 was also characterized. The frequency of drought showed a decrease during this period.
R Script for Classifying Patterns of Urban Growth
Authors: Perez Joan , Ornon Alexandre , Usui Hiroyuki
Published: March 2020

This paper presents a script that classify spatial patterns of residential urban growth using a morpho-structural approach. The script performs a combination of variography analysis and morphological closings over buildings possessing a residential function in 2002 and 2017 within a region located in southern France named Centre-Var. The different bounding regions then allow classifying new residential buildings into different categories according to their degrees of clustering/scattering and to their locations regarding existing urban areas. Preliminary results show that this protocol is able to provide useful insights regarding the degree of contribution of each new residential building to different patterns of urban growth (clustered infill, scattered infill, clustered edge-expansion, scattered edge-expansion, clustered leapfrog and scattered leapfrog). Open-access to the script and to the test region data is provided.
Tuning of Localized Surface Plasmon Resonance in Copper-Copper Oxide Core-Shell Quantum Dots for the Application in Biosensors
Authors: Prasannan Geetha Prabhash , Ramachandran Ajith , Nair Swapna S.
Published: March 2020

Surface Plasmon Resonance (SPR) is an attracting property of certain transition metals when they are synthesized in nano-range giving rise to promising optical applications. However, most SPR and associated applications are limited to the noble metal nanoparticles, which limits their potential due to high production cost. We report surface plasmon resonance in copper-copper oxide core-shell quantum dots synthesized via chemical route studied by using UV-Visible spectrophotometry. Tuning of the plasmonic resonance with respect to the particle diameter is achieved by an inexpensive all chemical route. Photoluminescence measurements also support the data. This size reduction leads to remarkable changes in its optical response as compared to the bulk metal. The results point towards applications of these materials in tunable SPR based biosensors.
Deep Learning for Stock Market Prediction
Authors: Nabipour Mojtaba , Nayyeri Pooyan , Jabani Hamed , Shamshirband Shahab , Mosavi Amir
Published: March 2020

Prediction of stock groups values has always been attractive and challenging for shareholders. This paper concentrates on the future prediction of stock market groups. Four groups named diversified financials, petroleum, non-metallic minerals and basic metals from Tehran stock exchange are chosen for experimental evaluations. Data are collected for the groups based on ten years of historical records. The values predictions are created for 1, 2, 5, 10, 15, 20 and 30 days in advance. The machine learning algorithms utilized for prediction of future values of stock market groups. We employed Decision Tree, Bagging, Random Forest, Adaptive Boosting (Adaboost), Gradient Boosting and eXtreme Gradient Boosting (XGBoost), and Artificial neural network (ANN), Recurrent Neural Network (RNN) and Long short-term memory (LSTM). Ten technical indicators are selected as the inputs into each of the prediction models. Finally, the result of predictions is presented for each technique based on three metrics. Among all algorithms used in this paper, LSTM shows more accurate results with the highest model fitting ability. Also, for tree_based models, there is often an intense competition between Adaboost, Gradient Boosting and XGBoost.
Children's Health in the Digital Age
Authors: Dresp-Langley Birgitta
Published: March 2020

Environmental studies, metabolic research, and state of the art neurobiology point towards the reduced amount of natural day and sunlight exposure of the developing child’s organism as the consequence of increasingly long hours spent indoors online as the single unifying source of a whole set of health risks identified worldwide, as is made clear in this review of the current literature. Over exposure to digital environments, from abuse to addiction, now concerns even the youngest (ages 0 to 2), and triggers, as argued on the basis of clear examples herein, a chain of interdependent negative and potentially long-term metabolic changes. This leads to a deregulation of the serotonin and dopamine neurotransmitter pathways in the developing brain, currently associated with online activity abuse and/or internet addiction, and akin to that found in severe substance abuse syndromes. A general functional working model is proposed under the light of evidence brought to the forefront in this review.
GWAS and co-expression network combination uncovers multigenes with close linkage effects on oleic acid content accumulation in Brassica napus
Authors: Qian Lunwen , Yao Min , Guan Mei , Zhang Zhenqian , Cui Yixin , Chen Hao , Jan Habib U. , Voss-Fels Kai P. , Werner Christian R. , He Xin , Guan Chunyun , Snowdon Rod J. , Hua Wei
Published: March 2020

