bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Behavioral Competencies for Effective Medical Practice in Nigeria
Authors: Chukwuma Adanna , Obi Uche , Agu Ifunanya , Mbachu Chinyere 
Published: December 2020

Introduction: Clinical performance varies due to academic, clinical, and behavioral factors. However, in many countries, selection of medical professionals tends to focus on exclusively academic ability and clinical acumen. Appropriate selection processes for medical professionals should consider behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice in Nigeria, by medical students and doctors, and compared with other contexts. Methods: This mixed methods study draws on a scoping review and nominal group technique exercises. We undertook a scoping review to develop a list of behavioral attributes that may correlate with effective service provision in the empirical literature, across contexts. Drawing on nominal group technique exercises with 17 medical students and 11 physicians, this starting list was modified through scoring and ranking of selected competencies. We compared the list of competencies and rankings between medical students, doctors, and the scoping review. Results: The scoping review identified 9 articles for full-text review, resulting in a starting list of 21 behavioral competencies defined in studies, all of which had been conducted in non-African countries. The nominal group technique exercises conducted with medical students and doctors yielded a condensed list of 32 and 27 behavioral competencies respectively. For doctor-client interactions, effective communication and patient-centeredness were ranked highly, while for doctor-colleague interactions, teamwork, respectfulness, and management ability were ranked highly. There were also divergences in the condensed list of behavioral competencies and the scoping review, which may be explained by cultural and non-cultural factors. Discussion: This study is one of the few to examine the perspectives of medical students and physicians on behavioral competencies for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across countries. Our study illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered.
Intravesical holmium laser fragmentation and removal of a retained piece of tree branch from the urinary bladder of a young male
Authors: Afolayan Peter O. , Abdel Goad E. H. , Singh Avikar , Pillay Shaun 
Published: December 2020

Abstract
Background
Holmium laser has been used primarily for lithotripsy, and on soft tissue and tumor. Its effect on wood has never been described in the literature. Here-in case we were able to successfully laser intravesical wood particles in a young male.

Case presentation
A 12-year-old boy was referred to our urology center following a history of recurrent urinary tract infection to which an intravesical foreign body was picked up upon investigation. Imaging studies of an abdominal ultrasound had revealed an intravesical foreign body. He was found to have a piece of wood in the bladder that was too big to be extracted through the cystoscope and was lasered into fragments.

Conclusion
Our case showed a more versatile use of the holmium laser and concluded that it can be used successfully on wood.
A rather dry subject; investigating the study of arid-associated microbial communities
Authors: Osborne Peter , Hall Lindsay J. , Kronfeld-Schor Noga , Thybert David , Haerty Wilfried 
Published: December 2020

AbstractAlmost one third of Earth’s land surface is arid, with deserts alone covering more than 46 million square kilometres. Nearly 2.1 billion people inhabit deserts or drylands and these regions are also home to a great diversity of plant and animal species including many that are unique to them. Aridity is a multifaceted environmental stress combining a lack of water with limited food availability and typically extremes of temperature, impacting animal species across the planet from polar cold valleys, to Andean deserts and the Sahara. These harsh environments are also home to diverse microbial communities, demonstrating the ability of bacteria, fungi and archaea to settle and live in some of the toughest locations known. We now understand that these microbial ecosystems i.e. microbiotas, the sum total of microbial life across and within an environment, interact across both the environment, and the macroscopic organisms residing in these arid environments. Although multiple studies have explored these microbial communities in different arid environments, few studies have examined the microbiota of animals which are themselves arid-adapted. Here we aim to review the interactions between arid environments and the microbial communities which inhabit them, covering hot and cold deserts, the challenges these environments pose and some issues arising from limitations in the field. We also consider the work carried out on arid-adapted animal microbiotas, to investigate if any shared patterns or trends exist, whether between organisms or between the animals and the wider arid environment microbial communities. We determine if there are any patterns across studies potentially demonstrating a general impact of aridity on animal-associated microbiomes or benefits from aridity-adapted microbiomes for animals. In the context of increasing desertification and climate change it is important to understand the connections between the three pillars of microbiome, host genome and environment.
Pleuroperitoneal communication after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors: a case report and brief literature review
Authors: Ino Jun , Kaneko Haruna , Kasama Eri , Kodama Mio , Sato Keitaro , Eizumi Hitoshi , Nitta Kosaku 
Published: December 2020

