bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: Inter-professional training and task-sharing considerations
Authors: Stamper Paul D , Mlandu Khaya , Lowensen Kelly , Geiger Keri , Nguyen Yen , Ndjeka Norbert , Farley Jason E. 
Published: June 2020

Abstract
Background

Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: a) training needs across cadres; b) knowledge performance, by cadres; and c) training differences in knowledge by nurse type.
Methods

A 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre-post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre-post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care.
Results

Participants (N = 842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data was available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7–24 correct responses) and 85.9% (range 12–25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points) whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p < 0.000). APPNs performed the same as the MOs on post-test scores (p = NS).
Conclusions

The inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.
Clinical research of lower extremity exoskeleton robot In post-stroke hemiplegic patients
Authors: Wang Kan , Yu Haojun , Zhong Huimin , Peng Jing , Yan Weixin , Huang Ping , Guan Yangtai 
Published: June 2020

Abstract
Background

In recent years, the number of people suffering from stroke-induced motor function lost increased considerably. Recovery of motility is essential in improving their quality of life. However, the existing rehabilitation methods cannot fulfill patients’ training requirements. As a new rehabilitation technology, exoskeleton robot provides a new treatment scheme for post-stroke hemiplegic patients.

Objective

To explore the safety and effectiveness of exoskeleton-assisted gait training for post-stroke hemiplegic patients.

Methods

A lower extremity hip joint exoskeleton robot was designed by the cooperation team, and 9 post-stroke hemiplegic patients were included for exoskeleton-assisted gait training. The three-dimensional gait parameters, plantar pressure and surface electromyography were used to validate the effectiveness of the exoskeleton robot in post-stroke hemiplegic patients.

Results

Exoskeleton-assisted ambulation training for post-stroke hemiplegic patients can correct the asymmetry of gait and abnormal phase of gait cycle, increase the toe-ground clearance and the angle of hip joint, reduce the pressure of non-paretic plantar and the impulse of bilateral feet, which help balance the plantar pressure distribution. It can also improve the integral electromyography value of specific muscle, which means that corresponding muscles are stimulated to generate activities.

Conclusions

The exoskeleton robot designed by our team can correct the hemiplegic gait and foot drop phenomenon of post-stroke patients, protecting them from damage caused by long-term abnormal gait, which contributes to the recovery of lower extremity motor function in hemiplegic patients. The results also provide important information for the design of lower extremity exoskeleton robot. In the future, we should further explore the rehabilitation function of exoskeleton robot in post-stroke hemiplegic patients, as well as the ambulation and rehabilitation function in other lower extremity motor dysfunction patients.
Study of 10kW molten carbonate fuel cell power generation system and its performance test
Authors: Lu Chengzhuang , Zhang Ruiyun , Li Hao , Cheng Jian , Xu Shisen , Yang Guanjun , Huang Hua 
Published: June 2020

Abstract
The test of 10 kW high-temperature molten carbonate fuel cell of the carbon dioxide near-zero emission technology project was carried out. The key materials of the molten carbonate fuel cell single cell were characterized and analyzed by XRD and SEM. The results show that the pore size of key electrode material was 6.5 µm and the matrix material is α-LiAlO2.The open circuit voltage of the single cell is 1.23V in experiment. The current density is greater than 100 mA / cm2 when the operating voltage is 0.7V. The 10 kW fuel cell stack was constitutive of 80 pieces single fuel cells with area of 2000 cm2. The open circuit voltage of the stack reaches above 85V. The fuel cell stack power and current density can reach 11.7 kW and 104.5 mA/cm2 when the operating voltage is 56V. The influence and long-term stable operation of the stack were also analyzed and discussed.
Cronobacter Spp. – The Serious Risk In A Baby Food
Authors: Gemba Mateusz , Rosiak Elżbieta , Kołożyn-Krajewska Danuta 
Published: June 2020