Background: Strong artificial and natural selection causes the formation of highly conserved haplotypes that harbor agronomically important genes. GWAS combination with haplotype analysis has evolved as an effective method to dissect the genetic architecture of complex traits in crop species. Results: We use the 60K Brassica Infinium SNP array to perform a genome-wide analysis of haplotype blocks associated with oleic acid (C18:1) in rapeseed. Six haplotype regions were identified as significantly associated with oleic acid (C18:1) that mapped to chromosomes A02, A07, A08, C01, C02, and C03. Additionally, whole-genome sequencing of 50 rapeseed accessions revealed three genes ( BnmtACP2-A02 , BnABCI13-A02 and BnECI1-A02 ) in the A02 chromosome haplotype region and two genes ( BnFAD8-C02 and BnSDP1-C02 ) in the C02 chromosome haplotype region that were closely linked to oleic acid content phenotypic variation. Moreover, the co-expression network analysis uncovered candidate genes from these two different haplotype regions with potential regulatory interrelationships with oleic acid content accumulation. Conclusions: Our results suggest that several candidate genes are closely linked, which provides us with an opportunity to develop functional haplotype markers for the improvement of the oleic acid content in rapeseed.
The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study
Authors: ZHAO Yun , GAO YING , SUN Guoqiang , YU Lin , LIN Ying
Published: March 2020

Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change is overall cesarean delivery (CD) and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods The neuraxial labor analgesia（NA） was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not according to her own requirement. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from May 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001), but the rate of multiparous women had no change (p＞0.05). There was a negative correlation between the rate of NA and that of overall CD, r=-0.803 (95%CI[-0.951, -0.642], p=0.002), and also a negative correlation between the utilization rate of NA and that of MRCD, r=-0.790 (95%CI[-0.971, -0.497], p=0.004). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women underwent CD remained unchanged from May 1st 2015 to April 30th 2016. Conclusions: Our study shows that the rates of CD and MRCD in our department significantly were decreased over a year period (2015. 05.01~2016. 04.30), which may be due to the increasing use of NA during vaginal delivery by the help of NPLD. Key Words: Neuraxial Labor Analgesia; Cesarean Delivery; Maternal Request Cesarean Delivery
Matrine protects retinal ganglion cells from apoptosis in experimental optic neuritis
Authors: Kang Jian , Liu Shu-Qing , Song Yi-Fan , Wang Meng-Ru , Chu Yao-Juan , Shi Ya-Min , Zhang Feng-Yan , Zhu Lin
Published: March 2020

Background: Inflammatory demyelination and axonal injury of the optic nerve are hallmarks of optic neuritis (ON), which often occurs in multiple sclerosis and is a major cause of visual disturbance in young adults. Although a high dose of corticosteroids can promote visual recovery, it cannot prevent permanent neuronal damage. Novel and effective therapies are thus required. Given the recently defined capacity of matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae flavescens, in immunomodulation and neuroprotection, we tested in this study the effect of matrine on rats with experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis.
Results: MAT administration, started at disease onset, significantly suppressed optic nerve infiltration and demyelination, with reduced numbers of Iba1 + macrophages/microglia and CD4 + T cells, compared to those from vehicle-treated rats. Increased expression of neurofilaments, an axon marker, reduced numbers of apoptosis in retinal ganglion cells (RGCs), and reduced numbers of Iba1 + macrophages/microglia and CD4 + T cells were also observed in the retina after MAT treatment.
Conclusions: Taken as a whole, our results demonstrate that MAT attenuated inflammation, demyelination and axonal loss in the optic nerve, and protected RGCs from inflammation-induced cell death. MAT may therefore have potential as a novel treatment for this disease that may result in blindness.
Continuous intrapartum support to reduce primary cesarean in Mexico
Authors: Cardona-Torres Luz Maria , Leyva-Jimenez Rafael
Published: March 2020

Background

Cesarean deliveries are effective in saving maternal and infant lives, but only when they are necessary for medical reasons. In Mexico, the average cesarean delivery rate in 2015 was reported at 45%, the high incidence of cesarean deliveries is considered a problem of public health in the country, our purpose was to reduce the cesarean delivery rate for primary cesarean, in nulliparous women, term, singleton, vertex presentation and under 40 years through continuous intrapartum support provided by a professional nurse.

