bluuebunny/crossref_metadata_2025 huggingface dataset:
Bleeding from band ligation-induced ulcers following the treatment of oesophageal varices: a retrospective case–control study.
Authors: Hu Zixuan , Swai Joel
Published: December 2020

Background Band ligation (BL) plays a vital role in the treatment of oesophageal varices; however, the procedure carries a considerable risk of band slippage, variceal site ulcer formation and post-treatment bleeding. Our study aimed to explore the incidence of post-BL ulcer bleeding and to identify possible associated factors.Methods We retrospectively reviewed the records of patients with oesophageal varices who underwent endoscopic haemostasis by BL at our institution between 2015 and 2020. We statistically compared the patients with post-BL ulcer bleeding and those without (controls). The outcome variable was the development of BL-induced ulcer bleeding. The patients’ demographics, clinical and laboratory parameters, BL procedure outcomes and experts’ opinions were used as the independent variables and possible associated factors. Results Of the 4579 eligible patients 388 (8.5%) presented with post-BL ulcer bleeding. Proton pump inhibitor (PPI) use was associated with a lower risk of post-BL ulcer bleeding (odds ratio, 0.77; 95% confidence interval [CI]: 0.603–0.983). The presence of high-risk stigmata indicated a 1.276 times higher risk of bleeding (CI: 1.024–1.592), and a greater number of varices was associated with an increased risk of post-BL ulcer bleeding (P = 0.007). The use of fewer bands per variceal site was associated with fewer bleeding incidents (P = 0.008), while lower haemoglobin levels were associated with a higher probability of bleeding (P = 0.007).Conclusions The overall incidence of post-BL ulcer bleeding was 8.5%. The presence of high-risk stigmata and a higher number of varices and bands per variceal site were associated with an increased risk of bleeding. Adequate haemoglobin levels and the use of adjuvant PPIs and having were protective factors.
In Vivo Measurement of Carbon-13 Labeling of Glutamate and Glutamine in Human Brain Using Proton Magnetic Resonance Spectroscopy
Authors: An Li , Li Shizhe , Araneta Maria Ferraris , Victorino Milalynn , Johnson Christopher , Shen Jun
Published: December 2020

A single-step spectral editing 1H magnetic resonance spectroscopy (MRS) technique was used to measure fractional enrichments of glutamate and glutamine in the dorsal anterior cingulate cortex of five healthy volunteers after oral administration of [U-13C]glucose. Strong pseudo singlets of glutamate and glutamine were induced at an echo time of 56 ms using an always-on editing pulse at 2.12 ppm. At 113 ± 9 minutes after oral administration of [U-13C]glucose, fractional enrichment of glutamate was found to be 64 ± 5% with 1.7% within-subject coefficient of variation (CV) and fractional enrichment of glutamine was found to be 40 ± 10% with 11% within-subject CV. This study demonstrated that 13C labeling of both glutamate and glutamine can be measured with the high sensitivity and spatial resolution of proton MRS using a proton-only MRS technique with standard commercial hardware. Furthermore, it is now feasible to measure 13C labeling of glutamate and glutamine in limbic structures, which play major roles in behavioral and emotional responses and whose abnormalities are involved in many neuropsychiatric disorders.
Face Masks, Public Policies and Slowing the Spread of COVID-19: Evidence from Canada
Authors: Karaivanov Alexander , Lu Shih En , Shigeoka Hitoshi , Chen Cong , Pamplona Stephanie
Published: December 2020

We estimate the impact of indoor face mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada. Mask mandate introduction was staggered over two months in the 34 public health regions in Ontario, Canada. Using this variation, we find that mask mandates are associated with a 25 percent or larger weekly reduction in new COVID-19 cases in July and August, relative to the trend in absence of mandate. Province-level data provide corroborating evidence. We control for factors such as mobility (using Google geo-location data) and past cases. Our analysis of additional survey data shows that mask mandates led to an increase of about 30 percentage points in self-reported mask wearing in public. Counterfactual policy simulations suggest that mandating indoor masks nationwide in early July could have reduced new COVID-19 cases in Canada by 25 to 40 percent in mid-August (700 to 1,100 fewer cases per week).
Evolution of Inequalities in Returns to Education: A Study Based on Tunisian Data
Authors: abidi Monem
Published: December 2020

These paper aims are to study and estimate the evolution of the inequalities to the return on educational and professional investment, thus offering vast opportunities for analysis, in particular the dynamic links "profitability" - "investment". The general view is titled in the research field of human capital theory by analyzing three surveys provided by the National Statistical Institute that focus on wage-employment. We initially use a corrected Mincer model where we specify two types of regression then we will integrate the indicator of depreciation of human capital. Thus giving results that are used to understand the dynamics of individual investment choices. The results show a decrease in profitability and an increase in catch-up time (Overtaking). The study also makes it possible to understand the evolution of returns on educational and professional investments. To look for points of failure and imbalances in the education system and its relation to the labor market and to serve as a guide to government policy as it relates to long-term educational programs. J.E.L classification: E24, I21, J24, J31.‎
Mediation Analysis of Entrepreneurship Development on the Economic Growth of Women Entrepreneurs in Nigeria
Authors: Obianefo Chukwujekwu Aloysius , Mailafia Luka , Yusuf Ismaila , Ezeano Ike C. , Isaiah Godswill I. , Ohalete Ifeanyi P.
Published: December 2020

