bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness and Application of the School Meal Policy in Improving the Behavior of the High School Students in a Satuan Pendidikan Kerjasama Private School
Authors: Syahman Syarif , Kamaluddin  , Simbolon Bintang
Published: August 2021

The Effectiveness and Application of the School Meal Policy in Improving the Behavior of the High School Students in a Satuan Pendidikan Kerjasama Private School.

The purpose of this study was to explore the possible relationship between the school meal policy towards the high school student’s behavior academically and non academically in school.

Student’s behavior is determined by their daily habits in school. These habits will result in their everyday behavior such as their interest in going to school, their honesty in doing test without cheating, having a healthy relationship with their peers and teacher, and their ability to be punctual in ariving to school or respecting the school timetable as a whole.

The researcher recommends that the school administrator should utilize the result of this research to make a better meal policy, with the soul objective of honing the student’s dicipline and improving their behavior in school.
PERAN ORANGTUA DALAM MENANGANI ANAK AUTISME
Authors: Sidabutar Bontor Eben Ezer , Neolaka Amos , Simbolon Bintang
Published: August 2021

Tujuan penelitian untuk mengetahui peran orangtua di dalam menangani anak Autisme yang sedang mengikuti program terapi di Pusat Penanganan Anak Berkebutuhan Khusus Kenosis. Partisipan penelitian ini terdiri dari empat orangtua dan empat anak Autisme. Pengambilan data dilakukan dengan wawancara, observasi dan dokumentasi. Keabsahan data menggunakan teknik triangulasi data. Temuan hasil penelitian ini adalah: Peran orangtua sangat penting, karena mereka adalah orang yang paling mengetahui kondisi anak. karena dengan pemahaman yang baik tentang hal ini, orangtua akan selektif mencari jalan keluar untuk anak berkaitan dengan pusat terapi maupun program, keterlibatan orangtua di setiap program sangat di harapkan untuk memberikan semangat  anak, dan kemampuan Financial sangat menentukan di dalam melaksanakan program untuk anak.

Orangtua sebagai manager dan supervisor di segala aktivitas yang di lakukan agar bisa mencapai tujuan yang diharapkan. Peran orangtua perlu ditingkatkan, pemahamannya, keterlibatan dan kemampuan financial yang memadai. Pusat terapi mengharapkan orangtua dapat melanjutkan program terapi dirumah sehingga tercapai hasil yang diinginkan di dalam penanganan anak Autisme.
INOVASI PEMBELAJARAN PAI PADA MATA PELAJARAN FIQIH
Authors: Sugianto Hendi
Published: August 2021

Abstrak: Dalam agama Islam, kedudukan Fiqih sangatlah penting. Di dalamnya memuat seperangkat aturan, norma-norma dan tata nilai sebagai jalan hidup (way of life) bagi umat Islam. Untuk menyampaikan materi Fiqih kepada peserta didik, terutama bagi pemula dibutuhkan tahapan-tahapan, model, metode dan langkah-langkah yang sesuai dengan kapasitas peserta didik yang hendak diajarkan. Tulisan ini bertujuan untuk memaparkan tahapan-tahapan, model, metode dan langkah-langkah dalam inovasi pembelajaran mata pelajaran Fiqih pada tingkat Madrasah Tsanawiyah yang masih tergolong pemula. Sebagai materi pokok dalam pelajaran agama Islam, pembelajaran Fiqih harus didesain dengan model, metode dan langkah-langkah dari teori ke praktik dengan tepat. Dengan demikian, peserta didik dengan mudah bisa memahami materi dengan utuh serta mampu mengaplikasikan dalam kehidupan sehari-hari.
DAMPAK SISTEM ZONASI DALAM PERMENDIKBUD NO. 20 TAHUN 2019 DI KABUPATEN PAMEKASAN
Authors: Huda Mohammad Nurul , Khoiri Ach.
Published: August 2021

Regulation of the Minister of Education and Culture Number 20 of 2019 concerning Amendments to the Regulation of the Minister of Education and Culture Number 51 of 2018 concerning the Admission of New Students in Kindergartens, Elementary Schools, Junior High Schools, Senior High Schools, and Vocational High Schools is a guideline for public schools from kindergarten to high school level to implement the Zoning system for the admission process of new students.The purpose of this research is to find out and analyze the effectiveness of the enactment of the minister of education and culture regulation number 20 of 2019 for schools, students, and parents / guardians in Pamekasan. This research uses empirical methods or non-doctrinal research. This type of research was chosen because the subject of the research plan seeks to trace and study the impact of the enactment of the minister of education and culture regulation number 20 of 2019 for schools, students, and parents in Pamekasan.Of the 220 respondents, divided from teachers, parents / guardians and students, the results of the respondents' level of understanding of the Zoning system PPDB really understood. Schools disobedience to PPDB Zoning system are private schools and schools that are under the auspices of the Ministry of Religion. In addition, the ineffectiveness of the PPDB Zoning system in Pamekasan Regency is the result of the many educational institutions that are under the auspices of Islamic boarding schools.
THE CONCEPT OF INDEPENDENT LEARNING IS VIEWED FROM THE PERSPECTIVE OF THOMAS LICKONA'S CHARACTER EDUCATION
Authors: Rizky Mochammad , Astutik Anita Puji
Published: August 2021

