bluuebunny/crossref_metadata_2025 huggingface dataset:
Gambaran Drug Related Problems (DRP’s) pada Penatalaksanaan Pasien Stroke Hemoragik dan Stroke Non Hemoragik di RSUD Dr M Yunus Bengkulu
Authors: Handayani Dian , Dominica Dwi
Published: August 2019

Pendahuluan: Stroke merupakan penyakit serebrovaskular yang menjadi penyebab utama kematian yang sering terjadi di Indonesia. Jumlah penderita stroke di seluruh dunia yang berusia dibawah 45 tahun terus meningkat. Adanya penyakit penyerta serta berbagai faktor resiko pasien stroke mengakibatkan pasien akan sering mengkonsumsi lebih dari dua macam obat dan dapat berisiko pada ketidakefektifan pengobatan dan memungkinkan terjadi drug related problems (DRPs). Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran kejadian DRPs pada pasien stroke yang menjalani pengobatan di poli saraf RSUD Dr M Yunus Bengkulu. Metode: Penelitian ini dilakukan dengan metode cross sectional secara prospektif pada pasien rawat jalan di poli saraf selama 2 bulan. Subjek yang memenuhi kriteria inklusi sejumlah 89 pasien. Kriteria eksklusi adalah pasien yang tidak bersedia terlibat hingga akhir penelitian dan tuli. Pengumpulan data dilakukan dengan melakukan wawancara dan pengisian kuesioner kualitas hidup menggunakan Short Form 36 (SF-36). Hasil: Dari 89 pasien stroke sebanyak 85 pasien (95,5%) menderita stroke non hemoragik, kejadian drug related problems (DRP’s) pada pasien stroke di poliklinik rawat jalan RSUD Dr M Yunus Bengkulu meliputi: ada indikasi yang tidak diterapi sebanyak 20 kasus (22,5%), obat yang tidak diperlukan sebanyak 3 kasus (3,4%), efek samping obat sebanyak 4 kasus (4,5%), dan pemilihan obat yang tidak tepat sebanyak 4 kasus (4,5%). Tidak ada hubungan antara faktor risiko umur dan jumlah obat yang diterima pasien dengan kejadian drug related problems (DRP’s), ada hubungan antara kualitas hidup pasien stroke dengan drug related problems (DRP’s) pada domain keadaan fisik. Kesimpulan: Jenis stroke yang paling banyak terjadi di RSUD Dr M Yunus Bengkulu adalah stroke non hemoragik sebanyak 85 pasien (95,5%). Kejadian drug related problems (DRP’s) pada pasien stroke di poliklinik rawat jalan RSUD Dr M Yunus Bengkulu terjadi sebesar 31 kasus. Jenis drug related problems (DRP’s) yang terjadi meliputi ada indikasi yang tidak diterapi sebanyak 20 kasus (22,5%), ada obat yang tidak perlu sebanyak 3 kasus (3,4%), efek samping obat sebanyak 4 kasus (4,5%), dan pemilihan obat yang tidak tepat sebanyak 4 kasus (4,5%). Tidak ada hubungan antara faktor risiko umur dan jumlah obat yang diterima pasien dengan kejadian drug related problems (DRP’s). Terdapat hubungan antara kualitas hidup pasien stroke dengan drug related problems (DRP’s) pada domain keadaan fisik.
Efektivitas Penggunaan Kombinasi Vitamin B pada Pasien Neuropati Diabetikum
Authors: Pinzon Rizaldy Taslim , Sanyasi Rosa De Lima Renita
Published: August 2019

Pendahuluan: Neuropati diabetikum (ND) adalah salah satu bentuk neuropati yang paling umum dijumpai. Terapi yang ada saat ini lebih ditujukan untuk mengatasi gejala. Pemberian kombinasi vitamin B ditujukan bukan hanya untuk mengendalikan gejala, namun memperbaiki fungsi saraf. Penelitian terdahulu tentang vitamin untuk neuropati diabetika masih terbatas dan belum konklusif. Tujuan: Penelitian ini bertujuan untuk menilai efektivitas vitamin B kombinasi terhadap gejala klinis neuropati diabetika dan kualitas hidup (QoL) pada pasien diabetes melitus (DM). Metode: Metode yang digunakan dalam penelitian ini adalah metode penelitian observasional pada pasien DM dengan ND. Setiap subjek memperoleh vitamin B kombinasi yang terdiri dari vitamin B1, vitamin B6, dan vitamin B12 dengan dosis masing-masing secara berurutan 100 mg, 100 mg, dan 5 mg. Gejala klinis ND dinilai dengan menggunakan Total Symptom Score (TSS). QoL dinilai dengan menggunakan kuesioner SF-8. Penilaian dilakukan sebanyak 5 kali, yaitu penilaian awal hingga 3 bulan. Hasil: Total terdapat 104 subjek pada awal penelitian. Tujuh subjek tidak dapat mengikuti penelitian sampai selesai, sehingga tersisa 97 subjek pada akhir penelitian. Terdapat perbaikan berbagai gejala ND, yang meliputi sensasi nyeri tertusuk, sensasi nyeri terbakar, kesemutan, dan rasa kebas/baal, setelah pemberian vitamin B kombinasi. Perubahan tersebut bermakna secara statistik (p < 0,0001). Hal serupa juga tampak pada QoL. Terdapat perbaikan QoL dari awal penelitian hingga akhir penelitian. Perbedaan tersebut bermakna secara statistik (physical component summary dengan p < 0,0001 dan mental component summary dengan p = 0,0001). Kesimpulan: Vitamin B kombinasi efektif untuk memperbaiki gejala klinis dan meningkatkan kualitas hidup pada pasien ND.
Formulasi dan Evaluasi Hidrogel Mukoadhesif Metronidazol Menggunakan Kombinasi Kitosan dan Natrium Karboksimetilselulosa Menggunakan Desain Faktorial
Authors: Fahrurroji Andhi , Setyawan Agus , Wijianto Bambang
Published: August 2019

