bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of mid trimester pregnancy loss in a tertiary care hospital
Authors: Zardad Bushra , Fawad Anisa , Ismail Ayesha , Mehreen Shazia , Bibi Sadia 
Published: February 2021

Introduction: Mid trimester of pregnancy is relatively a safe time of pregnancy with minimal and no complications. Mid trimester pregnancy loss constitutes 1 to 5 % of total miscarriages. The purpose of this study is to evaluate the causes of second trimester miscarriages so as to improve the outcome in future pregnancies.
Materials & Methods: This was a prospective cross-sectional study. Demographic features, relevant information and risk factors were recorded in a predesigned proforma. Detailed history was followed by thorough clinical examination and appropriate investigations were advised.
Results: Total number of miscarriages admitted in the unit over the period of two years were 336 and among them 30 patients presented with second trimester miscarriages (8.9%). The mean age of the patients was 31.4 years. In 19 patients (63.4%) there were identifiable causes for the miscarriage. 7 patients (23.33%) had fibroids in the uterus, 5 patients (16.67%) had bacterial vaginosis, 4 patients (13.33%) had cervical incompetence and in 3 patients (10%) there were congenital abnormalities in the uterus.
Conclusion: Patients with second trimester pregnancy loss are at significantly increased risk (10 times more likely) for recurrent second trimester loss. In 50 to 70% of patients no cause can be identified. After single loss there is 80% chance of successful pregnancy outcome in future. Even after two and three mid trimester losses still there is 60% chance of alive pregnancy next time, so thorough evaluation and management plan is needed to prevent this mishap in future pregnancies.
Internationalization of the curriculum in Japanese higher education
Authors: Radjai Leyla , Hammond Christopher 
Published: February 2021

Internationalization of university curricula has received growing attention among scholars and policymakers who recognize the importance of providing international and intercultural opportunities to all students, not only those able to partake in education abroad. Much of the research in this area has been done in Anglosphere and European contexts (Leask 2017; Beelen and Jones 2015; Haigh 2002), with less scholarly attention given elsewhere. Our study focuses on Japan, analyzing the approaches taken to internationalize the curriculum in English-medium instruction (EMI) programs in Japanese universities. We seek to understand the experiences of educators and students involved in teaching and learning in these internationalized classroom contexts, with a view to contribute novel insights that can inform future policy and practice at internationalizing universities. The research questions guiding this mixed methods project are: 1)What does internationalization of curriculum mean for educators in the Japanese university context? 2)How do faculty members incorporate intercultural/global dimensions into curriculum design in their EMI programs? 3)What factors do educators and students perceive to enable or block the internationalization of the curriculum in these programs?
The Challenges of Quality Assurance and Accreditation in Afghanistan: A Policy Implementation Analysis
Authors: Mussawy Sayed Ahmad Javid 
Published: February 2021

The quest for quality has evolved as a major concern for higher education institutions (HEIs) in developing world. A majority of these countries have adopted quality assurance and accreditation (QAA) policies in order to improve the quality of higher education services. However, implementation of QAA has generated diverse responses among different types of HEIs as their mission and scope of work vary from one another. As a result, implementing a QAA in a public HEI is not a straightforward process. The current research examines the challenges faced by public universities in Afghanistan as they implement a QAA system. More specifically, the study investigates how sensemaking and sensegiving occur as QAA is implemented at teaching vs. research universities, and ways that key-informants at various institutions make use of sensemaking and sensegiving as a tool to interpret the policy.
Universities going global?
Authors: Sfredo Miorando Bernardo 
Published: February 2021

