bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengaruh Edukasi Gizi terhadap Asupan dan Status Gizi Pasien Sirosis Hati
Authors: Mustika Syifa , Nurmalita Shafira , Samichah Samichah , Putri Fildzah Karunia , Sembiring Frinny , Ruliana Ruliana , Handayani Dian
Published: May 2021

ABSTRAK Malnutrisi adalah masalah yang umum terjadi pada pasien sirosis hati. Kurangnya pengetahuan tentang gizi sehingga menyebabkan adanya pembatasan diet yang tidak perlu dan kemudian berkontribusi pada kejadian malnutrisi. Penelitian ini bertujuan untuk mengetahui adanya pengaruh pemberian edukasi gizi terhadap status gizi dan asupan pasien sirosis hati di Poli Gastroenterohepatologi Rumah Sakit dr. Saiful Anwar Malang. Jenis penelitian yang dilakukan termasuk dalam penelitian experimental dengan desain penelitian pre-post test control group design. Kelompok intervensi adalah kelompok yang diberi edukasi gizi pada awal pengambilan data, sedangkan kelompok kontrol adalah kelompok yang tidak diberi edukasi gizi. Data yang diambil pada penelitian ini adalah data antropometri, data asupan saat pengambilan data awal dan akhir serta data asupan makan partisipan yang dimonitoring selama 1 bulan menggunakan food diary. Hasil penelitian ini menunjukkan tidak terdapatnya penurunan yang signifikan (p=0.48) pada Indeks Massa Tubuh partisipan di kelompok intervensi dan kontrol. Sedangkan asupan energi dan karbohidrat pada kelompok intervensi mengalami peningkatan yang signifikan (p<0.05). Pemberian edukasi akan memberikan efek positif dan efektif jika dilakukan bersama dengan peningkatan aktivitas fisik. Efek dari pemberian edukasi gizi akan nampak bila durasi monitoring dan evaluasi diperpanjang.Â Kata kunci: edukasi gizi, sirosis hati, status gizi, asupan zat gizi, antropometri giziABSTRACT Malnutrition is a common problem among liver cirrhosis patients. Lack of knowledge about nutrition causes unnecessary dietary restrictions and leads to the incidence of malnutrition. This study aimed to determine the effect of nutrition education on intake and nutritional status of patients with liver cirrhosis at the Gastroenterohepatology Department, dr. Saiful Anwar General Hospital, Malang. The design used was an experimental study with a pre-post test control group. The intervention group is the group given nutrition education, while the control group is the group without nutrition education. The data taken in this study were anthropometric, intake data when taking initial and final data, and participants' daily food intake monitored for a month using a food diary. The study results showed no significant decrease (p = 0.48) in the body mass index of participants in the intervention and control groups. However, the energy and carbohydrate intake in the intervention group experienced a significant increase (p <0.05). Providing nutrition education will have a positive and effective effect if done together with increased physical activity. The duration of monitoring and evaluation should be extended to see the effectiveness of the nutrition educationKeywords: nutritional education, liver cirrhosis, nutritional status, nutrient intake, nutritional anthropometry
User Perspectives on a Resilience-Building App (JoyPop): Qualitative Study
Authors: Mushquash Aislin R , Pearson Erin S , Waddington Kayla , MacIsaac Angela , Mohammed Shakira , Grassia Elizabeth , Smith Savanah , Wekerle Christine
Published: May 2021

Background

Resilience is the capability, resources, and processes that are available to a person or system to adapt successfully in the face of stress or adversity. Given that resilience can be enhanced, using advances in technology to deliver and evaluate the impact of resilience interventions is warranted. Evidence supports the effectiveness of the resilience-building JoyPop app in improving resilience-related outcomes after use; however, experiential data from users is also needed to provide a more comprehensive account of its utility.

Objective

The aim of this study was to explore users’ experiences with the JoyPop app and their perspectives on its utility.

Methods

This qualitative description study involved a combination of group and one-on-one semistructured interviews with a subset of first-year undergraduate students who participated in a larger evaluation of the JoyPop app. Participants used the app for a 4-week period and were subsequently asked about their frequency of app use, most and least used features (and associated reasons), most and least helpful features (and associated reasons), barriers to use, facilitators of use and continuation, and recommendations for improvement. Data were coded and categorized through inductive content analysis.

Results

The sample of 30 participants included 24 females and 6 males, with a mean age of 18.77 years (SD 2.30). App use ranged from 1 to 5 times daily (mean 2.11, SD 0.74), with the majority indicating that they used the app at least twice daily. The Rate My Mood, Journal, and SquareMoves features were reported to be used most often, while the Rate My Mood, Journal, and Breathing Exercises features were identified as the most helpful. A number of themes and subthemes pertaining to facilitators of app use (prompts, creating routine, self-monitoring opportunities, expressive opportunities), barriers to app use (editing, lack of variety, student lifestyle), outcomes of app use (increased awareness, checking in with oneself, helpful distraction, emotional control), and recommendations for app improvement (adding more features, enhancing existing features, enhancing tracking abilities, providing personalization) were identified.

Conclusions

This study provides insight into the aspects of the JoyPop app that motivated and benefitted users, as well as measures that can be taken to improve user experiences and promote longer-term uptake. Users were willing to engage with the app and incorporate it into their routine, and they valued the ability to self-monitor, express emotion, and engage in distraction.
Evaluating Scholars’ Impact and Influence: Cross-sectional Study of the Correlation Between a Novel Social Media–Based Score and an Author-Level Citation Metric
Authors: Oliveira J e Silva Lucas , Maldonado Graciela , Brigham Tara , Mullan Aidan F , Utengen Audun , Cabrera Daniel
Published: May 2021

Background

The development of an author-level complementary metric could play a role in the process of academic promotion through objective evaluation of scholars’ influence and impact.