Abstract
Background
Peritoneal dialysis (PD) is associated with various complications, some of which may result in its discontinuation. Pleuroperitoneal communication (PPC) is commonly recognized by the presence of a diaphragmatic defect and pressure elevation in the abdominal cavity due to the dialysate. PPC is unpredictable and its presence prevents the continuation of PD. We present the clinical course and pathological findings of PPC in a PD patient after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors. We provide a brief review of PD-related complications that develop due to a non-infectious pathology, including those related to catheter use and an elevated intra-abdominal pressure.

Case presentation
A 65-year-old Japanese man, who had been receiving PD treatment for 1 year, visited our hospital owing to a cloudy dialysate. Bacteria were detected in the dialysate. He had been previously diagnosed with gastric neuroendocrine tumors and gastrectomy had been planned. On admission, we started a 14-day antibiotic treatment for PD-related peritonitis. The patient showed a good clinical course. Gastrectomy was performed as planned, and the postoperative course was uneventful. During the perioperative period, PD was temporally changed to hemodialysis. Five weeks after the gastrectomy, PD treatment was resumed with gradual increase in the exchange volume. After returning to PD overnight, using an automated peritoneal dialysis machine, the patient complained of breathing difficulty and he gained weight. Right-sided pleural effusion was observed on a chest radiograph, and PPC was confirmed by scintigraphy when a mixture of technetium-99m and dialysate was seen entering the right hemithorax within 120 min. The patient did not consent to surgery for the PPC and he hoped to continue to receive PD treatment conservatively. We advised the patient to undergo dialysate exchange in a semi-seated position, and he was prohibited from lying down during the daytime. He continued PD treatment without signs of pleural effusion and over-volume.

Conclusions
This case of PPC occurring after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors in a PD patient demonstrates the necessity of recognizing the PPC pathology in PD management and establishing methods for preventing PPC development after bacterial peritonitis or surgical procedures.
A novel method for locating the source of sustained oscillation in power system using synchrophasors data
Authors: Zuhaib Mohd , Rihan Mohd , Saeed Mohd Tayyab 
Published: December 2020

AbstractLarge interconnected power systems are usually subjected to natural oscillation (NO) and forced oscillation (FO). NO occurs due to system transient response and is characterized by several oscillation modes, while FO occurs due to external perturbations driving generation sources. Compared to NO, FO is considered a more severe threat to the safe and reliable operation of power systems. Therefore, it is important to locate the source of FO so corrective actions can be taken to ensure stable power system operation. In this paper, a novel approach based on two-step signal processing is proposed to characterize FO in terms of its frequency components, duration, nature, and the location of the source. Data recorded by the Phasor Measurement Units (PMUs) in a Wide Area Monitoring System (WAMS) is utilized for analysis. As PMU data usually contains white noise and appears as multi-frequency oscillatory signal, the first step is to de-noise the raw PMU data by decomposing it into a series of intrinsic mode functions (IMF) using Improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (ICEEMDAN) technique. The most appropriate IMF containing the vital information is selected using the correlation technique. The second step involves various signal processing and statistical analysis tools such as segmented Power Spectrum Density (PSD), excess kurtosis, cross PSD etc. to achieve the desired objectives. The analysis performed on the simulated two-area four-machine system, reduced WECC-179 bus 29 machine system, and the real-time power system PMU data set from ISO New England, demonstrates the accuracy of the proposed method. The proposed approach is independent of complex network topologies and their characteristics, and is also robust against measurement noise usually contained in PMU data.
Sequential CT arterioportography-arteriosplenography depicts individual haemodynamic changes in children with portal hypertension without cirrhosis
Authors: Hammer Simone , Schlitt Hans Jürgen , Knoppke Birgit , Huf Veronika Ingrid , Wohlgemuth Walter Alexander , Uller Wibke 
Published: December 2020

