bluuebunny/crossref_metadata_2025 huggingface dataset:
Meningkatkan Keterampilan Proses Sains dan Hasil Belajar IPA Melalui Model Pembelajaran Inkuiri Terbimbing
Authors: Rafiah Rafiah , Arifuddin Muhammad , Mahardika Andi Ichsan
Published: August 2019

Proses belajar mengajar hanya berpusat pada guru, akibatya siswa tidak terlatih untuk mengembangkan keterampilan proses sains dan berimbas pada rendahnya hasil belajar siswa. Penelitian ini bertujuan untk mendeskripsikan peningkatkan hasil belajar dan keterampilan proses sains siswa melalui model pembelajaran inkuiri terbimbing pada mata pelajaran IPA di kelas VIII A SMP Muhammadiyah 1 Banjarmasin. Tujuan khususnya adalah mendeskripsikan: 1) keterlaksanaan Rencana Pelaksanaan Pembelajaran, 2) keterampilan proses sains siswa, dan 3) hasil belajar siswa. Jenis penelitian ini adalah model penelitian tindakan kelas Kemmis dan Mc Taggart yang terdiri dari 2 siklus. Subjek penelitian adalah 20 siswa kelas VIII A SMP Muhammadiyah 1 Banjarmasin. Teknik pengumpulan data berupa observasi dan tes. Hasil penelitian menunjukkan bahwa: 1) Keterlaksanaan RPP meningkat setiap siklusnya, yaitu dengan reliabilitas 99,64% dan 99,77%; 2) Peningkatan keterampilan proses sains siswa (merumuskan masalah, merumuskan hipotesis, melakukan percobaan, menganalisis data, menyimpulkan, dan memprediksi) pada siklus I selama proses pembelajaran  sebesar 79,5%  dan pada akhir siklus senilai 85,6% dengan kategori sangat baik; dan 3) Peningkatan hasil belajar siswa setelah menggunakan model pembelajaran inkuiri terbimbing  adalah 40% yang tuntas pada siklus I dan 80% pada siklus II.
Penerapan Model Pembelajaram 5E Untuk Meningkatkan Aktivitas Siswa
Authors: Soraya Siva , Hartini Sri , Miriam Sarah
Published: August 2019

Penelitian ini dilatar belakangi oleh rendahnya aktivitas dan hasil belajar siswa. Oleh karena itu dilakukan penelitian yang bertujuan untuk meningkatkan aktivitas siswa dengan  menggunakan model pembelajaran 5E (Engangement, Exploration, Explanation, Elaboration, Evaluation). Tujuan khusus penelitian mendeskripsikan: 1) keterlaksanaan rencana pelaksanaan pembelajaran (RPP), 2) aktivitas dan 3) hasil belajar. Jenis penelitian ini menggunakan penelitian tindakan kelas model Kemmis dan Mc Taggart yang terdiri dari dua siklus, setiap siklus terdiri dari dua kali pertemuan yang meliputi perencanaan, tindakan & observasi, dan refleksi. Subjek penelitian ini adalah siswa kelas X B Multimedia SMK Negeri 1 Banjarmasin yang berjumlah 26 orang. Data diperoleh melalui observasi dan tes. Hasil penelitian siklus I dan siklus II yaitu: 1) keterlaksanaan RPP pada siklus I dan II bergategori sangat baik 2) aktivitas siswa pada siklus I dan II berkategori cukup aktif, cukup aktif, aktif, dan sangat aktif 3) hasil belajar siswa pada siklus I dan II berkategori tuntas. Diperoleh simpulan bahwa model pembelajaran 5E dapat meningkatkan aktivitas siswa kelas X B Multimedia SMK Negeri 1 Banjarmasin.
Over-Production of Therapeutic Growth Factors for Cartilage Regeneration by Protein Production Platforms and Protein Packaging Cell Lines: A Narrative Review of the Current State-of-the-Art
Authors: Mobasheri Ali , Martín-Vasallo Pablo
Published: August 2019

This article focuses on the current state-of-the-art in the area of cellular and molecular biotechnology for over-production of clinically relevant therapeutic growth factors and how the technology can be used for the treatment of osteoarthritis (OA). Transfected and irradiated protein packaging cell lines may be used as “cellular factories” for large-scale production of therapeutic proteins and pro-anabolic growth factors, particularly in the context of cartilage matrix regeneration. We discuss the potential for new innovations in regenerative medicine for degenerative diseases of synovial joints using mammalian protein production platforms, specifically protein packaging cell lines, for over-producing growth factors for cartilage tissue regeneration and give recent examples. Mammalian protein production platforms that incorporate protein packaging cell lines are superior to bacterial expression systems and are likely to have a significant impact on the development of new biological therapies for treating focal cartilage defects and more generally for the treatment of degenerative joint diseases such as OA.
Concept and Position of Peremptory Norms (Jus Cogens) in International Law: A Preliminary Study
Authors: Handayani Irawati
Published: August 2019

