bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Physicians' Departure from General Practitioners Field in Developing Countries: A Case Study in Iran
Authors: Shokri Azad , Mirbahaeddin Elmira , Akbari-Sari Ali , Harirchi Iraj , Farzianpour Fereshteh , Foroushani Abbas Rahimi , Shokri Somaieh , Moghadam Sima Mirzaei , Bayat Mahboubeh 
Published: July 2020

Abstract
Background: Migration, intersectoral flows, early retirement, illness and premature death of General Practitioners (GPs), maintaining adequate and effective workforce has become a major challenge in many countries. The present study aimed to investigate the factors affecting the departure of physicians from the GPs field in developing countries.Methods: We used qualitative research and performed as a conventional content analysis through in-depth interview. Sampling method was purposeful sampling which was performed with variation in individuals include policy makers and different situation in GPs (including immigration, unemployment, specialty student, employment in other non-medical jobs, etc.). Lincoln and Guba evaluation method were used to determine the validity and reliability of the study. The conceptual model was used to illustrate the situation and deeper understanding of the problemResults: The results of the interviews showed, eight themes, 22 sub-themes were identified as factors influencing tendency GPs to other states. Major themes included income, referral system, specialization, human resource policy-making, education related issues, working environment conditions, quality of life and community attitude. The causal relationships were shown inside and outside each theme in the conceptual model.Conclusion: According to the results, there are various factors that lead people out of the field of GP and their tendency to different states, while lack of awareness of policy makers and officials can make decisions for years to come. A wide range of interventions is recommended to reduce these stimuli include pre-selection reforms such as "information about physicians' working conditions", during academic training such as "changing hospital education to clinic education and rural community experience" and after entering areas of the medical profession such as "defining the career path for physicians 'distribution and physicians' career development" and long-term reforms include fundamental reforms to promote family medicine referral and change community attitudes.
RAPD and ERIC-PCR coupled with HRM for species identification of non-dysenteriae Shigella species isolated from clinical specimens; As a potential of alternative method
Authors: Pakbin Babak , Basti Afshin Akhondzadeh , Khanjari Ali , Azimi Leila , Karimi Abdollah 
Published: July 2020

Abstract
Background: Species identification of Shigella isolates are so prominent for epidemiological studies and implementing infection prevention strategies. We developed and evaluated RAPD and ERIC-PCR assays coupled with HRM for differentiation of non-dysenteriae Shigella species as potential alternative methods. isolation of eighteen Shigella strains from faecal specimens collected from children under 2 years old with diarrhea symptom (n=143), species of the isolates were identified by slide agglutination assay as the golden standard method. Species of isolates were identified using developed RAPD-PCR-HRM and ERIC-PCR-HRM assays and differentiation of data sets obtained from difference plots of HRM was implemented by PCA as a dimension reduction method then sensitivity and specificity of the methods were evaluated using ROC curve. Results: Consequently, we found that RAPD-PCR-HRM with sensitivity and specificity of 100 and 85% respectively is significantly more suitable for identification of non-dysenteriae Shigella species. However, sensitivity and specificity of ERIC-PCR-HRM were evaluated 33 and 46% respectively.Conclusion: Regardless of inherent poor reproducibility of DNA fingerprinting based methods, RAPD-PCR-HRM assay can be considered as a potential of alternative method for species identification. Also, HRM technique used in this study is more rapid, inexpensive, and sensitive than gel electrophoresis for characterization of PCR amplicons.
Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI
Authors: Assakran Bandar Saad , Alrakbi Khaled Mohammed , Alharbi Meshari Abdulrahman , Almatroudi Moath Abdullah , Alshowaiman Asim Nizar , Alromaih Abdullah Homood , Alharbi Basil Abdulrahman , Alaqil Naif Suliman , Alsoghayer Ali Saleh 
Published: July 2020

Abstract
Background In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia.Aim The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy screening and correlation with BMI.Materials and Methods This was an observational retrospective cohort study conducted at King Fahad Specialist hospital-Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had upper gastrointestinal endoscopy screening between January 2017 – December 2019. Data were tabulated in MS Excel and were analyzed using SPSS version 21.Results Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.3%. Chi-square test revealed that the use of Proton-pump inhibitors (PPI) (X2=6.876; p=0.009) and abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023) significantly decreased the risk of HH while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH.Conclusion Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was a protective factor of HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.
A pragmatic randomized controlled trial reports the efficacy of hydroxychloroquine on coronavirus disease 2019 viral kinetics
Authors: Lyngbakken Magnus Nakrem , Berdal Jan-Erik , Eskesen Arne , Kvale Dag , Olsen Inge Christoffer , Rueegg Corina Silvia , Rangberg Anbjørg , Jonassen Christine Monceyron , Omland Torbjørn , Røsjø Helge , Dalgard Olav 
Published: July 2020

