bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolving complexities of infant HIV diagnosis within Prevention of Mother-to-Child Transmission programs
Authors: Haeri Mazanderani Ahmad , Sherman Gayle G.
Published: September 2019

Early diagnosis of HIV infection among infants and children is critical as prompt initiation of antiretroviral therapy prevents morbidity and death. Yet despite advances in the accuracy and availability of infant HIV diagnostic testing, there are increasing challenges with making an early definitive diagnosis. These challenges relate primarily to advances in prevention of mother-to-child transmission (PMTCT) of HIV. Although PMTCT programs have proven to be highly effective in reducing infant HIV infection, infants who are HIV-infected may achieve virological suppression and loss of detectability of HIV nucleic acid prior to diagnosis because of antiretroviral drug exposure. Hence, false-negative and indeterminate HIV polymerase chain reaction (PCR) results can occur, especially among high-risk infants given multi-drug prophylactic regimens. However, the infant HIV diagnostic landscape is also complicated by the inevitable decline in the positive predictive value of early infant diagnosis (EID) assays. As PMTCT programs successfully reduce the mother-to-child transmission rate, the proportion of false-positive EID results will increase. Consequently, false-negative and false-positive HIV PCR results are increasingly likely despite highly accurate diagnostic assays. The problem is compounded by the seemingly intractable prevalence of maternal HIV within some settings, resulting in a considerable absolute burden of HIV-infected infants despite a low mother-to-child transmission rate.
Information B2B Markets: Segment Stability and Positioning
Authors: Харионовская А. , Harionovskaya A.
Published: September 2019

The article is devoted to the sustainability of segments of information B2B markets in the context of the functional level of marketing activities: segmentation, selection of target segments, positioning. The features of information B2B markets, such as the propensity to change and the dependence of the consumer behavior of client companies on the consumer behavior of users of information products, are considered. The concept of segment stability is considered - its essence, its place in segmentation, its role in the selection of target segments. On the example of the market of legal reference systems, the perception of information products by users in the context of generations and in comparison with their positioning is considered. A hypothesis is formulated about the factors that determine the sustainability of users' perception of information products.
Design of a New Paradigm Model of Cultural Industry Development
Authors: Мальшина Н. , Mal'shina N.
Published: September 2019

The development of the cultural industry can prevent unnecessary loss of time and various resources in the process of organizing the interaction of participants in the life cycle of the cultural industry services. To assess the effectiveness of the functioning and development of creative industries, the method of «analysis of the functioning environment» is used. In the paradigms framework of the support mechanism for the IR discusses several components: classification services culture; classification of the market of cultural industries; formation of the complex system of services in the cultural industry (IR); state support, forms of public-private support (PPP); risk minimization; the formation and implementation of programs services culture within integrated service systems (Integs). Economic support measures include the main elements: assessing the potential of IR; the formation of information-analytical database (IABD) IR; creation of economic-mathematical models support IR services; optimization of costs (creating Integs IR); improving the efficiency of IR (economic, social, cultural). The vertical of realization of the organizational and economic mechanism of integral support of the culture industry is defined. Theoretical and methodological basis for the development of integrated support for EC services OEM solve an important state task to improve the living standards of the population and economic growth of the RF subjects and the formation of a new paradigm of the RF IC development. The proposed model of the new paradigm of IC development reflects the logic of actions and is aimed at the formation of integrated support for the system of cultural services of the Russian Federation, taking into account the needs of a particular subject of activity and is a way of coordination and allocation of resources, a condition for effective realization of the potential of the subject of activity.
The Problem of Multi-Level Ethical Regulation in Personnel Management
Authors: Кожевникова Л. , Kozhevnikova L. , Старовойтова И. , Starovoytova I.
Published: September 2019

The article is devoted to methodological problems of personnel management: the problem of ethical values in the management of an organization, the problem of the relationship between ethics and economics, the problem of synthesizing positive and normative approaches within the framework of economics, the problem of balancing the basic values of the work ethic of an ethnos and socio-economic institutional factors of modern society. A classifi cation of ethical dilemmas in the organization is proposed: dilemmas at the individual level (professional ethics of the personnel manager), at the organizational level (ethics of the organization) and at the social level (economic ethics). The article shows the new ethical problems to which the spread of new information and communication technologies leads. The authors conclude that the humanistic economic theory of a civilized society has been developing.
It is no joke. Metaphorical language and sense of humor in schizophrenia
Authors: Wyszomirska Julia , Martyniak Ewa , Bąk-Sosnowska Monika
Published: September 2019

Poczucie humoru ma pozytywny wpływ na funkcjonowanie psychiczne i społeczne człowieka, poprzez wspieranie kompetencji interpersonalnych oraz efektywnego radzenia sobie w sytuacjach trudnych. Celem pracy jest przedstawienie dotychczasowych badań na temat przetwarzania treści humorystycznych przez osoby chorujące na schizofrenię, związanego z deficytami poznawczymi towarzyszącymi chorobie oraz ich podłożem neurobiologicznym. Rozumienie humoru oraz adekwatne posługiwanie się nim wymaga wielu umiejętności językowych oraz pozajęzykowych, obejmujących przetwarzanie sygnałów z otoczenia społecznego, takich jak adekwatne rozpoznawanie komunikatów emocjonalnych, rozumienie kontekstu sytuacji humorystycznej, prawidłowe wnioskowanie o stanach mentalnych innych osób. Sprawne posługiwanie się językiem metaforycznym pozwala na doświadczanie rozbawienia wynikającego z nieścisłości, różnorodnych interpretacji semantycznych, ironii i sarkazmu. Skłonność do nadmiernego konkretyzmu obecna w zaburzeniach rozumienia treści niedosłownych i złożonych semantycznie struktur językowych oraz inne deficyty poznawcze chorujących na schizofrenię często utrudniają posługiwanie się komunikatami humorystycznymi. Bliższe poznanie mechanizmów regulujących efektywne posługiwanie się humorem może pomóc w tworzeniu narzędzi terapeutycznych, mających na celu poprawę efektywności komunikacji pacjentów chorujących na schizofrenię oraz pozytywnie wpłynąć na ich funkcjonowanie społeczne.
Using a frame of reference for talking to patients about death and dying
Authors: Hussain Feryad A
Published: September 2019