This research wants to describe the perspective of character education from the thinking of Thomas Lickona which is linked to the free learning program pioneered by the Minister of Education and Culture of Indonesian (Kemendikbud) namely Nadiem Makarim, as a form of efforts to make the policy of independent learning plan has a concept in educating and improving the quality of personality of learners who are expected to have good traits, honest, devoted to parents, and responsible. The purpose of Thomas Lickona's education is to make the character of the child noble and smart using the method of shaping the child's personality in order to become a society, as well as a good citizen. This research has a qualitative approach and uses descriptive methods by collecting data and analyzing related programs of independent learning and character education of Thomas Lickona. The results of this study are expected to instil good habits so that students understand, can feel and want to do good.
Sosialisasi Pelayanan Kesehatan Maternal dan Perinatal pada Masa Pandemi Covid-19
Authors: Rizki Lailatul Khusnul , Windarti Yunik
Published: August 2021

Kegiatan pengabdian pada masyarakat ini dilakukan untuk meningkatkan pengetahuan, pemahaman dan kesadaran kader, pengunjung posyandu dan puskesmas dalam Pelayanan Kesehatan Maternal dan Perinatal di Era Pandemi Covid-19. Kegiatan ini dilakukan di Puskesmas Porong. Waktu pelaksanaan kegiatan dengan jangka waktu 3 bulan.Metode yang dilakukan adalah melakukan sosialisasi pada kader, pengunjung posyandu dan puskesmas. Sebelum melakukan sosialisasi, sasaran mengerjakan pre test, selanjutnya diberikan penyuluhan tentang Pelayanan Kesehatan pada Persalinan dan Bayi Baru Lahir di Era Pandemi Covid-19. Langkah terakhir memberikan post test untuk mengevaluasi peningkatan pengetahuan kader posyandu, pengunjung posyandu dan puskesmas. Hasil dari pre test dan post test di analisis menggunakan uji statistik paired T test.Berdasarkan hasil kegiatan pengabdian masyarakat yang dilakukan di UPTD Puskesmas Porong menunjukkan bahwa p value 0,001 (α<0,05) yang artinya terdapat perbedaan pengetahuan antara yang signifikan sebelum dan sesudah dilakukan sosialisasi.Berdasarkan hasil uji statistic dapat disimpulkan bahwa sosialisasi yang dilakukan mampu meningkatkan pengetahuan masyarakat tentang Pelayanan Kesehatan Maternal dan Perinatal di Era Pandemi Covid-19.Kata kunci: Pelayanan Kesehatan, Maternal, Perinatal, Covid-19.
Pengenalan Penguatan Kelembagaan Pada UMKM Bank Sampah Lestari 25
Authors: Rialmi Zackharia , Suciati Ranila , Hidayati Siti , Nugraheni Ranti
Published: August 2021

Institutional strengthening in the form of establishing an organizational structure model, drafting job descriptions and handling conflicts are very important issues today. The need for institutional strengthening is needed not only in large organizations but also very much needed by small organizations such as MSMEs (Micro, Small, and Medium Enterprises). The Garbage Bank is a type of investment from the sale of community waste that is not cashed directly but is recorded as personal savings. The Sustainable Waste Bank, which was established by a community of environmental care residents at Perum Taman Banten Lestari, has experienced ups and downs in its organizational journey, institutional strengthening is expected to be one of the supporting tools so that this organization can survive and grow in the future. From the results of the implementation of this institutional strengthening activity, results were obtained in the form of a more introduction to the importance of making a clear organizational structure and preparation of job descriptions so that there is no overlapping in the implementation of duties and authorities within the organization.
Abstrak
Penguatan kelembagaan berupa penetapan model struktur organisasi, penyusunan job description dan handling conflict menjadi isu yang sangat penting dewasa ini. Kebutuhan akan penguatan kelembagaan diperlukan tidak hanya di organisasi besar tetapi juga sangat diperlukan oleh organisasi kecil seperti UMKM (Usaha Mikro, Kecil, dan Menengah). Bank Sampah merupakan jenis investasi dari penjualan sampah masyarakat yang tidak secara langsung diuangkan akan tetapi dicatat sebagai tabungan pribadi. Bank Sampah Lestari yang didirikan komunitas warga peduli lingkungan hidup di Perum Taman Banten Lestari ini mengalami pasang surut di dalam perjalanan organisasinya, penguatan kelembagaan diharapkan menjadi salah satu tools yang mendukung agar organisasi ini bisa survive dan semakin berkembang ke depannya. Dari hasil pelaksanaan kegiatan penguatan kelembagaan ini didapatkan hasil berupa pengenalan lebih akan pentingnya pembuatan struktur organisasi yang jelas, dan penyusunan job description sehingga tidak terjadi tumpang tindih pelaksanaan tugas dan wewenang di dalam organisasi.
Kata Kunci: penguatan kelembagaan; struktur organisasi; job description; umkm bank sampah
Metástasis Cerebrales
Authors: Imbaquingo  Cabrera Andrés
Published: August 2021

Introducción: Las metástasis cerebrales constituyen una causa importante de mortalidad y son los tumores intracraneales más comunes en adultos, ocurren en aproximadamente el 20% y el 40% de los pacientes diagnosticados con cáncer. Los factores pronósticos que permiten estimar la esperanza de vida, son las herramientas que se deberían usar para proponer el fraccionamiento y duración del tratamiento con energía radiante.

Métodos: Estudio de tipo retrospectivo realizado en el Hospital de Solón Espinosa Ayala, SOLCA- Quito.  Se registraron los pacientes con metástasis cerebrales tratados con radioterapia holoencefálica en el período comprendido entre enero del 2003 a diciembre del 2018. Para el análisis de supervivencia se usaron las curvas de Kaplan Meier y la significación de diferencias con la prueba de Long-rank con un error tipo I o alfa del 5%.  Además se realizó un análisis bivariado con el modelo de regresión logística de Cox  entre la mediana de supervivencia y las variables: Indice de Karnofsky (IK), edad, número de metástasis cerebrales, metástasis extracraneales, tumor primario y  la escala “Graded Prognostic Assessment” (GPA).