AbstractWe evaluated sequential computed tomography (CT) arterioportography-arteriosplenography for the assessment of venous pathways in children with portal hypertension without cirrhosis. Institutional Review Board approval was obtained for this retrospective, single-centre study. CT was performed after contrast application via catheters placed in the superior mesenteric artery (CT arterioportography) and the splenic artery (CT arteriosplenography) consecutively. Venous pathways in 22 children were evaluated. In all patients, the detailed haemodynamic consequences of portal hypertension could be characterised. The supply of varices at different locations could be assigned to the superior mesenteric vein or splenic vein system. Retrograde blood flow through the splenic vein and inferior mesenteric vein, portosystemic shunting, and patency of splanchnic veins were determined. CT arterioportography-arteriosplenography allowed a complete evaluation of individual haemodynamic pathways in children with portal hypertension.
Semi-quantitative CT imaging in improving visualization of faint ground glass opacities seen in early/mild coronavirus (covid-19) cases
Authors: Ali Rasha Mostafa Mohamed , Ghonimy Mai Bahgat Ibrahim 
Published: December 2020

Abstract
Background
Chest CT is an essential and simple diagnostic method for early detection of pulmonary changes in COVID-19 patients. Semi-quantitative technique depending on both visual and color coded images helps to improve the early detection of COVID-19 chest affection and thus help to control spread of infection.

Results
From first of May to July 15, 2020, 30 patients in Cairo, Egypt who have positive RT-PCR tests and positive pulmonary manifestation were included in our study, 26 patients (86.6%) with faint ground glass opacities were detected by both visual and color coded images, while in 4 patients (13.3%) were only visualized by color coded images and confirmed by CT density assessment.

Conclusion
The combined use of visual and color coded images enhance and improve the early detection of faint ground glass opacities seen in early COVID-19 affection.
Chest CT in COVID-19 pneumonia: a correlation of lung abnormalities with duration and severity of symptoms
Authors: Dawoud Mohammed Mahmoud , Dawoud Tamer Mahmoud , Ali Noha Yousef Amin , Nagy Hanan Ahmad 
Published: December 2020

Abstract
Background
After the spread of COVID-19 pneumonia, chest CT examination was used as a substantial non-invasive complement to RT-PCR for diagnosing and as a rapid screening tool when RT-PCR results are unavailable. Our study aimed at the analysis of the lung abnormalities detected by chest CT in COVID-19 pneumonia according to the severity and duration of symptoms.

Results
In the early phase (n = 60), 32 patients had negative CT findings and 28 patients had positive findings with a mean total lung severity score of 2.13. In the intermediate phase (n = 116), 4 patients had negative CT findings and 112 patients had positive findings with a mean total lung severity score of 16.08. In the late phase (n = 36), all patients had positive findings with a mean total lung severity score of 17.83. CT lung abnormalities were progressed on follow-up CT studies. We found a high total lung severity score in many patients with mild symptoms with a mean of 14.77 and a low total lung severity score in many patients with moderate to severe symptoms with a mean of 9.14.

Conclusion
Chest CT should be used as a routine examination for diagnosing COVID-19 pneumonia and follow-up of disease advance. The progression of lung abnormalities was related to the duration more than the severity of symptoms.
High extinction ratio optical pulse characterization method via single-photon counting
Authors: Vanus Benoit , Baker Chams , Chen Liang , Bao Xiaoyi 
Published: December 2020

We present the characterization of high extinction ratio (

ε

) square optical pulses using a photon
counting technique, as other techniques only offer a limited range of
measurement up to 60 dB. High-