Abstract
We randomized 53 patients hospitalized with coronavirus disease 2019 (COVID-19) to hydroxychloroquine therapy (at a dose of 400 mg twice daily for seven days) in addition to standard care or standard care alone (ClinicalTrials.gov Identifier, NCT04316377). All severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients 18 years of age or older were eligible for study inclusion if they had moderately severe COVID-19 at admission. Treatment with hydroxychloroquine did not result in a significantly greater rate of decline of SARS-CoV-2 oropharyngeal viral load compared to standard care alone during the first five days. Our results suggest no important antiviral effect of hydroxychloroquine in humans infected with SARS-CoV-2.
Surveillance on schistosomiasis in five provinces of the People's Republic of China in post-elimination era
Authors: Guo Jing-yi , Xu Jing , Zhang Lijuan , Shan Lv , Cao Chun-li , Li Shi-zhu , Zhou Xiao-nong 
Published: July 2020

Abstract
Background: The People’s Republic of China (P. R. China) had made significant progress on schistosomiasis control. Among the 12 provinces (municipality, autonomous region with schistosomiasis endemic) in P.R. China, Guangdong, Shanghai, Fujian, Guangxi and Zhejiang provinces (following called as five provinces) had successively eliminated schistosomiasis during 1985-1995. However, given the increasing mobilization of the population and goods, wetland protection, climate changes etc., consolidation of the schistosomiasis elimination in these five provinces remain challenges. In the current study, we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis. Methods: (Ⅰ) Through the national schistosomiasis reporting system, annual data reflecting the interventions and surveillance on human beings, cattle and snails based on county level from 2005 to 2016 were collected and analyzed to understand the epidemic status of schistosomiasis in five provinces. (Ⅱ) A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five provinces and ten counties. Assessment on surveillance capacity consisted of two parts: the first part focused on the capacity of testing skills including schistosomiasis diagnostic skills, identification of snails’ living and infection status; the second part was to assess the knowledge level about schistosomiasis and its control.Results: The comprehensive assessments showed that no local cases in humans and cattle or infected snail were found in these five provinces from 2005, and the surveillance abilities on schistosomiasis of the prevention and control institutions in five provinces were appropriate. However, from 2005 to 2016, a total of 221 imported cases were detected in Zhejiang, Shanghai and Fujian provinces, and 11.98 hm2 of new snail habitats were found in Zhejiang, Shanghai and Guangxi provinces. In addition, snail infestation was reoccurred in 247.55 hm2 of former snail habitats since 2011.Conclusions: Elimination of schistosomiasis was consolidated successfully in five provinces of P.R. China due to effective and strong post-elimination surveillance. Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources among the five provinces to consolidate the achievements of schistosomiasis control.
An integer linear programming model to optimize the hub and spoke-based water desalinated transmission system
Authors: Al Gahtani Osama Saad , Mrad Mehdi 
Published: July 2020

Abstract
Desalinated water is becoming a significant resource in many countries. With limited water supply, several high-demand sites located far from the desalination plant and an efficient and cost-effective transmission and storage network have become critical. In many areas, desalinated water is not delivered efficiently through a pipeline and storage tank system capable of providing safe and cost-effective coverage to a wide range of demand sites. In addition, due to the limitation of transmission and storage distribution, many desalination plants are unable to achieve full production capacity. Many high-demand sites are at risk of disruption or water contamination due to single-source pipelines or desalination plants. In this study, the conceptual framework for an economically viable transmission and storage system helps decision-makers to define the requirements for the proper design of the system. The definition is introduced here to describe strategic tanks for efficient and economical supply allocation. The key aspects of setting up effective transmission and storage systems were outlined in the framework presented. To develop an efficient and cost-effective transmission and storage system, an integer linear program was constructed to solve the hub and spoke issue. A hypothetical example is presented and discussed to illustrate the advantages of the proposed model.
Multivariate drought risk analysis based on copula functions: a case study
Authors: Seyedabadi Mohammadreza , Kavianpour Mohammadreza , Moazami Saber 
Published: July 2020