Recent years have seen a recognition of the importance of talking openly to patients at the end of life about death and dying. This article aims to add to the existing body of literature on this subject. Conversations at the end of life can be difficult, particularly if the patient is experiencing mental distress alongside their terminal illness. A number of factors can disrupt a constructive and supportive conversation around death and dying. This article offers a frame of reference for nurses to consider when having such conversations.
The use of voice-assisted technology to enhance self-care
Authors: Glasper Alan
Published: September 2019

Emeritus Professor Alan Glasper, University of Southampton, discusses a new strand of the Government's NHS Long Term Plan, which is commited to more fully embrace digital innovations, including voice-assisted technology
From staff nurse to nurse consultant: Survival Guide part 4: Surviving as a senior clinical nurse
Authors: Fowler John
Published: September 2019

John Fowler, Educational Consultant, explores how to survive your nursing career
Exploring individuals' perceptions of living with a stoma
Authors: Perrin Angie
Published: September 2019

Angie Perrin, Clinical Lead for Innovation, Salts Healthcare, angie.perrin@salts.co.uk , discusses findings from interviews and surveys regarding ostomists' attitudes to their stoma, adjusting to their new reality, and product choice
Sharing practice CCTV footage with patients
Authors: Birch Rachel
Published: September 2019

How should practice managers respond to a patient's request for CCTV footage? Dr Rachel Birch, Medicolegal Consultant at Medical Protection has some advice for practice managers about the legal position with regard to data sharing
The cone of Z-transformations on Lorentz cone
Authors: Nemeth Sandor , Gowda Muddappa
Published: September 2019

In this paper, the structural properties of the cone of $\calz$-transformations on the Lorentz cone are described in terms of the semidefinite cone and copositive/completely positive cones induced by the Lorentz cone and its boundary. In particular, its dual is described as a slice of the semidefinite cone as well as a slice of the completely positive cone of the Lorentz cone. This provides an example of an instance where a conic linear program on a completely positive cone is reduced to a problem on the semidefinite cone.
The effect of ethanol extract of fruit peel jengkol (Archidendron pauciflorum) to spleen histological structure of streptozotocin-induced diabetic rats (Rattus norvegicus)
Authors: DESAK MADE MALINI  , Abadi Selma Alamanda , MADIHAH  , WAWAN HERMAWAN
Published: September 2019

Abstract. Malini DM, Abadi SA, Madihah, Hermawan W. 2019. The effect of ethanol extract of fruit peel jengkol (Archidendron pauciflorum) to spleen histological structure of streptozotocin-induced diabetic rats (Rattus norvegicus). Nusantara Bioscience 11: 157-161. Diabetes Mellitus (DM) is a chronic endocrine disorder associated with several secondary complications. The spleen is a lymph organ with the main function of filtering red blood cells, immune response and playing any kind of role in diabetes. Despite the currently available anti-diabetic drugs, there are need remedies for alternatives which are economical and safe. One alternative medicine well known by local Indonesian communities to treat DM is the fruit peel of Archidendron pauciflorum. This study aimed to evaluate the histological changes in the spleen following administration of ethanol extract of fruit peel Archidendron Pauciflorum (EEJFP) in the streptozotocin (STZ) - induced diabetic rats. Diabetic rats were used in this study consisting of six groups of four animals each. The treatments given are NC (CMC solution 0.5%), Positive Control (CMC solution 0.5%), G (glibenclamide), Treatment 1, 2, and 3 (EEJFP dose 385; 770; 1540 mg/kg bw). All of the treatment was administered orally to the experimental rats 14 days following induction. The spleen was collected and the histological study was performed using hematoxylin and eosin (H&E). The parameters observed were the number of necrosis and cell damage score, including fat degeneration, hydropic degeneration, and inflammatory cell. The result showed that EEJFP at dose 385 mg/kg bw and 770 mg/kg bw gave significant recovery (p<0.05) on spleen damage by the decreased of the number of necrotic cells and cell damage score which lower than other treatments and compared to negative control group. It was concluded that doses of 385 mg/kg bw EEJFP are the optimum dose to improve the histological structure of spleen damage in diabetic rats.
Gute Argumente
Authors: M. Eichinger Ludwig
Published: September 2019

Gerade allgemeinere Verben zeigen eine Variationsbreite der Verwendung, die nicht leicht zu einem einheitlichen Bild zu fassen ist. Am Beispiel des Verbs beginnen wird gezeigt, wie hier die Interaktion zwischen der Struktur der Aktanten und den grammatischen Regelmäßigkeiten funktioniert. Dabei wird versucht, in der Kombination von Valenzinformationen, Argumentstrukturpositionierungen und Musterbildungen im Gebrauch ein zusammenhängendes Bild dieses Verbs in seinen verschiedenen Verwendungen zu entwerfen.
Idiomatik in grammatischen und lexikalischen Konstruktionen mites
Authors: Czicza Dániel
Published: September 2019