Objective

The objective of this study was to evaluate the correlation between the Healthcare Social Graph (HSG) score, a novel social media influence and impact metric, and the h-index, a traditional author-level metric.

Methods

This was a cross-sectional study of health care stakeholders with a social media presence randomly sampled from the Symplur database in May 2020. We performed stratified random sampling to obtain a representative sample with all strata of HSG scores. We manually queried the h-index in two reference-based databases (Scopus and Google Scholar). Continuous features (HSG score and h-index) from the included profiles were summarized as the median and IQR. We calculated the Spearman correlation coefficients (ρ) to evaluate the correlation between the HSG scores and h-indexes obtained from Google Scholar and Scopus.

Results

A total of 286 (31.2%) of the 917 stakeholders had a Google Scholar h-index available. The median HSG score for these profiles was 61.1 (IQR 48.2), and the median h-index was 14.5 (IQR 26.0). For the 286 subjects with the HSG score and Google Scholar h-index available, the Spearman correlation coefficient ρ was 0.1979 (P<.001), indicating a weak positive correlation between these two metrics. A total of 715 (78%) of 917 stakeholders had a Scopus h-index available. The median HSG score for these profiles was 57.6 (IQR 46.4), and the median h-index was 7 (IQR 16). For the 715 subjects with the HSG score and Scopus h-index available, ρ was 0.2173 (P<.001), also indicating a weak positive correlation.

Conclusions

We found a weak positive correlation between a novel author-level complementary metric and the h-index. More than a chiasm between traditional citation metrics and novel social media–based metrics, our findings point toward a bridge between the two domains.
A Multimodal Imaging–Based Deep Learning Model for Detecting Treatment-Requiring Retinal Vascular Diseases: Model Development and Validation Study
Authors: Kang Eugene Yu-Chuan , Yeung Ling , Lee Yi-Lun , Wu Cheng-Hsiu , Peng Shu-Yen , Chen Yueh-Peng , Gao Quan-Ze , Lin Chihung , Kuo Chang-Fu , Lai Chi-Chun
Published: May 2021

Background

Retinal vascular diseases, including diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD), myopic choroidal neovascularization (mCNV), and branch and central retinal vein occlusion (BRVO/CRVO), are considered vision-threatening eye diseases. However, accurate diagnosis depends on multimodal imaging and the expertise of retinal ophthalmologists.

Objective

The aim of this study was to develop a deep learning model to detect treatment-requiring retinal vascular diseases using multimodal imaging.

Methods

This retrospective study enrolled participants with multimodal ophthalmic imaging data from 3 hospitals in Taiwan from 2013 to 2019. Eye-related images were used, including those obtained through retinal fundus photography, optical coherence tomography (OCT), and fluorescein angiography with or without indocyanine green angiography (FA/ICGA). A deep learning model was constructed for detecting DME, nAMD, mCNV, BRVO, and CRVO and identifying treatment-requiring diseases. Model performance was evaluated and is presented as the area under the curve (AUC) for each receiver operating characteristic curve.

Results

A total of 2992 eyes of 2185 patients were studied, with 239, 1209, 1008, 211, 189, and 136 eyes in the control, DME, nAMD, mCNV, BRVO, and CRVO groups, respectively. Among them, 1898 eyes required treatment. The eyes were divided into training, validation, and testing groups in a 5:1:1 ratio. In total, 5117 retinal fundus photos, 9316 OCT images, and 20,922 FA/ICGA images were used. The AUCs for detecting mCNV, DME, nAMD, BRVO, and CRVO were 0.996, 0.995, 0.990, 0.959, and 0.988, respectively. The AUC for detecting treatment-requiring diseases was 0.969. From the heat maps, we observed that the model could identify retinal vascular diseases.

Conclusions

Our study developed a deep learning model to detect retinal diseases using multimodal ophthalmic imaging. Furthermore, the model demonstrated good performance in detecting treatment-requiring retinal diseases.
Developing Adaptive Serious Games for Children With Specific Learning Difficulties: A Two-phase Usability and Technology Acceptance Study (Preprint)
Authors: Yildirim Oguzcan , Surer Elif
Published: May 2021

BACKGROUND

Specific learning difficulties (SpLD) include several disorders such as dyslexia, dyscalculia, and dysgraphia, and the children with these SpLD receive special education. However, the studies and the educational material so far focus mainly on one specific disorder.

OBJECTIVE

This study’s primary goal is to develop comprehensive training material for different types of SpLD, with five serious games addressing different aspects of the SpLD. The second focus is measuring the impact of adaptive difficulty level adjustment in the children’s and their educators’ usability and technology acceptance perception. Receiving feedback from the children and their educators, and refining the games according to their suggestions have also been essential in this two-phase study.

METHODS

A total of 10 SpLD educators and 23 children with different types of SpLD tested the prototypes of the five serious games (ie, Word game, Memory game, Category game, Space game, and Math game), gave detailed feedback, answered the System Usability Scale and Technology Acceptance Model (TAM) questionnaires, and applied think-aloud protocols during game play.

RESULTS

The games’ standard and adaptive versions were analyzed in terms of average playtime and the number of false answers. Detailed analyses of the interviews, with word clouds and player performances, were also provided. The TAM questionnaires’ average and mean values and box plots of each data acquisition session for the children and the educators were also reported via System Usability Scale and TAM questionnaires. The TAM results of the educators had an average of 8.41 (SD 0.87) out of 10 in the first interview and an average of 8.71 (SD 0.64) out of 10 in the second interview. The children had an average of 9.07 (SD 0.56) out of 10 in the first interview.