The study used structural equation modelling (SEM) techniques to examine the mediation analysis of entrepreneurship development on the economic growth of women entrepreneurs in Nigeria. The study assumes the existence of three null hypotheses; entrepreneurship development does not mediate business performance, psychological, and knowledge of business practice indicators for economic growth. Data were collected from 500 randomly selected women entrepreneurs in Nigeria. Our results suggest that separating household and business income, maintaining a separate business account, stock-keeping, record-keeping among other were the knowledge of business practice indicators; openness to change, desire for self-independent among others were the psychological indicators, and reduced inactivity, increase in the size of the inventory among others were the business performance indicators that stimulate entrepreneurship development. The aforementioned catalyzed higher formalization, increases in capital investment among others as entrepreneurship development indices, which stimulate economic growth of contribution to personal and children school fare, reduction in financial dependence, and increase in affordable health care fee among others. We also established that entrepreneurship development mediates knowledge of business practice to economic growth.
The Effect of Tax Incentives Practices on Sustainability of Micro, Small and Medium Enterprises in Ethiopia During the Outbreak of Corona Virus Pandemic
Authors: Orkaido Kanbiro Deyganto , Beriso Bekele Youna
Published: December 2020

Purpose: The aim of this study was to identify the effect of tax incentive practise on sustainability of MSMEs during outbreak of corona virus pandemic in Ethiopia. Design/methodology/approach: In order to achieve this objective, the researchers have employed quantitative research approach with explanatory research design in which six hypotheses have been tested. The primary data was collected from 300 respondents using structured questionnaires. Multiple regression model was employed to identify the effect of tax incentives on sustainability of MSMEs in Ethiopia. Findings: According to the regression analysis, this study revealed that tax holiday, tax allowance, reduction in tax rate, accelerated depreciation, loss carry forward and tax exemption have positive and statistically significant effect on the sustainability of the MSMEs. Based on the finding of the study was concluded that the existence of tax incentive practice has positive contribution to sustainability of the micro, small and medium sized enterprise.Research limitations/implications: The current study was geographically focus on Ethiopia by considering the micro, small and medium sized enterprises sector. The subject wise was focused on the effect of the tax incentives:(tax holiday, tax allowance, tax exemption, and accelerated depreciation, reduction in tax rate, and loss carry forward) and on the sustainability of MSMEs. The study used primary data which is limited to a year of 2020. It might be improved in the future if other researchers incorporate large firms in the country and uses secondary data for analysis. Practical implications: To survive, micro, small and medium scale enterprises need the support from the government in the form of tax incentives. The role of tax incentives in enhancing the growth of micro, small and medium sized enterprises is very significant on the sustainability of MSMEs as well as the economy as a whole. Hence, the findings and recommendations of the current study might serve as an ingredient and be informative to the policy makers on MSMEs sector. It might also give a general insight to the policy makers, academician and professional groups of society and the public at large with regard to the role of effect of tax incentives on the sustainability and growth of MSMEs during outbreak of coronavirus.Originality/value: This study contributes to empirical evidence about the effect of tax incentives practices on sustainability of micro, small and medium enterprises in Ethiopia by considering tax incentive practice in terms of tax holiday, tax allowance, reduction in tax rate, accelerated depreciation, loss carry forward and tax exemption. As tax incentives theories supported the findings of this study, we have concluded that tax incentive practices provided by government have positive contribution for the sustainability and growth of micro, small and medium sized enterprises in Ethiopia
Transvertebral Transposition of the Spinal Cord for Recovery of Motor Evoked Potentials and Somatosensory Evoked Potentials After Acute Paraplegia During Kyphoscoliosis Surgery: Technique Note, Case Reports and Literature Review
Authors: Chen Chao , Li Jing , Wang Bingjin , Zhu Lingwei , Gao Yong , Yang Cao
Published: December 2020

Background: Neurological impairment during spinal deformity surgery was the most serious complication. When confronting intraoperative neurophysiological monitoring alerts, various surgical management methods such as the release of implants and decompression of the spinal cord are always performed. Transvertebral transposition of the spinal cord is rarely performed, and its role in the management of acute paraplegia is seldom reported.Methods: The authors present two patients with kyphoscoliosis experienced intraoperatively or postoperatively neurological deficits and abnormal neurological monitoring was detected during correction surgery. Acute paraplegia was confirmed by a wake-up test. Subsequent spinal cord transposition was performed. Intraoperative neurophysiological monitoring motor evoked potentials (MEP) and somatosensory evoked potentials (SEP) was performed to detect the changes during the process.Results: After transvertebral transposition of the spinal cord, the MEPs and SEPs were significantly improved in both patients during surgery. The spinal cord function was restored postoperatively and recovered to normal at the final follow-up in two patients. Conclusions： This case demonstrated that instead of decreasing the correction ratio of kyphoscoliosis, transvertebral transposition of the spinal cord under intraoperative neurophysiological monitoring could be an effective therapeutic strategy for acute spinal cord dysfunction caused by deformity correction surgeries.
Radiographic and Clinical Outcomes of Dynesys Dynamic Stabilization Versus Instrumented Fusion for Degenerative Lumbar Spine Diseases With a Minimum Follow-Up Period of 2 Years: A Meta-Analysis
Authors: Zhou Lu-Ping , Zhang Ren-Jie , Zhang Lai , Ding Jing-Yu , Shen Cailiang
Published: December 2020