Pendahuluan: Metronidazol merupakan suatu antibiotik yang biasa digunakan dalam mengobati infeksi Helicobacter pylori. Metronidazol mempunyai kelarutan yang tinggi dalam asam.  Untuk mengoptimalkan kelarutan tersebut maka dibuatlah hidrogel mukoadhesif yang dapat mempertahankan waktu tinggal di lambung lebih lama sehingga terapi infeksi H.pylori lebih optimal. Tujuan: untuk mendapatkan formula optimum dari hidrogel dengan kombinasi polimer kitosan dan natrium karboksimetilselulosa yang dapat mengontrol pelepasan metronidazol secara in vitro. Metode: Metode yang digunakan untuk memprediksi formula optimum menggunakan desain faktorial. Rancangan formula awal untuk memprediksi formula optimum terdiri dari 4 formula dengan perbandingan polimer kitosan dan natrium karboksimetilselulosa berturut-turut 0,5:1,5; 1,0:1,5; 0,5:3,0; dan 1,0:3,0. Hasil: Variasi konsentrasi dari Na-CMC dan kitosan dapat mempengaruhi pelepasan obat, yakni pada formula I dengan kinetika pelepsan obat mengikuti kinetika higuchi dan mekanisme pelepasan mengikuti mekanisme difusi fickian. Sedangkan, pada formula 4 memiliki sediaan fisik yaitu kekuatan mukoadhesif yang paling tinggi dibandingkan formula yang lain karena adanya peningkatan konsentrasi kitosan dan natrium karboksimetilselulosa (Na-CMC). Sehingga kombinasi antara kitosan dan Na-CMC dapat menjadi model pelepasan metronidazol dari matriks hidrogel yakni pada rentang 55,633% - 68,319% dalam waktu 240 menit. Hasil observasi menunjukkan formula optimum dengan perbandingan polimer kitosan dan natrium karboksimetilselulosa sebesar 1,0% (kitosan) dan 3,0% (natrium karboksimetilselulosa), dengan respon untuk kemampuan mengembang sebesar 96,95%; kekuatan mukoadhesif sebesar 0,1911 N/cm2; pelepasan obat sebesar  67,457%. Berdasarkan uji independent sampel t-test pada program SPSS 22 trial menjelaskan bahwa formula hasil observasi tidak berbeda siginifikan dengan hasil prediksi (p-value > 0,05). Kesimpulan: Hasil menunjukkan bahwa metode desain faktorial dapat digunakan untuk menentukan formula optimum dari hidrogel mukoadhesif metronidazol.
Occurrence, Distribution and Ecological Risk of Bisphenol Analogues in The Surface Water from A Water Diversion Project in Nanjing, China
Authors: Zheng Chaoya , Liu Jianchao , Ren Jinghua , Shen Jie , Fan Jian , Xi Ruiyu , Chen Wei , Chen Qing
Published: August 2019

Because of the widespread use of bisphenol analogues (BPs) as the alternatives to bisphenol A (BPA), they have attracted considerable attention for health risk in aquatic ecosystems. The occurrence and distribution of six BPs were researched in soluble phase (< 5 kDa), colloidal phase (5 kDa to 1 µm) and suspended particulate matter (SPM > 1 µm) in a water diversion project of Nanjing, China. Except for bisphenol Z, all BPs were detected in the two or three phases, the total concentrations of detected BPs were 161-613 ng/L, 5.19-77.2 ng/L and 47.5-353 ng/g for the soluble phase, colloidal phase and SPM, respectively. Among the detected compounds, BPA still the dominant BPs in the soluble and colloidal phases, followed by BPS, while BPAF was the major contaminant in SPM, followed by BPA. The mean contribution proportions of colloids were 1-2 orders of magnitude higher than SPM, suggesting that colloids have an obvious impact on regulating BPs’ environmental behaviors. In terms of spatial distribution, although the water diversion project could reduce the pollution levels of BPs, which might further affect the ecological security of the Yangtze River.
Self-Supervised Contextual Keyword and Keyphrase Retrieval with Self-Labelling
Authors: Sharma Prafull , Li Yingbo
Published: August 2019

In this paper we propose a novel self-supervised approach of keywords and keyphrases retrieval and extraction by an end-to-end deep learning approach, which is trained by contextually self-labelled corpus. Our proposed approach is novel to use contextual and semantic features to extract the keywords and has outperformed the state of the art. Through the experiment the proposed approach has been proved to be better in both semantic meaning and quality than the existing popular algorithms of keyword extraction. In addition, we propose to use contextual features from bidirectional transformers to automatically label short-sentence corpus with keywords and keyphrases to build the ground truth. This process avoids the human time to label the keywords and do not need any prior knowledge. To the best of our knowledge, our published dataset in this paper is a fine domain-independent corpus of short sentences with labelled keywords and keyphrases in the NLP community.
“Is There a Doctor on Board?” The Plight of the In-Flight Orthopaedic Surgeon
Authors: Scollan Joseph P. , Lee Song-Yi , Shah Neil V. , Diebo Bassel G. , Paulino Carl B. , Naziri Qais
Published: August 2019

» The most common in-flight medical emergencies are syncope, gastrointestinal distress, and cardiac conditions that include arrhythmias and cardiac arrests. Treatment algorithms for these emergencies are important to review and are included in this article.