Peremptory norms or jus cogens hold a unique position in international law. Unlike customary international law and treaty law, they abide no derivation and bind all states regardless of their willingness to be bound. Some scholars had elaborated fundamental theories to answer the theoretical background of jus cogens. However, they have never reached a satisfactory result. This study aims to elaborate the theoretical background of jus cogens and to observe the relationship between jus cogens, obligation erga omnes, and customary international law. The positivists recognize that jus cogens is an imperative norm within state practice and opinio juris. The positivist theory is not in line with the concept that jus cogens bound to states without their consent since every state has their sovereignty and cannot be bound by any kind of provision without consent. The proponents of the natural law theory stated that peremptory norms are inherited from the tradition of natural law so that it is the highest norm in international law that directly binds countries. On the other hand, the public order theory states that international law recognizes important (imperative) norms, which are hierarchically higher than ordinary norms and customary international law to advance the interests of the international community and to preserve the main values of international law. The three theories are considered insufficient to answer the philosophical basis of jus cogens. In its development, therefore, some new theories have been developed to challenge the basis of jus cogens.
The aesthetic management of gingival enlargement and hyperpigmentation in maxillary anterior region: a case report
Authors: Kurnia Shafira
Published: August 2019

Objective: To describe the aesthetic treatment stage of gingival enlargement with gingival hyperpigmentation. Determination of the type of action detail will assist many clinicians in diagnosis and treat gingival enlargement with hyperpigmentation.Methods: The 17-year-old male patient, coming with his enlarged gums. Patients claimed to have no hypertension, blood disorders, diabetes and hepatitis. After general check-up and early treatment, gingivectomy and gingival depigmentation were performed using scalpel no. 15c. The oral administration administered was 500mg tid amoxicillin and 500mg tid.prn mefenamic acid.Results: after gingivectomy has performed multiple diastema appears and suggested orthodontia treatment. Conclusion: The combination of gingivectomy treatment with gingival depigmentation may be performed simultaneously using a scalpel periodontal instrument.Keywords: Gingival enlargement, Gingival hyperpigmentation, Gingivectomy, Gingival depigmentation
Single Implant Restoration and Adhesive Bridge for Anterior teeth (A Case Report)
Authors: Machmud Edy , Amiruddin Maqhfirah
Published: August 2019

Objective : The aim of this case report restore healthy tooth function so that patients can chew food properly, so the method of implant placement is a good choice for patients with tooth loss. The adhesive bridge denture treatment aims to restore a missing tooth. The indication of adhesive bridge denture treatment is a mild contact of occlusion, young patients and good oral hygiene.Methods : On first visit doing filling status and patient signed an informed consent and making study casts, then proceed with making a surgical templete. After that, a ct-scan was performed to determine the size of the implant that matches the size of the available bone. The second visit, carried out the edentulous 36 implantation process using implants measuring 3.7mm in diameter and 12 mm in length with the EZ Dent-I IDI brand. Third visit, tooth color selection wih shade guide, and preparation of the palatal part of abutment teeth 12 and 21 was made for bridge adhesive in edentulous teeth 11. Two months later, double impression was performed for the manufacture of supra structural teeth .Results : The advantage of dental implants is that they closely resemble natural teeth because they are embedded in the tissue so they can support aesthetics, protection of adjacent teeth and the development of self-confidence. Bone density obtained from Ct-Scan radiographic greatly determines this treatment choice, the higher the bone density, the better the prognosis produced.Conclusion : The use of dentures with implant support for posterior mandibular teeth and adhesive bridge dentures for maxillary anterior teeth provides satisfaction for patients because it can overcome aesthetic problems and improve good phonetic and masticatory functions.Keywords: Adhesif Bridge, Bone Density, Ct-Scan, Dental Implant.
Localize lesion of horner’s syndrome based on anhydrotic pattern
Authors: Basri Muhammad I. , Wardani Emy , Basir Hasmawaty , Wuysang Audry D.
Published: August 2019

Objective: The current case series will discuss about two horner syndrome cases with a different pattern of anhydrotic.Methods:Male 54 years old came with punctured and burned pain sensation at left hand for the last one year which radiated along the shoulder toward the tip of left fingers. There were 10 kgs of weight loss. Neurological examination showed unequal pupil size 2.5mm/1.5mm, left ptosis, left hemifacial and left arm anhidrosis. Cervical MRI showed burstfracture involved CV T1 pedicle.Results: CaseIMSCT Thorax showed suspicious of neurogenic tumor which resulted in CV T1 destructionandcaseIIMSCT thorax showed left lung collapse due to pleural effusionConclusion: Anhidrotic pattern will be an essential factor in making a topical diagnosis for patients with Horner syndrome, which also can be a fundamental basis in choosing the next additional examinations required to find the etiology.Keywords:Anhidrotic pattern, Horner’s syndrome, Sympathetic nerve
Population Genetic Structure and Habitat Connectivity for Jaguar (Panthera onca) Conservation in Belize
Authors: Menchaca Angelica , Rossi Natalia , Froidevaux Jeremy , Dias-freedman Isabela , Rabinowitz Salisa , Foster Rebecca , Harmsen Bart , Amato George
Published: August 2019