CONCLUSIONS

Both the educators and the children with SpLD enjoyed playing the games, gave positive feedback, and suggested new ways for improvement. The results showed that these games provide thorough training material for different types of SpLD with personalized and tailored difficulty systems. The final version of the proposed games will become a part of the special education centers’ supplementary curriculum and training materials, making new enhancements and improvements possible in the future.
Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study (Preprint)
Authors: Militello Lisa , Sobolev Michael , Okeke Fabian , Adler Daniel A , Nahum-Shani Inbal
Published: May 2021

BACKGROUND

Given the interrelated health of children and parents, strategies to promote stress regulation are critically important in the family context. However, the uptake of preventive mental health is limited among parents owing to competing family demands.

OBJECTIVE

In this study, we aim to determine whether it is feasible and acceptable to randomize digital prompts designed to engage parents in real-time brief mindfulness activities guided by a commercially available app.

METHODS

We conducted a 30-day pilot microrandomized trial among a sample of parents who used Android smartphones. Each day during a parent-specified time frame, participants had a 50% probability of receiving a prompt with a message encouraging them to engage in a mindfulness activity using a commercial app, Headspace. In the 24 hours following randomization, ecological momentary assessments and passively collected smartphone data were used to assess proximal engagement (yes or no) with the app and any mindfulness activity (with or without the app). These data were combined with baseline and exit surveys to determine feasibility and acceptability.

RESULTS

Over 4 months, 83 interested parents were screened, 48 were eligible, 16 were enrolled, and 10 were successfully onboarded. Reasons for nonparticipation included technology barriers, privacy concerns, time constraints, or change of mind. In total, 80% (8/10) of parents who onboarded successfully completed all aspects of the intervention. While it is feasible to randomize prompt delivery, only 60% (6/10) of parents reported that the timing of prompts was helpful despite having control over the delivery window. Across the study period, we observed higher self-reported engagement with Headspace on days with prompts (31/62, 50% of days), as opposed to days without prompts (33/103, 32% of days). This pattern was consistent for most participants in this study (7/8, 87%). The time spent using the app on days with prompts (mean 566, SD 378 seconds) was descriptively higher than on days without prompts (mean 225, SD 276 seconds). App usage was highest during the first week and declined over each of the remaining 3 weeks. However, self-reported engagement in mindfulness activities without the app increased over time. Self-reported engagement with any mindfulness activity was similar on days with (40/62, 65% of days) and without (65/103, 63% of days) prompts. Participants found the Headspace app helpful (10/10, 100%) and would recommend the program to others (9/10, 90%).

CONCLUSIONS

Preliminary findings suggest that parents are receptive to using mindfulness apps to support stress management, and prompts are likely to increase engagement with the app. However, we identified several implementation challenges in the current trial, specifically a need to optimize prompt timing and frequency as a strategy to engage users in preventive digital mental health.
igia: An Open-source Platform to Accelerate Innovation in Health Information Technology (Preprint)
Authors: Gordon William , Karipineni Neelima , Ainsworth Layne , Bapat Nikhil , Chulyadyo Rupendra , dela Paz Rory , Joshi Shreekanth , Mailly Carly , Oates Michael , Ostrovsky Yuri , Patel Rahul , Shin Jiyeon , Thotathil Sawad , Vernekar Vishal Pai , Wang Fei , Wagholikar Kavishwar B , Murphy Shawn , Aronson Samuel
Published: May 2021

BACKGROUND

While usage of EHRs has substantially increased over the past decade, building clinical applications remains challenging for multiple reasons, including security and privacy considerations, data integration, application distribution, and application deployment.

OBJECTIVE

We discuss the importance of platforms for health IT development, and specifically describe “igia,” an open-source collection of software packages that enable developers to build and deploy applications more efficiently.

METHODS

igia is an open-source collection of software packages and repositories that allow a healthcare application developer to develop and deploy EHR-linked applications more efficiently.

RESULTS

igia was built with several principles: first, it is open-source. Second, igia leverages best-practice solutions wherever possible. Third, it is designed to be used in operational, “clinically-ready” settings. Fourth, igia focuses on reusability and platform-level functionality, so that developers can focus on application development. Finally, igia leverages existing standards, to emphasize interoperability and health IT ecosystem integration. Features include a microservices architecture, SMART on FHIR, data integration, and care management modules.

CONCLUSIONS

Platforms could improve the efficiency of health IT software development. We describe “igia,” an open-source platform for building clinical applications. We hope that such a platform will reduce barriers to developing clinical applications by providing “out of the box” functionality for many common healthcare IT tasks. igia is released under an MPL v2.0 with code and documentation freely available on GitHub.
Accuracy and Acceptability of Wrist-Wearable Activity-Tracking Devices: Systematic Review of the Literature (Preprint)
Authors: Germini Federico , Noronha Noella , Borg Debono Victoria , Abraham Philip Binu , Pete Drashti , Navarro Tamara , Keepanasseril Arun , Parpia Sameer , de Wit Kerstin , Iorio Alfonso
Published: May 2021

BACKGROUND

Numerous wrist-wearable devices to measure physical activity are currently available, but there is a need to unify the evidence on how they compare in terms of acceptability and accuracy.

OBJECTIVE

The aim of this study is to perform a systematic review of the literature to assess the accuracy and acceptability (willingness to use the device for the task it is designed to support) of wrist-wearable activity trackers.

METHODS

We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and SPORTDiscus for studies measuring physical activity in the general population using wrist-wearable activity trackers. We screened articles for inclusion and, for the included studies, reported data on the studies’ setting and population, outcome measured, and risk of bias.