Der Beitrag fokussiert ausgewählte Vorkommen des nicht-phorischen es. Es wird argumentiert, dass das formale Subjekt-es im Vergleich zum formalen Objekt-es insofern eine größere Variabilität zeigt, als Ersteres lexikalische und grammatische Konstruktionen konstituiert, während Letzteres nur in lexikalischen Konstruktionen erscheint. Zur Differenzierung wird der Begriff der Idiomatizität herangezogen, deren Beschaffenheit in sprachverg
Schnittstelle Korpora und Fremdsprachenunterricht
Authors: Beeh Christoph
Published: September 2019

Der vorliegende Aufsatz zeigt überblicksartig auf, welches vielfältige Potenzial Korpora für den Einsatz im Fremdsprachenunterricht bieten und wo ihr Einsatz auf Schwierigkeiten stößt. Der Fokus liegt auf der vergleichenden Betrachtung des Einsatzes von Daten aus Belegsammlungen versus größer angelegten öffentlich zugänglichen Korpora. Zentrale Hypothesen sind, dass die Arbeit mit eigenen Belegsammlungen das naheliegendste bedeutungsvolle Bindeglied zwischen Autonomieförderung und datenbasiertem Lernen im Fremdsprachenunterricht ist und dass ein Fokus auf Transfer- und Interferenzphänomene vielversprechendes Potenzial bietet.
Am Anfang ist das ‚Wort‘, oder doch nicht?
Authors: Dabóczi Viktória
Published: September 2019

Zu Beginn des Spracherwerbs bzw. in der Anfangsphase der Sprachproduktion von Kleinkindern warten Eltern sehnsüchtig auf das erste Wort des Nachwuchses. Bei der ersten formal zielsprachlichen Äußerung der Kinder ist die Freude groß. ‚Wort‘ und andere Kategorien der traditionellen Grammatik dienen auch der Spracherwerbsforschung als Beschreibungskategorien. Dabei wird die Frage, ob solche Einheiten der kindlichen Sprachentwicklung gerecht werden können, selten gestellt. Im vorliegenden Beitrag wird genau diese Frage insbesondere in Bezug auf das ‚Wort‘ näher betrachtet. Im Mittelpunkt der Diskussion steht die Frage, ob und inwiefern frühe kindliche Äußerungen Wörtern der Erwachsenensprache entsprechen bzw. wie diese frühen kindlichen Äußerungen erfasst werden können.
Zur Frage des Normverständnisses im DaF-Unterricht
Authors: Knipf-Komlósi Elisabeth
Published: September 2019

Es gilt als Binsenwahrheit, dass eine gut ausgebildete Sprachkompetenz/Sprachhandlungskompetenz der Schlüssel zu einer erfolgreichen Partizipation am gesellschaftlichen und sozialen Leben ist. Die Schule trägt neben anderen Instanzen selbstverständlich auch in großem Maße die Verantwortung dafür, dass diese Sprach(handlungs)kompetenz auf bestmöglichem Wege, mit den angemessenen Methoden bei den Deutschlernenden ausgebaut wird. Die deutsche Sprache ist keine leicht zu erlernende Sprache, und hier wird häufig als eines von vielen Argumenten angeführt, dass Deutsch eine der variationsreichsten Sprachen Europas ist, die zudem in die Reihe der plurizentrischen Sprachen, so wie die großen Sprachen Europas, Englisch, Französisch, Spanisch etc. gehört. Im vorliegenden Beitrag wird der Frage nachgegangen, welche Überlegungen – theoretische, wie die Frage der Plurizentrik, die zentrale Frage der Norm(en), wie die curricale Gestaltung des DaF- Studiums – die Grundlage bei der Entwicklung eines Normverständnisses bei Lehrenden wie Lernenden eine Rolle spielen können/sollen, um eine positive, wenig frustrierende Einstellung zum Deutschlernen zu erreichen1 . In diesem Sinne gliedert sich mein Beitrag in die Fragen der Norm-Debatte, in die Gründe der Norm-Debatte in der Auslandsgermanistik bzw. in die kurze Darstellung einer empirischen Abfrage zum Thema mit einem Ausblick.
Adnominale Possessiva
Authors: Fabricius-Hansen Cathrine
Published: September 2019

Der Beitrag vergleicht die morpho-syntaktischen Systeme der adnominalen Possessiva des Norwegischen, Deutschen und Französischen und reflektiert über die sprachpaarspezifischen Herausforderungen, die ihre Beherrschung den Lernern der jeweils fremden Sprache zu bieten scheint.
Das Infinitivsubjekt in Kausativkonstruktionen im Sprachvergleich
Authors: Molnár Krisztina
Published: September 2019

Dass das logische Subjekt des Infinitivs bei Kausativkonstruktionen über den Akkusativ hinaus auch mit einer Präpositionalphrase ausgedrückt werden bzw. fehlen kann, ist hinlänglich bekannt. Da die Präpositionen, die in solchen Fällen auftreten, dieselben sind wie bei Agensausdrücken in Passivsätzen, werden Konstruktionen dieses Typs als „passivähnlich“ oder als „Kausativpassiv“ bezeichnet. Unklar ist jedoch, ob dieses Kausativpassiv als eine Art passivische Diathese zu kanonischen Kausativkonstruktionen betrachtet werden kann. Im vorliegenden Beitrag werden Ergebnisse einer Pilotanalyse beschrieben, in der semantische Eigenschaften von Infinitivsubjekten in kanonischen Kausativkonstruktionen und im Kausativpassiv in sprachvergleichender Perspektive untersucht wurden. Die Ergebnisse legen nahe, dass das Kausativpassiv unter den Vergleichssprachen lediglich im Italienischen eine mögliche Passivdiathese darstellt.
Die Konzeptualisierung von Grenze im deutschen und ungarischen Mediendiskurs über die Migration im Jahre 2015
Authors: V. Rada Roberta
Published: September 2019