» If confronted with a challenging in-flight medical emergency in which an orthopaedic surgeon believes that he or she is unable to offer sufficient help, consulting with ground-based physicians hired by the airlines is always an appropriate and readily available option.

» While providing care to the patient, the doctor is absolved from liability unless the care offered is grossly negligent and/or deliberately harmful.

» If the aircraft is registered in or is departing from countries within the European Union block or Australia, or if the patient is a citizen of one of those international bodies, the doctor is legally required to assist.
Influence of Salt Tectonics On Fault Displacements and Submarine Slope Failures from Algeria To Sardinia
Authors: Yeakley Julia A. , Shakoor Abdul , Johnson William
Published: August 2019

We used previously obtained marine geophysical and geotechnical data for the proposed Galsi pipeline route from Algeria to Sardinia to analyze the buried salt distribution, rates of fault displacements, and frequency and lateral extent of submarine slope failures. Crossing the convergent African/Nubian–European plate boundary, the southern section of the pipeline route traverses continental shelves and slopes of Algeria and Sardinia as well as the Algerian abyssal plain of the western Mediterranean. Deeply buried Messinian-aged salt is present throughout this area. Being less dense and more buoyant than the overburden sediment, the salt tends to flow upward to form diapiric structures that, in turn, result in the formation of faults and landslides in the overlying sediment. Measured offsets from seismic profiles of different resolutions were compared with predicted sediment age at depth of each offset, yielding an average rate of fault displacement of 1.5 cm/kiloyear (ky). The highest rates of displacement are along the Cagliari slope near Sardinia (2.5-2.7 cm/ky) and near the convergent plate boundary (2.3 cm/ky). Utilizing the same geophysical data, the frequency and lateral extent of submarine slope failures in the study area can also be linked to the distribution of salt and the influence of salt tectonics. Turbidity currents and hyperpycnal flows are present within the Algerian basin, whereas local debris flows, landslide runouts, and channelized debris flows are present along the Sardinian slope. The low sedimentation rates, determined in this study, suggest that the most recent slope failures related to salt tectonics occurred more than 12,000 years ago.
Immune Cell Infiltration in Bladder Cancer
Authors: liu shanhui , Li Lanlan , Wu Shan , He Wei , Lu Jianzhong , Tao Yan , Zhang Jing , Fu Shengjun , Wang Zhiping
Published: August 2019

Background Bladder cancer is one of the most common malignant diseases with high recurrence rates worldwide. Although immunotherapy has been applied in bladder cancer for a long period of time, the tumor-infiltrating immune cells (TIICs) in bladder cancer has not been systematical investigated.
Methods CIBERSORT, a versatile computational method for quantifying cell fractions from bulk tissue gene expression profiles (GEPs), was applied to calculate the TIICs fraction proportion in normal bladder tissues and in bladder cancer tissues with the TCGA data.
Results compared to normal bladder tissue, B cells naïve, T cells CD4 memory resting and Mast cells resting fractions proportion decreased, and NK resting, macrophages M0 and macrophages M1 increased. In BLCAs tissue, pro-tumorigenic related immune cells were negatively correlated with anti-tumor immune cells. New tumor with locoregional had high fraction proportion of macrophages M0 and macrophages M1. Dendritic cells activated, Monocytes, macrophages M1, Tregs and T cells follicular helper significantly increased in low grade BLCAs. Tregs had a high proportion in BLCAs patients accepted low radiation dose.
Conclusions This study indicates that macrophages M2 and Tregs could be the promising immunotherapy targets combined radiotherapy in BLCAs. The result provides valuable information to understand the immunity status in BLCAs.
No Observed Risk of Pregnancy and Maternal-Fetal Transmission of Zika Virus Following Blood Transfusion
Authors: DeGiorgi Valeria , Tan Jennifer , Fowler Sarah , Maciejewski Sonia , Gordon David , Alter Harvey J. , Allison Robert D
Published: August 2019

BACKGROUND: Zika virus (ZIKV) is primarily mosquito-borne, but can also be transfusion- and sexually transmitted. Maternal-fetal transmission may result in fetal loss or severe congenital defects. METHODS: We surveyed blood recipients enrolled in a donor-recipient-linked study of transfusion-transmitted infections to assess potential risk of ZIKV maternal-fetal transmission following transfusion. Participants were tested for antibodies to ZIKV, dengue and chikungunya viruses. Positive serology from post- and pre-transfusion samples and from linked donors were tested using real-time PCR. RESULTS: The mean age of female recipients was 65 years (36-80). Only one was < 50 years. None reported having sexual intercourse within the first month and none became pregnant within six months following transfusion. Male recipients were a mean 62 years of age (31-81). Twenty percent of males had sexual intercourse with a female partner within three months of transfusion; no pregnancies resulted. Females and males most commonly reported that they were no longer sexually active or felt too ill after transfusion. All of the respondents were IgM and RT-PCR negative. CONCLUSIONS: Our survey of blood recipients, combined with derived data and the literature, suggest that most transfused women are beyond the age of likely pregnancy and most transfused women and men are too infirm from the underlying condition to engage in sex. However, 20% of male recipients did report having sexual intercourse during the ZIKV infectious period.
Antimicrobial Susceptibility Profile of Gonococcal Isolates Obtained from Men Presenting with Urethral Discharge: Implication for National Syndromic Treatment guideline
Authors: Dinku Surafel Fentaw , Abubeker Rajiha , Asamene Nega , Assefa Meseret , Tigabu Eyasu
Published: August 2019