This article presents a doctoral research on how individuals in Brazilian and Finnish contexts of postgraduate education are processing changes in university as internationalization takes place. It problematizes how change, power and political action unfold across the fields of social action – national policy, educational institution, academic work – that compose each context. The research supporting this dissertation was organized as a comparative case study based on the qualitative analysis of semi-structured interviews with Brazilian and Finnish policy makers, institutional leaders and scholars involved with the internationalization of postgraduate education. The theoretical background deals with the political character of university and of higher education change, combining higher education studies and Brazilian social thought. It also connects globalization and internationalization from a critical perspective. The interviewees’ perspectives about the relations between their work and internationalization were sought as a source for understanding what changes when universities go global.
International Student Mentor Development Study
Authors: Cui Shasha 
Published: February 2021

Peer mentorship programs are promoted as reciprocal, where both mentors and mentees benefit; however, the majority of qualitative research focuses on the positive outcomes for mentees, while few (Haggard et al., 2011; Heirdsfield et al., 2008) focus on the experiences and positive outcomes for mentors. International student peer mentorship programs help mentors develop leadership, intercultural communication, and professional skills as they help others and interact with students from different cultures and backgrounds (Haggard et al., 2011).
This research study is going to fill the gap and contribute to international higher education by focusing on student peer mentors’ self-experience and how they value their roles. The research project specifically seeks to address the following questions: How do student mentors perceive and value the experiences of being peer mentors for international students? How does the international student peer mentor program contribute to mentors’ development?
Global Studies Certificates As An Instrument for Building Capacity for Community College Internationalization
Authors: Fraser Thompson Stacye 
Published: February 2021

Community college campus internationalization is only represented in a small portion of the institutions in the U.S. Global Studies Certificates (GSC) are in an even smaller proportion of community colleges, but offers a credentialed program for curricular and co-curricular activities to be used to work with campus internationalization. This pilot study looks at 23 community colleges with established GSC programs. Building capacity for campus internationalization cannot be just a tiny effort, it must be a comprehensive effort involving administration, faculty, staff and students. Utilizing Raby’s (2012) International Education model and Schultz’s (1960) Human Capital Theory in education, GSC’s will be examined to determine the effectiveness to establish pathways for integration of campus internationalization into the mission, outcomes, and culture of the campuses examined.
(Re)Learning to Live Together in 2020
Authors: Deardorff Darla K. 
Published: February 2021

Ten years ago, the world was quite a different place with the devastation of a 7.0 magnitude earthquake in Haiti, the exuberance of the 2010 Winter Olympics in Vancouver, the release of the first iPad, the launch of Instagram, and the beginning of Arab Spring. Fast forward to 2020 and not only is it the 10th anniversary of the Journal of International Students, but the world is facing unprecedented times with a global pandemic that has illustrated the interconnectedness of humankind like never before. We have all been reminded of the power of human connection as we experience isolation, confinement, social distancing, and even fear. We have witnessed powerful images of front-line workers giving their all, and neighbors in cities and towns across the world connecting from balconies and through windowpanes. These images have reminded us how much our lives depend on those around us, and how important it is that we renew our efforts in learning how to live together.
Peaks and Valleys
Authors: Stegall Jennifer 
Published: February 2021

This qualitative phenomenological study examined how 11 international students experienced learning English within an intensive English immersion program, which used an integrated skills approach for language learning. Participants included seven males and four females from Africa, Asia, Central America, Middle East, and South America. Drawing on sociocultural and sociolinguistic theories, data analysis suggested that the participants experienced a range of competing emotions and relied on instructors for support and guidance throughout the learning process. In addition, participant testimonies demonstrated that successful language learning occurred when instructors met their social needs (e.g., provided a sense of belonging) and respected their cultural mores (e.g., supported a family-orientation in class). Implications from this study offer insights for university-based immersion programs in the United States.
Palgrave Study Skills: The International Student Handbook
Authors: Johnson Karen , Wells Lisa 
Published: February 2021

The International Student Handbook addresses the needs of students whose first language is not English. Whether they are future or current students, as non-native English speakers who study at English-speaking universities, they will deal with issues ranging from adapting to the new academic culture to understanding the nuances of the language. This practical handbook can help prepare students adjust to the academic rigors of Western universities, understand the university culture, improve their English, and become successful university students. The three authors report a combined history of teaching at universities in 12 different countries.
The Role of Student Affairs in a New University in a Conflict Zone
Authors: Sengupta Enakshi 
Published: February 2021