Methods

This was a historical control study, in a health institution in Mexico, in the period de July-December 2018. The control group received the usual obstetric care, without continuous intrapartum support. The study group received the usual obstetric care plus continuous intrapartum support, it was obtained the cesarean delivery rate, estimating the risk ratio, the absolute risk reduction and odds ratio, in addition, a binomial logistic regression model was carried out and was adjusted with possible covariates.

Results

In the study group the cesarean delivery rate was 1.7% (1 of 60) significantly lower than in the control group (29.1% (16 of 55) [X 2 = 17.13, df = 1, N = 115, p < .001], with a risk ratio of 0.06 (95% CI: 0.01 to 0.42), the absolute risk reduction was 27.4%, (95% CI: 15% - 40%), also the hours of labor were significantly lower (p < 0.001) in the study group (median = 6.7 hours, 95% CI: 6.0-8.1), than in the control group (median = 13.4 hours, 95% CI: 10.7 - 16.1) and no significant covariates were found.

Keywords: Cesarean delivery rate, Continuous intrapartum support, labor
Patient-reported quality indicators to evaluate physiotherapy care for hip and/or knee osteoarthritis- development and evaluation of the QUIPA tool.
Authors: Teo Pek Ling , Hinman Rana S , Egerton Thorlene , Dziedzic Krysia S , Kasza Jess , Bennell Kim L
Published: March 2020

Background: There is no physiotherapy-specific quality indicator tool available to evaluate physiotherapy care for people with hip and/or knee osteoarthritis (OA). This study aimed to develop a patient-reported quality indicator tool (QUIPA) for physiotherapy management of hip and knee OA and to assess its reliability and validity.
Methods: To develop the QUIPA tool, quality indicators were initially developed based on clinical guideline recommendations most relevant to physiotherapy practice and those of an existing generic OA quality indicator tool. Draft items were then further refined using patient focus groups. Test-retest reliability, construct validity (hypothesis testing) and criterion validity were then evaluated. Sixty-five people with hip and/or knee OA attended a single physiotherapy consultation and completed the QUIPA tool one, twelve- and thirteen-weeks after. Physiotherapists (n=9) completed the tool post-consultation. Patient test-retest reliability was assessed between weeks twelve and thirteen. Construct validity was assessed with three predefined hypotheses and criterion validity was based on agreement between physiotherapists and participants at week one.
Results: A draft list of 23 clinical guideline recommendations most relevant to physiotherapy was developed. Following feedback from three patient focus groups, the final QUIPA tool contained 18 items (three subscales) expressed in lay language. The test-retest reliability estimates (Cohen’s Kappa) for single items ranged from 0.30-0.83 with observed agreement of 64-94%. The intraclass correlation coefficient (ICC) and 95% confidence interval (CI) for the Assessment and Management Planning subscale was 0.70 (0.54, 0.81), Core Recommended Treatments subscale was 0.84 (0.75, 0.90), Adjunctive Treatments subscale was 0.70 (0.39, 0.87) and for the total QUIPA score was 0.80 (0.69, 0.88). All predefined hypotheses regarding construct validity were confirmed. However, agreement between physiotherapists and participants for single items showed large measurement error (Cohen’s Kappa estimates ranged from -0.04-0.59) with the ICC (95% CI) for the total score being 0.11 (-0.14, 0.34).
Conclusions: The QUIPA tool showed acceptable test-retest reliability for subscales and total score but inadequate reliability for individual items. Construct validity was confirmed but criterion validity for individual items, subscales and the total score was inadequate. Further research is needed to refine the QUIPA tool to improve its clinimetric properties before implementation.
Ischemic stroke with a preceding Trans ischemic attack(TIA) less than 24 hours and thrombolytic therapy
Authors: Poupore Nicolas , Strat Dan , Mackey Tristan , Snell Ashley , Nathaniel Thomas
Published: March 2020