Background: Neisseria gonorrhoeae (gonococcus) is one of etiologic agent for sexually transmitted diseases with high global significant public health importance. The treatment regimens for gonorrhea have changed frequently over the past few decades due to the organism’s propensity for developing antibiotic resistance. This study was aimed to investigate quinolones, third-generation cephalosporins and other relevant antimicrobials susceptibility patterns of N. gonorrhoeae so that the national treatment regimen could be revised based on the information generated from this study.
Methods: Urethral discharge specimens were cultured on Modified Thayer Martín media and suspected gonococcal colonies were confirmed using Oxidase, Superoxol tests followed by commercial identification kit (API-NHR). Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method using ciprofloxacin(5ug), ceftriaxone (30ug), cefixime(5ug), cefoxitin (30 ug), and spectinomycin (100 ug), on enriched GC agar. Minimum Inhibitory Concentration (MIC) was also done using concentration gradient strips (E-test) of the same antimicrobial agents.
Results: The prevalence of gonococcal isolates from the current study was 69%. Out of the 361 gonococcal isolates, close to 68% were fluoroquinolone non susceptible with 60% resistant and 7% intermediate status. However, there was no detection of ceftriaxone non susceptible gonococcal isolates. The isolates also showed reduced non susceptible to spectinomycin and cefoxitin.
Conclusion: The prevalence of gonococcal isolates from the current study was high. There was a high level of fluoroquinolone resistance in gonococcal isolates recovered in this study.

Key words: Neisseria gonorrhoeae, Ciprofloxacin, Ceftriaxone MIC, Ethiopia
Prevalence, antimicrobial resistance and staphylococcal toxin gene of blaTEM-1a-producing Staphylococcus aureus isolated from animals in Chongqing, China
Authors: Wang Haoju , Chen Yao , Jia Xiaomei , Ding Honglei
Published: August 2019

Background

Livestock-associated Staphylococcus aureus is one of the most important etiological agents in both human and animals. It has been reported with high antimicrobial resistance and multiple staphylococcal superantigen genes in many countries and several provinces of China. However, large-scale investigation of this organism has not been documented in Chongqing, China. The aim of this study is to demonstrate the prevalence, antimicrobial susceptibility and some molecular characteristics of S. aureus acquired from animals in Chongqing.

Results

A total of 89 S. aureus isolates were cultured from 1371 samples picked up from March 2014 to December 2017. The isolates were originated from pigs (25), cattle (6), goats (10), rabbits (16) and chicken (32). Four MRSA strains were identified from 3 pig samples and 1 chicken sample. The isolates showed high resistance to penicillin (93.3%) and ampicillin (92.1%), but were more susceptible to amikacin and ofloxacin, since the resistance rates of these two drugs were less than 10%. Meanwhile, 74.2% isolates exhibited varying degree of MDR. Almost all strains, except for 3 chicken-originated isolates, were positive for blaTEM-1a, but did not harbor other ESBL genes. Nineteen staphylococcal SE/SEl/TSST-1 genes, except seq, were detected in isolates. The predominant genes were sei (58.4%), tst-1 (56.2%) and seg (51.7%).

Conclusions

The high antimicrobial resistance and prevalence of blaTEM-1a seriously reminded that it was urgent to standardize and cut down the usage of antimicrobials. The universal existence of staphylococcal toxin genes in isolated strains implied a potential threat of public health from animals to human through the food chain.
Prevalence and risk factors of myopia in Han and Yugur older adults in Gansu, China：a cross-sectional study
Authors: Wang Xuqian , He Huijing , Wang Xujiao , Shan Guangliang , Pan Li , Tao Zhiyan , Li Jun , Ren Xiaolan , Zhao Hongjun , Pan Zhouxian , Wang Meng , Zhong Yong , Ma Jin
Published: August 2019

Background

Few studies have investigated the prevalence of myopia in Northwest China. This study aimed to investigate the prevalence and risk factors of myopia and high myopia in adults aged 40-80 years in Han and Yugur ethnicities living in Gansu Province, Northwest China.

Methods

The cross-section study is part of the China National Health Survey (CNHS), which was conducted in 2016, Gansu Province. We compared the age- and sex-standardized prevalence of myopia, high myopia and hyperopia in Han and Yugur participants. Risk factors for myopia and high myopia were identified using multivariable logistic regression models.

Results

3845 participants were included. The overall adjusted prevalence of myopia (spherical equivalent (SE)<-0.5 D), high myopia (SE<-6.0D) and hyperopia (SE>+0.5D) were 16.4%, 0.7% and 26.2% in Yugur, and 34.3%, 5.0% and 19.2% in Han. In the multivariable logistic regression model, Han ethnicity (Odds Ratio(OR),0.56; 95% confidence interval (CI): 0.45-0.69), P<0.001), birth in rural areas (OR,0.69; 95%CI: 0.56-0.85, P<0.001), higher education level (OR,1.48; 95%CI:1.18-1.85, P=0.001for middle/high school group and OR, 3.62; 95%CI:2.73-4.82, P<0.001 for Undergraduate/graduate group), indoor work (OR, 0.64; 95%CI: 0.51-0.80, P<0.001), smoking history (OR, 0.69; 95%CI: 0.52-0.90, P=0.007) and a family history of myopia (OR,2.83; 95%CI: 1.22-6.51, P=0.015 for one patient) were found to be associated with myopia. The risk factors of high myopia included Han ethnicity (OR, 0.33; 95%CI: 0.15-0.73, P=0.006), 50-59 age group (OR, 0.65; 95%CI:0.43-1.0, P=0.049), 60-69 age group (OR,0.49; 95%CI: 0.25-0.97, P=0.039), birth in rural area (OR, 0.61; 95%CI: 0.40-0.94, P=0.025) and a family history of myopia (OR, 4.32; 95%CI: 1.74-10.7, P=0.002 for one patient; OR, 22.3; 95%CI: 2.41-206.1, P=0.006 for both patients).