Resultados: Se registraron309 pacientes, la mediana de supervivencia global fue de 5 meses. Todos los factores afectan la supervivencia (p ?0.05); los que alcanzaron los mejores resultados en términos de sobrevida fueron: IK ?90, grupo etario entre 51-60 años, los pacientes con 1 metástasis cerebral, ausencia de metástasis extra craneales y las metástasis cerebrales originadas en mama con puntuaciones de GPA entre 3,5-4.

Conclusiones: La edad, el índice de Karnofsky, el número de metástasis cerebrales, la presencia de metástasis extra craneales, tumor primario y clasificación GPA son factores que permiten estimar el tiempo de supervivencia en pacientes con metástasis cerebrales.
ANALISA KUALITATIF FORMALIN PADA SAMPEL IKAN ASIN DI PASAR SEDERHANA KOTA BANDUNG
Authors: Noorrela Lusi , Munggaran Indra Putra
Published: August 2021

Ikan asin merupakan salah satu makanan dengan sumber nutrisi lengkap yang paling banyak dikonsumsi di Indonesia namun sangat mudah mengalami pembusukan. Cepatnya proses pembusukan pada ikan asin mengakibatkan banyaknya pedagang yang menggunakan formalin sebagai pengawet ikan asin. Peraturan Menteri Kesehatan Republik Indonesia Nomor 1168/Menkes/PER/X/1999 menyatakan bahwa formalin merupakan bahan pengawet yang dilarang untuk digunakan sebagai pengawet makanan karena dapat menyebabkan kerusakan pada saluran pencernaan, ginjal, hati dan paru-paru, bahkan dapat menyebabkan kanker. Tujuan dari penelitian ini untuk mengidentifikasi kandungan formalin pada ikan asin yang dijual di Pasar Sederhana Kota Bandung. Penelitian ini dilaksanakan dengan pengambilan sampel ikan asin di Pasar Sederhana Kota Bandung. Pengujian analisa kualitatif formalin dilaksanakan di Laboratorium Bidang Pengujian Kimia Balai Besar Pengawas Obat dan Makanan di Bandung pada Oktober 2020. Dilakukan identifikasi formalin sebanyak 25 sampel ikan secara kolorimetri menggunakan test kit MERCK. Berdasarkan pengelompokan jenis ikan asin didapatkan hasil positif sebesar 20 % pada ikan asin teri jengki,  dan 100% pada ikan asin cucut, sedangkan untuk kategori ikan asin kapas, cumi, dan sepat tidak mengandung formalin. Kesimpulan dari penelitian ini adalah 24% ikan asin yang beredar di Pasar Sederhana Kota Bandung positif mengandung formalin. Kelompok yang paling banyak mengandung formalin adalah ikan asin cucut.
EVALUASI PENERAPAN GOOD MANUFACTURING PRACTICES (GMP) PADA UKM DIMSUM XYZ DI KOTA BANDUNG
Authors: Sridaryati Euis , Hakiki Dini Nur
Published: August 2021

Tingginya minat akan produk makanan beku selama pandemi menyebabkan banyak industri pangan dengan skala Usaha Mikro Kecil dan Menengah (UMKM) mulai memproduksi jenis makanan beku (frozen food) seperti dimsum. Dimsum sendiri termasuk produk dalam resiko sedang sehingga perlu memiliki izin edar MD. GMP menjadi persyaratan dasar pemberian sertifikat izin edar MD oleh BPOM. Tujuan penelitian ini mengevaluasi penerapan GMP (Good Manufacturing Practices) pada UKM dimsum XYZ di kota Bandung. Kajian dilakukan dengan wawancara dan observasi langsung ke lapangan. Hasil kajian menunjukan penerapan GMP pada UKM dimsum XYZ masih belum memenuhi persyaratan pedoman GMP karena masih dijumpai penyimpangan minor sebesar 6 kasus, penyimpangan mayor sebanyak 7 kasus dan penyimpangan serius 9 kasus. Penyimpangan serius dalam penerapan GMP pada UKM dimsum XYZ terletak pada sanitasi pabrik, peralatan produksi, metode pengujian produk, pengawasan terhadap proses produksi, dan penyimpanan bahan kimia.
Crystal Structure of Inorganic Pyrophosphatase From Schistosoma japonicum Reveals the Mechanism of Chemicals and Substrate Inhibition
Authors: Wu Qun-Feng , Wang Wei-Si , Chen Shen-Bo , Xu Bin , Li Yong-Dong , Chen Jun-Hu
Published: August 2021