ObjectiveDynesys stabilization (DS) is utilized to preserve mobility at the instrumental segments and prevent adjacent segment pathology (ASP) in clinical practice. However, the advantages of DS method remain controversial. This meta-analysis was to compare the radiographic and clinical outcomes between DS and instrumented fusion in patients with or without grade I spondylolisthesis at a minimum follow-up period of 2 years. MethodsWe conducted a comprehensive search of PubMed, EMBASE, Cochrane, and Web of Science databases for potentially eligible articles. Clinical outcomes were assessed in terms of surgical time, intraoperative blood loss, length of hospital stay, in-hospital complications, VAS and ODI scores, screw loosening and breakage, and reoperation. Radiographic outcomes were assessed in terms of postoperative range of movement (ROM) and disc heigh. Moreover, adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis) were evaluated. Data are expressed as risk ratio or standardized mean difference with the associated 95% confidence intervals. The meta-analysis was performed using RevMan 5.3 and STATA 15.1 software.ResultsFourteen studies with 1078 patients were included in the meta-analysis. The mean durations of follow-up ranged from 26.64 ± 5.16 months to 93.6 ± 16.5 months. The DS group was associated with significantly shorter surgical time, fewer intraoperative blood loss, shorter length of hospital stay, less in-hospital complications, lower postoperative VAS scores for low-back and leg pain than the fusion group (P < 0.05). Moreover, the ROM at the stabilized segments of the fusion group decreased significantly (P < 0.01) and that at the adjacent segments increased significantly compared with those of the Dynesys group (P < 0.01). Additionally, the Dynesys group showed significantly less ASDeg than the fusion group (P < 0.01) but showed no significant advantage over the fusion group in terms of preventing ASDis (P = 0.33). Furthermore, the Dynesys group was insignificantly different from the fusion group in terms of ODI, screw loosening, screw breakage, surgical reoperation, and disc heigh at stabilized and adjacent segments (P > 0.05).ConclusionDynesys stabilization showed satisfactory clinical outcomes and provided additional benefits in preserving the motion at the stabilized segments and limiting the hypermobility at the adjacent segments compared with fusion method. Dynesys stabilization represented a complementary choice in the treatment of degenerative spinal lumbar disease with or without grade I spondylolisthesis.
A Study on the Short-Term Mortality and Related Risk Factors of Fragile Hip Fracture
Authors: Wang Pei-Wen , Zhuang Hua-Feng , Li Yi-Zhong , Xu Hao , Lin Jin-Kuang , Yao Xue-Dong
Published: December 2020

BackgroundThis study aimed to observe the mortality of patients with fragile hip fractures and assess the death-associated risk factors.MethodsSix hundred and ninety patients with osteoporotic hip fractures(aged 50-103-years-old) that were treated from January 2010 to December 2015 were enrolled in this study and followed-up and the clinical data were retrospectively examined. Three months, one year, and the total mortality during the follow-up time were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications.ResultsThe 286 patients were followed up between 6 months and 42 months, with an average of 21.42±9.88 months. The three-month mortality was 7.69%, the number of patients who were followed up over one year was 231, the one-year mortality was 16.02%, and the total mortality of the follow-up time was 17.48%. The higher mortality was related to age over 75 years, associated cardio-respiratory diseases, male gender, non-operative treatment, surgery delayed over 5 days. Binary Logistic regression analysis showed that the independent risk factors affecting mortality included age (OR=5.385, P=0.003), surgery (OR=21.217, P=0.000), the number of complications (OR=9.038, P=0.000), and pre-injury cardiovascular disease (OR=3.201, P=0.041).ConclusionThe early mortality of fragile hip fractures was high and was also related to many risk factors. Age, surgery, the number of complications, and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of patients with fragile hip fractures. Effective treatment without complications and early surgery can lower early mortality in patients with fragile hip fractures.
Minimally Invasive Transforaminal Lumbar Interbody Fusion Ameliorates Persistent Pain After Lumbar Fusion Surgery
Authors: Li Jun , Liu Kai , Yang Li , WANG DEGUO
Published: December 2020