RESULTS

A total of 65 articles were included in our review. Accuracy was assessed for 14 different outcomes, which can be classified in the following categories: count of specific activities (including step counts), time spent being active, intensity of physical activity (including energy expenditure), heart rate, distance, and speed. Substantial clinical heterogeneity did not allow us to perform a meta-analysis of the results. The outcomes assessed most frequently were step counts, heart rate, and energy expenditure. For step counts, the Fitbit Charge (or the Fitbit Charge HR) had a mean absolute percentage error (MAPE) <25% across 20 studies. For heart rate, the Apple Watch had a MAPE <10% in 2 studies. For energy expenditure, the MAPE was >30% for all the brands, showing poor accuracy across devices. Acceptability was most frequently measured through data availability and wearing time. Data availability was ≥75% for the Fitbit Charge HR, Fitbit Flex 2, and Garmin Vivofit. The wearing time was 89% for both the GENEActiv and Nike FuelBand.

CONCLUSIONS

The Fitbit Charge and Fitbit Charge HR were consistently shown to have a good accuracy for step counts and the Apple Watch for measuring heart rate. None of the tested devices proved to be accurate in measuring energy expenditure. Efforts should be made to reduce the heterogeneity among studies.
Correction: Measurement of Digital Literacy Among Older Adults: Systematic Review (Preprint)
Authors: Oh Sarah Soyeon , Kim Kyoung-A , Kim Minsu , Oh Jaeuk , Chu Sang Hui , Choi JiYeon
Published: May 2021

UNSTRUCTURED

Corrigenda
ORIGAMI untuk Meningkatkan Efikasi Diri: Mengajarkan Pencegahan KSA pada Orang Tua dengan Anak Tunarungu
Authors: Wahyuni Sitti , Wimbarti Supra
Published: May 2021

Efikasi diri merupakan salah satu komponen sikap yang harus dimiliki oleh setiap orang tua, khususnya dalam mengajarkan pencegahan kekerasan seksual pada anak. Pada penelitian ini anak secara lebih spesifik merupakan anak yang mengalami hambatan dalam pendengaran (tunarungu). Orang tua seringkali kebingungan ketika harus mengajarkan tentang KSA pada anak sehingga mereka membutuhkan sebuah pelatihan yang dapat melatih mereka untuk meningkatkan pengetahuan serta keterampilan dalam mengajarkan pencegahan KSA pada anak. Pelatihan ORIGAMI merupakan salah satu media yang dapat meningkatkan efikasi diri orang tua dalam mengajarkan pencegahan KSA pada anak tunarungu. Penelitian dilakukan dengan metode untreated control group design with dependent pretest and posttest samples. Partisipan dalam penelitian ini adalah 28 orang tua yang memiliki anak tunarungu berusia 10-12 tahun, di mana 14 orang tua tergabung di dalam kelompok eksperimen dan 14 lainnya dalam kelompok kontrol. Hasil analisis statistik menggunakan anova mixed design menunjukkan bahwa tingkat efikasi diri pada kelompok eksperimen berbeda secara signifikan dengan kelompok kontrol (F = 13,617 dan p = 0,000). Hasil penelitian menunjukkan bahwa pelatihan ORIGAMI dapat secara efektif meningkatkan efikasi diri orang tua dalam mengajarkan pencegahan kekerasan seksual pada anak tunarungu
Program Pengasuhan Positif dengan Co-parenting untuk Menurunkan Penerapan Pengasuhan Disfungsional
Authors: Trisnadi Melissa Catalina , Andayani Budi
Published: May 2021

Penelitian ini bertujuan untuk menguji efektivitas program pengasuhan positif dengan co-parenting untuk menurunkan penerapan pengasuhan disfungsional. Penelitian ini dilakukan melalui eksperimen kuasi dengan desain untreated control group design with dependent pretest and posttest samples dan analisisnya menggunakan Mann Whitney U Test dan Wilcoxon Sign Rank Test. Partisipan berjumlah 10 pasang orang tua dan terbagi dalam kelompok kontrol dan eksperimen. Penerapan pengasuhan disfungsional diukur melalui skala pengasuhan disfungsional yang disusun oleh Subekti. Hasil penelitian membuktikan “Program Pengasuhan Positif Dengan Co-parenting” efektif untuk menurunkan penerapan pengasuhan disfungsional (posttest-pretest z = -2,958, p = 0,003 (p < 0,05)). Hasil analisis kualitatif juga menunjukkan adanya perubahan dalam praktik co-parenting meliputi, terbentuknya kesepakatan dalam membuat aturan untuk anak, ayah lebih peka terhadap kebutuhan pasangan, dan adanya keterbukaan mengungkapkan harapan serta dukungan yang dibutuhkan pasangan.
Penerapan Intervensi Picture Plus Discussion pada Anak Retardasi Mental Ringan
Authors: Tunnajah Sofina , Kartika Aniya , Panjaitan Lena N
Published: May 2021

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh intervensi Picture Plus Discussion (PPD) dalam meningkatkan kemampuan pemahaman bacaan anak retardasi mental ringan. Penelitian ini menggunakan single case experimental design jenis A-B. Partisipan penelitian berjumlah tiga orang anak retardasi mental ringan. Partisipan dipilih berdasarkan kriteria tertentu yakni memiliki kemampuan membaca minimal pada tahap kata dan bersedia mengikuti proses intervensi dengan menandatangani inform consent. Pengumpulan data dilakukan dengan teknik wawancara, observasi, tes kecerdasan, tes informal akademik. Intervensi Picture Plus Discussion (PPD) dilakukan selama sepuluh kali pertemuan. Instrumen pengukuran menggunakan alat tes ASER. Pengukuran skor 1 atau 0 didasari oleh ketepatan partisipan dalam menjawab alat tes ASER. Follow up dilakukan sepuluh hari setelah dilakukan intervensi dengan memberikan 16 soal pertanyaan pemahaman teks bacaan. Hasil analisis data menunjukkan bahwa intervensi PPD dapat meningkatkan kemampuan pemahaman anak retardasi mental ringan. Median skor masing-masing partisipan mengalami kenaikan.
EVROPA PRED POLITIČKIM OGLEDALOM
Authors: Lazarevic Radak Sanja
Published: May 2021