Soluble inorganic pyrophosphatases (PPases) are essential for facilitating the growth and development of organisms, making them attractive functional proteins. To provide insight into the molecular basis of PPases in Schistosoma japonicum (SjPPase), we expressed the recombinant SjPPase, analyzed the hydrolysis mechanism of inorganic pyrophosphate (PPi), and measured its activity. Moreover, we solved the crystal structure of SjPPase in complex with orthophosphate (Pi) and performed PPi and methylene diphosphonic acid (MDP) docking into the active site. Our results suggest that the SjPPase possesses PPi hydrolysis activity, and the activity declines with increased MDP or NaF concentration. However, the enzyme shows unexpected substrate inhibition properties. Through PPi metabolic pathway analysis, the physiological action of substrate inhibition might be energy saving, adaptably cytoprotective, and biosynthetic rate regulating. Furthermore, the structure of apo-SjPPase and SjPPase with Pi has been solved at 2.6 and 2.3 Å, respectively. The docking of PPi into the active site of the SjPPase-Pi complex revealed that substrate inhibition might result from blocking Pi exit due to excess PPi in the SjPPase-Pi complex of the catalytic cycle. Our results revealed the structural features of apo-SjPPase and the SjPPase-Pi complex by X-ray crystallography, providing novel insights into the physiological functions of PPase in S. japonicum without the PPi transporter and the mechanism of its substrate inhibition.
Distinct Immune Profiles of Exhausted Effector and Memory CD8+ T Cells in Individuals With Filarial Lymphedema
Authors: Horn Sacha , Borrero-Wolff Dennis , Ritter Manuel , Arndts Kathrin , Wiszniewsky Anna , Debrah Linda Batsa , Debrah Alexander Y. , Osei-Mensah Jubin , Chachage Mkunde , Hoerauf Achim , Kroidl Inge , Layland Laura E.
Published: August 2021

CD8+ T cells are crucial for the clearance of viral infections, and current research begins to highlight their importance in parasitic diseases too. In-depth research about characteristics of CD8+ T-cell subsets and exhaustion remains uncertain, especially during filariasis, a chronic helminth infection. Lymphatic filariasis, elicited by Wuchereria bancrofti, remains a serious health problem in endemic areas in Ghana, especially in those suffering from morbidity due to lymphedema (LE). In this observational study, the characteristics and profiles of CD8+ T cells were compared between asymptomatic Wuchereria bancrofti-infected individuals, uninfected endemic normals, and those with LE (grades 2–6). Focusing on exhausted memory (CD8+exmem: CD8+ T-betdimEomeshi) and effector (CD8+exeff: CD8+T-bethiEomesdim) CD8+ T-cell subsets, advanced flow cytometry revealed that LE individuals presented reduced frequencies of IFN-γ+CD8+exmem T cells expressing Tim-3 or LAG-3 which negatively correlated to the presence of LE. Moreover, the LE cohort further showed significantly higher frequencies of IL-10+CD8+exeff T cells expressing either Tim-3, LAG-3, CD39, KLRG-1, or PD-1, all associated markers of exhaustion, and that these frequencies positively correlated with the presence of LE. In summary, this study shows that distinct exhausted CD8+ T-cell subsets are prominent in individuals suffering from LE, suggesting that enhanced inflammation and constant immune activation might drive exhaustion of CD8+ T cells. Since T-cell exhaustion is known to be associated with insufficient control of persisting antigen, the data presented here reveals that these CD8+ T-cell exhaustion patterns in filarial LE should be taken into consideration for prevention and control management of LE.
Caldera’s Breathing: Poroelastic Ground Deformation at Campi Flegrei (Italy)
Authors: Todesco Micol
Published: August 2021

Ground deformation at Campi Flegrei has fuelled a long-term scientific debate about its driving mechanism and its significance in hazard assessment. In an active volcanic system hosting a wide hydrothermal circulation, both magmatic and hydrothermal fluids could be responsible, to variable degrees, for the observed ground displacement. Fast and large uplifts are commonly interpreted in terms of pressure or volume changes associated with magma intrusion, while minor, slower displacement can be related to shallower sources. This work focuses on the deformation history of the last 35 years and shows that ground deformation measured at Campi Flegrei since 1985 is consistent with a poroelastic response of a shallow hydrothermal system to changes in pore pressure and fluid content. The extensive literature available for Campi Flegrei allows constraining system geometry, properties, and conditions. Changes in pore pressure and fluid content necessary to cause the observed deformation can then be calculated based on the linear theory of poroelasticity. The predicted pore pressure evolution and fluid fluxes are plausible and consistent with available measurements and independent estimates.
New Insights Into Mitochondrial Dysfunction at Disease Susceptibility Loci in the Development of Type 2 Diabetes
Authors: Maude Hannah , Lau Winston , Maniatis Nikolas , Andrew Toby
Published: August 2021

This study investigated the potential genetic mechanisms which underlie adipose tissue mitochondrial dysfunction in Type 2 diabetes (T2D), by systematically identifying nuclear-encoded mitochondrial genes (NEMGs) among the genes regulated by T2D-associated genetic loci. The target genes of these ‘disease loci’ were identified by mapping genetic loci associated with both disease and gene expression levels (expression quantitative trait loci, eQTL) using high resolution genetic maps, with independent estimates co-locating to within a small genetic distance. These co-locating signals were defined as T2D-eQTL and the target genes as T2D cis-genes. In total, 763 cis-genes were associated with T2D-eQTL, of which 50 were NEMGs. Independent gene expression datasets for T2D and insulin resistant cases and controls confirmed that the cis-genes and cis-NEMGs were enriched for differential expression in cases, providing independent validation that genetic maps can identify informative functional genes. Two additional results were consistent with a potential role of T2D-eQTL in regulating the 50 identified cis-NEMGs in the context of T2D risk: (1) the 50 cis-NEMGs showed greater differential expression compared to other NEMGs and (2) other NEMGs showed a trend towards significantly decreased expression if their expression levels correlated more highly with the subset of 50 cis-NEMGs. These 50 cis-NEMGs, which are differentially expressed and associated with mapped T2D disease loci, encode proteins acting within key mitochondrial pathways, including some of current therapeutic interest such as the metabolism of branched-chain amino acids, GABA and biotin.
Live Birth Rate of Frozen-Thawed Single Blastocyst Transfer After 6 or 7 Days of Progesterone Administration in Hormone Replacement Therapy Cycles: A Propensity Score-Matched Cohort Study
Authors: Yang Xinhong , Bu Zhiqin , Hu Linli
Published: August 2021

Background

Progesterone administration before transfer in hormone replacement treatment (HRT) is crucial to pregnancy outcomes in frozen-thawed blastocyst transfer (FET), but the optimal progesterone duration is inconsistent. The objective of this study was to investigate live birth rate (LBR) of different progesterone duration before blastocyst transfer in HRT–FET cycles.