ε

pulses are generated by applying a
square pulse modulation on sinusoidally modulated optical signals,
then inducing self-phase modulation (SPM) using the nonlinear Kerr
effect and extracting an SPM-generated sideband. We measured a 10 ns
Kerr-generated optical pulse exhibiting a 120.1 dB extinction ratio,
originating from a conventional electro-optic modulator delivering a
pulse with a 20-dB extinction ratio, by counting the number of photons
at the peak and the pedestal of the generated pulse. These proven high-

ε

pulses allow for long-range
distributed vibration sensing in optical time-domain reflectometry
systems and open new horizons in high-Q microring sensors.
Silicon Brewster plate wavelength separator for a mid-IR optical parametric source
Authors: Csanaková Bianka , Novák Ondřej , Smrž Martin , Huynh Jaroslav , Jelínková Helena , Lucianetti Antonio , Mocek Tomáš 
Published: December 2020

The availability of optical elements for the mid-infrared wavelength range, such as polarizers and wavelength separators, is limited especially when a broadband wavelength range coverage is required. We propose a polarizer based on uncoated silicon Brewster plates. A detailed analysis of the polarizer’s contrast and the influence of parasitic reflections, its dependence on wavelength, and the angular misalignment is shown. Two different arrangements of the two- and four-plate polarizers are discussed. With contrast including the influence of parasitic reflections of over

10

3

for the whole transparency range of silicon (1.2–6.5 µm), the four-plate polarizer is an effective, low-cost, high-power compatible tool providing sufficient contrast for signal and idler beam separation of the broadband mid-infrared Type II optical parametric sources. The proposed polarizers can function as an attenuator assembly without any wave plate.
Endoscopic Ultrasound-Guided Gastrojejunostomy and Rescue Technique to Simplify Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy
Authors: Chin Jerry , Storm Andrew C. 
Published: December 2020

ABSTRACT
Patients with surgically altered gastrointestinal anatomy are susceptible to gallstone disease and anastomotic strictures. In such cases, enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) is traditionally used to access the biliary system through the Roux limb, with suboptimal success rates. With the advent of endoscopic ultrasound (EUS) and therapeutic tools including lumen-apposing metal stents, access to the biliary system in surgically altered anatomy has been made simpler. We report a case of EUS-guided transenteric ERCP done in a patient with surgically altered anatomy and a rescue technique for difficult gastrojejunal anastomosis creation.
Controlled Delivery of Bile Acids to the Colon
Authors: Steiger Christoph , Phan Nhi V. , Sun Haoying , Huang Hen-Wei , Hess Kaitlyn , Lopes Aaron , Korzenik Joshua , Langer Robert , Traverso Giovanni 
Published: December 2020

INTRODUCTION:
Bile acids, such as chenodeoxycholic acid, play an important role in digestion but are also involved in intestinal motility, fluid homeostasis, and humoral activity. Colonic delivery of sodium chenodeoxycholate (CDC) has demonstrated clinical efficacy in treating irritable bowel syndrome with constipation but was associated with a high frequency of abdominal pain. We hypothesized that these adverse effects were triggered by local super-physiological CDC levels caused by an unfavorable pharmacokinetic profile of the delayed release formulation.

METHODS:
We developed novel release matrix systems based on hydroxypropyl methylcellulose (HPMC) for sustained release of CDC. These included standard HPMC formulations as well as bi-layered formulations to account for potential delivery failures due to low colonic fluid in constipated patients. We evaluated CDC release profiles in silico (pharmacokinetic modeling), in vitro and in vivo in swine (pharmacokinetics, rectal manometry).

RESULTS:
For the delayed release formulation in vitro release studies demonstrated pH triggered dose dumping which was associated with giant colonic contractions in vivo. Release from the bi-layered HPMC systems provided controlled release of CDC while minimizing the frequency of giant contractions and providing enhanced exposure as compared to standard HPMC formulations in vivo.