Higher education necessitates an understanding that students cannot be confined to the classroom, as a large part of their curriculum comprises extracurricular activities to educate intellectually, in spirit, and body. AS a result, community building, advising, and career development became a part of the traditional routine of student affairs. This article explores the role of student affairs in a newly formed university in a conflict zone ravaged by war and terrorism for decades. The data explored in this article reveals some interesting facts, which are different from that of the traditional student affairs manager. In this university, student affairs personnel are viewed as a ‘job giver,’ someone who will arrange funds, bursaries, and scholarships in keeping with the war-ravaged economic scenario of the province in northern Iraq.
Book Review- Developing the Global Student: Higher Education in an Era of Globalization Internationalization in Higher Education Series
Authors: Nasser, Jr. Roger "Mitch" 
Published: February 2021

While administrators may consider increasing their international student population as a plausible solution to the enrollment crisis, they must also consider how these students navigate the campus environments. What are our responsibilities as higher education administrators? How will U.S. students respond to their international classmates? Moreover, will native students understand and accept the differences they encounter? David Killick’s book, Developing the Global Student: Higher Education in an Era of Globalization asks how prepared students are for the international community. Killick’s discussion methods include philosophy, student development, and self-reflection, which will appeal to most readers.
Grading Principles in Pandemic-Era Learning: Recommendations and Implications for Secondary School Leaders
Authors: Townsley Matt 
Published: February 2021

As the COVID-19 pandemic unfolded in K-12 education, school leaders quickly pivoted from prioritizing continuous instruction and technology access to the output, grades. In response to these unprecedented times, secondary schools utilized “do no harm” grading methods, such as freezing previous grades and replacing letter grades with pass-fail. The purpose of this essay is to describe grading principles that secondary school leaders should consider during future pandemic era learning, and to suggest implications based upon previous literature.
The Meaning of Video Gameplay
Authors: Bayeck Rebecca Y. 
Published: February 2021

Reseaech on African immigrant students video gameplay is still in its infancy . Yet, the popularity of video games among college students in the United States suggest that African immigrant students may be video game players. This paper explores the video gameplay of three Black African immigrant students at an institution of higher education. This study draws on research on immigrants use of media and on video game literature to analyze the participants ‘experiences. This exploratory qualitative case study of three Black African immigrant students uses semi-structured interviews as the primary data collection technique. The findings show that gameplay was a means to adjust to the new environment, a way to preserve identity, and ensure cultural continuity.
Análise de desempenho da atenção odontológica especializada em rede de cuidados à pessoa com necessidades especiais
Authors: Couto Graziane Ribeiro , Santos Marcos Antônio Lima dos , Oliveira Lívia Santos Cisneiros de , Paiva Saul Martins de , Fonseca Emílio Prado da , Amaral Regiane Cristina do 
Published: February 2021