Background: Approximately 4-20% patients with degenerative lumbar diseases showed persistent pain after lumbar fusion surgery that may develop into failed back surgery syndrome (FBSS), and this persistent pain may be related to the postoperative increased release of inflammatory mediators. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) can obviously reduce the intraoperative soft tissue trauma. The aim of this study is to investigate the persistent pain in the patients with degenerative lumbar diseases undergoing MIS-TLIF compared with conventional‑invasive TLIF. Material and methods: This study retrospectively included 146 patients (MIS-TLIF vs. conventional‑invasive TLIF: 56 vs. 90), and the incidence of persistent pain were evaluated. Furthermore, inflammation related markers in both blood and drainage fluid samples, including white blood cell (WBC) count, C-reactive protein (CRP), creatine kinase (CK), interleukin-6 (IL-6) and IL-1β, were tested before and after operation. Results: Significantly larger number of patients undergoing conventional‑invasive TLIF showed postoperative persistent pain compared to those undergoing MIS-TLIF (4/56, 7.1% vs. 20/90, 22.2%; P < 0.05). In both treatment groups, the patients with postoperative persistent pain showed increased IL-6 and IL-1β in drainage fluid, as well as increased IL-6 in blood samples (P < 0.05), and there is significant correlation between the inflammation markers in drainage fluid and the extent of postoperative persistent pain in patients with postoperative persistent pain (P < 0.05). Conclusions: Local inflammatory substance accumulation may be potential cause for postoperative persistent pain, and MIS-TLIF may reduce this inflammatory accumulation at the surgical site and subsequently reduce the risk of persistent pain.
Arthroscopic Treatment for Intraosseous Ganglion Cyst of Carpal Bone Combined With Occult Wrist Instability
Authors: Zhao Gang , Tao Shanchun , Mi Jingyi , Yao Qun
Published: December 2020

Background: Intraosseous ganglion cysts (IOGs) of the carpal bone are uncommon tumors that may represent rare causes of chronic wrist pain. Arthroscopic resection has been described in isolated symptomatic cases as a feasible technique; however, there is no published study investigating this technique in an unstable wrist. We aimed to study the outcome of arthroscopic lesion resection combined with intercarpal ligament thermal shrinkage for the IGOs in the wrists with occult instability.Methods: Fourteen patients from our hospital database between 2013 and 2015 who had IOGs combined with occult carpal instability were retrospectively reviewed. Diagnosis was exclusively established based on persistent wrist pain and functional limitation before surgery. The IOGs were removed under arthroscope, and bone grafting was performed accordingly dependent on the sizes and locations of the lesion. The lax intercarpal ligaments were tightened by radiofrequency shrinkage. Results were analyzed for demographic data and functional outcomes.Results: At a mean follow-up of 27 months, all patients were satisfied with pain relief and the patients’ grip power improved. The pre- and postoperative range of motion of the affected wrist had no significant difference. Radiologically, cyst recurrence and joint instability development were not observed. The postoperative function of the wrists significantly improved based on the Mayo Wrist Score and Patient-rated Wrist Evaluation score.Conclusions: For IOGs of carpal bones in the wrist with occult instability, arthroscopic treatment, including cyst resection and ligament thermal shrinkage, was an effective way to improve pain and function of the effected wrist.
Finite Element Analysis of the Indirect Reduction of Posterior Pedicle Screw Fixation for a Thoracolumbar Burst Fracture
Authors: Song Yuanzheng , Li Wei , Zhu Fahao
Published: December 2020

Background: Because burst fractures often involve damage to the column and posterior structures of the spine, the fracture block may invade the spinal canal and compress the spinal cord or the cauda equina, causing corresponding neurological dysfunction. When a thoracolumbar burst fracture is accompanied by the presence of bone in the spinal canal, whether posterior surgery requires spinal canal incision decompression remains controversial.Methods: Computed tomography (CT) images of the thoracolumbar spine of a 31-year-old male with an L1 burst fracture and Mimics 10.0 were used to establish a three-dimensional fracture model for simulating the indirect reduction process. The model was imported into Ansys 10.0, and a 1-10 mm displacement was loaded 10° behind the Z-axis on the upper endplate of the L1 vertebral body to simulate position reduction and open reduction. The displacement and stress changes in the intervertebral disc, fractured vertebral body and posterior longitudinal ligament were observed during reduction.Results: Under a displacement loaded 10° behind the Z-axis, the maximum stress in the vertebral body was concentrated on the upper disc of the injured vertebrae. The maximum displacement corresponded to the anterior edge of the vertebral body of the injured vertebrae, and the vertebral body height and the anterior lobes were essentially restored. When the displacement load was applied in the positive Z-axis direction, the maximum displacement corresponded to the posterior longitudinal ligament behind the injured vertebrae. Under a 6 mm load, the posterior longitudinal ligament displacement was 11.3 mm. Under an 8 mm load, this displacement significantly increased to 15.0 mm, and the vertebral stress was not concentrated on the intervertebral disc.Conclusions: The reduction of thoracolumbar burst fractures by positioning and distraction allowed the injured vertebrae to be restored to the normal height and kyphotic angle. The reduction of the posterior longitudinal ligament can move the bone block in the spinal canal into the reset space and yield good reset results.
The Analysis of Hepatitis B Virus Precore/core Mutations Arising in Different States of Infection
Authors: Hosseini Seyed Younes , Sanaei Neda , Hashemi Seyed Mohammad Ali , Dehno Seyedeh Zahra Salehi , Asl Mozhde Mahmoudi , Moini Maryam , Malek-Hosseini Seyed Ali , Sarvari Jamal
Published: December 2020