Background: Effective connectivity between jaguar ( Panthera onca ) populations across the American continent will ensure the natural gene flow and the long-term survival of the species throughout its range. Jaguar conservation efforts have focused primarily on connecting suitable habitat in a broad-scale. However, accelerated habitat reduction, limited funding, and the complexity of jaguar behaviour have proven challenging to maintain connectivity between populations effectively. Here we used individual-based genetic analysis in synthesis with landscape permeability models to assess levels of current genetic connectivity and identify alternative corridors for jaguar movement between two core areas in central and southern Belize. Results: We use 12 highly polymorphic microsatellite loci to identify 50 distinct individual jaguars, including 41 males, 3 females and 6 undetermined animals, from scat samples collected in The Cockscomb Basin Wildlife Sanctuary and The Central Belize Corridor. Using Bayesian and multivariate models of genetic structure, we identified one single group across two sampling sites with low genetic differentiation between them. We used fine-scale data on biodiversity features as vegetation types to predict the most probable corridors using least-cost path analysis and circuit theory. Conclusions: The results of our study highlight the importance of expanding the boundaries of the Central Belize Corridor to effectively cover areas that would more easily facilitate jaguar movement between locations.
A high-density genetic linkage map for Chinese perch (Siniperca chuatsi) using genotyping-by-sequencing (GBS)
Authors: Guo Wen-jie , He Shan , Liang Xu-fang , Tian Chang-xu , Dou Ya-qi , Lv Li-yuan
Published: August 2019

Background: Chinese perch, Siniperca chuatsi (Basilewsky), is one of the most commercially important cultured fishes in China. In the present study, a high-density genetic linkage map of Chinese perch was constructed by genotyping-by-sequencing (GBS) technique with an F1 mapping panel containing 190 progenies. Result: A total of 2328 SNPs were assigned to 24 linkage groups (LGs), agreeing with the chromosome haploid number in this species (n = 24). The sex-averaged map covered 97.9% of the Chinese perch genome, with the length of 1694.3 cM and a marker density of 0.7 cM/locus. The number of markers per LG ranged from 57 to 222, with a mean of 97. The length of LGs varied from 43.2 cM to 108.2 cM, with a mean size of 70.6 cM. The recombination rate of females was 1.50 : 1, which was higher than that of males. In order to better understand the distribution pattern of segregation distortion between the two sexes of Chinese perch, the skewed markers were retained and used to reconstruct the sex-specific maps. The 16 SDRs were identified on 10 LGs of the female map, while 12 SDRs on 8 LGs of the male map. Among these LGs, 6 LGs matched between the sex-specific maps. Conclusion: This high-density linkage map could provide a solid basis for identifying QTLs associated with economically important traits, and for implementing marker-assisted selection breeding of Chinese perch.
Characterizing clinical carbapenem-resistant Klebsiella pneumoniae phenotypes and genomic information reveals its molecular epidemiology
Authors: Yu Xiaoling , Zhang Wen , Zhao Zhiping , Ye Chengsong , Zhou Shuyan , Wu Shaogui , Han Lifen , Han Zhaofang , YE HANHUI
Published: August 2019

The enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 promoted this investigation to study gene phenotypes and resistance genes of emergence regarding the CRKP strains. In current study, seven inpatients are enrolled in the hospital with complete treatments. The carbapenem-resistant K. pneumoniae whole genome is sequenced using MiSeq short-read and Oxford Nanopore long-read sequencing technology. Prophages are identified to assess genetic diversity within CRKP genomes. The investigation encompassed eight CRKP strains that collected from the patients enrolled as well as the environment, which illustrate that bla KPC-2 is responsible for phenotypic resistance in six CRKP strains that K . pneumoniae sequence type (ST-11) is inferred. The plasmid with IncR, ColRNAI and pMLST type with IncF[F33:A-:B-] co-exist in all ST-11 with KPC-2-producing CRKP strains. Along with carbapenemases, all K. pneumoniae strains harbor two or three extended spectrum β-lactamase (ESBL)-producing genes. F osA gene is detected amongst all the CRKP strains. The oqxA and oqxB expressions in CRKP strains may lead to carbapenem resistance since antimicrobials are expelled from pathogenic bacteria by efflux pump. The single nucleotide polymorphisms (SNP) markers are indicated and validated among all CRKP strains, providing valuable clues for distinguishing carbapenem-resistant strains from conventional K. pneumoniae .
Genomic-wide analysis and prediction of genes involved in biosynthesis of polysaccharide and bioactive secondary metabolites in high-temperature-tolerance of wild Flammulina filiformis
Authors: Chen Juan , Li Jia-Mei , Tang Yan-Jing , Ma Ke , Li Bing , Zeng Xu , Liu Xiao-Bin , Li Yang , Yang Zhu-Liang , Xu Wei-Nan , Xie Bao-Gui , Guo Shun-Xing
Published: August 2019