O objetivo do presente estudo foi analisar o desempenho da atenção odontológica especializada nos Pacientes com Necessidades Especiais (PNE) atendidos no Centro de Especialidades Odontológicas (CEO) de Aracaju, Brasil. Trata-se de um estudo transversal, observacional e analítico em que a coleta dos dados foi feita a partir dos prontuários dos PNE atendidos no CEO nos anos de 2017 até 2019. Foram avaliadas as produções ambulatoriais realizadas nos PNE nos anos de 2018 e 2019 através de informações cadastradas no Departamento de Informática do Sistema Único de Saúde (DATASUS) por meio do aplicativo de domínio público TABNET e comparadas com a meta preconizada pela Portaria nº 1.464 de 24 de junho de 2011 do Gabinete do Ministro (GM) / Ministério da Saúde (MS). Foram avaliados 218 prontuários, sendo encontrado o registro de 23,4% dos pacientes com o diagnóstico de distúrbios comportamentais, observando-se que em 86 prontuários houve o registro de atividade de educação em saúde bucal, incluindo escovação supervisionada nos PNE, 10% dos atendimentos foram exodontia e 62% dos que procuravam o serviço era via referenciamento. Quanto às produções registradas no DATASUS verificou-se no ano de 2018, que em 3 meses não conseguiram atingir a meta preconizadas pelo MS e para o ano de 2019, 8 meses ficaram abaixo do preconizado. Os resultados demonstram desempenho insatisfatório do cumprimento global das metas, no que concerne ao registro da produção realizada nos PNE do CEO Aracaju, sendo assim é necessário regularizar os atendimentos mensais desses pacientes, tendo como parâmetro a Portaria 1.464 GM/MS.
Quantitative Ultrasonographic Analysis of Changes of the Suprascapular Nerve in the Aging Population With Shoulder Pain
Authors: Wu Wei-Ting , Chen Lan-Rong , Chang Hsiang-Chi , Chang Ke-Vin , Özçakar Levent 
Published: February 2021

BackgroundOlder people are vulnerable to painful shoulder syndromes, the majority of which are derived from degenerative rotator cuff pathologies. The suprascapular nerve (SSN) is closely related to the rotator cuff complex, and its role in shoulder pain has recently been highlighted. This study aimed to explore the differences in SSN among older people with and without shoulder pain, and to investigate the potential factors influencing the nerve size using ultrasound (US) imaging.MethodsParticipants aged ≥60 years were enrolled in the study. A systematic and bilateral US examination of the rotator cuff tendons was performed. The SSN was examined from its origin in the brachial plexus to the spinoglenoid notch of the infraspinatus fossa. The association between the nerve’s cross-sectional area (CSA) and rotator cuff lesions was analyzed using the generalized estimation equation.ResultsAmong the 94 participants, 45 (with bilaterally asymptomatic shoulders) were classified into the control group, whereas 49 (with at least one-sided shoulder pain) were classified into the group with shoulder pain. The average CSAs of the SSN at the level of the brachial plexus, supraspinatus fossa, and infraspinatus fossa were comparable between the patients in the control group and those with shoulder pain. There was a higher prevalence of rotator cuff lesions and enlarged distal SSNs in the painful shoulders than in the asymptomatic shoulders of patients with unilateral involvement. A full-thickness tear of the supraspinatus tendon was associated with swelling of the SSN in the supraspinatus fossa (β coefficient = 4.068 mm2, p &lt; 0.001).ConclusionIn the older population, full-thickness tears of the supraspinatus tendon are independently associated with enlargement of the distal SSN. In cases with large rotator cuff tendon tears with poor response to conservative treatments, possible SSN entrapment should be considered and managed accordingly.
Gene Expression Profiles Reveal Extracellular Matrix and Inflammatory Signaling in Radiation-Induced Premature Differentiation of Human Fibroblast in vitro
Authors: Herskind Carsten , Sticht Carsten , Sami Ahmad , Giordano Frank A. , Wenz Frederik 
Published: February 2021