Method

In this retrospective cohort study, patients underwent first HRT–FET (including suppression HRT) from January 2016 to December 2019 were included. Logit-transformed propensity score matching (PSM) was performed to assess covariates. The primary outcome was live birth rate after 28 weeks’ gestation. Basing on different duration of progesterone before transfer, patients were classified into P6-protocol (blastocyst transfer performed on the sixth day), or P7-protocol (blastocyst transfer performed on the seventh day). Subgroup analyses were conducted as follows: age stratification (–35, 35–38, 38–), development days of blastocyst (D5 or D6), blastocyst quality (high-quality or poor-quality), and endometrial preparation protocols (HRT or suppression HRT).

Result

After case matching with propensity score methods, a total of 1,400 patients were included finally: 700 with P6-protocol and 700 with P7-protocol. Significantly higher live birth rate (38.43% versus 31.57%, respectively, P = 0.01) and clinical pregnant rate (50.43% versus 44.14%, respectively, P = 0.02) were observed in P6-protocol than those of P7-protocol. First-trimester abortion rates (18.13% versus 20.71%, P = 0.40) and ectopic pregnancy rates (2.27% versus 1.94%, P = 0.77) were similar between P6- and P7-groups. Preterm birth rate, low birth weight rate, newborn sex proportion, neonatal malformation rate were comparable between groups. Significantly higher LBRs were observed in patients with: age under 35, D5 blastocyst transfer, high-quality blastocyst transfer, and undergoing HRT cycles combined P6-protocol.

Conclusion

Frozen-thawed blastocyst transfer on the sixth day of progesterone administration in first HRT cycle is related to higher live birth rate compared with transfer on the seventh day, especially among patients aged under 35, D5 blastocyst and/or high-quality blastocyst transfer.
21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients
Authors: Zhu Yifei , Wang Tiange , Tong Yiwei , Chen Xiaosong , Shen Kunwei
Published: August 2021

Background

Comprehensive investigations of the associations between 21-gene recurrence assay and metabolic profiles in Chinese breast cancer patients are limited.

Methods

We evaluated the relations of the 21-gene recurrence risk score (RS) and the expression of cancer-related genes with metabolic factors and biomarkers of insulin and the insulin-like growth factor (IGF) axis, and examined the interactions between the 21-gene RS and these metabolic profiles on breast cancer recurrence in Chinese women with HR-positive, HER2-negative early-stage breast cancer.

Results

The 21-gene RS was inversely associated with body mass index ([BMI]β: −0.178 kg/m2; P=0.040), the homeostasis model assessment of insulin resistance index ([HOMA-IR] β: −0.031; P=0.042), insulin (β: −0.036 uIU/ml; P=0.009), and C-peptide (β: −0.021 ug/L; P=0.014) and was positively associated with high-density lipoprotein cholesterol (β: 0.025 mmol/L; P=0.004), which were driven by the relation patterns between specific cancer-related genes and these metabolic profiles. Each 10-unit increase in the 21-gene RS was associated with 28% (95% CI: 5–47%) higher risk of breast cancer recurrence; this association was also observed in patients with favorable metabolic profiles in relevant to an absence of obesity, insulin resistance, hyperglycemia, hypertension, or dyslipidemia (28–44% higher risk) and among women with a low level of insulin, C-peptide, or the IGF1/IGFBP3 ratio (41–155% higher risk).

Conclusions

The 21-gene RS was related to favorable metabolic profiles including lower BMI, HOMA-IR, insulin, and C-peptide, and higher HDL in Chinese breast cancer patients, and its prognostic impact on breast cancer recurrence was more likely to present among patients with relatively favorable metabolic profiles.
Metabolic Syndrome Impairs Executive Function in Bipolar Disorder
Authors: Dalkner Nina , Bengesser Susanne A. , Birner Armin , Fellendorf Frederike T. , Fleischmann Eva , Großschädl Katja , Lenger Melanie , Maget Alexander , Platzer Martina , Queissner Robert , Schönthaler Elena , Tmava-Berisha Adelina , Reininghaus Eva Z.
Published: August 2021

Background: Metabolic syndrome (MetS) is more prevalent in individuals with bipolar disorder and has a negative impact on cognition, in particular on executive function, which is already impaired in individuals with bipolar disorder compared to healthy controls.

Methods: In a cross-sectional study, we compared 148 euthymic patients with bipolar disorder and 117 healthy controls in cognitive function depending on the diagnosis of MetS. A neuropsychological test battery was used including the Trail Making Test A/B, Stroop Color and Word Interference Test, the d2 Test of Attention Revised, and the California Verbal Learning Test. In addition, MetS variables as well as the defining variables waist circumference, serum triglyceride levels, high-density lipoprotein cholesterol levels, blood pressure, fasting glucose levels, and body mass index were compared between patients and controls. In addition, illness-related variables were associated with MetS in individuals with bipolar disorder.