DISCUSSION:
Bi-phasic CDC release could help treat constipation while mitigating abdominal pain observed in previous clinical trials. Further studies are necessary to demonstrate the therapeutic potential of these systems in humans.
O PROGRAMA MAPA DO TURISMO BRASILEIRO E SUA ESPACIALIDADE NO MUNICÍPIO DE MARABÁ-PA
Authors: Rogério Hage Serra Hugo , Rodrigues Paz Izabela 
Published: December 2020

Este trabalho possui o objetivo de analisar a espacialidade do Programa Mapa do Turismo Brasileiro no município de Marabá por meio da regionalização do território paraense empreendida pelo governo federal. Parte-se de uma metodologia baseada na leitura dos documentos oficiais que possuem no traçado das políticas públicas de turismo no território brasileiro, por meio do Programa de Regionalização do Turismo. Empreende-se uma análise de conteúdo baseada na dedução e na inferência de fatos geográficos da referida política, entre as quais percebe-se uma tentativa de regionalizar o território a partir das diretrizes governamentais expostas na política de Estado. Os resultados mostram que agentes públicos e privados envolvidos no turismo de Marabá aderem ao PMTB apenas para angariarem fundos públicos, os quais, não necessariamente se manifestam em obras de repercussão espacial turística. Associado a isso, o PMTB toma o conceito de região turística como somatória de municípios sem haver um efeito regional entre eles.
Palavras-chave: Programa Mapa do Turismo Brasileiro. Turismo. Território. Região. Marabá.
Efektivitas Penambahan Ragi Roti (Saccharomyces cerevisiae) pada Pakan Buatan Ikan Tawes (Puntius javanicus) Terhadap Laju Pertumbuhan, Efisiensi Pemanfaatan Pakan dan Kelulushidupan
Authors: Sumardiyani Desy , Rachmawati Diana , Samidjan Istiyanto 
Published: December 2020

Ikan tawes (Puntius javanicus) merupakan komoditas ikan air tawar yang bernilai ekonomis tinggi tetapi memiliki kendala didalam budidaya yaitu pertumbuhannya lambat dan pemanfaatan pakan yang kurang efisien. Salah satu solusi untuk mengatasi permasalahan tersebut adalah dengan penambahan ragi roti (S. cerevisiae) pada pakan. Penelitian ini bertujuan untuk mengetahui pengaruh penambahan S. cerevisiae pada pakan terhadap tingkat kosumsi pakan (TKP), efisiensi pemanfaatan pakan (EPP), laju pertumbuhan relatif (RGR) dan kelulushidupan. Materi yang digunakan adalah ragi roti (S. cerevisiae) yang dicampurkan pada pakan buatan ikan dengan cara disemprotkan dan setelah kering diberikan sebagai pakan ikan tawes. Penelitian dilakukan dengan metode ekperimental menggunakan rancangan acak lengap (RAL) dengan 4 perlakuan dan 3 kali pengulangan. Perlakuan yang diberikan yaitu dengan dosis A (0 g/kg pakan), B (3 g/kg pakan), C (6 g/kg pakan) dan D (9 g/kg pakan). Hewan uji yang digunakan adalah ikan tawes (P. javanicus) sebanyak 120 ekor dengan bobot rata-rata 18,20±0,62 g/ekor. Wadah yang digunakan pada penelitian adalah hapa dengan ukuran 50x50x50 cm3 dengan padat penebaran ikan tawes pada perlakuan yaitu 1 ekor/2 liter. Ikan tawes diberi makan 3 kali sehari sebanyak 5% dari bobot biomassa. Hasil penelitian menunjukkan bahwa penambahan S. cerevisiae pada pakan memberikan pengaruh nyata (P<0,05) terhadap rasio konversi pakan (FCR) dan pertumbuhan spesifik (SGR) tetapi tidak berpengaruh nyata (P>0,05) terhadap kelulushidupan. Hasil terbaik diperoleh pada pemberian pakan dengan dosis 3 g/kg pakan (B) dengan nilai rasio konversi pakan (FCR) 1,28±0,03, pertumbuhan spesifik (SGR) 5,90±0,09% dan kelulushidupan 95,00±8,66%. Kata Kunci : Saccharomyces cerevisiae, ikan tawes dan pertumbuhan