Background Acute ischemic stroke attack with and without a recent TIA within or less than 24 hours may differ in clinical risk factors, and this may affect treatment outcomes following thrombolytic therapy. We examined whether the odds of exclusion or inclusion for thrombolytic therapy are greater in ischemic stroke with TIA less than 24 hours preceding ischemic stroke(TIA-24hr-ischemic stroke patients) as compared to those without recent TIA or non-TIA <24 hours. Methods A retrospective hospital-based analysis was conducted on 6,315 ischemic stroke patients, of whom 846 had proven brain diffusion-weighted magnetic resonance imaging (DW-MRI) of an antecedent TIA within 24 hours prior to ischemic stroke. The logistic regression model was developed to generate odds ratios (OR) to determine clinical factors that may increase the likelihood of exclusion or inclusion for thrombolytic therapy. The validity of the model was tested using a Hosmer-Lemeshow test, while the Receiver Operating Curve (ROC) was used to test the sensitivity of our model. Results In TIA-24hr-ischemic stroke population, patients with a history of alcohol abuse (OR = 5.525, 95% CI, 1.003-30.434, p = 0.05), migraine (OR=4.277, 95% CI, 1.095-16.703, p=0.037), and increasing NIHSS score (OR=1.156, 95% CI, 1.058-1.263, p = 0.001) were associated with the increasing odds of receiving rtPA, while older patients (OR = 0.965, 95% CI, 0.934‐0.997, P = 0.033) were associated with the increasing odds of not receiving rtPA. Conclusion In TIA-24hr-ischemic stroke patients, older patients with higher INR values are associated with increasing odds of exclusion from thrombolytic therapy. Our findings demonstrate clinical risks factors that can be targeted to improve the use and eligibility for rtPA in in TIA-24hr-ischemic stroke patients.
Performance, metabolic and hormonal responses of grazing Nellore cows to an energy-protein supplementation during the pre-partum phase
Authors: Ferreira Matheus Fellipe de Lana , Rennó Luciana Navajas , Detmann Edenio , Paulino Mário Fonseca , Filho Sebastião de Campos Valadares , Moreira Samira Silveira , Martins Hudson Caio , de Oliveira Bruno Inácio Correa , Marquez Julia Avansi , Cidrine Isabela de Paula
Published: March 2020

Background: Supplementation programs for prepartum beef cows are usually adopted because the nutritional status of the cows upon calving is a main factor impacting reproductive performance of the next production cycle. This study evaluated the effects of 60-d pre-partum energy-protein supplementation on performance, metabolic and hormonal responses during the peripartum phase of grazing beef cows. Thirty-eight pregnant multiparous Nellore cows were assigned to a completely randomized design with two treatments: control (no supplement) and supplementation (1.5 kg of energy-protein per d with 30% crude protein, dry matter basis) Results: The supplemented cows had higher ADG pre-partum (P<0.10), but postpartum ADG did not differ between treatments. Supplementation did not affect BCS and calf BW upon calving, on days 45 and 90, milk yield and composition (P>0.10). No differences were found for forage intake and neutral detergent fiber digestibility (P>0.10). The intake and digestibility of CP and OM increased in response to supplementation (P<0.10). An interaction occurred between supplementation and peripartum days for BUN, βHB, T3 and T4, which had higher concentrations for supplemented cows at pre-partum period (P<0.10). Concentration of others blood parameters significantly changed along peripartum days (P<0.10). There was no difference in pregnancy rates and days from calving to conception between treatments (P>0.10). Conclusions: Providing an energy and protein supplement to grazing Nellore cows over the last 60 d of gestation improved their pre-partum energy balance. However, no post-partum carryover effects were detected. Keywords: nutrition, metabolism, parturition, Zebu
Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa: a systematic review
Authors: Chisompola Namaunga Kasumu , Streicher Elizabeth Maria , Muchemwa Chishala Miriam Kapambwe , Warren Robin Mark , Sampson Samantha Leigh
Published: March 2020