Abstract
Drought is asserted as a natural disaster that encompasses vast territories for a long time and affects human life. Indicators are powerful tools for understanding this phenomenon. However, in order to get more information about the drought, multivariate indices were introduced for simultaneous evaluation of multiple variables. In this study, a combined drought index (CDI) based on three drought indices, the Standardized Precipitation Index (SPI), Streamflow Drought Index (SDI), and Standardized Water-level Index (SWI), is defined. Then, the Entropy method is used to determine the weight of each indicator. Among the calculated weights, SDI and SPI had the highest and lowest weight, respectively. The CDI is utilized to identify drought characteristics, such as duration and severity. In addition, the joint distribution function of drought characteristics is formed by copula functions and consequently the probability of different droughts is calculated. For the study area, data and information from eight regions located in Golestan province in the northern part of Iran are used to evaluate the performance of the proposed index. Four categories of drought were defined and their return period calculated. The shortest return period of severe drought was observed in the east and then in the west. In the south and center, the return period of severe drought was longer. Over the course of 30 years, all parts of the province experienced all drought categories.
An Insight into Unani Hypoglycemic Drugs and Their Mechanism of Action
Authors: Fazil Mohammad , Nikhat Sadia , Ali Imran 
Published: July 2020

Background:Diabetes mellitus type-II is a major health problem characterized by hypoinsulinemia and insulin resistance, leading to hyperglycemia and its complications. In Unani medicine, it is known as ziyābetus. Several drugs are prescribed in Unani medicine as single and compound formulations for this disease. Most of these drugs have been studied on scientific parameters and shown significant activity in reducing the symptoms and complications of diabetes.Objectives:Critical evaluation of Unani medicines for treating diabetes patients have been conducted. The aim of the study is to provide complete information on this subject with the action of the mechanism so that proper treatment should be done with prospective research.Methods:Unani literature was reviewed extensively via various search engines for the herbs, shrubs used for diabetes treatment. Ten drugs were selected for the present review.Results and Conclusion:There is convincing evidence to suggest that the selected drugs have promising actions against diabetes and its complications. In addition, none of the studies has reported any adverse effects with the drugs. Also, there is evidence to suggest that the method of usage described in Unani medicine may reduce or eliminate adverse events, if any. Further, there is a great need to do more research on making medicine more effective. Besides, the review article is useful for treating patients effectively by advancing the research.
Current Approaches in Diabetes Treatment and Other Strategies to Reach Normoglycemia
Authors: Sirhan Worood , Piran Ron 
Published: July 2020

:
Cells are mainly dependent on glucose as their energy source. Multicellular organisms need to
adequately control individual glucose uptake by the cells, and the insulin-glucagon endocrine system
serves as the key glucose regulation mechanism. Insulin allows for effective glucose entry into the cells
when blood glucose levels are high, and glucagon acts as its opponent, balancing low blood glucose levels.
A lack of insulin will prevent glucose entry to the cells, resulting in glucose accumulation in the
bloodstream. Diabetes is a disease which is characterized by elevated blood glucose levels. All diabetes
types are characterized by an inefficient insulin signaling mechanism. This could be the result of insufficient
insulin secretion, as in the case of type I diabetes and progressive incidents of type II diabetes or due
to insufficient response to insulin (known as insulin resistance). We emphasize here, that Diabetes is actually
a disease of starved tissues, unable to absorb glucose (and other nutrients), and not a disease of high
glucose levels. Indeed, diabetic patients, prior to insulin discovery, suffered from glucose malabsorption.

:
In this mini-review, we will define diabetes, discuss the current status of diabetes treatments, review the
current knowledge of the different hormones that participate in glucose homeostasis and the employment
of different modulators of these hormones. As this issue deals with peptide therapeutics, special attention
will be given to synthetic peptide analogs, peptide agonists as well as antagonists.
Left Ventricular Noncompaction: New Insights into a Poorly Understood Disease
Authors: Filho Dário C. Sobral , do Rêgo Aquino Pedro L. , de Souza Silva Guilherme , Fabro Caroline B. 
Published: July 2020

:
Left ventricular noncompaction (LVNC) is a congenital pathology that directly affects
the lining walls of myocardial tissue, causing trabeculations with blood filling in the inner wall of
the heart, concomitantly with the development of a mesocardial thinning. Although LVNC was described
for the first time as long ago as 1984, our understanding of the disease with regard to its genetic
pattern, diagnosis, clinical presentation and treatment is still scanty. LVNC can present as an
isolated condition or associated with congenital heart disease, genetic syndromes or neuromuscular
disease. This suggests that LVNC is not a distinct form of cardiomyopathy, but rather a morphological
expression of different diseases. Recognition of the disease is of fundamental importance
because its clinical manifestations are variable, ranging from the absence of any symptom to congestive
heart failure, lethal arrhythmias and thromboembolic events. The study of this disease has
emphasized its genetic aspects, as it may be of sporadic origin or hereditary, in which case it most
commonly has an autosomal dominant inheritance or one linked to the X chromosome. Echocardiography
is the gold standard for diagnosis, and magnetic resonance imaging may refine the identification
of the disease, especially in those patients with non-conclusive echocardiography. This article
sets out to review the main characteristics of LVNC and present updates, especially in the genetic
pattern, diagnosis and treatment of the disease.
Weighted Aggregation Operators of Fuzzy Credibility Cubic Numbers and their Decision Making Strategy for Slope Design Schemes
Authors: Ye Jun , Du Shigui , Yong Rui , Zhang Fangwei 
Published: July 2020

Background:
A Fuzzy Cubic Set (FCS) is composed of a Fuzzy Set (FS) (certain fuzzy
numbers) and an Interval-Valued Fuzzy Set (IVFS) (uncertain fuzzy numbers) to describe the hybrid
information of both. To enhance the credibility of both, they should be closely related to the
measures/degrees of credibility owing to the vagueness and uncertainty of humans’ cognitions regarding
the real world.