Abstract

Cronobacter spp. are considered opportunistic pathogens in all age groups, especially in premature babies, children with low birth weight, the elderly and immunocompromised people. Currently, the genus Cronobacter includes seven species: C. sakazakii, C. malonaticus, C. turicensis, C. muytjesii, C. universalis, C. dublinensis and C. condimenti. The first three species of Cronobacter have been associated with clinical infections of newborns and premature babies. Cronobacter bacterial infections can cause neuritis, encephalomyelitis, the formation of abscesses and cysts of the brain leading to hydrocephalus and necrotizing enterocolitis. Often infected with Cronobacter spp. are rare, the mortality rate is very high, as well as the costs associated with temporarily treating post-infection complications. Cronobacter spp. due to the production of capsule and biofilm, high thermotolerance is resistant to drying and survival loads in milk replacers and other products with water activity. Cronobacter spp. isolated from milk replacers used for the initial feeding of infants, with vegetables, cereals, potatoes, spices, meat, fish, cheese, tofu, rice, pasta, chocolate, tea and abiotic surfaces in a hospital, with medical products and equipment. Under the Regulation (EC) No 2073/2005 of 15 November 2005, Cronobacter spp. should be absent in thirty 10 g samples of infant formulas and infant dietetic powders intended for infants up to 6 months old. The subject of the study is the assessment of the occurrence the hazard caused by Cronobacter in food in the light of applicable requirements.
1. Introduction. 2. Symptoms and pathogenicity Cronobacter spp. 3. Legal requirements. 4. Virulence mechanism Cronobacter spp. 5. Taxonomy Cronobacter spp. 6. Occurrence Cronobacter spp. in food. 7. Resistance Cronobacter spp. to stress conditions. 8. Biofilm formation by bacteria genus Cronobacter. 9. Detection and determination of numbers Cronobacter spp. 10. Antibiotic resistance Cronobacter spp. 11. Summary
Mechanisms Of Dermatophyte Resistance To Antifungal Substances
Authors: Łagowski Dominik , Gnat Sebastian , Nowakiewicz Aneta 
Published: June 2020

Abstract
Dermatophytes are pathogenic fungi with high affinity for keratinised structures present in nails, skin, and hair causing superficial infections known as skin mycoses or dermatomycoses. The disease is characterised by variable prognosis. Its clinical picture is largely dependent on the immune status of the host and can range from local skin or subcutaneous infections to invasive, disseminated, and life-threatening infections. In the first decades of the 20th century, the first concerns were raised about the growing prevalence of fungal infections in humans, which was ascribed to various environmental factors and anthropopressure. Consequently, the first therapeutic attempts were made to treat these infections. At present, at least several different groups of antifungal drugs are available for medical treatment. Nevertheless, the overlapping mechanisms of action of these substances and discontinuation of therapy by patients may contribute to the emergence of resistance of strains, including multi-drug resistance. The aim of this study is to review the literature focused on the mechanisms of resistance developed by dermatophytes to antifungal substances. Through evolution, these fungi have developed complex cellular response systems comprising elements of the environment-cell signalling system, responses to stressors, and tolerance to harmful chemical substances. Such stimuli as exposure of dermatophytes to an antifungal drug, damage to their cell wall, and disturbances in the osmolarity of the environment with generation of reactive oxygen species can be activators of signalling pathways targeted at mitigation of the effects of sudden cellular stress. A majority of molecular mechanisms underlying the response to these stressors also constitute a mechanism of tolerance and resistance to antifungal substances. In the future, elucidation of these mechanisms may lead to development of new chemotherapeutics that will become a key strategy in the treatment of dermatophyte strains exhibiting resistance to currently available antifungal drugs.
1. Introduction. 2. Current antifungal drugs. 3. Exposure of the pathogen to drugs, stress response, and adaptation. 4. Mechanisms of drug efflux from the cell. 5. Mechanisms of drug detoxification. 6. Transcriptional modulation of signalling pathway genes. 7. Role of heat shock proteins in drug resistance. 8. Mutations in target enzyme genes inducing drug resistance. 9. Structural elements of the cell contributing to drug resistance. 10. Summary
Multivariate groundwater drought analysis using copulas
Authors: Saghafian Bahram , Sanginabadi Hamid 
Published: June 2020