Background: In hepatitis B virus (HBV) infection, an association between Precore/Core variations and liver disease progression has been suggested. In this study, we aimed to determine the frequency of Precore/Core mutations in HBV-infected patients at various clinical stages. Methods: Totally, 73 HBV-infected patients including 26 inactive carriers, 20 chronic active and 27 patients with liver cirrhosis/hepatocellular carcinoma were randomly selected. The HBV DNA was extracted from the sera and subjected to nested PCR for amplification of pre-core/core region. The PCR product was then sequenced by Sanger method. Results: The stop codon of W/*28 was determined as the most prevalent mutation (55%) of pre-core region. The comparison of groups also demonstrated that core substitutions at residues of S21, E40 and I105 (<0.05) correlated with the development of inactive carrier state. Furthermore, the total substitutions in Th epitopes (117-131) were significantly higher in C/HCC group than IC and CA groups (P=0.001). Conclusion: Our results indicated a high frequency of W/*28 mutation in HBV studied patients. Moreover, variations including S21, E40 and I105 and R151 that were mapped onto cellular epitopes might be related to inactive state development.
The Perception of Ideal Facial Aesthetics Among Middle Eastern University Dental Students
Authors: Al-Harbi Asma , Al-Sanea Shoug , Al-Harbi Hajar , Kamal Mohammad
Published: December 2020

Background: The perception of facial aesthetics has been the subject of debate since ancient times and it is not considered to be absolute or fixed, rather relative. The dynamic relativity of facial aesthetics is thought to be affected by many factors, including but not limited to ethnicity, demographic variations, geographic locations, and other social backgrounds. The aim of this study was to assess the perception of ideal facial aesthetics among dental students in their preclinical and clinical years.Methods: A cross-sectional study of all dentistry students (n= 175 students) at Kuwait University Faculty of Dentistry. A morphometric questionnaire of six computer-generated 3D avatar female models with various facial features were constructed by altering the facial units: jaw shapes, chin shapes, nose shapes, mouth shapes, cheek shapes, profile shapes. Students were asked to choose the most and least preferred among the 6 avatar models.Results: A total of 149 questionnaire were completed by the students, with an overall response rate of 85.1%. The majority of students were female (92.6%). The preclinical and clinical students agreed on the most and least attractive facial model for all features except jaw shape. Students agreed that models with a broad jaw shape, moderately protruded chin with moderate height, short and less projected nose, prominent and full projected lips, prominent cheek bone with minimal buccal fat, and straight profile, were considered the most attractive faces.Conclusion: The study showed that dental students at Kuwait University have a perception of the facial esthetics that is largely in accordance with previously published studies. Dental students must recognize the variations of facial units and ideals of esthetics to better understand the demands and wishes of the patients, and thus, optimizing the treatment plan to achieve this goal.
Out-of-pocket Payments for Health Care Under the National Health Insurance Scheme in Ghana: What Do Clients Pay for?
Authors: Akweongo Patricia , Aikins Moses , Wyss Kaspar , Salari Paola , Tediosi Fabrizio
Published: December 2020

Background: The introduction of social health insurance in developing countries is an important policy to improve financial access to health care. In 2003, Ghana implemented a national health insurance scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments by insured clients is one such challenges of the scheme. This study seeks to examine the types of services that these unauthorized charges are made for, who pays these charges and how much clients pay out-of-pocket.Methods: This was a descriptive cross-sectional health facility survey. A total of 2066 respondents were interviewed using structured questionnaires at the point of health care exit in the Ashanti, Northern and Central regions of Ghana. Health facilities of different levels were selected from 3 districts in each of the three regions. Data were collected between April and June 2018. Using Epidata and STATA Version 13.1 data analyses were done using multiple logistic regression and simple descriptive statistics and results presented as proportions and means.Results: Of all respondents in the study 49.7% reported paying out-of-pocket for out-patient health care while 48.6% of insured clients paid out-of-pocket. 42% of the insured poorest quintile also paid out-of-pocket. Respondents suffered fever-malaria like symptoms (45.7%). Insured clients paid for consultation (75%) and drugs (68.5%) and 34.9% purchased drugs outside the health facility visited. The unavailability of the drugs (67.9%) and drugs not covered by the NHIS (20.8%) led to out-of-pocket payments. On average patients paid GHS33.00 (USD6.6) out-of-pocket. Compared to the Northern region, patients living in the Ashanti region were 4.4 times more at odds to pay out-of-pocket for health care. Conclusions: Insured clients of Ghana’s NHIS seeking health care in accredited health facilities make out-of-pocket payments for consultation and drugs that are covered by the scheme. The out-of-pocket payments are largely attributed to unavailability of drugs at the facilities. These out of-pocket payments occur in disadvantaged regions, among individuals and in all health facilities. Out-of-pocket payments under NHIS leads to inequity in access to health care.
Determinants of Severe Acute Malnutrition Among Children 6-36 Months in Kalafo District, Riverine Context, Ethiopia. Unmatched Case Control With Qualitative Study.
Authors: Ahmed Ahmed Tahir , Elmi Abdifatah , Abas Abdulahi , Omer Abdilahi
Published: December 2020