Prikaz knjige:
Vukasović, Dejana. 2020. Constructing a (EU)ropean Identity. The Balkans and the Western Balkans as the Other. Beograd: Institut za političke studije, str. 194.
ŠARL DE GOL: POSLEDNJI VELIKI FRANCUZ
Authors: Kolakovic Aleksandra
Published: May 2021

Prikaz knjige:
Julian Jackson. 2018. A Certain Idea of France The life of Charles de Gaulle. London: Penguin Random House UK, pp. 887.
KONCEPT DRUŠTVENE PRAVDE I NAGON ZA MOĆ
Authors: Jovanovic Dejan
Published: May 2021

Predmet ovog članka je odnos između moći i pravde u ljudskom društvu, govoreći u širem smislu. Uže posmatrano, odnos između, od čoveka neodvojivog, osećaja inferiornosti, iz kojeg se, usled sprege straha i potrebe za većom bezbednošću tela, rađa nagon za moć, koji u većini slučajeva nikada ne biva zadovoljen. Cilj članka je da pokaže da postoji veza između nedovoljne količine akumulirane moći koja se uvek meri u odnosu na nečiju tuđu moć, sa jedne strane, i porekla potrebe za društvenom pravdom, sa druge strane. Teorijski okviri koji su korišćeni se odnose, pre svega, na psihologiju čoveka Alfreda Adlera i teoriju pravde Džona Rolsa, ali i na teorije društvenog ugovora i realpolitičku teoriju. U članku smo došli do zaključaka koji se odnose na potvrdu teze da se održavanje koncepta društvene pravde pre da objasniti kroz realpolitičku teorijsku paradigmu, nego gledajući sa pozicija normativno-ontološke paradigme politike.
Phenotypic and Genotypic Detection of Methicillin Resistant Staphylococcus aureus in Health Care Workers and Its Containment in a Tertiary Care Hospital, in South India
Authors: Rahman Shamim , Kashid Ragini Ananth
Published: May 2021

MRSA causes nosocomial and community based infections. It is associated with significant mortality and morbidity. Resistance in MRSA is encoded by mecA gene. Anterior nares are the ecological niche of Staphylococcus aureus. HCWs who are colonized with MRSA, act as agents of cross contamination of hospital and community acquired MRSA. Treating MRSA infections is a therapeutic challenge as it is resistant to beta lactam group of drugs. Therefore, there is a need for rapid and accurate detection of MRSA carriage in HCWs and to understand its antibiotic susceptibility pattern.The objective of the present study is to estimate the occurrence of MRSA in HCWs, using phenotypic and genotypic methods. A prospective study for six months was conducted after obtaining Institutional Ethical Committee clearance. Anterior nasal swabs of those HCWs who gave informed consent were taken processed for culture and sensitivity as per standard protocol. To detect MIC for oxacillin, E-strip method was used. mecA gene detection was done by PCR. A total of 300 HCWs were sampled.14.66% (44/300) of the isolates were identified as Staphylococcus aureus, of which 10 isolates were detected as MRSA. The overall isolation rate of MRSA is 3.33 %(10/300). MRSA carriage was high amongst nurses (5/59, 8.47%), followed by doctors (4/105, 3.80%).Antibiotic sensitivity pattern showed that highest resistance was to penicillin (75%) followed by amoxiclav (70.45 %).9 MRSA isolates were detected as mecA gene positive by PCR. MRSA carriers were decontaminated successfully with 2% mupirocin ointment and 2% chlorhexidine shampoo. This study reiterates the need for rapid and accurate identification of HCWs who have nasal colonization with MRSA, for reinforcing hospital infection control measures and decontamination protocol. This will help prevent the spread of MRSA in our community.
Molecular Characterization of Isolated Multidrug-Resistant Bacteria from Tertiary Care Hospitals of Ahmedabad: A Comparison Study Between Previous to COVID-19 and Current Scenario
Authors: Zaveri Anurag D. , Zaveri Dilip N. , Bhaskaran Lakshmi
Published: May 2021

Hospital Acquired Infections (HAIs) are a significant concern for healthcare setups, as it increases the overall cost of treatment, patients stay in hospitals, making them susceptible to secondary and tertiary infections and, sometimes, mortality1. To prevent or control HAIs, evaluating the organisms isolated from the critically maintained areas is considered of epitome importance and everlasting practice in the healthcare industry. Identifying such organisms and screening them for antibiotic resistance is mandatory, but it also helps professionals understand colonization trends. Sensitive areas of healthcare setups were screened monthly from years 2017 to 2020. A total of 4400 samples of hospital hygiene, e.g., intravenous drip stands, ventilator surface, anesthetist’s trolley, patient’s bed, instrument trolley, etcetera, were collected. Isolated organisms were cultured and screened using the CLSI technique.
E. coli, Pseudomonas spp., and Klebsiella spp. were found in both previous to COVID current samples. Multidrug-resistant organisms were subjected to molecular characterization to detect the presence of carbapenem genes. Evaluation data of both pre-and during Coronavirus Disease or COVID-19 were compared. The prevalence of pathogenic (Klebsiella spp., E. coli, and Pseudomonas spp.) and non-pathogenic (Staphylococcus aureus and Bacillus spp.) strains in healthcare setups decreased drastically (Klebsiella spp. from 80% to 20%, E.coli from 90% to 10% and Pseudomonas spp. from 80% to 20%). It is possible only because of the awareness in non-specialists and healthcare workers due to the unforeseen critical situation proving to be a blessing for the future generation.
Recent studies of synthetic antibody-based 3-MCPD determination technology
Authors: MUNAWAR Hasim , LUNA Prima , KRESNAWATY Irma , WIDIASTUTI Happy
Published: May 2021