Abstract
Drought characteristics are among major inputs in the planning and management of water resources. Although numerous studies on probabilistic aspects of meteorological drought characteristics and their joint distribution functions have been reported, multivariate analysis of groundwater (GW) drought is rarely available. In this paper, while proposing a framework for statistical analysis of disturbed hydrological systems, copula-based multivariate GW drought analysis was performed in an over-drafted aquifer. For this purpose, a 1,000-year synthetic time series of naturalized GW level was produced. GW drought was monitored via the Standardized GW Index (SGI) index while the multivariate GW drought probability and return period were determined via copulas. Comparison between the copula and empirical GW drought probabilities using statistical goodness-of-fit tests proved sufficient accuracy of copula models in multivariate drought analysis. The results showed strong dependence among GW drought characteristics. Generally speaking, multivariate GW drought analysis incorporates major drought characteristics and provides concrete scientific basis for planning drought management strategies.
Adsorption dynamics of dye onto crab shell chitosan/neem leaf composite
Authors: Francis Asokogene Oluwadayo , Ahmad Zaini Muhammad Abbas , Muhammad Idris Misau , Abdulsalam Surajudeen , El-Nafaty Usman Aliyu 
Published: June 2020

Abstract
The aim of this study was to evaluate the adsorption dynamics of crab shell chitosan/neem leaf composite against methylene blue dye at varying concentrations (50 and 200 mg/L), bed depths (2.5 and 5.0 cm), and flow rates (2.17 and 2.90 mL/min). The chitosan composite has a specific surface of 258 m2/g. Its surface is rich in amine/amide groups. The results reflect better dye adsorption at higher operating conditions. The maximum dye adsorption capacity observed was almost 77 mg/g. The kinetics models showed good correlation with the experimental data and described the breakthrough behaviour of dye removal. The Thomas model predicts external and internal diffusion as the rate controlling mechanisms, while the Adams-Bohart model indicates a simultaneous steady state process of intraparticle diffusion and ionic interaction. Chitosan composite is a promising adsorbent candidate for dye wastewater treatment.
Real-time model predictive control of a wastewater treatment plant based on machine learning
Authors: Bernardelli A. , Marsili-Libelli S. , Manzini A. , Stancari S. , Tardini G. , Montanari D. , Anceschi G. , Gelli P. , Venier S. 
Published: June 2020

Abstract
Two separate goals should be jointly pursued in wastewater treatment: nutrient removal and energy conservation. An efficient controller performance should cope with process uncertainties, seasonal variations and process nonlinearities. This paper describes the design and testing of a model predictive controller (MPC) based on neuro-fuzzy techniques that is capable of estimating the main process variables and providing the right amount of aeration to achieve an efficient and economical operation. This algorithm has been field tested on a large-scale municipal wastewater treatment plant of about 500,000 PE, with encouraging results in terms of better effluent quality and energy savings.
Reflexões Sobre o Turismo Inclusivo
Authors: Medeiros Márcia Maria de , Santana Solange Pereira de , Ruiz da Silva Luiz Alberto 
Published: June 2020

Este artigo tem como objetivo refletir sobre as questões inerentes ao turismo inclusivo. Para tanto, realizou uma pesquisa bibliográfica e documental observando como as práticas relacionadas à inclusão e sua relação com o turismo acontece no Brasil, com base na legislação vigente. O texto também procura entender como ocorre o processo de turismo inclusivo em outras partes do mundo, especificamente em Portugal. É possível concluir que avanços já foram feitos em relação às práticas inclusivas, mas ainda há necessidade de maior conscientização sobre as questões que envolvem a inclusão, bem como a implementação concreta da legislação pertinente no Brasil.Palavras-chave: Turismo; Inclusão; Turismo Inclusivo; Legislação; Brasil.
Técnicas anestésicas em odontologia: o que o profissional precisa saber?
Authors: Figueiredo de Brito Resende Rodrigo 
Published: June 2020