PurposeFibroblasts are considered to play a major role in the development of fibrotic reaction after radiotherapy and premature radiation-induced differentiation has been proposed as a cellular basis. The purpose was to relate gene expression profiles to radiation-induced phenotypic changes of human skin fibroblasts relevant for radiogenic fibrosis.Materials and MethodsExponentially growing or confluent human skin fibroblast strains were irradiated in vitro with 1–3 fractions of 4 Gy X-rays. The differentiated phenotype was detected by cytomorphological scoring and immunofluorescence microscopy. Microarray analysis was performed on Human Genome U133 plus2.0 microarrays (Affymetrix) with JMP Genomics software, and pathway analysis with Reactome R-package. The expression levels and kinetics of selected genes were validated with quantitative real-time PCR (qPCR) and Western blotting.ResultsIrradiation of exponentially growing fibroblast with 1 × 4 Gy resulted in phenotypic differentiation over a 5-day period. This was accompanied by downregulation of cell cycle-related genes and upregulation of collagen and other extracellular matrix (ECM)-related genes. Pathway analysis confirmed inactivation of proliferation and upregulation of ECM- and glycosaminoglycan (GAG)-related pathways. Furthermore, pathways related to inflammatory reactions were upregulated, and potential induction and signaling mechanisms were identified. Fractionated irradiation (3 × 4 Gy) of confluent cultures according to a previously published protocol for predicting the risk of fibrosis after radiotherapy showed similar downregulation but differences in upregulated genes and pathways.ConclusionGene expression profiles after irradiation of exponentially growing cells were related to radiation-induced differentiation and inflammatory reactions, and potential signaling mechanisms. Upregulated pathways by different irradiation protocols may reflect different aspects of the fibrogenic process thus providing a model system for further hypothesis-based studies of radiation-induced fibrogenesis.
The “TIDE”-Algorithm for the Weaning of Patients With Cardiogenic Shock and Temporarily Mechanical Left Ventricular Support With Impella Devices. A Cardiovascular Physiology-Based Approach
Authors: Tschöpe Carsten , Spillmann Frank , Potapov Evgenij , Faragli Alessandro , Rapis Konstantinos , Nelki Vivian , Post Heiner , Schmidt Gunther , Alogna Alessio 
Published: February 2021

Objectives: Mechanical circulatory support (MCS) is often required to stabilize therapy-refractory cardiogenic shock patients. Left ventricular (LV) unloading by mechanical ventricular support (MVS) via percutaneous devices, such as with Impella® axial pumps, alone or in combination with extracorporeal life support (ECLS, ECMELLA approach), has emerged as a potential clinical breakthrough in the field. While the weaning from MCS is essentially based on the evaluation of circulatory stability of patients, weaning from MVS holds a higher complexity, being dependent on bi-ventricular function and its adaption to load. As a result of this, weaning from MVS is mostly performed in the absence of established algorithms. MVS via Impella is applied in several cardiogenic shock etiologies, such as acute myocardial infarction (support over days) or acute fulminant myocarditis (prolonged support over weeks, PROPELLA). The time point of weaning from Impella in these cohorts of patients remains unclear. We here propose a novel cardiovascular physiology-based weaning algorithm for MVS.Methods: The proposed algorithm is based on the experience gathered at our center undergoing an Impella weaning between 2017 and 2020. Before undertaking a weaning process, patients must had been ECMO-free, afebrile, and euvolemic, with hemodynamic stability guaranteed in the absence of any inotropic support. The algorithm consists of 4 steps according to the acronym TIDE: (i) Transthoracic echocardiography under full Impella-unloading; (ii) Impella rate reduction in single 8–24 h-steps according to patients hemodynamics (blood pressure, heart rate, and ScVO2), including a daily echocardiographic assessment at minimal flow (P2); (iii) Dobutamine stress-echocardiography; (iv) Right heart catheterization at rest and during Exercise-testing via handgrip. We here present clinical and hemodynamic data (including LV conductance data) from paradigmatic weaning protocols of awake patients admitted to our intensive care unit with cardiogenic shock. We discuss the clinical consequences of the TIDE algorithm, leading to either a bridge-to-recovery, or to a bridge-to-permanent LV assist device (LVAD) and/or transplantation. With this protocol we were able to wean 74.2% of the investigated patients successfully. 25.8% showed a permanent weaning failure and became LVAD candidates.Conclusions: The proposed novel cardiovascular physiology-based weaning algorithm is based on the characterization of the extent and sustainment of LV unloading reached during hospitalization in patients with cardiogenic shock undergoing MVS with Impella in our center. Prospective studies are needed to validate the algorithm.