Die Migration stellt die europäischen Länder seit 2015 vor immer schwierigere und komplexere Herausforderungen. Sie wird längst nicht mehr nur im Kontext von nationalen Medienkursen sondern auch auf der gesamteuropäischen Ebene, auf der Ebene der Europäischen Union diskutiert. In der ganzen Diskussion und daher auch in den thematisch einschlägigen Mediendiskursen spielen die Landesgrenzen und deren Schutz eine wesentliche Rolle. Ziel des vorliegenden Beitrags ist es, die Wissensbestände, Denk- und Bewertungsmuster zu ermitteln, die in dem deutschsprachigen und ungarischen Mediendiskurs über die Migration im Zusammenhang mit Grenzen sprachlich vermittelt werden. Dies soll auf der Folie der Diskurslinguistik, im Rahmen einer wortorientierten, deskriptiven linguistischen Diskursanalyse erfolgen. Im Rahmen von quantitativen und qualitativen Untersuchungen sollen die mit dem deutschen Wort Grenze bzw. dem ungarischen Wort határ benannten Konzepte aufgedeckt werden. Die erzielte Analyse versteht sich als international-interlingualer Vergleich von Diskursen.
Valenzgeschichte, Sprachgeschichte und historische Syntax
Authors: Greule Albrecht
Published: September 2019

Der Beitrag greift die Feststellung von Péter Bassola auf, dass die wichtigsten Valenzinformationen die Satzbaupläne sind, und überträgt sie in die deutsche Sprachgeschichte. Dadurch kann die historische Valenzlexikographie, die zum Stillstand gekommen ist, belebt werden. An den beiden Verben zahlen und bieten wird gezeigt, wie auf der Grundlage des Deutschen Wörterbuchs online und der Sprachstadienwörterbücher online Einträge für das geplante Historisch syntaktische Verbwörterbuch und in der Folge „Valenzgeschichten“, die den Verbwandel syntaktisch und semantisch beschreiben, ausgearbeitet werden können.
Alcoholic Liver Disease Epidemiology in the United States: A Retrospective Analysis of 3 US Databases
Authors: Dang Katherine , Hirode Grishma , Singal Ashwani K. , Sundaram Vinay , Wong Robert J.
Published: September 2019

OBJECTIVES:

Alcoholic liver disease (ALD) prevalence, particularly the subset with advanced liver disease, is not well defined. Herein, we aim to provide a comprehensive assessment of ALD epidemiology across the spectrum of disease severity and across different settings using 3 unique US databases.

METHODS:

We performed a retrospective, observational study of US adults with ALD using 2001–2016 National Health and Nutrition Examination Survey (NHANES), 2007–2014 Nationwide Inpatient Sample (NIS), and 2007–2017 United Network for Organ Sharing (UNOS) registry. ALD in the NHANES was defined using clinical laboratory data and self-reported alcohol use, among which fibrosis-4 score of >2.67 defined stage ≥3 fibrosis. Alcoholic cirrhosis (AC) in the NIS was identified using International Classification of Diseases, Ninth Revision codes. ALD in the UNOS was identified using UNOS coding.

RESULTS:

From 2001–2002 to 2015–2016, the overall weighted ALD prevalence was stable from 8.8% to 8.1% (P = 0.102), whereas the proportion of ALD with stage ≥3 fibrosis increased from 2.2% (95% CI: 0.4–4.0) to 6.6% (95% CI: 2.0–9.9; P = 0.007) (NHANES). From 2007 to 2014, the number of hospitalizations among patients with AC per 1,000 increased by 32.8%, and the proportion of hospitalizations among the patients with AC with ≥3 cirrhosis complications increased from 11.6% in 2007 to 25.8% in 2014 (P
trend < 0.0001) (NIS). From 2007 to 2017, the total number of adults with ALD listed for liver transplant increased by 63.4% and the proportion with concurrent hepatocellular carcinoma increased by 178% (UNOS).

DISCUSSION:

Among these 3 US databases, consistent observations of increasing ALD severity emphasize the urgent need for greater awareness about the consequences of unhealthy alcohol use and interventions aimed specifically at addressing alcohol use disorders.
Histologic Findings of Advanced Fibrosis and Cirrhosis in Patients With Nonalcoholic Fatty Liver Disease Who Have Normal Aminotransferase Levels
Authors: Gawrieh Samer , Wilson Laura A. , Cummings Oscar W. , Clark Jeanne M. , Loomba Rohit , Hameed Bilal , Abdelmalek Manal F. , Dasarathy Srinivasan , Neuschwander-Tetri Brent A. , Kowdley Kris , Kleiner David , Doo Edward , Tonascia James , Sanyal Arun , Chalasani Naga ,   and the NASH Clinical Research Network
Published: September 2019

OBJECTIVES:

Patients with nonalcoholic fatty liver disease (NAFLD) and normal aminotransferase levels may have advanced liver histology. We conducted a study to characterize the prevalence of and factors associated with advanced liver histology in patients with histologically characterized NAFLD and normal aminotransferase levels.

METHODS:

We evaluated 534 adults with biopsy-proven NAFLD and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <40U/L within 3 months of their liver biopsy. Histological phenotypes of primary interest were nonalcoholic steatohepatitis (NASH) with stage 2–3 fibrosis (NASH F2-3) and cirrhosis. Using multiple logistic regression models with Akaike's Information Criteria (AIC), we identified variables associated with these histological phenotypes. We developed and internally validated their clinical prediction models.