RESUMOO uso de soluções e técnicas anestésicas são recursos utilizados para o controle local da dor. Esses artifícios sofreram mudanças nas substâncias utilizadas, bem como nas técnicas de acordo com o passar do tempo. A maioria das evoluções teve como objetivo a melhoria do bem-estar do paciente durante as consultas odontológicas. Diante da variedade de técnicas e de bibliografias, possivelmente há diversas dúvidas, onde a maioria deve abranger a escolha do melhor método e das regiões anestesiadas. A partir disso, o objetivo deste trabalho é facilitar a visualização das técnicas anestésicas, bem como auxiliar o atendimento do profissional e seu paciente, otimizando-o.Palavras – Chave: Odontologia; Técnicas anestésicas; Cirurgia oral. ABSTRACT The use of anesthetic solutions and techniques, the resources used do not control the local website. These are suffered artifacts that were used, as settlement techniques or passing the time. Most developments aim to improve the patient's well-being during dental consultations. By various techniques and bibliographies, it is possible to ask several questions, on the other hand, from the beginning to the blocking of the anesthetized regions method. Based on this, or the objective of this work, it is to facilitate the visualization of anesthetic techniques, such as assisting or assisting professional and patient, optimizing it.Key words: Dentistry; Anesthetic techniques; Oral surgery.
Role of Patatin-Like Phospholipase Domain–Containing 3 Gene for Hepatic Lipid Content and Insulin Resistance in Diabetes
Authors: Zaharia Oana P. , Strassburger Klaus , Knebel Birgit , Kupriyanova Yuliya , Karusheva Yanislava , Wolkersdorfer Martin , Bódis Kálmán , Markgraf Daniel F. , Burkart Volker , Hwang Jong-Hee , Kotzka Jörg , Al-Hasani Hadi , Szendroedi Julia , Roden Michael ,   GDS Group, Roden M. , Al-Hasani H. , Burkart V. , Buyken A.E. , Eckel J. , Geerling G. , Hwang J.H. , Herder C. , Icks A. , Jandeleit-Dahm K. , Kahl S. , Kotzka J. , Kuss O. , Lammert E. , Trenkamp S. , Rathmann W. , Szendroedi J. , Ziegler D. 
Published: June 2020

OBJECTIVE
The rs738409(G) single nucleotide polymorphism (SNP) in the patatin-like phospholipase domain–containing 3 (PNPLA3) gene associates with increased risk and progression of nonalcoholic fatty liver disease (NAFLD). As the recently described severe insulin-resistant diabetes (SIRD) cluster specifically relates to NAFLD, this study examined whether this SNP differently associates with hepatic lipid content (hepatocellular lipids [HCL]) and insulin sensitivity in recent-onset diabetes.

RESEARCH DESIGN AND METHODS
A total of 917 participants in the German Diabetes Study (GDS) underwent genotyping, hyperinsulinemic-euglycemic clamps with stable isotopic tracer dilution, and MRS.

RESULTS
The G allele associated positively with HCL (β = 0.36, P &lt; 0.01), independent of age, sex, and BMI across the whole cohort, but not in the individual clusters. Those with SIRD exhibited lowest whole-body insulin sensitivity compared with those with severe insulin-deficient (SIDD), moderate obesity-related (MOD), moderate age-related (MARD), and severe autoimmune diabetes (SAID) clusters (all P &lt; 0.001). Interestingly, the SIRD group presented with higher prevalence of the rs738409(G) SNP compared with other clusters and the glucose-tolerant control group (P &lt; 0.05). HCL was higher in the SIRD group (median 13.6% [1st quartile 5.8; 3rd quartile 19.1] compared with the MOD (6.4 % [2.1; 12.4], P &lt; 0.05), MARD (3.0% [1.0; 7.9], P &lt; 0.001), SAID (0.4% [0.0; 1.5], P &lt; 0.001), and glucose-tolerant (0.9% [0.4; 4.9), P &lt; 0.001) group. Although the PNPLA3 polymorphism did not directly associate with whole-body insulin sensitivity in SIRD, the G-allele carriers had higher circulating free fatty acid concentrations and greater adipose tissue insulin resistance compared with noncarriers (both P &lt; 0.001).