Conclusion

The prevalence of myopia and high myopia in Han adults aged 40-80 was significantly higher than that in Yugur. The risk factors of myopia included Han ethnicity, birth in rural area, higher education level, indoor work and a family history of myopia. This study provided valuable information on risk factors of myopia and revealed an ethnic disparity on the susceptibility of myopia, which would be useful in identifying high-risk population and initiating more targeted strategies preventing myopia in China.
Development and Validation of the Study Quality Assessment of Design (SQUAD) Tool for Systematic Reviews
Authors: Tierney Aaron , Haverfield Marie , Bharadwaj Shreyas , Zulman Donna
Published: August 2019

Background

Despite consensus about the need to assess study design quality in systematic reviews, there remains a need for practical tools that can be used for quality assessment across diverse study designs.

Methods

We developed the Study Quality Assessment of Design (SQUAD) tool by combining and streamlining the Cochrane tool for grading randomized controlled trials and the risk of bias criteria developed for Effective Practice and Organisation of Care (EPOC) reviews. We validated the tool and refined it through a four-iteration pilot. We then used the tool to evaluate the quality of studies in a systematic review of the effects of interpersonal interventions on Quadruple Aim outcomes (i.e., population health, cost, patient and provider experience).

Results

During a pilot with 12 studies (8 randomized controlled trials and 4 observational studies), the ICC (1,1) improved from 0.41 to 0.89. In the systematic review of 77 studies (68 randomized control trials and 9 observational studies), the ICC (2,1) was 0.72.

Conclusions

SQUAD is a practical and reliable tool for assessing the quality of studies of various designs when synthesizing findings for systematic reviews. Standardized practices for quality assessment are critical to the reliability of systematic reviews. This pragmatic and standardized tool can facilitate efficient and high-quality assessments for a broad range of studies.
Characteristics and outcomes of patients after multiple (≥3) catheter ablation procedures for atrial fibrillation
Authors: Wang Hao , Chen Jindong , Zhou Mengmeng , Zhao Liang
Published: August 2019

Background: Many atrial fibrillation (AF) patients require more than one radiofrequency catheter ablation (RFCA) procedure to maintain sinus rhythm. This study aimed to evaluate risk and risk factors of atrial tachyarrhythmia (ATa) recurrence in patients undergoing multiple (≥3) RFCA procedures for AF.
Methods: This single-center, retrospective, observational study enrolled 118 consecutive patients who underwent multiple ablation procedures for paroxysmal and non-paroxysmal AF with circumferential pulmonary vein ablation (CPVA), and bidirectional block of lines with disappearance of complex fractionated atrial electrograms (CFAEs) as index procedural endpoints, respectively.
Results: At a median follow-up of 18 (range, 6-91) months after the last procedure (mean, 3.2 procedures), freedom from ATa recurrence was 40.7% (48/118). Initially diagnosed non-paroxysmal AF (P=0.039), baseline LA size (P=0.044), and recurrent AF after the second procedure (P=0.044) were univariate predictors of ATa recurrence, while only the latter (P=0.010) was an independent multivariate predictor (hazard ratio for ATa recurrence of 1.88 [95% CI, 1.16-3.05]. Conversion of recurrent types between AF and AFL/AT occurred in 52.9% (37/70) of patients with ATa recurrence, and 29.2% (14/48) of patients with sinus rhythm after last procedure. Few patients (7.8% [20/257]) recovered PV potential induced recurrent ATa during multiple procedures, and most (87.6% [141/161]) were bystanders of recurrent ATa.
Conclusions: Multiple (>3) RFCA for paroxysmal or non-paroxysmal AF yielded unsatisfactory ATa recurrence rates with recurrent AF after the second procedure as multivariate predictor and recovered PV potential as a bystander commonly as underlying mechanism. Conversion of recurrent types between AF and AFL/AT was common.
The Prognostic Significance of Different Bleeding Classifications in Off-pump Coronary Artery Bypass Grafting
Authors: Xi Ziwei Xi , Gao Yanan , Yan Zhenxian , Zhou Yujie , Liu Wei
Published: August 2019

Background: Perioperative bleeding during cardiac surgery are known to make patients susceptible to adverse outcomes and several bleeding classifications have been developed. Further validation of different classifications was needed.

Objectives: The aim of present study was to validate and explore the prognostic value of different bleeding classifications in patients undergoing off-pump coronary artery bypass grafting (OPCAB).

Methods: Data on baseline and operative characteristics of 3,988 patients who underwent OPCAB in Beijing Anzhen Hospital from February 2010 to December 2014 were available. The primary endpoint was composite of in-hospital death and postoperative myocardial infarction (MI). The secondary endpoint was postoperative acute kidney injury (AKI). We explored the association of major bleeding defined by the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Bleeding Academic Research Consortium (BARC) classification and Study of Platelet Inhibition and Patient Outcomes (PLATO) with primary endpoints by using multivariable logistic regression analysis and investigated their significance of adverse event prediction using goodness-of-fit tests of -2 log likelihood.

Results: Baseline characteristics of 3,988 consecutive patients were summarized in Table 1. In-hospital mortality was 1.23% (n=49) and postoperative MI was observed in 5.01% (n=200) of patients, AKI in 24.69% (n=985). The incidence of the primary outcome was 5.99% (n=239). Multivariable logistic regression analysis showed that BARC type 4 (OR=2.64, 95% CI: 1.66–4.19, P<0.001), UDPB class 4 (OR=3.52, 95% CI: 2.05–6.02, P<0.001) and E-CABG class 2-3 (class 2: OR=2.24, 95% CI: 1.36–3.70, P=0.001; class 3: OR=12.65, 95% CI: 2.74–18.43, P=0.002) bleeding but not PLATO bleeding were associated with an increased risk of in-hospital death and postoperative MI. Major bleeding defined by all the four classifications mentioned above was an independent risk factor of AKI after surgery. Inclusion of major bleeding defined by these four classifications improved the predictive performance of the multivariable model with baseline characteristics.