Objective:
This paper presents the notions of a Fuzzy Cubic Credibility Set (FCCS) and a Fuzzy
Cubic Credibility Number (FCCN) as the new generalization of the FCS notion to enhance the credibility
level of FCS by means of the credibility degrees of both FS and IVFS. Next, we define operations
of FCCNs, an expected value of FCCN, and the FCCN Weighted Arithmetic Averaging
(FCCNWAA) and FCCN Weighted Geometric Averaging (FCCNWGA) operators for Decision
Making (DM) strategy.

Method:
A DM strategy using the FCCNWAA or FCCNWGA operator is proposed to solve multicriteria
DM problems in the environment of FCCNs. Then, the proposed DM strategy is applied to
a DM example of slope design schemes for an open-pit mine in the environment of FCCNs to reflect
the feasibility of the proposed DM strategy.

Result:
By comparison with the fuzzy cubic DM strategy, the DM results with and without the degrees
of credibility, can impact on the ranking of alternatives in the DM example to reflect the effectiveness
of the proposed DM strategy.

Conclusion:
However, the highlighting advantage of this study is that the proposed DM strategy not
only indicates the degrees of credibility regarding the assessed values of FCNs in the DM process
but also enhances the DM reliability in the environment of FCCNs. Hence, the proposed DM strategy
is superior to the fuzzy cubic DM strategy in the environment of FCCNs.
'White pages' in the academy: Plagiarism, consumption and racist rationalities
Authors: Saltmarsh Sue 
Published: July 2020

This paper is situated against the backdrop of the global market in tertiary education, and recent moral panics in the Australian press concerning the implications of international education for what is perceived by many as a decline in academic standards and a potential devaluing of Australian tertiary qualifications in the global marketplace. This paper poses a challenge to these notions, and draws on poststructuralist theories of consumption, production and power, to consider how discourses of educational consumption are mapped onto the racialised commodification of tertiary education. The paper argues that racism—under the rhetorical guise of neoliberal ideals such as maintaining academic standards, ensuring institutional accountability
and protecting market share in the interest of the national economy— shapes the discursive terrain of international education in the tertiary sector.
Editorial Volume 6 (2)
Authors: Moore Christopher , Walker Ruth 
Published: July 2020

Introduction to the special issue:
"Digital technologies and educational integrity"

When Roger Silverstone (1999, p.10) asked "what is new about new media?" more than a decade ago at the launch of the first edition of the journal New Media and Society, he framed the question as an inquiry about the relationship between continuity and change. To address the issues relating to the interest and reliance on technologies in educational contexts - whether we are talking about web 2.0, digital media, social media, new media, or even next media - requires us to consider what is most important about the standards, traditions and practices that we hold as crucial to teaching, learning and research, as well as their relationship to change.

This special issue broaches these issues to consider how changes in technologies used by teachers and learners - both in and out of educational contexts - has impacted on our understandings of educational integrity. To do this, we have had to ask questions about the integrity of the educational enterprise itself: just as the expanding research and writing capacities of digital media have complicated notions of authorship, so too does the increasing reliance on technologies in educational settings complicate expectations about the open or gated nature of educational institutions. However, it is not so much the digital technologies themselves, but how they are used, regarded, implemented and positioned by institutions, that offer a new twist to our interpretation of education as both 'borderless' and 'gatekeeping'.

Download PDF to view full editorial
Negotiating identity and integrity on social network sites for educators
Authors: Robards Brady 
Published: July 2020

Discussion around the use of social network sites, especially amongst young people, is pervaded by sentiments heralding the decline of privacy. In this context, it is important for scholarship in this area to attend to the array of ways in which individuals are managing their information and identity-projects in these spaces in
highly strategic ways, such as audience segregation. Drawing in part on empirical data collected through an ethnography of young Australian users of MySpace and Facebook, this article seeks to draw out the tension between authenticity and integrity that operates in these spaces. In doing so, I suggest that educators must be especially cognisant of the complexity occurring in the strategic management of these spaces, given the ongoing push for universities and agents within the university to engage with these spaces, along with the tension such engagement can bring to the teacher-student relationship.