Background The burden of drug resistant tuberculosis in Africa is largely driven by the emergence and spread of multidrug resistant (MDR) and extensively drug resistant (XDR) Mycobacterium tuberculosis strains. MDR-TB is defined as resistance to isoniazid and rifampicin, while XDR-TB is defined as MDR-TB with added resistance to any of the second line injectable drugs and any fluoroquinolone. The highest burden of drug resistant TB is seen in countries further experiencing an HIV epidemic. The molecular mechanisms of drug resistance as well as the evolution of drug resistant TB strains have been widely studied using various genotyping tools. The study aimed to analyse the drug resistant lineages in circulation and the transmission dynamics of these lineages in Africa by describing outbreaks, nosocomial transmission and migration. Viewed as a whole, this can give a better insight into the transmission dynamics of drug resistant TB in Africa. Methods A systematic review was performed on peer reviewed original research extracted from PubMed reporting on the lineages associated with drug resistant TB from African countries, and their association with outbreaks, nosocomial transmission and migration. The search terms “Tuberculosis AND drug resistance AND Africa AND (spoligotyping OR molecular epidemiology OR IS6110 OR MIRU OR DNA fingerprinting OR RFLP OR VNTR OR WGS)” were used to identify relevant articles reporting the molecular epidemiology of drug resistant TB in Africa. Results Diverse genotypes are associated with drug resistant TB in Africa, with variations in strain predominance within the continent. Lineage 4 predominates across Africa demonstrating the ability of these “modern strains” to adapt and spread easily. Most studies under review reported primary drug resistance as the predominant type of transmission. Drug resistant TB strains are associated with community and nosocomial outbreaks involving MDR- and XDR-TB strains. The under-use of molecular epidemiological tools is of concern, resulting in gaps in knowledge of the transmission dynamics of drug resistant TB on the continent.Conclusions Genetic diversity of M. tuberculosis strains has been demonstrated across Africa implying that diverse genotypes are driving the epidemiology of drug resistant TB across the continent.
Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.
Authors: Loffredo Lorenzo , Spalice Alberto , Salvatori Francesca , Giovanna De Castro , Guido Cristiana Alessia , Zicari Anna Maria , Ciacci Paolo , Battaglia Simona , Brindisi Giulia , Ettorre Evaristo , Nocella Cristina , Salvatori Guglielmo , Duse Marzia , Violi Francesco , Carnevale Roberto
Published: March 2020

Background: paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (8-iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods: in this study we wanted to compare serum levels of soluble NOX2-dp (sNOX-2-dp), iso-PGF2α and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay.Results: compared with CT, PANDAS children had increased serum levels of sNOX-2-dp, 8-iso-PGF2α and LPS. Bivariate analysis showed that serum sNOX2-dp was signiﬁcantly correlated with LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and 8-iso-PGF2α (Rs=0.704; p<0.001). Serum LPS signiﬁcantly correlated with zonulin (Rs=0.610; p<0.001), and 8-iso-PGF2α (Rs=0.591; p=0.001). Finally, a multiple linear regression analysis showed that serum 8-iso-PGF2α and zonulin were the only independent variables associated with sNOX2-dp (R2=68%).Conclusion: this study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be involved in the process of neuroinflammation.
Preparation and bioactivity of anti-Newcastle disease virus-phosphoprotein cytoplasmic transduction peptide antibody
Authors: Li Benqiang , Wang Man , Zhu Jianguo
Published: March 2020

On the basis of cell-penetrating peptide’s character that it can penetrate cytomembrane and transfer macromolecular protein to cytoplasm so to play biological function, we took the experiments. The fuse penetrating peptide our experiment adoptted is HIV-TAT derived fragment-CTP512, with good transmember effect and distinct cytoplasm-position. In this chapter, the research of transmembrane character was processed first. According to the tests on trans- member protein with different concentrations, the best trans-member concentration is 3µM. Afterwards, we found that the location of trans-member antibody is overlapping with phosphoprotein using indirect immunofluorescence test analysis. According to MTT test, there is no significant difference between CTP fusion protein and control on cell proliferation and viability. TCID50 test was used to detect the protective effect of trans-member antibody on cell. Result showed that trans- member antibody has significant cell protection effect compared to the control in the order: ZL.103>ZL.17>Control. Fluorogenic quantitative PCR result showed that trans- member antibody can disturb the duplication and transcription of Newcastle disease virus. This results not only paved a good way to research the transport of disease related protein, but also provide a splendid tool on protein function research.
Perspectives of health care providers on the role of culture in the self-care of patients with chronic heart failure: a qualitative interview study conducted in Israel
Authors: Joensson Adam , Cewers Emilie , Weinstein Jean Marc , Gal Tuvia Ben , Stromberg Anna , Jaarsma Tiny
Published: March 2020