Results: The prevalence of MetS in patients with bipolar disorder was higher than in controls (30.4 vs. 15.4%). Patients with bipolar disorder with MetS had impaired executive function compared to patients without MetS or healthy controls with and without MetS (p = 0.020). No MetS effects or interaction MetS × Group was found in attention/processing speed (p = 0.883) and verbal learning/memory (p = 0.373). Clinical variables (illness duration, suicidality, number of affective episodes, medication, age of onset, and history of psychosis) did not relate to MetS in bipolar disorder (p > 0.05).

Conclusion: Bipolar disorder comorbid with MetS bears additional risk for impaired executive function. Executive function includes action planning, inhibition, and impulse control and could play a critical role in keeping long-term goals in mind associated with gaining and maintaining a healthy weight.
Association of Parental Height With Offspring Stunting in 14 Low- and Middle-Income Countries
Authors: Wu Han , Ma Chuanwei , Yang Liu , Xi Bo
Published: August 2021

Background: Maternal height has been confirmed to be associated with offspring stunting in low- and middle-income countries (LMICs), but only limited studies have examined the paternal-offspring association, and few studies have examined the joint effect of maternal and paternal height on stunting.

Objective: To investigate the association between parental height and stunting of children aged under five in LMICs.

Methods: We obtained data from the Demographic and Health Surveys (DHS) conducted in 14 LMICs from 2006 to 2016. The association between maternal and paternal height and height-for-age z score (HAZ) of children aged under five was analyzed using a linear regression model in consideration of complex survey design, and regression coefficients (β) with 95% confidence intervals (CIs) were reported. Then, the association between maternal and paternal height quintile and child stunting was analyzed using a modified Poisson regression approach with robust error variance in consideration of complex survey design with adjustment for covariates. The effect estimates were expressed as relative risks (RRs) with 95% CIs.

Results: A total of 50,372 singleton children were included and the weighted prevalence of stunting was 34.5%. Both maternal height and paternal height were associated with child HAZ (β = 0.047; 95% CI, 0.043, 0.050; and β = 0.022; 95% CI, 0.018, 0.025, respectively). Compared with those born to the tallest mothers and fathers, children from the shortest mothers and the shortest fathers had higher risks of stunting (adjusted RR = 1.89; 95% CI, 1.78, 2.01; adjusted RR = 1.56; 95% CI, 1.47, 1.65, respectively). The mother-offspring associations are substantively larger than the father-offspring associations for each corresponding height quintile. Children from the shortest parents had the highest risk of stunting compared with children from the tallest parents (adjusted RR = 3.23; 95% CI, 2.83, 3.68).

Conclusions: Offspring born to short parents are at increased risk of stunting in LMICs, and this intergenerational effect is partly driven by maternal intrauterine influence. This suggests the importance of improving the nutritional status of children and adults in LMICs, especially female caregivers.
Stromal Neutrophil Extracellular Trap Density Is an Independent Prognostic Factor for Cervical Cancer Recurrence
Authors: Yan Bin , Dai Xuan , Ma Quanfu , Wu Xufeng
Published: August 2021

Background

Emerging evidence indicates that the tumor microenvironment influences tumor progression and patient prognosis through various inflammatory cells. Polymorphonuclear neutrophils (PMNs) and their functional structures termed neutrophil extracellular traps (NETs) are prominent constituents of several malignant tumors and affect the tumor microenvironment and cancer evolution. Here, we investigate the prognostic value of PMNs and NETs for recurrence in patients with cervical cancer.

Methods

The study comprised 126 cervical cancer patients who were retrospectively enrolled. CD66b+ neutrophils and myeloperoxidase/citrullinated histone H3 (MPO/H3Cit)-labeled NETs were assessed by immunofluorescence, and the relationships with clinical and histopathologic features and patient outcome were evaluated.

Results

The highest density of CD66b+ neutrophils were observed in the stromal compartment (median 55 cells/mm2). Above median densities of stromal CD66b+ neutrophils and NETs were significantly associated with short recurrence-free survival (RFS) (P = 0.041 and P = 0.006, respectively). Multivariate analysis identified high clinical stage (hazard ratio [HR] 6.40; 95% confidence interval [CI] 3.51-11.64; P < 0.001), lymph node metastases (HR 4.69; 95% CI 3.09-9.66; P = 0.006) and high density of NETs (HR 2.66; 95% CI 1.21-5.82; P = 0.015) as independent prognostic factors for short RFS, whereas a high density of CD66b+ neutrophils was not significant. Patients with a high NET density showed worse recurrence status in every stage, but the difference was only significant for stage I (P = 0.042), not stages II, III, or IV (all P > 0.05). Combining stromal NET density and the tumor, nodes, metastasis (TNM) staging system had better prognostic accuracy for cervical cancer than the TNM staging system alone at five and six years respectively (P = 0.010 and P = 0.023).

Conclusion

Stromal NET density is an independent prognostic factor for RFS in cervical cancer. Combining NETs with the TNM staging system may further improve prognostic stratification.
Assessment Practice of Patient-Centered Outcomes in Surgical Neuro-Oncology: Survey-Based Recommendations for Clinical Routine
Authors: Weiss Lucas Carolin , Renovanz Mirjam , Jost Johanna , Sabel Michael , Wiewrodt Dorothee , Rapp Marion
Published: August 2021