CONCLUSIONS
Members of the SIRD cluster are more frequently carriers of the rs738409(G) variant. The SNP-associated adipose tissue insulin resistance and excessive lipolysis may contribute to their NAFLD.
Comparison of the effects of inhalation anesthetics in the intraand postoperative periods during kidney transplantation
Authors: Kuznetsova N. K. , Aleksandrova V. E. , Utkina I. I. , Talyzin A. M. , Zhuravel S. V. 
Published: June 2020

Background. Every year the number of patients with chronic renal failure is steadily increasing. Allogeneic kidney transplantation from a post-mortem donor is a radical method to cope with chronic renal failure, improving the quality and life expectancy of patients. Currently available inhalation anesthetics make it easy to control the depth of anesthesia; they are excreted by the lungs unchanged, providing a quick emergence from anesthesia and easy waking up of the patient. An “ideal” inhalation anesthetic used for kidney transplantation should have a minimal amount of adverse effects.The aim was to compare the efficacy of inhaled anesthetics used for allogeneic kidney transplantation from a posthumous donor.Material and methods. A randomized, prospective, single-center study included 62 patients with end-stage chronic renal failure. The subjects were divided into three groups depending on the type of the inhalation anesthetic used. The first group included patients who underwent low-flow inhalation anesthesia with desflurane, the second and third groups were comparator groups where patients received sevoflurane or isoflurane, respectively, as an inhalation anesthetic. When assessing hemodynamic parameters, most episodes of hemodynamic instability were seen in the isoflurane group; the most stable statistically significant values were observed in the sevoflurane group, and desflurane took an intermediate position.Results. The use of desflurane as an inhalation anesthetic in a kidney transplant provided a quicker recovery of consciousness and early extubation of the patient after anesthesia compared to the sevoflurane or isoflurane use. So desflurane proved to be the most efficient of the three studied inhalation anesthetics. Conclusion. Desflurane is the optimal inhalation anesthetic used in kidney transplantation.
O ensino de transformações geométricas: uma síntese da literatura envolvendo tarefas e a prática do professor
Authors: Delmondi Natalia Nascimben , Pazuch Vinícius 
Published: June 2020

Esse artigo tem como objetivo apresentar uma síntese da literatura acerca do ensino do conteúdo matemático de transformações geométricas, contemplando dois aspectos em relação ao tema: prática do professor e tarefas. Assim, as questões norteadoras deste trabalho foram: (i) Que perfil apresentam as pesquisas em Educação Matemática que tratam da prática do professor? e (ii) Qual a natureza das tarefas elaboradas para abordar as transformações geométricas na prática em sala de aula? Para responder tais questões, foram selecionados 16 artigos publicados em revistas brasileiras da área de Ensino, classificadas com os Qualis A1, A2 e B1, no portal WebQualis CAPES, no quadriênio 2013-2016. A análise desses artigos evidenciou que (i) são pesquisas empíricas, que possuem como focos de análise a formação continuada, a formação inicial e os conhecimentos do professor; e (ii) a natureza das tarefas presentes nos artigos que tratam das transformações geométricas foi diversa: exercícios, problemas, explorações e investigações, com predomínio dos primeiros e das últimas, e correlação entre as demandas cognitivas da tarefa e a progressão do conteúdo. A partir disso, constataram-se lacunas no conhecimento do professor e a carência de uma maior diversidade tanto nas tarefas acerca do conteúdo matemático de transformações geométricas, aplicadas a propósitos variados, quanto nas habilidades do professor para adequá-las de acordo com os seus objetivos. Tais aspectos podem ser minimizados por meio de processos de formação continuada que explorem esses temas.