Background: Flammulina filiformis (=Asian “F.velutipes”) is a popular commercial edible mushroom. Many bioactive compounds such as polysaccharides and sesquiterpenoids with medicinal effects have been isolated and identified, but their biosynthesis and regulation in molecular level is unclear. In this study, we sequenced the genome of the wild strain F. filiformis Liu 355, predicated the biosynthetic gene clusters (BGCs) and profiled these genes expression between wild and cultivar strains and among different development stages of the wild strain of F. filiformis by a comparative transcriptomic analysis.
Results: The results revealed that the genome of the F. filiformis was 35.01 M bp in length and annotated with 10396 gene models. 12 putative terpeniod gene clusters were predicted, 12 sesquiterpenes synthase genes belonged to four different groups and two type I PKS (polyketide synthase) gene clusters were identified from F. filiformis genome. The gene number related terpeniod biosynthesis is higher in wild strain (119 genes) than cultivar strain (81 genes) and most of them are up regulated in primodium and fruiting body of the wild strain, while PKS genes are usually up-regulated in the mycelium of wild strain. Moreover, genes encoding UDP-glucose pyrophosphorylase and UDP-glucose dehydrogenase involved in polysaccharide biosynthesis have relative high transcripts both in mycelium and fruiting bodies of F. filiformis.
Conclusions: We identified candidate genes involved in the biosynthesis of polysaccharide and terpenoid bioactive compounds and profiled these genes expression during the development of F. filiformis. This study expends our knowledge for understanding the biology of F. filiformis and provides valuable data for elucidating the secondary metabolism regulation of the special strain of F. filiformis.
The Molecular basis of N-acetylmuramoyl-L-alanine amidase (Rv3915) and Protein Kinase B (PknB) essentiality in Mycobacterium tuberculosis
Authors: Ezechukwu Ifunanya N , Onyekwelu Kenechukwu , Nwokolo Loreta , Turapov Obolbek
Published: August 2019

Background: Protein kinase B (PknB) is critical for the survival of Mycobacterium tuberculosis (M. tuberculosis) in vitro and in hosts. It phosphorylates various enzymes involved in biosynthesis of cell wall and a particular autolysin classified as CwIM or Rv3915 has been recently identified as a PknB substrate. However, in-depth knowledge of this protein is still unknown. The aims of this study were to purify and investigate the activity of Rv3915, as well as monitor the phosphorylation of Rv3915 and the influence of phosphorylation on the activity of this protein. Results: Using the C41 E. coli strain containing a plasmid, with a gene encoding the protein, Rv3915 was either expressed alone or co-expressed with PknB. Sodium dodecyl sulfate polyacrylamide gel (SDS-PAGE) was used to observe the amount of Rv3915 purified, anti-poly His and anti-phosphothreonine western blot techniques were used to confirm the presence and phosphorylation of Rv3915 and zymogram assays were run to examine its activity. The results showed that Rv3195 was successfully expressed and was deemed soluble when observed in soluble fraction of E. coli lysate. It was confirmed that Rv3915 is produced as a ~45kDa protein, which does not possess any muralytic activity. However a shorter version of the protein (~25kDA) was active in zymogram, suggesting that Rv3915 is activated by cleavage. Conclusion: Rv3915 was phosphorylated by PknB and phosphorylation apparently controls stability of the protein.
Second-line treatment strategy for urothelial cancer patients who progress or are unfit for cisplatin therapy: a network meta-analysis
Authors: Wang Huitao , Liu Jianhe , Fang Kewei , Ke Changxing , Jiang Yongming , Wang Guang , Yang Tongxin , Chen Tao , Shi Xin
Published: August 2019