The psycho-oncological burden related to the diagnosis of an intracranial tumor is often accompanied by neurocognitive deficits and changes in character, overall affecting health-related quality of life (HRQoL) and activities of daily living. Regular administration of adequate screening tools is crucial to ensure a timely detection of needs for support and/or specific interventions. Although efforts have been made to assure the quality of neuro-oncological care, clinical assessment practice of patient-reported outcomes (PROs) remains overall heterogeneous, calling for a concise recommendation tailored to neuro-oncological patients. Therefore, this survey, promoted by the German Society of Neurosurgery, was conducted to evaluate thestatus quoof health care resources and PRO/neurocognition assessment practices throughout departments of surgical neuro-oncology in Germany. 72/127 (57%) of registered departments participated in the study, including 83% of all university hospital units. A second aim was to shed light on the impact of quality assurance strategies (i.e., department certification as part of an integrative neuro-oncology cancer center; CNOC) on the assessment practice, controlled for interacting structural factors, i.e., university hospital status (UH) and caseload. Despite an overall good to excellent availability of relevant health care structures (psycho-oncologist: 90%, palliative care unit: 97%, neuropsychology: 75%), a small majority of departments practice patient-centered screenings (psycho-oncological burden: 64%, HRQoL: 76%, neurocognition: 58%), however, much less frequently outside the framework of clinical trials. In this context, CNOC affiliation, representing a specific health care quality assurance process, was associated with significantly stronger PRO assessment practices regarding psycho-oncological burden, independent of UH status (common odds ratio=5.0, p=0.03). Nevertheless, PRO/neurocognitive assessment practice was not consistent even across CNOC. The overall most commonly used PRO/neurocognitive assessment tools were the Distress Thermometer (for psycho-oncological burden; 64%), the EORTC QLQ-C30 combined with the EORTC QLQ-BN20 (for HRQoL; 52%) and the Mini-Mental Status Test (for neurocognition; 67%), followed by the Montreal Cognitive Assessment (MoCA; 33%). Accordingly, for routine clinical screening, the authors recommend the Distress Thermometer and the EORTC QLQ-C30 and QLQ-BN20, complemented by the MoCA as a comparatively sensitive yet basic neurocognitive test. This recommendation is intended to encourage more regular, adequate, and standardized routine assessments in neuro-oncological practice.
Tyrosine Kinase Inhibitors Stimulate HLA Class I Expression by Augmenting the IFNγ/STAT1 Signaling in Hepatocellular Carcinoma Cells
Authors: Takahashi Aya , Umemura Atsushi , Yano Kota , Okishio Shinya , Kataoka Seita , Okuda Keiichiro , Seko Yuya , Yamaguchi Kanji , Moriguchi Michihisa , Okanoue Takeshi , Itoh Yoshito
Published: August 2021

Combination treatment with tyrosine kinase inhibitors (TKIs) and immunotherapies has shown efficacy in the treatment of multiple cancers, but the immunomodulatory effect of TKIs on the tumor cell phenotype remains unknown in hepatocellular carcinoma (HCC). Given that human lymphocyte antigen class I (HLA-I) is essential for tumor antigen presentation and subsequent antitumor immunity, we examined the effects of regorafenib, as well as other TKIs (sorafenib, lenvatinib and cabozantinib) on HLA-I expression in HCC cell lines. Regorafenib increased cell surface HLA-I and β2-microglobulin protein expression in the presence of interferon γ (IFNγ). The expressions of various genes associated with the HLA-I antigen processing pathway and its transcriptional regulators were also upregulated by regorafenib. Furthermore, we found that regorafenib had an activating effect on signal transducers and activators of transcription 1 (STAT1), and that regorafenib-induced HLA-I expression was dependent on the augmented IFNγ/STAT1 signaling pathway. Trametinib, an inhibitor of the extracellular signal-regulated kinase (ERK) kinase MEK, also activated IFNγ/STAT1 signaling and increased HLA-I expression, whereas the phosphatidylinositol 3-kinase (PI3K) inhibitor buparlisib did not. Given that regorafenib directly inhibits Raf/MEK/ERK signaling, the downregulation of the MEK/ERK pathway appears to be one of the mechanisms by which regorafenib promotes STAT1 activation. Sorafenib, lenvatinib, and cabozantinib also showed the same effects as regorafenib, while regorafenib had most potent effects on HLA-I expression, possibly dependent on its stronger inhibitory activity against the MEK/ERK pathway. These results support the clinical combination of TKIs with immunotherapy for the treatment of HCC.
Dose-Dependent Efficacy of Aripiprazole in Treating Patients With Schizophrenia or Schizoaffective Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Qian Li , Xuemei Liao , Jitao Li , Yun'Ai Su , Tianmei Si
Published: August 2021

Purpose: To compare the efficacy and tolerability of different administration strategies of aripiprazole.

Methods: We searched MEDLINE, EMBASE, the Cochrane Central, Web of Science, China National Knowledge Infrastructure(CNKI), and Wanfang Data Knowledge Service Platform(Wanfang) for randomized controlled trials (RCTs) of aripiprazole, using the terms: (aripiprazole) AND (schizophr* OR schizoaff*) AND (“syndrome scale” OR PANSS) AND (clini* OR trial). We retrieved study design, participant characteristics, comparison groups, and outcomes from each study.

Results: In total, nine RCTs were selected for meta-analysis, which covered ~1,187 participants. We defined two treatment groups that represent different treatment strategies: (1) the high-dose group (the high-dose strategy) rapidly increased to doses higher than 15 mg/day in 2 weeks or began with doses higher than 15 mg/day, otherwise the group was defined as (2) the low-dose group (the low-dose strategy). If the initial or target doses of aripiprazole in a study were all higher than 15 mg/day, the high- and low-dose groups were created based on the relative level of the dose. The high-dose group showed significantly greater reductions in Positive and Negative Syndrome Scale (PANSS) total scores (standardized mean differences = −8.31, 95% confidence interval [CI] = −16.48, −0.13; P < 0.01; I2 = 96%) than the low-dose group. The high-dose group showed superior effects compared with the low-dose group in long-term studies (more than 8 weeks) (standardized mean differences = −13.81, 95% CI = −25.07, −2.55; P < 0.01; I2 = 96%). With exception of somnolence, we did not find significant differences in side effects or discontinuation due to adverse events. Sensitivity analyses produced similar results.