Background: Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries.Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia.Methods: Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition(SAM) among children between 6 to 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6-36 months using multivariate logistic regression.Results: The Odds of Severe Acute Malnutrition was 2.28(1.22,4.26); 4.68(2.29,9.58); 2.85(1.26,6.45); 2.39(1.16,4.96) and 3.262(1.46,7.31) and 3.237(1.45,7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past two weeks, their mothers had not nutrition counselling during pregnancy, Children’s age between 6-11 and 12-17 months as compared to controls.Conclusion: The finding of this study reveals that the main determinants of severe acute malnutrition in riverine context are multi-level. On top of poor childcare and polygamy in qualitative finding, Diarrhea and inadequate dietary intake under the category of immediate cause of malnutrition. Having more than (≥3) under-five children, young age (6-11 and 12-17months) and not having nutrition counseling during pregnancy were also among basic determinants of severe acute malnutrition in riverine context. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.
Foreign Language Teaching to Romani Students Through the Use of Differentiated Instruction and Portfolio Assessment. A Case Study.
Authors: Aikaterini Theodoropoulou Aristea , Zafiri Makrina
Published: December 2020

The authors have requested that this preprint be removed from Research Square.
Occupational Noise-Induced Tinnitus：Knowledge, Attitude and Practice (KAP)
Authors: Bai Lu , Yu Jianping , Du Hong , Shen Zhuang , Yang Hongyan
Published: December 2020

Background: Occupational noise is the most common hazards in the workplaces. Noise exposure may induce tinnitus (ringing in the ears), which seriously affects workers’ normal life, even impair their work performance. To investigate associations between if respondents are awareness of tinnitus induced by occupational noise (Knowledge), what the viewpoint they have (Attitude) and how they cope with it (Practice). Methods: A questionnaire based cross-sectional study was conducted. 519 noise-exposed workers in railway transportation mechanical manufacturers were recruited as the exposed group. 515 non noise-exposed workers as the control group. To investigate the effects of noise exposure level, the exposed group was classified into 4 subgroups according to sound level measurements reported by industrial hygienists., while the exposed group was categorized into 3 subgroups according to usage of personal hearing protection device (PHPD). Questionnaire was focused on medical history, occupational history, life habits and tinnitus for all participants. Qualified audiologists assessed hearing threshold by using standardized audio-metric procedures assuring at least 48 h of noise avoidance.Results: The prevalence of tinnitus were 36.6% and 18.8% in the exposed group and in the control group, respectively. The difference was statistically significant (c2=40.725, P<0.05). The prevalence of tinnitus were 36.2%, 20.5% and 41.7% in 3 using PHPD subgroups of the exposed group. The difference was statistically significant (c2=6.072, P<0.05). The prevalence of tinnitus were 34.7%，8.3%，63.6% and 54.0% in 4 sound level subgroups. The difference was statistically significant (c2trend=30.491, P < 0.05). The percentage of clinic visit for tinnitus was 15.8% in the exposed group. 93.2% workers claimed tinnitus symptoms were unimproved since they still heard buzzing or ringing in ears. 81.05% of them gave up treatment. The percentage of clinic visit for tinnitus was 7.2% in the control group and 99.0% workers claimed tinnitus symptoms were unimproved. Conclusions: Only when workers have awareness of tinnitus and tinnitus treatment can they have positive attitude and better practice. Noise-exposed workers should periodically attend educational courses on “taking care of your ears” and should be under the supervision.
SZABADIDŐ? SZABADULÁS? – Exit games a rekreációban
Authors: Petykó Csilla , Nagy Adrienne , Magyar Márton
Published: December 2020

Az elmúlt évtizedben a városok szabadidős kínálatában új, innovatív termékek is megjelentek, melyek egyik új fejlődési iránya a gamifikáció. Egy játék áll az aktvitás középpontjában, emlékezetes élmények kialakítása érdekében. Napjainkban a kreatív turizmus és gamifikáció egyik nemzetközi szinten is legnépszerűbb szolgáltatása a szabadulószoba, amelynek európai meghonosításában a magyar szolgáltatók úttörő szerepet játszottak. Kutatásunkban feltérképezzük Budapest ilyen típusú szolgáltatásait, melyek a lakosság és a turisták számára is egyre fontosabb vonzerőt jelentenek.
Ethambutol Induced Lichenoid Drug Eruption: A Case Report
Authors: Yuyaem Thitaree , Sudchada Patcharaporn , Srisuttiyakorn Chutika , Juntawong Jirapan , Khanngern Naruemon , Watcharapokin Natwara , Chansangiam Pitchayakorn
Published: December 2020

Background:

A rare type of cutaneous adverse drug reaction (CADR), lichenoid drug
eruption (LDE), can be associated with ethambutol.

Case Report:

A 60-year-old woman with spinal tuberculosis received multiple anti-TB medications
and developed rashes after 3 months of the treatments. A skin biopsy from the posterior auricular
area confirmed lichenoid dermatitis, and the Naranjo causality assessment indicated ethambutol
as a probable cause of LDE in the patient. The rashes slowly improved after discontinuation of
ethambutol. Unfortunately, the residual of brown hyperpigmentation on the body still persisted for
over 16 months.