3-Chloro-1,2-propanediol (3-MCPD) is classified by the International Agency for Research on Cancer as carcinogenic material. 3-MCPD will also become one of the European Union's requirements, proposing the maximum level of the 3-MCPD in palm oil until 2.5 ppm. Although the reported technologies GCMS and HPLC-FLD demonstrated high sensitivity and selectivity on 3-MCPD determination, those technologies invest in chemical and time-consuming sample preparation and analysis. Molecularly imprinted polymer (MIP), or a synthetic antibody, can be used to recognize 3-MCPD. MIP is more robust under extreme environments such as temperature and pH. This paper, therefore, aims to discuss the application of MIP on sample extraction and analysis to detect 3-MCPD. MIP is synthesized by polymerization of functional monomers surrounding 3-MCPD as a template. 3-MCPD is then removed from the MIP, leaving active cavities. Thus, these sites can either covalently or non-covalently rebind to 3-MCPD. Computational or empirical studies could investigate the composition of MIP. MIP can be manufactured as MIP-based solid phase extraction (MIPSPE) and MIP-based sensor. Both applications showed significant analytical parameters, such as recovery higher than 90% and detection limit lower than 2.5 ppm.  Therefore, the application of MIP can be flexible for sample preparation and analysis on the 3-MCPD determination. MIP-based technology would be a prospective instrument to detect 3-MCPD.  In the future, producing MIP on an industrial scale will be a challenge to monitor the 3-MCPD level in palm oil.
The role of calcium in drought stress response induced through antioxidant activity in oil palm (Elaeis guineensis Jacq.) seedlings
Authors: NURWAHYUNI Endah , PUTRA Eka Tarwaca Susila
Published: May 2021

Oil palm productivity in Indonesia faces challenges related to drought that occur during the dry season. Calcium is an element that plays a role in determining the response of plant resistance to drought through biochemical activity. This study aims to determine the contribution of calcium in biochemical mechanisms involving various antioxidants. The treatment was arranged in factorial of 3 x 4 in a split-plot design. The first factor was calcium dosage, which consisted of 0 g (control/without calcium), 0.04 g, 0.08 g, and 0.12 g of calcium per plant. The second factor was the intensity of drought stress, referred as the Fraction of Transpirable Soil Water (FTSW) at 1 (control/field capacity), 0.35 (moderate drought), and 0.15 (severe drought) with a week duration of intensity. Calcium was applied in a ring placement on four-month-old seedlings planted in 40 x 40 cm polybags with alfisol soil planting medium and given drought treatment two months later for three weeks. The results showed that calcium could induce plant response to drought through the increase in superoxide dismutase (SOD) activity, the decrease in hydrogen peroxide   (H₂O₂) concentration, and the decrease in malondialdehyde (MDA) concentration. The study concluded that calcium is an essential element used to reduce the effects of drought on oil palm seedlings through the change of biochemical activities regulated by enzymatic antioxidants.
ANALISIS GENDER DALAM NOVEL “AKU LUPA BAHWA AKU PEREMPUAN” KARYA IHSAN QUDDUS PERSPEKTIF EMANSIPASI PEREMPUAN QASIM AMIN
Authors: Ch Mufidah , Basri Hasan , Sholihah I’if Nur
Published: May 2021

Sejumlah karya sastra seringkali masih menghadirkan narasi bias gender yang merugikan perempuan. Hal ini disebabkan penulis kurang memiliki kepekaan gender dan pemahaman konsep gender, sehingga tidak mampu mengintegrasikannya ke dalam tulisannya. Kertas kerja ini bertujuan untuk menganalisis novel karya Ihsan Qudus yang berjudul “Saya Lupa Bahwa Saya Adalah Seorang Perempuan”. Judul novel tersebut terkesan provokatif dan diskriminatif terhadap perempuan. Namun jika dilihat dengan analisis kritis, ditemukan hasil yang berbeda dan menarik. Sosok perempuan sebagai tokoh utama dalam novel tersebut menggambarkan bentuk perlawanan perempuan di tengah latar belakang sosial budaya masyarakat Mesir yang masih meninggalkan bias gender dan diskriminasi terhadap perempuan. Melalui novel ini, novelis ingin mengungkap fakta bahwa perempuan di Mesir juga memiliki kepekaan gender, meniti karir, menempati posisi strategis, mendominasi ruang publik dan berkontribusi bagi kemajuan bangsanya. Dengan pendekatan deskriptif kualitatif, analisis gender dan cara pandang Qasim Amin tentang emansipasi perempuan, hasilnya ditemukan nilai-nilai kesetaraan gender dalam novel “Saya lupa bahwa saya perempuan”, yaitu keberhasilan Suad dalam mewujudkan semua mimpinya. Sedangkan permasalahan gender yang ditemukan dalam novel ini adalah konstruksi budaya Mesir yang membatasi peran perempuan dalam masyarakat, baik dari aspek akses, partisipasi, penguasaan sumber daya dan manfaat bagi laki-laki maupun perempuan dalam kehidupan. Terdapat pula diskriminasi gender berupa stereotipe gender, subordinasi, marginalisasi, beban ganda dan kekerasan berbasis gender.
FEMINISME DALAM PESANTREN KAJIAN KRITIK SASTRA FEMINIS DALAM NOVEL DUA BARISTA KARYA NAJHATY SHARMA
Authors: Afiah Khoniq Nur
Published: May 2021