Conclusions: Bleeding assessed by BARC, E-CABG and UDPB classifications were significantly associated with poorer immediate outcomes. These classifications seemed to be valuable tool in the assessment of prognostic effect of perioperative bleeding.
RISK FACTORS FOR MORTALITY AND TREATMENT OUTCOMES OF PATIENTS WITH CEFTRIAXONE RESISTANT E. COLI BACTEREMIA RECEIVING CARBAPENEM VERSUS BETA LACTAM/BETA LACTAMASE INHIBITOR THERAPY
Authors: Nasir Nosheen , Ahmed Sara , Razi Samrah , Awan Safia , Mahmood Faisal
Published: August 2019

Background:
Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumonia bacteremia have limited treatment options and high mortality.
Objective:
To determine the risk factors for in-hospital mortality particularly treatment with Carbapenem versus Beta lactam/beta lactamase combination (BL/BLI) in patients with Ceftriaxone resistant E. coli bacteremia.
Methods:
A retrospective descriptive study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with monomicrobial Ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis.
Results:
Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI: 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI: 0.11-0.58).
Conclusions:
In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality.
Comparison of GeneXpert and Line Probe Assay for Detection of Mycobacterium tuberculosis and Rifampicin-Mono resistance at the National Tuberculosis Reference Laboratory, Kenya
Authors: Aricha S.A. , King'wara Leonard , Mwirigi N.W. , Chaba Linda , Kiptai T. , Wahogo J. , Otwabe J.S , Onyango P.O. , Karanja Muthoni , Ayieko C. , Matu S.W.
Published: August 2019

Background:
The dual challenge of low diagnostic sensitivity of microscopy test and technical challenge of performing a TB culture test poses a problem for case detection and initiation of Tuberculosis (TB) second-line treatment. There is thus need for a rapid, reliable and easily accessible assay. This comparative analysis was performed to assess diagnostic performance characteristics of GeneXpert MTB/RIF and Line Probe Assay (LPA)
Methods:
329 sputum samples of patients across the 47 counties in Kenya suspected to have drug resistant TB were picked and subjected to GeneXpert, LPA and Culture MGIT at the National TB Reference Laboratory. Sensitivity, specificity and predictive values were then determined to assess the performance characteristics of the various assays.
Results:
Against culture MGIT as the gold standard for TB diagnosis, GeneXpert had a sensitivity, specificity, positive predictive value, and negative predictive value of 78.5%, 64.9%, 59.4 % and 82.2% respectively while LPA had 98.4%, 66.0 %, 65.4% and 98.4%. For diagnosis of rifampicin mono-resistance GeneXpert had a moderate agreement (Kappa=0.59, P<0.01) (sensitivity= 62.50%, specificity = 96.50 %) while LPA that had almost perfect agreement (Kappa= 0.89, p<0.01) with a (sensitivity= 90.0% and specificity= 99.1%).
Conclusion:
LPA has a better performance characteristic to GeneXpert and an alternative to culture with regards to detection of RIF’s mono-resistance.
Keywords:
LPA, GeneXpert, Sensitivity, Specificity, Drug-resistant TB
Readiness of the education manager to provide the organizational development of institutions (based on the sociological research)
Authors: Semenets-Orlova Inna , Klochko Alla , Nestulya Svitlana , Mykhailych Oleksandr , Omelyanenko Vitaliy
Published: August 2019

The article contains the analysis of scientific approaches to understanding of organizational development in the field of educational institutions management as a complex of successive educational changes. Scientific researches on the change of education managers’ behavior in the course of changes are presented.Types of education managers attitude to changes and their quantitative expression were determined and revealed based on the data of an empirical research. Almost half of the surveyed education managers are represented by such types as “traditionalist” and “realist”, which indicates the insufficient orientation of education managers in introducing innovative changes in educational institutions. This indicates a low level of education managers’ readiness to provide the organizational development of educational institutions. The results obtained can be used by the government in developing and implementing the programs for the professional development of education managers. The authors offer the most practical tools for implementing the concept of organizational development. It is proposed to distinguish between special requirements for both professional and personal qualities of education managers.
América Latina: uma integração regional agônica? A institucionalidade da integração regional E alguns de seus principais desafios
Authors: Vitte Claudete de Castro Silva
Published: August 2019

Esta pesquisa enfocou o Acordo Estratégico Transpacífico (TPP/TPP-11), a Aliança Bolivariana para os Povos de Nossa América-Tratado de Comércio dos Povos (Alba) e a Comunidade de Estados Latino-Americanos e Caribenhos (Celac), considerando a institucionalidade de cada organização e suas caracterizações. Na metodologia de pesquisa foi feito um balanço preliminar da literatura sobre organizações regionais e sobre os casos específicos, em tentativa de correlacioná-las entre si, observando semelhanças e diferenças. Como resultados, verificamos que a arquitetura regional latino-americana é complexa e o regionalismo latino-americano não vive seu melhor momento. Com crise econômica, os processos de integração regional na América Latina refluem. O cenário político mais instável na região também dificulta a integração regional.
A influência da geografia no comportamento eleitoral: contexto social de vizinhança
Authors: Zolnerkevic Aleksei
Published: August 2019