Conclusion:

The medications were reduced to isoniazid 300 mg/day and rifampicin 450 mg /day
as planned for another 3 months. This case report points out the essentials of early recognition of
ethambutol LDE by health care professionals.
A Comparative Study on Cultivars of Capsicum: Critical Assessment based on Colour Values, Pungency and total Capsaicinoids Content
Authors: Sarojam Smitha , Mohan Nikhil , Paul Sumi S. , Chacko Baby K. , Nema Neelesh K. , Jacob Viju
Published: December 2020

Introduction:

Chillies or red peppers are consumed globally as a spice, condiment, culinary and as folk medicine because of their pungent taste, spicy flavour and therapeutic values. Colour, pungency and capsaicinoids are the potential characteristic attributes for assessing the quality of the dried chilli and are accountable for market price, trade and standardisation of the oleoresins.

Objective:

The present study was designed to prepare crude oleoresins from nineteen varieties of chilli and to enrich carotenoids contents in oleoresin paprika and capsaicinoids extractives in oleoresin capsicum separately for the evaluation and standardisation of colour, pungency and total capsaicinoids content.

Methods:

Crude oleoresins from dried fruits of chilli were prepared using conventional solvent extraction method, which were further enriched for the carotenoid and capsaicinoids extractives by fractionation techniques, and yielded oleoresin paprika and oleoresin capsicum separately. Oleoresins and their derivatives were subjected to analytical estimation of colour values, pungency and capsaicinoids content. The colour content was quantified using a UV Vis Spectrophotometer, whereas pungency was determined using HPLC and quantified as Million Scoville Heat Units. Total capsaicinoids contents were also quantified.

Results:

The highest extraction yield was found in the variety Teja (S-17) that is 8.82%, whereas enriched versions of oleoresin paprika and oleoresin capsicum were calculated higher in the varieties 273 and Teja (S-17) with the values 6.04 and 2.62%, respectively. The colour value of crude extract was the highest (3085.2 CU) in the variety 5531-IPM, whereas paprika was enriched high in the variety Lolly Chilli (3400.5 CU). The highest pungency (1.59 MSHU) was noted in the variety 5531-HPH. In the case of oleoresin capsicum, the pungency was highly enriched in the two varieties 4884 and Teja (S-17), with the MSHU values 6.11 and 5.5, respectively. Total capsaicinoids contents in the crude oleoresin were found maximum in the variety 5531-HPH (10.60%), whereas after purification (oleoresin capsicum), the maximum capsaicinoids contents were enriched in the varieties 4884 and Teja (S-17) with the values 40.73 and 36.67%, respectively.

Conclusion:

The outcome of our elaborated studies elucidates that Teja (S-17) 5531-HPH, 5531-IPM and 4884 varieties are better for extractive yield, pungency, and total capsaicinoids content, whereas 5531-IPM and Lolly Chilli varieties are better for colour extraction compared to all other varieties.
Preschool education that protects one's health and life, grows oneself, and cultivates a foundation for physical, mental and social health
Authors: Watanabe Kanae
Published: December 2020

Dr Kanae Watanabe, from Kanagawa University in Japan, has focused her career on researching children's health and education in Japan. She is now working with a team of researchers to synthesise best practices for human science and childhood studies that has potential to revolutionise
society. Her recent on-the-ground research has been based on travelling to countries that place a lot of emphasis on childcare and childhood. Here she undertakes a comprehensive analysis of the system to include not only the positive aspects, but also the downsides to their approaches. Her
aim is to demonstrate to both workplaces and local governments the benefits of improving the lives of small children, and how this will ultimately benefit society.
Effects of Ultrasound Visual Feedback
Authors: Yamane Noriko , Shinya Masahiro , Wilson Ian , Gick Bryan
Published: December 2020

Dr Noriko Yamane is an expert in speech production and perception based at Hiroshima University in Japan. Yamane is leading a team which is carrying out research to elucidate the precise mechanisms of the tongue and speechgestures that are required to learn English as a second language.
Yamane's goal is to help people who do not respond well to traditional approaches to improving articulation. Her long-term goal is to work with engineers and develop an app available for speakers, communities of the deaf and/or atypical speech, to help them to improve their communication.
Examining the wider social impact of COVID-19
Authors: Annette Lucy
Published: December 2020

The 2020 COVID-19 pandemic, declared by the World Health Organization (WHO) in January 2020 as a Public Health Emergency of International Concern, has led to global upheaval, causing over a million deaths as well as considerable social and economic disruption.
Overview of the research work undertaken by Prof. Tanaka and five collaborators
Authors: Tanaka Takako
Published: December 2020

Takako Tanaka, Masakazu Tamori, Yoshitaka Terada, Emi Okada, Jun Obi and Hidetoshi Kobinata have formed a collaborative research team who are creating a reliable and inclusive database of Indian classical music for academic use. Each of the six researchers has unique and valuable knowledge,
as well as different areas of expertise within music that they are bringing to this project. The aim of their work is to establish a large cultural resource about Indian classical music that musicologists and music lovers can use to carry out their own research.
Nature-based cultural diversity and tourism management for traditional crafts
Authors: Maruya Kota
Published: December 2020