RESULTS:

The prevalence of NASH F2-F3 and cirrhosis was 19% and 7%, respectively. The best multiple regression AIC model for NASH F2-3 consisted of type 2 diabetes, white race, lower low-density lipoprotein, lower platelet count, higher AST/ALT ratio, higher serum triglycerides, and hypertension. The best AIC model for cirrhosis consisted of lower platelet count, lower AST/ALT ratio, higher body mass index, and female sex. The area under the receiver operator curves of the prediction models were 0.70 (95% confidence interval: 0.65–0.76) for detecting NASH-F2-3 and 0.85 (95% confidence interval: 0.77–0.92) for detecting cirrhosis. When models were fixed at maximum Youden's index, their positive and negative predictive values were 35% and 88% for NASH F2-F3 and 30% and 98% for cirrhosis, respectively.

DISCUSSION:

Clinically significant histological phenotypes are observed in patients with NAFLD and normal aminotransferase levels. Our models can assist the clinicians in excluding advanced liver histology in NAFLD patients with normal aminotransferase levels.
Graft-Versus-Host Disease After Pancreatic Transplantation
Authors: Saffo Saad , Peng Chengwei , Kibbi Nour , Patel Natalie , Robert Marie E. , Adekolu Evelyn , Asch William S. , Sanchez Mayra
Published: September 2019

Graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation but can rarely occur after solid organ transplants. Small bowel and liver transplants are typically implicated, but solid organ transplant-associated GVHD has also been associated with other organs. We present a 40-year-old diabetic woman who underwent renal followed by pancreatic transplantation over a span of 21 months and ultimately developed acute classic GVHD. The diagnosis proved to be challenging in the context of confounding infections and inconclusive bone marrow and skin biopsy findings. She had multiorgan failure at the time of endoscopic confirmation and died after having minimal response to aggressive immunosuppression.
Isolated Intestinal Angioedema Secondary to a Food Allergen
Authors: Hassan Ammar , Weissman Simcha , Sciarra Michael A. , Sotiriadis John
Published: September 2019

Intestinal angioedema is the dilatation or thickening, or both, of a segment of bowel. It is a diagnostic phenomenon that manifests itself clinically as acute abdominal pain, diarrhea, and emesis. Generally, this condition occurs in tandem with angioedema of the face and tongue and/or in association with the use of an angiotensin-converting enzyme inhibitor (ACE-I). We present a rare case of a 63-year-old woman who developed isolated intestinal angioedema due to the ingestion of a food allergen.
Factors That Affect Prevalence of Small Intestinal Bacterial Overgrowth in Chronic Pancreatitis: A Systematic Review, Meta-Analysis, and Meta-Regression
Authors: El Kurdi Bara , Babar Sumbal , El Iskandarani Mahmoud , Bataineh Adam , Lerch Markus M. , Young Mark , Singh Vijay P.
Published: September 2019

OBJECTIVES:

Small intestinal bacterial overgrowth (SIBO) can complicate chronic pancreatitis (CP) and interfere with management. Its predisposing factors in CP and treatment response are unknown. In this review, we evaluated factors affecting disease burden.

METHODS:

A computerized search of PubMed and EMBASE databases from inception through May 2019 was done for studies correlating SIBO with CP. Studies were screened, and relevant data were extracted and analyzed. Pooled prevalence, odds ratio (OR), and meta-regression were performed using the random effects model as classically described by Borenstein et al. (2009). SIBO's relation to diabetes mellitus (DM), pancreatic exocrine insufficiency (PEI), narcotic use, and proton-pump inhibitor use was investigated. Treatment response was pooled across studies. P value < 0.05 was considered significant.

RESULTS:

In 13 studies containing 518 patients with CP, SIBO prevalence was 38.6% (95% confidence interval [CI] 25.5–53.5). OR for SIBO in CP vs controls was 5.58 (95% CI 2.26–13.75). Meta-regression showed that PEI and the diagnostic test used were able to explain 54% and 43% of the variance in SIBO prevalence across studies, respectively. DM and PEI were associated with increased SIBO in CP with OR (2.1, 95% CI 1.2–3.5) and OR (2.5, 95% CI 1.3–4.8), respectively. Symptomatic improvement was reported in 76% of patients after SIBO treatment.

DISCUSSION:

SIBO complicates 38% of CP with OR of 5.58 indicating a predisposition for this condition. PEI correlates with SIBO in CP and might play a role in pathophysiology. DM and PEI are associated with increased SIBO in CP. Treatment of SIBO may lead to symptomatic improvement.
Potensi dan peluang Produk Halal Berbasis Rumput Laut
Authors: Diah Madusari Benny , Edi Wibowo Dwi
Published: September 2019

75 persen wilayah Indonesia  berupa laut dengan lebih dari 17 ribu pulau, serta panjang garis pantai mencapai 95.181 km. Potensi ini menunjukan sektor kelautan dan perikanan dengan segenap potensinya memiliki peluang menjadi tulang punggung pembangunan bangsa ini. Rumput laut salah satu potensi Perikanan kelautan Indonesia saat sekarang sudah mampu menjadi produk ekspor . Rumput laut tersebar di pantai Idonesia dan dapat berkembang biak dari erairan payau hingga perairan laut .Terdapat beragam jenis rumput laut yang telah dibudidayakan, namun terdapat beberapa jenis rumput laut unggulan yang telah dibudidayakan dan berpotensi di Indonesia. Berikut beberapa jenis rumput laut yang memiliki potensi dan merupakan produk potensi untuk  ekspor yakni Gracilaria sp, Eucheuma cottoni, eucheuma spinosum, Gelidium, Acanthopora. Chondrococcus Hypnea, Ulva lactuta, Sargasum ,TurbinariaMelalui program Blue Economy telah menerapkan rumput laut sebagai produk yang mempunyai potensi pasca panen yang dapat dikonsumsi masyarakat sebagai makanan sehat dan halal. Berbagai produk pasca panen rumputlaut yang dikelola sesuai prosedur akan menghasilkan produk yang sehat dan halal. Diantara produk yang sudah dihasilkan dan memiliki pangsa pasar yang baik yakni agar agar, jelly, pewarna alami yang sangat dibutuhkan sebagai bahan dasar untuk pengolahan lebih lanjut sehingga menghasilkan produk makanan, obat obat dan kosmetika yang berkelanjutan, sehat dan halal.Kata kunci : Halal,sehat, rumput laut
Analisis Kualitatif Kandungan Boraks Pada Bahan Pangan Daging Olahan dan Identifikasi Sumber Boron dengan FTIR – ATR
Authors: Septiani Triayu , Roswien Anna P
Published: September 2019