O tema de estudo que trata da influência da geografia nas eleições, mais especificamente da influência do contexto social ou “lugar” onde o eleitor vive, é pouco explorado pela literatura geográfica brasileira. O artigo apresenta as principais teorias sobre esse tema na literatura anglo-saxônica, buscando demostrar como o desenvolvimento das pesquisas nessa área no Brasil pode fazer com que a geografia alcance uma posição de maior destaque dentro dos estudos eleitorais. Por fim, apresentamos o resultado de uma pesquisa de survey na cidade de São Paulo, onde encontramos evidências da influência do contexto social de vizinhança no comportamento eleitoral.
Proposta metodológica para adequação das informações do Censo Demográfico do IBGE na análise da vulnerabilidade social a eventos extremos na zona costeira
Authors: Lima Cibele Oliveira , Bonetti Jarbas
Published: August 2019

Tendo em vista a intensificação dos efeitos dos eventos extremos nas zonas costeiras do Brasil, particularmente na Região Sul, são oportunos estudos que considerem a vulnerabilidade social das populações locais de forma a entender como estas podem ser mais ou menos afetadas por esses eventos. Neste sentido, diferentes estratégias para a caracterização da população sob risco e sua vulnerabilidade, tendo por base o uso de dados de censos demográficos, têm sido propostas por diversos autores, sobretudo ao longo das duas últimas décadas. Todavia, no país ainda é pequeno o debate relativo à seleção dos descritores mais efetivos e à representatividade espacial das amostragens censitárias disponíveis. Esse artigo tem por objetivo avaliar as limitações do uso de variáveis censitárias, através do desenvolvimento de uma metodologia capaz de ajustar o recorte espacial dos setores censitários do IBGE às áreas costeiras expostas a eventos extremos. Os resultados obtidos ilustram a importância de se realizar ajustes prévios quando da utilização dos setores censitários para estudos de vulnerabilidade social costeira.
Diagnóstico da gestão costeira e das políticas públicas do Município de São Francisco do Sul, SC, Brasil
Authors: Lima André de Souza de , Figueirôa Apoena Calixto , Coelho Victor Gabriel Zapelini Guião , Vieira Celso Voos , Lima Francisco Arenhart da Veiga , Scherer Marinez Eymael Garcia
Published: August 2019

Foram analisadas as ações relacionadas ao gerenciamento costeiro no município de São Francisco do Sul/SC para obter um panorama geral com relação à integração entre as secretarias municipais. Para isso, foi realizada a aplicação de um Decálogo, que consiste em dez temas chave que possibilitam a análise da estrutura pública municipal em relação ao gerenciamento costeiro. Para a análise foram realizadas reuniões com a prefeitura e consultas a documentos públicos e materiais cartográficos. Constatou-se que a prefeitura apresenta diversas iniciativas no setor ambiental, todavia é incipiente em relação ao gerenciamento costeiro integrado. Este conhecimento poderia dar as primeiras diretrizes para que seja possível o aperfeiçoamento dos atuais processos de gestão ambiental e a elaboração de uma Política de Gerenciamento Costeiro.
Weight Loss Trajectories After Bariatric Surgery for Obesity: Mathematical Model and Proof-of-Concept Study
Authors: Dimeglio Chloe , Becouarn Guillaume , Topart Philippe , Bodin Rodolphe , Buisson Jean Christophe , Ritz Patrick
Published: August 2019

Background

Obesity surgery has proven its effectiveness in weight loss. However, after a loss phase of about 12 to 18 months, between 20% and 40% of patients regain weight. Prediction of weight evolution is therefore useful for early detection of weight regain.

Objective

This proof-of-concept study aimed to analyze the postoperative weight trajectories and to identify “curve families” for early prediction of weight regain.

Methods

This was a monocentric retrospective study with calculation of the weight trajectory of patients having undergone gastric bypass surgery. Data on 795 patients after a 2-year follow-up allowed modeling of weight trajectories according to a hierarchical cluster analysis (HCA) tending to minimize the intragroup distance according to Ward. Clinical judgement was used to finalize the identification of clinically relevant representative trajectories. This modeling was validated on a group of 381 patients for whom the observed weight at 18 months was compared to the predicted weight.

Results

Two successive HCA produced 14 representative trajectories, distributed among 4 clinically relevant families: Of the 14 weight trajectories, 6 decreased systematically over time or decreased and then stagnated; 4 decreased, increased, and then decreased again; 2 decreased and then increased; and 2 stagnated at first and then began to decrease. A comparison of observed weight and that estimated by modeling made it possible to correctly classify 98% of persons with excess weight loss (EWL) >50% and more than 58% of persons with EWL between 25% and 50%. In the category of persons with EWL >50%, weight data over the first 6 months were adequate to correctly predict the observed result.

Conclusions

This modeling allowed correct classification of persons with EWL >50% and could identify early after surgery the patients with potentially less that optimal weight loss. Further studies are needed to validate this model in other populations, with other types of surgery, and with other medical-surgical teams.
The Reliability Model of Artificial Monitoring on the Anomalous Event in Expressway Tunnels and Monte Carlo Simulation
Authors: WU Ling , HU Yueqi , ZHAO Weihua , ZHU Tong
Published: August 2019

Artificial monitoring remains to be a major way to detect anomalous events in expressway tunnels. To estimate the reliability of artificial monitoring on anomalous events in expressway tunnels, the video surveillance and mobile inspection based reliability models of artificial monitoring on the anomalous event in the expressway tunnel were built, and Monte Carlo method was applied to calculate the probability and mean time to detect the anomalous event at the specific time. The results showed that the Monte Carlo method could simulate video surveillance and mobile inspection, and obtain the probability distribution and mean time of detecting anomalous events. The mean time to spot the anomalous event was in reverse relation with the number of inspectors, the time of mobile inspection, and the reliability probability of the monitoring pre-warning system in tunnels and was in positive relationships with the departure interval. Combined with the actual operation cost, the model serves as a basis for the artificial monitoring package.
 EL MURCIELAGO BLANCO (Diclidurus albus) EN CHIAPAS, MEXICO
Authors: Vidal López Roberto , Martínez Coronel Matías
Published: August 2019