Background Second-line treatment for urothelial carcinoma (UC) patients is used if progression or failure after platinum-based chemotherapy occurs or if patients are cisplatin-unfit. However, there is still no widely accepted treatment strategy. We aimed to analyze the effectiveness and safety of second-line treatment strategies for UC patients. Methods The PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) that included UC patients who were cisplatin-ineligible or unfit up to April 19, 2019. The primary outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Results Thirteen trials that assessed 3502 UC patients were included. This study divided the network comparisons into three parts. The first part contained studies comparing taxanes and other interventions; the second part assessed investigator’s choice chemotherapy (ICC)-related comparisons; and the third part assessed best support care (BSC). In the OS results of the first part, pembrolizumab (87.5%), ramucirumab plus docetaxel (74.6%), and atezolizumab (71.1%) had a relative advantage. Pembrolizumab also had advantages in ORR and severe adverse effect (SAE) results. Vinflunine and ramucirumab plus docetaxel had a relatively high surface under the cumulative ranking (SUCRA) rank by exploratory cluster analysis. Conclusions This study concluded that atezolizumab and pembrolizumab are superior to other treatments, mainly in OS results, but no treatment confers a significant advantage in PFS. Pembrolizumab still has relative advantages in ORR and SAE results compared to ICC.
Prevalence and determinants of undernutrition among school children of Ethiopia: a systematic review and meta-analysis
Authors: Hailegebreil Tamirat
Published: August 2019

Background: Ethiopia is the second populous countries in Africa where millions of children are affected by malnutrition. Several original works are available online about child malnutrition in Ethiopia. The aim of this study was to summarize the existing epidemiological data on undernutrition and possible determinants among school children in Ethiopia. Methods: We conducted a systematic review using open access articles which report prevalence of stunting and wasting/thinness from PubMed Central, Scopus and Science direct. From 358 articles accessed online, 39 of them were eligible for this meta-analysis. The heterogeneities among studies were evaluated using I2 test and the pooled prevalence was calculated using a random effect model. Results: A total of 24, 716 school children were included in 39 eligible articles for this meta-analysis. The pooled prevalence of stunting and wasting/thinness among school children in Ethiopia were 23.1% (95% CI: 19.0 - 27.0%) and 22% (95% CI: 17% - 26%), respectively. The risk of stunting was increased among the student with meal frequency ≤ 3 times a day (OR= 3.02, 95% CI: 1.90 - 4.14), age > 10 years (OR= 2.16, 95% CI: 1.47 - 2.85) and family size ≥ 5 (OR= 1.88, 95% CI: 1.40 - 2.35). Similarly, the risk of wasting/thinness was increased with male sex (OR= 2.06, 95% CI: 1.54 - 2.58), low family income (OR= 2.16, 95% CI: 1.30 - 3.01) and age > 10 years (OR= 1.78, 95% CI: 0.74 - 2.82). High heterogeneity about the prevalence of stunting and wasting/thinness was observed among studies included in this meta-analysis (I2 > 98.6). Conclusions: This study showed that stunting and wasting/thinness are common nutritional problems in school children in Ethiopia. Large family size, male sex and age above 10 years were consistently associated with stunting and wasting/thinness in children. The finding of this study highlights the importance of new strategies to reduce undernutrition in Ethiopia. Keywords: stunting, wasting, thinness, undernutrition, systematic review, meta-analysis
Determinants of incomplete immunization among children age 12-23 months in Southwest Ethiopia
Authors: G/Mariam Meseret , Ayele Gistane , Shegaze Mulugeta , Wassihun biresaw
Published: August 2019

Background Vaccination is recognized as an important immunization tool which is used in preventing and eradicating communicable diseases. Even though increase in global vaccination coverage, many children in the world particularly in low resource countries still are left unvaccinated and it remains to be a public health problem.Objective To identify determinants of incomplete vaccination among children 12-23 months of age in Semen Bench district, Bench Maji Zone, Southwest Ethiopia, 2018.Methods Community based case-control study design was employed. By using simple random sampling a total 312 children aged between 12-23 months from households were selected from 7 kebeles in Semen Bench district, Bench Maji Zone southern regional state. Data was entered into Epi Inof version 7 and was exported into SPSS version 21.0 for analysis. . Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. P values <0.05 with 95% confidence level were used to declare statistical significance.Results A total of 312 respondents participated in the study with a response rate of 100%. The multivariable analysis indicated that respondents having no antenatal visit [AOR=8.3(95%CI; 1.87-36.91], giving birth in home delivery AOR=4.5(95%CI; 1.411-14.27], and respondents having no postnatal visit AOR=4.2(95%CI; 1.67-10.41], were some of the variables continued to have statistically significant predictors of incomplete vaccination.Conclusion This study was identified some of the factors associated with incomplete vaccination. In order to decrease neonatal mortality resulted from communicable diseases Strengthen antenatal care visit and prompting postnatal service and institutional delivery is very important in addition to this it is crucial that, local programmatic intervention should be strengthened to promote awareness of the community on the importance of Vaccination.
Safety and Efficacy of 25G vitrectomy surgery for malignant glaucoma in pseudophakia
Authors: you fei
Published: August 2019

Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly，it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively
The clinicopathologic characteristics of Immunoglobulin A nephropathy related to C3 deposits
Authors: Wu Lingzhi , Liu Di , Chen Guochun , Liu Yu , You Jing , Tang Xiaofang , Xia Ming , Zhu Xuejing , Liu Hong
Published: August 2019

Background

C3 deposits are widely detected in patients with immunoglobulin A nephropathy (IgAN). However, the relationship between the location and intensity of the C3 deposition and prognosis of IgAN is uncertain.