ABSTRAK Pangan terbagi menjadi pangan alami dan pangan olahan, pangan olahan umumnya menggunakan berbagai food additive agar memiliki shelf life yang panjang, rasa yang lezat dan penampilan yang menarik. Bahan tambahan pangan yang digunakan pada proses produksi pangan harus menggunakan bahan tambahan pangan yang disetujui oleh FDA dan Codex Alimentarius. Namun, pada prakteknya produsen juga seringkali menambahkan bahan tambahan pangan yang telah dilarang dan bersifat karsinogenik. Salah satu bahan yang dilarang penggunaannya dalam pengolahan pangan adalah boraks, namun bahan ini masih sering digunakan oleh produsen nakal karena harganya yang murah dalam memproduksi pangan olahan. Boraks atau natrium tetraborate yang umum digunakan sebagai pengawet merupakan senyawa dengan BM 381.37. Tujuan dari penelitian ini adalah untuk mengetahui keberadaan boraks dalam pangan daging olahan seperti bakso. Pada penelitian ini menggunakan bakso yang diperoleh dari pasar tradisional dan pedagang kaki lima di sekitar Universitas YARSI. Hasil dari penelitian ini adalah sepuluh sampel dengan berat pada kisaran 39.3470 – 55.6263 telah diuji kualitatif dengan pengulangan sebanyak dua kali menggunakan turmeric paper menunjukkan mengalami perubahan warna yang mengindikasikan sampel positif mengandung boraks. Pengujian kualitatif juga dilanjutkan dengan menggunakan FTIR spectrometry untuk mengidentifikasi finger print pada boric acid, natrium tetraborate, dan disodium tetraborate. Perbedan finger print pada transmitant boric acid, natrium tetraborate, dan disodium tetraborate diamati pada region wavenumber 1800 – 600 cm-1.Key Words : Boraks, Boric Acid, Sodium Tetraborate, Disodium Tetraborate
Analisis Lemak Sapi dan Lemak Babi Menggunakan Gas Chromatography (GC) dan Fourier Transform Infra Red Spectroscophy Second Derivative (FTIR-2D) untuk Autentifikasi Halal
Authors: Yunita Prabawati Susy , Fajriati Imelda
Published: September 2019

ABSTRAKTelah dilakukan penelitian analisis lemak sapi dan lemak babi menggunakan Gas Chromatography (GC) dan FTIR second derivative (2D). Penelitian dilakukan untuk mempelajari perbedaan karakteristik dan profil kedua lemak dalam proses autentifikasi halal. Sampel lemak dipisahkan menggunakan ekstraksi Soxhlet dengan pelarut n-heksana selama 2 jam. Hasil ekstraksi selanjutnya dianalisis menggunakan GC dan FTIR 2D. Hasil penelitian menunjukkan bahwa, dengan GC didapatkan kandungan asam lemak jenuh (asam palmitat dan asam okta-dekanoat) pada lemak sapi lebih banyak daripada asam lemak jenuh pada lemak babi. Adapun kandungan asam lemak tak jenuh (asam oleat, linoleat dan asam linolenat) pada lemak babi lebih tinggi daripada lemak sapi. Hasil ini dibuktikan dengan profil spektra FTIR 2D, dimana munculnya serapan pada bilangan gelombang 3000-3010 cm-1 yang merupakan vibrasi ulur dari ikatan rangkap –C=CH cis pada profil spektra lemak babi, dan tidak nampak serapan pada bilangan gelombang tersebut pada profil lemak sapi. Dengan demikian, analisis lemak sapi dan lemak babi menggunakan GC dan FTIR 2D dapat digunakan untuk autentifikasi halal. Kata Kunci: Ekstraksi Soxhlet, GC, FTIR second derivative(2D), autentifikasi halal.
Analisis Kadar Etanol dalam Obat Batuk dengan Metode Kromatografi Cair
Authors: Nuur Annisa Arianti , Nuryadi Handung , Widayat Widayat , Ayu Sofiati Dita
Published: September 2019

Etanol merupakan senyawa kimia yang umum digunakan sebagai pelarut dalam obat-obatan. Keberadaan etanol dalam obat dapat diragukan kehalalannya. Diperlukan analisa kandungan etanol dalam suatu produk. Kromatografi cair merupakan metode yang akurat untuk mengetahui keberadaan etanol dalam sampel. Penelitian ini bertujuan untuk menganalisa kandungan etanol dalam obat batuk menggunakan metode HPLC. Metode yang dilakukan terdiri dari persiapan standar etanol dan sampel obat batuk, serta analisa sampel dengan HPLC. Data hasil analisa diolah dengan menggunakan software Lab Solutions. Selanjutnya disusun kurva analitik dan persamaan linear. Hasil analisa menunjukkan sampel obat batuk jenis XXX memiliki kandungan senyawa etanol. Dari hasil yang diperoleh dapat disimpulkan bahwa metode HPLC tepat digunakan untuk menentukan kehalalan suatu produk.
4-Channel Tunable Optical Demultiplexer Based on Nonlinearity Phenomenon in 2D Resonant Cavity Photonic Crystals
Authors: Talebzadeh Reza , Mehdizadeh Farhad , Naseri Ali
Published: September 2019