Palabras clave: Diclidurus albus, Chiroptera, Selva Lacandona, Chiapas.
LA ARDILLA VOLADORA Glaucomys volans goldmani (NELSON, 1904) EN PUEBLA, MÉXICO
Authors: Castillo Meza Lucía , Gaona Salvador , García Chávez Juan
Published: August 2019

Palabras clave: Distribución, Glaucomys volans goldmani, Puebla, México.
EL TEPEZCUINTLE, Agouti paca (RODENTIA: AGOUTIDAE), EN TAMAULIPAS, MEXICO
Authors: Moreno Valdez Arnulfo , Lavín Murcio Pablo A. , Hinojosa Falcón Oscar M.
Published: August 2019

Palabras clave: Agouti paca, distribución, Tamaulipas, México.
NOTAS ACERCA DE LA DISTRIBUCIÓN DE ALGUNOS MAMÍFEROS DEL SUR DE NUEVO LEÓN, MÉXICO.
Authors: Zepeda Gonzalez José , Arroyo-Cabrales Joaquín , J. Polaco Oscar , Jiménez Guzmán Arturo
Published: August 2019

Palabras Clave: Mamíferos, distribución, ecología, Nuevo León, México.
Comparación morfométrica entre los conejos Romerolagus diazi, Sylvilagus floridanus y S. audubonii en México.
Authors: Cervantez Reza Fernando A. , Vargas Cuenca Julieta
Published: August 2019

Resumen. Se compararon los conejos Sylvilagus floridanus, S. audubonii y Romerolagus diazi de México para examinar la magnitud de sus diferencias morfométricas. Se evaluaron cinco variables somáticas y 29 variables craneales usando estadística univariada y multivariada. Se confirmó que las diferencias entre las tres especies son notables y debidas principalmente a variación en tamaño; sin embargo, se mantiene gran similitud fenotípica entre la especie grande y la chica. Se confirmó tambien que existen, aunque en menor proporción, diferencias en forma craneal entre las especies. Estas diferencias fueron más bien entre la especie intermedia en dimensiones con las especies de los extremos. En conjunto, las distancias morfométricas mayores son entre cualquiera de las dos especies de Sylvilagus y R. diazi. Por un escaso margen, la distancia entre S.floridanus y R. diazi resultó menor que la de este último con S. audubonii.Abstract. The rabbits Sylvilagus floridanus, S. audubonii y Romerolagus diazi from Mexico were examined to assess the extent of their morphometric differences. Five somatic and 30 cranial variables were analyzed using univariate and multivariate statistical procedures. It was confirmed that the most important differences among species were due to size despite the phenotypicsimilarity among these species. It was also confirmed that there were differences in cranial shape, although the species intermediate in size was the most distinctive in this regard. Overall the largest morphometric distances recorded were between the pair Sylvilagus - Romerolagus whereas the distance between S.floridanus and R. diazi is barely smaller than that between S. audubonii and R. diazi.Palabras clave: Morfometría, México, Lagomorpha, Leporidae, Romerolagus diazi, Sylvilagus audubonii, Sylvilagus floridanus.
Mamíferos de la Reserva de la Biósfera El Triunfo, Chiapas.
Authors: Espinoza Medinilla Eduardo , Anzures Dadda Alberto , Cruz Aldan Epigmenio
Published: August 2019

Resumen. Se elaboró una lista de los mamíferos silvestres de la Reserva de la Bíosfera "El Triunfo". Se colectaron en campo, entre mayo de 1994 y agosto de 1996, 136 ejemplares (píel y cráneo), 72 huellas en molde de yeso y 25 restos óseos. También se consultaron las bases de datos de nueve museos nacionales y extranjeros en los que existen 528 registros para la reserva. Se registraron 112 especies, 75 géneros, 26 familias y 10 órdenes. El 86.6% de las especies pertenecen a los órdenes Chiroptera, Rodentia y Carnivora. Así mismo 39 especies están clasificadas con alguna categoría de riesgo. Comparada con Los Tuxtlas, El Ocote y Montes Azules, El Triunfo tiene el menor porcentaje de similitud de especies (indice de Szymkiewicz-Simpson). Los datos aportados por el estudio pueden ser de utilidad en los planes de manejo de la reserva, pero deben ser completados con investigación sobre distribución y abundancia en diferentes tipos de vegetación.Abstract. We compiled a checklist ofwild mammals from "El Triunfo" Biosphere Reserve. From May 1994 to August 1996 we collected 136 specimens (skin and skull), 72 footprints gypsum molds and 25 fragments osseous. Were reviewed also data of9 Mexican and foreign museums in which 528 records are present. The checklist is composed of 112 species, 75 genus, 26 families and 10 orders. 86.6% of these species belong to Chiroptera, Rodentia and Carnívora Orders. 39 species are cIassified in one of the categories of conservation concern. Compared with Los Tuxtlas, El Ocote and Montes Azules reserves, the mastofauna richness of "El Triunfo", has the lowest percentage of similarity among species (Szymkiewicz-Simpson' s index). The data obtained from this survey, can be used as part ofthe management plans of this reserve. However must be completed with research about distribution and abundance in several kinds of vegetation.Palabras clave: El Triunfo, mamíferos, diversidad, conservación, Síerra Madre de Chiapas.