Artikel ini membahas kajian kritik sastra feminis dalam sebuah karya sastra novel Dua Barista karya Najhaty Sharma. Novel Dua Barista sebagai karya sastra yang lahir dari penulis dari pesantren menjadi sebuah instrumen untuk menyanpaikan sebuah kritik sosial terhadap fenomena yang terjadi di pesantren dan memicu lahirnya penindasan perempuan. Kajian ini akan fokus melihat aliran feminisme yang ada dalam novel dan nilai-nilai feminisme di pesantren dalam novel Dua Barista. Tujuan peneltian ini adalah mendiskripsikan aliran feminisme dan nilai-nilai feminisme yang berkembang di pesantren dalam Novel Dua Barista. Metode penelitian yang digunakan adalah diskriptif kualitatif, pendekatan feminisme dan pisau analisis kritik sastra feminis. Hasil dari penelitian ini bahwa aliran feminisme yang terdapat dalam novel ini adalah aliran feminisme sosialis dan nilai-nilai feminisme yang berkembang di lingkungan pesantren dalam novel Dua Barista tergambar melalui citra perempuan kuat dan dukungan-dukungan monogami yang dibungkus dengan sebuah kisah oleh Najhaty Sharma sebagai penulis.
The downfall of Transmar Cocoa
Authors: Feuz Ryan , Montoya Joseph
Published: May 2021

As a large cocoa bean trader, Transmar group ltd. bought millions of dollars’ worth of beans relying on financing from a syndicate of banks. To monitor amounts of eligible collateral, the banks required Transmar prepare periodic borrowing base (BB) reports. At some point, Transmar developed a discrepancy in collateral recorded on the BB report versus the amount of funds borrowed. The case discusses how this discrepancy grew larger as many questionable and fraudulent entries were included on subsequent BB reports. The case is written from the perspective of Peter B. Johnson, head of Transmar’s European affiliate and son of CEO and founder of Transmar, Peter G. Johnson. In late 2014, Peter B. Johnson first learned about the deceptive practices being employed in preparing the BB reports. How will he react? The case is also rich in details surrounding the cocoa industry supply chain and history of cocoa production.
Prediction of leopard habitat suitability in Taman Negara main forest complex, Malaysia
Authors:   Earth Science and Environmental Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia, Khodri N.F. , Lihan T. ,   Earth Science and Environmental Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia, Mustapha M.A. ,   Earth Science and Environmental Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia, Taher T.M. ,   Earth Science and Environmental Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia, Arifin N.A.T. ,   Earth Science and Environmental Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia, Abdullah N.I. ,   Biological Science and Biotechnology Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600,Bangi, Malaysia, Nor S.M. ,   Biological Science and Biotechnology Department, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600,Bangi, Malaysia
Published: May 2021

Aim: This research assessed the distribution of leopard to predict the habitat suitability in Taman Negara National Park and adjacent forest area. Methodology: Environmental factors for habitat suitability were derived from geographical information system (GIS) data such as elevation, slope, land-use, distance from urban and distance from river. Leopard presence data from 1993 to 2008 were integrated with the environmental parameters using maximum entropy (MaxEnt) modeling to assess habitat suitability across the study area. Results: The results showed that distance from river contributed the most (39.3%) in the habitat suitability modeling followed by distance from urban (31.4%), elevation (12.3%), land use types (10.1%), and slope (6.9%). Distance from river and urban showed highest contribution that influenced leopard distribution in which most suitable habitat occurred in proximity with river and further from urban. Habitat suitability of leopard were distributed among 48% over 2,218,389 ha of the study area. Interpretation: The findings of this study provides knowledge on how the species move and exploit different habitat niches for more effective conservation management. It provide models for future wildlife conservation and urban planning.
Circunferencia de la cintura como predictor de factores de riesgo de enfermedad cardiovascular en residentes costarricenses de 60 años y más.
Authors: Aguilar Fernández Eduardo , Carballo Alfaro Ana Maricela
Published: May 2021

Introducción: Existe un efecto negativo de la obesidad abdominal sobre la salud de los adultos mayores. Objetivo: Investigar la relación entre la circunferencia de cintura (CC) y los factores de riesgo metabólico asociados a la enfermedad cardiovascular en esta población. Métodos: El estudio incluye 2 418 personas participantes en el proyecto Costa Rica: Estudio de Longevidad y Envejecimiento saludable (CRELES). Se calcularon coeficientes de correlación entre la CC y distintos factores de riesgo de enfermedad cardiovascular y modelos de regresión logística para calcular la razón de posibilidades que una persona presente un factor de riesgo cardiovascular según los distintos niveles de la CC. 

Resultados: Las personas con cinturas más anchas tienen un mayor riesgo de tener bajo colesterol HDL, altos niveles de triglicéridos, diabetes e hipertensión. En los hombres, la correlación más fuerte fue con los triglicéridos (r = 0,345) y en las mujeres con hemoglobina glicosilada (r = 0,262). Conclusiones: El tamaño de la cintura puede predecir algunos factores de riesgo de enfermedad cardiovascular en residentes de Costa Rica de 60 años y más.
Lymphocyte subsets in 32 patients with multisystem inflammatory syndrome in children (MIS-C)
Authors: Okarska-Napierała Magdalena , Mańdziuk Joanna , Feleszko Wojciech , Stelmaszczyk-Emmel Anna , Panczyk Mariusz , Demkow Urszula , Kuchar Ernest
Published: May 2021