Methods

244 patients diagnosed with IgAN were enrolled in our study during 2010- 2016. Patients were divided into groups according to the location of C3 deposits: mesangial area only versus mesangial area and glomerular capillary loops. We also divided those patients into 4 groups according to the intensity of C3 deposition at the base of location. Renal outcomes were end-stage renal disease(ESRD)or a ≥50% reduction in estimated glomerular filtration rate(eGFR), performed by Kaplan–Meier analysis and Cox proportional hazards models.

Results

Among the 244 recruited patients with IgAN, 139(56.97%) were female. Compared to patients with C3 deposition in the mesangial area only, those with C3 deposition in the mesangial area and glomerular capillary loops had significantly older, lower levels of serum albumin and eGFR, higher levels of uric acid (UA), severe proteinuria, more intense C3 deposits, were more prone to receive corticosteroids and immunosuppression. There were no other significant differences between C3 deposition in the mesangial area only (≤2+ in intensity) group and C3 deposition in the mesangial area and glomerular capillary loops (≤2+ in intensity) group except for age. Patients in C3 deposition in the mesangial area and glomerular capillary loops (>2+ in intensity) group were associated with lower levels of serum albumin, serum IgG and eGFR, higher levels of serum IgM, UA and blood urea nitrogen (BUN),heavier proteinuria and higher interstitial fibrosis/tubular atrophy scores than C3 deposition in the mesangial area deposits only(>2+ in intensity) group. After a median follow-up of 41.86 months,28(11.48%) patients reached the renal outcomes. Higher intensity of C3 deposition in the mesangial area and glomerular capillary loops (95%CI:1.262-76.832, p=0.029) remained an independent risk factor of renal outcomes by multivariate Cox proportional hazards models.

Conclusions

IgAN patients who had glomerular capillary loops C3 deposits had worse clinical outcomes. Furthermore, the effect of the C3 deposition site on IgA nephropathy is affected by the intensity of C3 deposits.
Effects of Physical Activity and Counselling Interventions on Health Outcomes among Working Women in Shanghai
Authors: Wang Hongying , Xiao Yi , Ren Xiaoling , Zhang Pei , Zhang Tao
Published: August 2019

Background：Working women in Shanghai are a special group with higher risk of suffering work stress and burnout. They were disturbed by the work-family conflicts, which results in lower health-related quality of life (HRQoL), higher job stress and burnout. This study evaluated the potential physical activity and counselling intervention effects on health outcomes of working women in Shanghai participating in a group- or an individual-based physical activity and counselling intervention compared to a control group.
Methods：A sample of 121 female workers from eight Shanghai communities was used in this study. They were randomly divided into three groups: a control group and two observation groups (individual- and group-based intervention). The observation groups accepted 12-week moderate physical activity and counselling intervention. Subjective perceptions of work stress, burnout, and HRQoL were measured before and after the intervention.
Results：In the control group (Ctr), no significant difference was found between participants for stress (p = 0.752) and burnout (p = 0.622) before and after the experiment. However, the HRQoL value decreased after the experiment, with the mean value falling from 91.59 to 87.10. After the experiment, the value of stress and burnout decreased, and the value of HRQoL increased in the two intervention groups. At the intervention’s completion, there were significant differences compared intervention groups (Exp_G and Exp_I) to control group separately regarding changes in burnout and HRQoL over time (Exp_G vs. Ctr: p < 0.01, p < 0.01, respectively; Exp_I vs. Ctr: p < 0.01, p < 0.01, respectively). For stress, Exp_G exhibited a significant difference compared to Ctr (Exp_G vs. Ctr: p < 0.01), while Exp_I did not exhibit a significant difference compared to Ctr (Exp_I vs. Ctr: p = 0.128).
Conclusion：Physical activity and counselling intervention delivered either in group or individual format could reduce stress, burnout, and improve HRQoL of working women in Shanghai, and group interventions were more effective than those targeted at individuals.
The introduction of colorectal endoscopic submucosal hydrodissection at a Western Center: results and learning curve
Authors: Ramos-Zabala Felipe , Parra-Blanco Adolfo , Beg Sabina , García-Mayor Marian , Domínguez-Pino Ana , Cárdenas-Rebollo José Miguel , Moreno-Almazán Luis
Published: August 2019