Cultural tourism is a term relating to the act of tourists visiting a particular region of a country in order to experience and gain an appreciation for its culture. This might come in the form of the people who live in the region, their art, architecture, lifestyle, food and other
elements that have shaped their life. Dr Kota Maruya is a researcher based at Kanazawa University in Japan, his research into cultural tourism targets manufacturing and is spread across three themes: cultural diversity; cultural landscape; and cultural tourism. Part of Maruya's investigations
are concerned with finding ways of preserving and developing the culture that is unique to a particular region. By doing so, he hopes to promote cultural tourism as an opportunity for visitors to understand precisely what the residents have protected and what the underlying culture is.
Utilization of digital materials as a research resource for historical materials and applied interdisciplinary research for history and archaeology, including the research work and projects of Prof. Sato and Prof. Kikuchi
Authors: Kikuchi Hiroki , Sato Asei
Published: December 2020

The preservation of historical artefacts is an important means of understanding more about the past. Japan is home to thousands of stone inscriptions, many of which are not stored in research institutions of museums, but rather, are scattered across the country in places like roadsides
or graveyards in rural locations. While these inscriptions might well be of interest to local residents, there is a need to increase awareness of their cultural importance. A team led by Hiroki Kikuchi, who is based at The Historiographical Institute within The University of Tokyo in Japan,
is working to create a database which will digitise 2,700 inscription rubbings. The database will be open to the public and will provide a fascinating historical narrative as well as an important research resource.
The Impact of Literature in Construction the People of Modern Culture
Authors: Thi Hue Hoang , Phuong Thao Do , Thuy Hang Phan
Published: December 2020

This study clearly shows the value of literature and arts in general, contemporary Vietnamese poetry in particular, in the discovery and building of a modern, radical human model with Vietnamese cultural identity, on the basis of foreign cultural quintessence screening and processing department. The results of the study confirm the urgent need to establish new cultural values, modern human cultural personality, consistent with the cultural traditions of each nation and humanity.
Initial data required for forensic construction and technical examination related to the implementation of heritage site preservation works
Authors: Lisin Dmitry V. , Subbotin Artem S. , Ushakov Vladislav N. , Revunov Aleksandr A.
Published: December 2020

Introduction. The article addresses capital construction errors in historic areas of populated localities. The present-day construction industry places particular emphasis on problems associated with reconstruction and restoration of cultural heritage sites. Most of Russia’s famous cities date back to the early Middle Ages, some of them were first mentioned in the days of the ancient world. Each of them has its own unique history of foundation and development, traceable in historic districts, their unique cultural monuments, architectural styles and designs. The condition of numerous monuments of history and culture is deplorable: they need restoration. However, difficulties and legislative hurdles are on the way to permits and approvals authorizing restoration. The relevance of this work deals with the reconstruction of buildings and structures, improvement and inevitable development of areas that will accommodate new construction projects.

Materials and methods. The following research methods were applied: study of regulatory and legal documents pertaining to the field of research, analysis and theoretical generalization of the data collected, their comparison and systematization.

Results. A study of literary sources on theoretical and practical issues of forensic construction and technical examination was conducted. The list of information and documents needed for this examination to be performed in respect of cultural heritage preservation work was compiled.

Conclusions. The co-authors provide examples of frequent mistakes and difficulties encountered by developers at all stages of construction. The co-authors offer guidelines for the proper understanding of the line of efforts and operating procedures that may help to avoid difficulties and problems.
pactos de coparticipación en el gobierno ocurridos en la segunda mitad del siglo XIX y principio del siglo XX en Uruguay: Mutaciones constitucionales orales y proceso constituyente
Authors: Rodríguez Almada Pablo
Published: December 2020

En Uruguay, en la segunda mitad del siglo XIX y principio del siglo XX, ocurrieron tres hechos políticos significativos para la historia de la coparticipación de los partidos políticos en el Gobierno: los dos principales fueron el Pacto de Abril del año 1872 y el Pacto de la Cruz del año 1897 y el tercero, menos significativo por su duración, el Pacto de Nico Pérez del año 1903. Los pactos referidos, que eran orales, significaban la coparticipación de los partidos políticos en los gobiernos departamentales y, como consecuencia, también en el Poder Legislativo. Los acuerdos políticos mencionados, que fueron precedidos de revoluciones promovidas por el Partido Nacional, se aplicaron, con algunas interrupciones y modificaciones, durante treinta y dos años, inclusive en gobiernos de facto. El presente artículo analiza estos pactos de coparticipación y la vulneración de la Constitución que representaban, al convertirse en mutaciones constitucionales orales. Se pretende demostrar que, si bien dichas mutaciones constitucionales no tenían fuerza normativa —porque la costumbre no es fuente formal de derecho en Uruguay— y no tenían consenso político —se aplicaban como forma de evitar conflictos armados— formaron parte de un proceso constituyente que continuó con modificaciones de procedimientos constitucionales y leyes electorales, y que finalizó con la entrada en vigencia de la Constitución del año 1918.