BACKGROUND: Lymphopenia is a hallmark of multisystem inflammatory
syndrome in children (MIS-C). We aimed to characterize lymphocyte
subsets’ shifts and their correlations with other severity markers of
MIS-C. METHODS: In this prospective cross-sectional study, we performed
peripheral lymphocyte phenotyping in 32 patients with MIS-C. We analyzed
lymphocyte subsets at three time-points of the disease: the acute (A),
convalescent (B), and recovery (C) phases. Based on age-normalized
lymphocyte counts, we distinguished two groups of patients: “the mild”
and “the severe”. In addition, we examined differences between these
groups regarding other severity markers. RESULTS: In phase A, 84% of
children had lymphopenia. Decreased absolute counts of CD3, CD4, and CD8
cells were observed in, respectively, 88%, 72%, and 84% of patients.
The natural killer cells were decreased in 63% and CD19 in 59% of
children. “The severe” group had significantly higher procalcitonin
and troponin I levels and lower platelets and albumin. Moreover, “the
severe” group had hypotension more frequently (73% vs. 20%, p=0.008).
In phase B, all lymphocyte counts increased, and 32% of children had
lymphocytosis. The increase of CD3, CD4, and CD8 counts correlated with
some laboratory severity markers (hemoglobin, procalcitonin, D-dimer,
lactate dehydrogenase, N-terminal prohormone of brain natriuretic
peptide, albumin), but not with steroid use. In phase C, most children
had normal lymphocyte counts. CONCLUSIONS: Substantial shifts in
lymphocyte counts during MIS-C apply most to T lymphocytes and correlate
with the disease severity markers, particularly hypotension prevalence.
A proportion of children with MIS-C develops transient lymphocytosis
during convalescence.
Sustained impact of subcutaneous immunotherapy among patients with allergic rhinitis who experienced treatment delay due to the COVID-19 pandemic: A multicenter, two-arm, real-world study
Authors: ZHOU SUIZI , Liu Yibin , Xue Jianrong , Tang Juan , Yu Qingqing , Qu Shenhong , Zhang Shaojie , Mo Binyu , Li Jihui , Liu Yinhong , Yang Yueying , Wang De Yun , Qiu Qianhui
Published: May 2021

Background: The aim of this study is to investigate the impact of
COVID-19 related treatment delay on subcutaneous immunotherapy (SCIT)
efficacy in patients with allergic rhinitis (AR). Methods: The study was
performed in 643 patients with SCIT appointments between February 1 and
May 31, 2020. The clinical assessment, performed at baseline (V0) and
one year later (V1), included visual analogue scale (VAS); daily symptom
score (dSS); daily medication score (dMS); combined symptom and
medication scores (CSMS); quality of life (QoL); self-rating anxiety
scale (SAS); and self-rating depression scale (SDS) for each patient.
Results: At V0, 249 patients were treated on schedule, and 394 were
delayed (7 ± 4.68 weeks). Among them, 319 patients (105 on schedule, and
214 delayed) also completed the assessments at V1, with the absence of
25.39% patients due to completion of SCIT, and 25.35% patients were
withdrawal. The results of all assessments were within the normal range
for all patients at V0 and V1, with the exception of a slightly higher
SDS score (56.13) at V0. In the SCIT delayed group. there was a
significant positive correlation between the length (weeks) of the delay
and SDS score, and this was significantly higher in patients with poor
control of nasal symptoms. Conclusions: This study showed the long-term
efficacy of SCIT for AR patients, including those who have had to delay
normal therapy due to the COVID-19 outbreak. The psychological status of
SCIT patients in response to lockdown of hospital services during this
critical period should be considered.
TITLE PAGE: NEUROCOGNTIVE OUTCOMES IN SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA: EXPERIENCE FROM A TERITARY CARE CENTRE IN INDIA
Authors: CR Vishwa , Das Gargi , Seth Rachna , Sapra Savita , Siri Prasanth , Meena Jagdish , Gupta Aditya , Vishnubhatla Sreenivas
Published: May 2021

BACKGROUND: Neurocognitive deficits are an important late effect in
survivors of acute lymphoblastic Leukemia(ALL). Data from low middle
income countries is scarce and highly influenced by biological and
cultural variations. Such data would be useful for highlighting the
importance of early intervention in an already disadvantaged population.
PROCEDURE: 70 consecutive survivors of childhood ALL were evaluated for
neurocognitive deficits by the Indian adaptation of Wechsler
Intelligence Scale for Children-Fourth Edition(WISC-INDIA). Prevalence
of neurocognitive deficits was calculated based on Full Scale
Intelligence Quotient(FSIQ) and scores in discrete domains like Verbal
Comprehension, Perceptual Reasoning, Working Memory and Processing Speed
were calculated and compared to baseline characteristics, chemotherapy
and radiation dose received. RESULTS: The mean FSIQ was 86.1 ± 20.5,
with significant neurocognitive deficit(FSIQ <90) being
prevalent in 50%(95% CI 38% to 62%) of the cohort. The proportion of
survivors with deficits in individual domains of verbal comprehension,
perceptual reasoning, working memory and processing speed were 49%,
50%, 47% and 44% respectively. The odds of having deficits in
neurocognitive function was higher when a child belonged to lower
socioeconomic strata, had parents with less than primary school
education and whose birth order was higher(All p<0.05). Age at
diagnosis, current age at assessment, receiving lower or higher dose of
radiotherapy, high dose methotrexate or cytarabine did not have a direct
impact on neurocognitive function. CONCLUSIONS AND RELEVANCE: The
current need is to develop country specific neurocognition assessment
tools to initiate early screening and develop culturally appropriate
preventive and rehabilitative interventions.
Synchronous gastric cancer and carcinoma in situ of the pancreas detected by SPACE
Authors: Inoue Masashi , Hakoda Keishi , Sawada Hiroyuki , Hotta Ryuichiro , Omori Ichiro , Miyamoto Kazuaki , Toyota Kazuhiro , Sadamoto Seiji , Takahashi Tadateru
Published: May 2021

Gastric cancer was diagnosed with dilation of the main pancreatic duct.
SPACE revealed adenocarcinoma, total gastrectomy with distal
pancreatectomy were underwent. More case reports are needed to determine
whether adjuvant chemotherapy is indicated for patients with PCIS and
whether the extent of lymph node dissection can be safely reduced.