Background
Colorectal endoscopic submucosal dissection (CR-ESD) is an evolving technique in Western countries. The use of hydrodissection has been established as an effective technique for safe resection. However, it is unknown if the adoption of this technique can help a novice perform ESD safely without prior experience or formal tutorial. Here we aimed to determine the results of the introduction of endoscopic submucosal hydrodissection for the treatment of complex colorectal polyps and establish the learning curve for this technique, at a European tertiary hospital.
Methods
This study included data from 80 consecutive CR-ESDs performed for complex colorectal polyps, by a single endoscopist within a structured training program. The main outcome was en bloc resection rate, while secondary outcomes included complications (perforation and bleeding), knife en bloc (KEB) resection rate, knife-snare en bloc resection rate, conversion rate to endoscopic piecemeal mucosal resection (EPMR), complete resection rate, curative resection rate. To explore the impact of experience, procedures were divided into 4 groups of 20 each, with outcomes measures compared between these.
Results
The overall en bloc resection rate was 75%. KEB resection was obtained in 15%, 25%, 50%, and 80% cases in the consecutive periods (period 1 vs 4, p<0.001; periods 1, 2 and 3 vs 4, p<0.001). Conversion rate to EPMR was obtained in 40%, 25%, 25% and 5% respectively (period 1,2 and 3 vs 4; p=0.031). Curative resection was achieved in 55%, 75%, 70% and 95% respectively (p=0.037). Series results were 75% R0 resection, 23.7% conversion to EPMR, and 1.2% incomplete resection. Complications included perforations (7.5%) and bleeding (3.75%), there was no significant difference in the 4 periods of training. Multivariate analysis revealed factors more likely to result in non-en bloc versus en bloc resection were polyp size > 35 mm [70% vs. 23.4%; OR 13.2 (95% CI: 1.7-100.9); p=0. 013], severe fibrosis [40% vs. 11.7%; OR 10.2 (95% CI: 1.2-86.3); p= 0.033] and non-use of CO2 [65% vs. 30%; OR 0.09 (95% CI: 0.01-0.53); p= 0.008].
Conclusions
CR-ESD by hydrodissection can be implemented in a western centre and offers safe and effective treatment for complex polyps.
High resolution esophageal manometry and life exposure factors in non-cardiac chest pain patients with refractory gastroesophageal reflux disease
Authors: Li Yuan , Lyu Peicong , Zhang Zhifeng , Wang Liya , Sun Xiaoyu , Yang Dong , Wang Lixia , Duan Zhijun
Published: August 2019

Background: Refractory gastroesophageal reflux disease (RGERD) is defined by the presence of troublesome GERD symptoms despite proton pump inhibitors (PPIs) treatments for 8-12 weeks. Non-cardiac chest pain (NCCP) is the most common atypical presentations. This study was aimed at clarifying the features of High Resolution Esophageal Manometry (HREM) and life exposure factors of NCCP in RGERD patients for guiding further therapeutic strategies.
Methods: 83 RGERD patients were enrolled, in which 44 patients afflicted with NCCP as P group and 39 patients without NCCP as NP group. According to the endoscopy results, P group was further divided into reflux esophagitis group (RE group), non-erosive reflux disease group (NERD group) and Barrett’s esophagus group (BE group). HREM was performed to assess esophageal motility. Diverse questionnaires were conducted to evaluate severity of symptoms, quality of life, risk factors, degrees of anxiety and depression and so on.
Results: a)Average resting pressures of the lower esophageal sphincter (LES), residual pressures of the LES and the esophageal distal contractile integral (DCI) score in P group were significantly lower than those in NP group (p<0.05). b)Average resting pressures of the upper esophageal sphincter (UES), residual pressures of the UES, lengths of the LES and the UES showed no difference between the two groups (p>0.05). c)Compared with NP group, the patients in P group had higher exposure to alcohol, coffee, sweets, overeating and stress (p<0.05). d)Anxiety and depression status of patients in P group were remarkably severer than those in NP group (p<0.05). e)The pain intensity in RE group and BE group was higher than NERD group (P<0.05), while there was no difference between RE group and BE group (P>0.05).
Conclusions: Esophageal motility related anti-reflux barriers are much weaker in the RGERD patients with NCCP than those without NCCP, which mainly presents as the much lower average resting and residual pressures of the LES and DCI. Alcohol, coffee, sweets, overeating, stress, anxiety and depression are risk factors of RGERD-related NCCP. It’s suggested that the recovery of anti-reflux barriers and the avoidance of risk factors may be essential therapeutic strategies for improving the curative effect.
Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse
Authors: Halliwell Gemma , Dheensa Sandi , Fenu Elisabetta , Jones Sue K , Asato Jessica , Jacob Suzanne , Feder Gene
Published: August 2019

Background
Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services.
Methods
Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services.
Results
Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,076 per patient per year. This offset the average cost of providing hospital IDVA services.
Conclusions
Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.
Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions
Authors: Hailu Berhane Yohannes , Berhe Derbew Fikadu , Gudina Esayas Kebede , Gidey Kidu , Getachew Mestwat
Published: August 2019