In this paper, we propose a new structure based on photonic crystals to realise a demultiplexing operation for dense wavelength division multiplexing transmission systems. In this demultiplexer, the resonant cavities were responsible for selecting the wavelength. By imposing defect rods to these cavities, the modes could resonate at the desired frequencies. As we wanted to see the nonlinear effects, the material that was chosen for defect rods were doped glass. The refractive index of this glass in 1550 nm is 1.41. Increasing the input power causes variation in the refractive index of defect rods and as a result resonant condition of whole cavity alerts so a tenable demultiplexer can be investigated. Based on the results, the average pass bands of channels are near to 1.5 nm and the channel spacing is approximately 3.95 nm. The proposed demultiplexer acts in a near-complete transmission efficiency and the mean value of the crosstalk was −19 dB.
Pasireotide-LAR in acromegaly patients treated with a combination therapy: a real-life study
Authors: Lasolle Hélène , Ferriere Amandine , Vasiljevic Alexandre , Eimer Sandrine , Nunes Marie-Laure , Tabarin Antoine
Published: September 2019

Purpose

Little data are available regarding the safety and efficacy of switching to Pasireotide-LAR monotherapy in acromegaly patients with partial resistance to first-generation somatostatin agonists (1gSRL) who require combination treatment with cabergoline or pegvisomant.

Method

In this monocentric prospective study within a tertiary university hospital, 15 consecutive acromegalic adults partially resistant to 1gSRL treated with octreotide LAR or lanreotide SR, and cabergoline (n = 4, 3.5 mg/week) or pegvisomant (n = 11, median dose 100 mg/week), were switched to Pasireotide-LAR (8 with 40 mg/month; 7 with 60 mg/month). Immunohistochemical expression level of SSTR5 and the granulation pattern of nine somatotroph adenomas were retrospectively determined to test for a correlation with the therapeutic efficacy of Pasireotide-LAR.

Results

Median IGF-1 concentration at the first evaluation (median 3 months) was similar to baseline (1.0 vs 1.1 ULN). 11/15 patients had IGF-1 levels ≤1.3 ULN before and after the switch but individual changes were variable. Hyperglycemia was frequent and greater in diabetic patients. 7/15 patients stopped Pasireotide-LAR due to lack of control of IGF-1 or intolerance. 8/15 patients received Pasireotide-LAR for a median of 29 months with IGF-1 levels ≤1.3 ULN and acceptable glucose tolerance (median HbA1c 6.1%). Two patients required initiation of oral antidiabetic treatment. The intensity of SSTR5 expression and the granulation pattern of adenomas were of limited value for the prediction of Pasireotide-LAR effectiveness.

Conclusion

Pasireotide-LAR may represent a suitable therapeutic alternative in a subset of acromegalic patients requiring combination therapy involving a 1gSRL
Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study
Authors: Alvarez Mauricio , Sierra Oswaldo Rincón , Saavedra Ginna , Moreno Sergio
Published: September 2019

Objective

Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy.

Methods

A cross-sectional study was conducted with 162 patients. Vitamin B12 levels were measured by chemiluminescence immunoassay. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. Additional data, including demographic characteristics were collected. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy.

Results

Low vitamin B12 levels were found in 7.3% (95% CI: 4.0–12%) of patients. In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47–78%) compared to 17% (95% CI: 10–26%) in patients without diabetic neuropathy (coefficient: −110.8; CI 95%: −165.8, −59.7). Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: −0.061; CI 95%: −0.09, −0.024). In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3–95).

Conclusions

Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12.
Multidrug-Resistant Bacteria and Disease Progression in Patients with End-Stage Liver Disease and after Liver Transplantation
Authors: Friedrich Kilian , Krempl Jessica , Schamoni Shigehiko , Hippchen Theresa , Pfeiffenberger Jan , Rupp Christian , Gotthardt Daniel Nils , Houben Philip , Von Haken Rebecca , Heininger Alexandra , Brenner Thorsten , Mehrabi Arianeb , Weiss Karl-Heinz , Mieth Markus
Published: September 2019

Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients.

Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128).

Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p < 0.001) and hepatorenal syndrome (p < 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p < 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx: p < 0.001; second LTx: p = 0.037) and reduced actuarial survival (first LTx: p < 0.001; second LTx: p = 0.046).

Conclusions: We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx.
Endoscopic Ultrasound Guided Gallbladder Interventions: a Review of the Current Literature
Authors: Crino Stefano Francesco , Rimbaș Mihai , Gabbrielli Armando , Larghi Alberto
Published: September 2019

Interventional endoscopic ultrasound (EUS) is a rapidly expanding field with a wide variety of indications, including different drainage procedures and delivery of locoregional treatment mainly for pancreatic solid tumors. Transgastric or transduodenal gallbladder drainage in high-risk patients with acute cholecystitis or biliary decompression in patients with unresectable distal biliary malignant obstruction who failed endoscopic retrograde colangiography is one of the newest areas of EUS-guided intervention. The large-caliber lumen apposing metal stents placed during these procedures allow direct endoscopic gallbladder access and the possibility of performing gallstone treatment or resection of mucosal polyps. The current review presents the indications of endoscopic gallbladder interventions and discusses the results of available studies, foreseeing future potential applications.
Exertional heat stroke associated with acute liver failure in a young refugee. Implications in the era of social-economic crisis
Authors: Politis Dimitrios S. , Baltagiannis Gerasimos , Tzampouras Nikolaos , Kalambokis George N , Koulouras Vasileios , Christodoulou Dimitrios K
Published: September 2019

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Step layered combination of noninvasive fibrosis models improves diagnostic accuracy of advanced fibrosis in nonalcoholic fatty liver disease
Authors: Yang Mei , Jiang Lina , Wang Yijin , Li Xi , Zou Zhengsheng , Han Tao , Nan Yuemin , Lu Fengmin , Zhao Jingmin
Published: September 2019

Background and Aims: Liver fibrosis is stage-dependently associated with non-alcoholic fatty liver disease (NAFLD) progression. The increased awareness of non-invasive diagnosis has led to the establishment of many fibrosis diagnosis models with various accuracies. We aimed to evaluate the diagnostic performance of nine clinical non-invasive fibrosis models in NAFLD and provide an optimal diagnostic method for advanced fibrosis by step layered combination of non-invasive models.