Conclusion: The high-dose treatment strategy of aripiprazole for patients with schizophrenia or schizoaffective disorder may bring more benefits without obvious side effects.
Reviewing School Uniform through a Public Health Lens: Evidence about the Impacts of School Uniform on Education and Health
Authors: Reidy Johanna
Published: August 2021

This study uses a public health lens to review evidence about the impacts of wearing a school uniform on students’ health and educational outcomes. It also reviews the underlying rationales for school uniform use, exploring historical reasons for uniform use, as well as how questions of equity, human rights, and the status of children as a vulnerable group are played out in debates over school uniforms. The literature identified indicates that uniforms have no direct impact on academic performance, yet directly impact physical and psychological health. Girls, ethnic and religious minorities, gender-diverse students and poorer students suffer harm disproportionately from poorly designed uniform policies and garments that do not suit their physical and socio-cultural needs. Paradoxically, for some students, uniform creates a barrier to education that it was originally instituted to remedy. The article shows that public health offers a new perspective on and contribution to debates and rationales for school uniform use. This review lays out the research landscape on school uniform and highlights areas for further research.
Observer-Based Coordinated Control for Blended Braking System with Actuator Delay
Authors: Li Wenfei , Li Huiyun , Huang Chao , Xu Kun , Sun Tianfu , Du Haiping
Published: August 2021

The coordinated control of a blended braking system is always a difficult task. In particular, blended braking control becomes more challenging when the braking actuator has an input time-delay and some states of the braking system cannot be measured. In order to improve the tracking performance, a coordinated control system was designed based on the input time-delay and state observation for a blended braking system comprising a motor braking system and friction braking system. The coordinated control consists of three parts: Sliding mode control, a multi-input single-output observer, and time-delay estimation-based Smith Predictor control. The sliding mode control is used to calculate the total command braking torque according to the desired braking performance and vehicle states. The multi-input single-output observer is used to simultaneously estimate the input time-delay and output braking torque of the friction braking system. With time-delay estimation-based Smith Predictor control, the friction braking system is able to effectively track the command braking torque of the friction braking system. The tracking of command braking torque is realized through the coordinated control of the motor braking system and friction braking system. In order to validate the effectiveness of the proposed approach, numerical simulations on a quarter-vehicle braking model were performed.
Impact of Rural–Urban Migration Experience on Rice Farmers’ Agricultural Machinery Expenditure: Evidence from China
Authors: Sun Yiduo , Hu Ruifa , Zhang Chao
Published: August 2021

In China, return migrants’ rural–urban migration experience and its impact on agricultural production have attracted increasing attention. Using the random survey data of 1122 rice farmers from the Yangtze River Basin in 2016, this study utilizes the endogenous treatment–effect model to investigate the impact of rural–urban migration experience on farmers’ agricultural machinery expenditure. The results demonstrate that return migrants with rural–urban migration experience account for 23.3% of the total sampled farmers. After addressing the endogeneity issue, rural–urban migration experience can increase rice farmers’ agricultural machinery expenditure by 500–600 yuan/ha. Meanwhile, the positive impact of rural–urban migration experience on agricultural machinery expenditure is also heterogeneous in terms of farmers’ age and rice farm size. Based on the results, this study proposes assisting return migrants’ engagement in agriculture, supporting agricultural mechanization for the aged farmers, and enhancing the coordination between agricultural mechanization and appropriately scaled agricultural operations.
Microbial Resource Limitation in Aggregates in Karst and Non-Karst Soils
Authors: Wang Yunqiu , Shahbaz Muhammad , Zhran Mostafa , Chen Anlei , Zhu Zhenke , Galal Yehia Galal Mohamed , Ge Tida , Li Yuhong
Published: August 2021

Karst is a widespread ecosystem with properties that affect the microbial activity and storage and cycling of soil organic carbon. The mechanisms underlying microbial resource availability in karst, which limit the microbial growth and activity in soil aggregates, remain largely unknown. We assessed the microbial resource limitations using exoenzymatic stoichiometry and key extracellular enzyme activities in bulk soil and aggregates in karst and non-karst forest soils. Soil organic carbon, total nitrogen, and microbial biomass carbon and nitrogen were significantly higher in bulk soil and the aggregate fractions in karst forests. However, the microbial biomass accumulation was higher in finer aggregates than in macroaggregate fractions. This may be attributed to the surface area of finer aggregates that increase the microbial C accumulation. In karst forests, the activity of extracellular enzymes β-d-glucosidase, β-N-acetylglucosaminidase, α-glucosidase, and α-d-1,4-cellobiosidase was two to three times higher in microaggregates (0.053–0.25 mm) and mineral fractions (<0.053 mm) than in macroaggregates. This coincided with the distribution of microbial biomass carbon and phosphorus in finer aggregate fractions. The microorganisms in bulk soil and aggregates in karst forests were largely co-limited by carbon and phosphorus and rarely by nitrogen and only by phosphorus in non-karst soils. The microbial phosphorus limitation in non-karst soils was alleviated in finer soil aggregates, while these fractions reflected slightly higher. microbial C limitations than bulk and other aggregates in karst forests. The patterns of microbial resource limitations in the bulk and aggregate fractions in karst ecosystems reflected the regulation of enzyme activity and soil organic carbon accumulation in finer aggregate fractions but not in other aggregates.