Background : Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.Methods : A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).Conclusions : Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.
Physical, nutritional and psychological states interfere with health related quality of life of institutionalized elderly
Authors: Farias Ilky Pollansky Silva e , Montenegro Luiza Almeida Souto , Wanderley Rayssa Lucena , de Pontes Jannerson Cesar Xavier , Pereira Antonio Carlos , Almeida Leopoldina Fátima Dantas , Cavalcanti Yuri Wanderley
Published: August 2019

Purpose

Nursing home residents experience many problems that may influence their quality of life, in example of cognitive, mental, nutritional and physical disabilities. Concerning about elders’ wellbeing may help them living with dignity. This study aimed to investigate factors associated with Health-Related Quality of Life (HRQoL) of institutionalized elderly in a capital city of Brazilian Northeast.Methods

A cross-sectional study was conducted with 193 institutionalized elderly living in the metropolitan region of João Pessoa (Brazil). A theoretical-conceptual model was build to guide the multiple regression analysis. The following variables were tested regarding their association with the residents’ HRQoL: 1) socio-demographic characteristics; 2) data associated with general health (Performance of daily-living activities, Frailty status, Cognitive status, Nutritional status, Self-perception of oral health and Depression status). Multiple linear and logistic regressions analyses were performed in order to assess the impact of each independent variable on HRQoL, considering a significance level of 5%.Results

The mean ± SD and the median of HRQoL among institutionalized elderly people were 62.69 ± 15.24 and 62, respectively. Elderly were mostly (72.02%) female, being those with 80 years and over the more frequent (54.92%). Dependence on daily activities (OR=2.06, 95%CI=1.32-3.23), frailty (OR=1.68, 95%CI=1.15-2.45) and depression (OR=2.22, 95%CI=1.51-3.27) were statistically associated with poor HRQoL (p<0.05).Conclusions

Dependent, frail and depressed institutionalized elderly presented a greater chance to have a worse HRQoL. It is necessary to plan and implement actions that would reduce the factors associated with the low quality of life of institutionalized elderly.
The Association between Sleep Quality and Loneliness in Rural Elderly Individuals: A Cross-Sectional Study in Shandong, China
Authors: Jia Gaizhen , Yuan Ping
Published: August 2019

Background

There is evidence for negative associations between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural elderly. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults.

Methods

A face-to-face questionnaire survey was conducted among 1568 rural elderly people in Shandong, China. Loneliness was assessed using the Univesity of California at Los Angels loneliness scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression were conducted to examine the association of loneliness and sleep quality after adjusting for multiple confounding variables.

Results

After controlling for age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking, drinking, chronic diseases, quality of life such as variables in multivariable analysis, Poor sleep quality still predicted loneliness in rural elderly.

Conclusion

This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.
Neuraxis metastases from central nervous system tumors: a review of clinicopathological and radiographic characters of 198 cases in a single center
Authors: Liu Hailong , Zhang Junping , Liu Yongqiang , Sun Youliang , Li Cheng , Gu Chunyu , Wang Haoran , Zhang Hongwei , Yu Chunjiang , Mingshan Zhang
Published: August 2019

Background Neuraxis metastases (NM) from systemic and central nervous system (CNS) tumors have become increasingly common. However, a lack of systematic information restricts the development of the accurate diagnosis and treatment. The aim of this study is to facilitate the understanding of NM arising from CNS tumors in the largest cohort. Methods Based on the clinicopathological and neuroimaging findings, we retrospectively analyze the epidemiological characters, radiographic classification, therapeutic strategies and prognostic factors. Results A total of 198 cases are enrolled and the most common primary tumor is medulloblastoma (34.34%). The median age is 15.0 years and the majority of NM (79.29%) occur in the children and young adult groups. 149 (75.25%) cases suffer from intracranial metastases, and 169 (85.35%) have the intraspinal NM. The whole leptomeninges and cauda equine are the most preferential disseminated sites. Upon MRI parameters, the massive and miliary subgroup occur most frequently in the intracranial and intraspinal NM, respectively. Treatment includes surgery (21.71%), chemotherapy alone (19.19%), radiation alone (10.10%) and combined therapy (55.56%). Operations are performed in order to identify pathology and relive masses, as well as the triple chemotherapeutic scheme consisting of ifosfamide, carboplatin and etoposide is recommended to most of NM. The median overall survival is 11.6 months. The younger age, coexistence of NM with primary tumors, shorter interval from primaries to metastases, glioma, leptomeningeal seeding and nodal subtype on MRI are significantly associated with the poor prognosis. Conclusion In spite of the controversial therapies and poor outcomes, the neuroimaging classification and comprehensive treatment contribute to the efficient administration of NM.