Methods: 453 consecutive patients with biopsy-proven NAFLD were enrolled from three centers and were divided into study cohort and validation cohort randomly. Aspartate aminotransferase-to-platelet ratio index (APRI), BARD, FiB-4, FibroMeter NAFLD, Forns’ Index, Hui model, non-invasive Koeln-Essen- index (NIKEI), S Index and NAFLD fibrosis score (NFS) were calculated. The high area under the receiver operating characteristic curve (AUROC) models were stepwise combined for further diagnosing NAFLD advanced fibrosis.

Results: All models had good performance with high negative predictive value (NPV) and specificity for diagnosing fibrosis, while positive predictive value (PPV) and sensitivity were low. APRI, BARD, FibroMeter NAFLD and NIKEI had higher AUROCs and their step layered combination for diagnosing advanced fibrosis showed high specificity, sensitivity, NPV and PPV up to 89.13%, 72.50%, 74.36%, and 88.17%, which also performed well in the validation cohort.

Conclusions: APRI, BARD, FibroMeter NAFLD and NIKEI had better diagnostic accuracy, and could be preferred for diagnosing NAFLD fibrosis. The step layered combination of these models performed much better than each single scoring system for diagnosing advanced fibrosis, provides valuable reference for clinical practice and might be a potential substitution of liver biopsy.
A főúri lakóhelyek társasági és gyűjteményes tereinek funkcionális elrendezése a 18–19. században
Authors: Fekete J. Csaba
Published: September 2019

A főúri lakóhelyek funkcionális rendszerében jól kifejeződik annak a társadalmi kapcsolati hálónak a szerkezete, amelybe a tulajdonosok háza (udvar- vagy háztartása) beágyazódik. A 19. század folyamán a főnemességet ért társadalmi változások (hivatali állások vállalása, politikai működés, részvétel gazdasági vállalkozásokban stb.) a köz- és magánszféra, az intim és a nyilvános funkciók határozott szétválását eredményezték. Ennek leglátványosabb megnyilvánulása, hogy a magánlakosztályok nyilvánossága és közéleti szerepe jórészt megszűnt, és ezt a társasági terek számban jelentősen megnőtt csoportja vette át. A főnemesi réteg ugyanis olyan tágas, külön saját életvitelt lehetővé tevő mozgástérrel rendelkezett, ahol párhuzamosan a férjnek és a feleségnek külön érintkezési körei lehettek. Az illem, a konvenció és a reprezentációs kötelezettségek azonban megköveteltek bizonyos érintkezést a házastársak között is, és a kapcsolatoknak ez a társadalmilag elvárt minimuma szabhatott korlátokat mindkettőjük életének. Ez határozta meg a nemzedékeket átfogó egység, a ház jelentéstartalmában kifejeződő, a férj és a feleség közötti nyilvánosan legitimált társadalmi kapcsolatot. A társasági terek, a fogadóhelyiségek, vendéglakrészek elrendezése, száma és kiterjedése a tulajdonosok rangszerű, a nyilvános közösségbe való beleszövődésének módját és mértékét tükrözi. A társasági terek kialakítása pontosan meghatározott társadalmi jelentéssel bírt, ezek a ház urának és úrnőjének szűkebb érintkezési köre számára voltak fenntartva. Itt fogadták azokat, akik rövid vendégségbe érkeztek, amikor a látogatások nem elsősorban a reprezentációt szolgálták, hanem inkább a kényelmes, bensőséges és az etikett szempontjából kevéssé kötött társasági együttlétet, szalonéletet. Az ebédlő ezzel szemben annak a sajátos, nyilvános társadalmi állásnak a jelképe volt, amelyet a tulajdonosok a főnemesség hierarchiájában elfoglaltak. Az ebédlő és az ehhez kapcsolódó vendéglakosztály lehetett alkalmas a rangban egyenlők vagy a magasabban állók hivatalos látogatásainak fogadására, utóbbi pedig elhelyezésére, elszállásolására. Az 1790-es évektől a számban megszaporodó, funkciójában specializálódó társasági és integrálódó gyűjteményes rendeltetések lineáris sorának differenciált beosztása alakult ki, amely ezeket a lakófunkcióktól a korábbinál jóval karakteresebben elválasztotta. A 19. században így a társasági funkciók teljesen vagy részben a lakófunkcióktól differenciáltan, a példák döntő többségénél a földszintre osztva, gyalogos feltárással jelentek meg. Az 1810-es években, a lineáris struktúrában kialakuló rendeltetéscsoport eredményezte több társasági helyiség egyidejű, központi feltárásának igényét, amely e hagyományos struktúra jelentőségét adta a korszakban. A nagyszámú társasági rendeltetést differenciáltan befoglaló centrális, háromtraktusos térstruktúrák kialakulása az 1850-es évektől volt jellemző, míg a lineáris kétmenetes elrendezések hagyományosnak tekinthetők a korszakban.