Background: Self-care is recognized as important behaviour in chronic diseases such as heart failure (HF). The cultural background of patients with HF is one of the factors that can be considered to affect their adherence to self-care. The cultural background of the health care providers might also influence their view on self-care behaviour and the education they provide. The aim of this study was to describe health care providers' perceptions of the role of culture in self-care and how those perceptions shape their experiences and their practices.Methods: A qualitative study was performed in Israel, a country with a culturally diverse population. Data was collected using semi-structured interviews with 12 healthcare providers from different cultural backgrounds, selected by purposeful sampling, from two hospitals in Israel. Interviews were audio recorded and transcribed verbatim. Data was analysed using content analysis.Results: Healthcare providers experienced cultural background influenced their patients’ self-care behaviour. Perceived cultural-specific barriers to self-care such as: dietary traditions interfering with the recommended HF diet, willingness to undertake self-care and beliefs conflicting with medical treatment were identified. Healthcare providers described that they adapted their patient education and care based on the cultural background of the patients. Shared cultural background, awareness and knowledge of differences were described as positively influencing self-care education, while cultural differences could complicate this process. These findings are encapsulated within four categories regarding perceptions of health care providers: ‘Culture permeates self-care behaviours’, ‘Culture influence the way care is provided’, ‘Mutual cultural background impacts the mindset to address self-care’ and ‘Culture is only a small piece of the puzzle...’Conclusions: Cultural-specific barriers for self-care were perceived by health care providers and they identified that their own cultural background shapes their experiences and their practices.
A giant hepatic cavernous hemangioma with an abdominal wall hemangioma: a case report
Authors: Liu Yan , Gu Xue , Zhou Zhang , Yang Na , Luo Cheng-jun , Li Li
Published: March 2020

Introdoction: Hepatic cavernous hemangioma is the most common benign tumor of the liver without special treatment，which is very common in clinical work.But some larger cavernous hemangioma has the risk of bleeding, clinical diagnosis and treatment of large hepatic cavernous hemangioma is of great significance.Case presentation: The patient was a 45-year-old middle-aged woman who was admitted to the hospital due to a large lesion of the abdominal wall. At first, she was considered as having a melanoma of the abdominal wall. After imaging and pathological examinations, she was diagnosed as having a giant cavernous hemangioma of the liver. Percutaneous hepatic artery superselective angiography and embolization significantly reduced the lesions.Conclusion: Hepatic cavernous hemangioma is relatively more common clinically, but there are few reports of multiple and huge hemangioma, as reported here, our patient had a large abdominal wall hemangioma. It is speculated that the coexistence of the two is related. In fact,during embryonic development,the fetus and mother are connected by two umbilical arteries and one umbilical vein. An aneurysm-like deformity caused by excessive development or abnormal differentiation of blood vessels during the developmental process may be the cause of the patient's massive abdominal wall and liver hemangiomas.
Trends in Research Related to Premenstrual Syndrome and Premenstrual Dysphoric Disorder: a Bibliometric Analysis
Authors: Gao Mingzhou , SUN Hui , ZHANG Changlong , GAO Dongmei , QIAO Mingqi
Published: March 2020

Background The global incidence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is increasing, with increasing suicide reports. However, the bibliometric analysis of global research on PMS and PMDD is rare. We aimed to evaluate the global scientific output of research on PMS and PMDD and to explore their research hotspots and frontiers from 1945 to 2018 using a bibliometric analysis methodology.Methods Articles with research on PMS and PMDD between 1945 and 2018 were retrieved from the Web of Science Core Collection (WoSCC). We used the bibliometric method, CiteSpace V and VOSviewer to analyze publication years, journals, countries, institutions, authors, research hotspots, and trends. We plotted the reference co-citation network, and we used keywords to analyze the research hot spots and trends.Results We identified 2,833 publications on PMS and PMDD research from 1945 to 2018, and the annual publication number increased with time, with fluctuations. Psychoneuroendocrinology published the highest number of articles. The United States ranked the highest among the countries with the most publications, and the leading institute was UNIV PENN. Keyword and reference analysis indicated that the menstrual cycle, depression and ovarian hormones were the research hotspots, whereas prevalence, systematic review, anxiety and depression and young women were the research frontiers.Conclusions We depicted overall research on PMS and PMDD by a bibliometric analysis methodology. Prevalence and impact in young women , systematic review evaluations of risk factors, and the association of anxiety and depression with menstrual cycle phases are the latest research frontiers that will pioneer the direction of research in the next few years.