bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Efficacy of Volatile Anesthetic Agents Compared With Standard Intravenous Midazolam/Propofol Sedation in Ventilated Critical Care Patients: A Meta-analysis and Systematic Review of Prospective Trials
Authors: Jerath Angela , Panckhurst Jonathan , Parotto Matteo , Lightfoot Nicholas , Wasowicz Marcin , Ferguson Niall D. , Steel Andrew , Beattie W. Scott
Published: November 2016

BACKGROUND:

Inhalation agents are being used in place of intravenous agents to provide sedation in some intensive care units. We performed a systematic review and meta-analysis of prospective randomized controlled trials, which compared the use of volatile agents versus intravenous midazolam or propofol in critical care units.

METHODS:

A search was conducted using MEDLINE (1946–2015), EMBASE (1947–2015), Web of Science index (1900–2015), and Cochrane Central Register of Controlled Trials. Eligible studies included randomized controlled trials comparing inhaled volatile (desflurane, sevoflurane, and isoflurane) sedation to intravenous midazolam or propofol. Primary outcome assessed the effect of volatile-based sedation on extubation times (time between discontinuing sedation and tracheal extubation). Secondary outcomes included time to obey verbal commands, proportion of time spent in target sedation, nausea and vomiting, mortality, length of intensive care unit, and length of hospital stay. Heterogeneity was assessed using the I
2 statistic. Outcomes were assessed using a random or fixed-effects model depending on heterogeneity.

RESULTS:

Eight trials with 523 patients comparing all volatile agents with intravenous midazolam or propofol showed a reduction in extubation times using volatile agents (difference in means, −52.7 minutes; 95% confidence interval [CI], −75.1 to −30.3; P < .00001). Reductions in extubation time were greater when comparing volatiles with midazolam (difference in means, −292.2 minutes; 95% CI, −384.4 to −200.1; P < .00001) than propofol (difference in means, −29.1 minutes; 95% CI, −46.7 to −11.4; P = .001). There was no significant difference in time to obey verbal commands, proportion of time spent in target sedation, adverse events, death, or length of hospital stay.

CONCLUSIONS:

Volatile-based sedation demonstrates a reduction in time to extubation, with no increase in short-term adverse outcomes. Marked study heterogeneity was present, and the results show marked positive publication bias. However, a reduction in extubation time was still evident after statistical correction of publication bias. Larger clinical trials are needed to further evaluate the role of these agents as sedatives for critically ill patients.
Perioperative Anesthesia Care and Tumor Progression
Authors: Sekandarzad Mir W. , van Zundert André A.J. , Lirk Philipp B. , Doornebal Chris W. , Hollmann Markus W.
Published: November 2016

This narrative review discusses the most recent up-to-date findings focused on the currently available “best clinical practice” regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included. The results of several recently published systematic reviews looking at the association between cancer recurrences and regional anesthesia have yielded inconclusive data and provide insufficient evidence regarding a definitive benefit of regional anesthesia. Basic science data suggests an anti tumor effect induced by local anesthetics. New refined animal models show that opioids can safely be used for perioperative pain management. Preliminary evidence suggests that NSAIDs should be an essential part of multimodal analgesia. Volatile anesthetics have been shown to increase tumor formation, whereas preclinical and emerging clinical data from propofol indicate tumor protective qualities. The perioperative period in the cancer patient represents a unique environment where surgically mediated stress response leads to immune suppression. Regional anesthesia techniques when indicated in combination with multimodal analgesia that include NSAIDs, opioids, and local anesthetics to prevent the pathophysiologic effects of pain and neuroendocrine stress response should be viewed as an essential part of balanced anesthesia.
Early bioelectric activities mediate redox-modulated regeneration
Authors: Ferreira Fernando , Luxardi Guillaume , Reid Brian , Zhao Min
Published: November 2016

Reactive oxygen species (ROS) and electric currents modulate regeneration; however, the interplay between biochemical and biophysical signals during regeneration remains poorly understood. We investigate the interactions between redox and bioelectric activities during tail regeneration in Xenopus laevis tadpoles. We show that inhibition of NADPH oxidase-mediated production of ROS, or scavenging or blocking their diffusion into cells, impairs regeneration and consistently regulates the dynamics of membrane potential, transepithelial potential (TEP) and electric current densities (JI) during regeneration. Depletion of ROS mimics the altered TEP and JI observed in the non-regenerative refractory period. Short-term application of hydrogen peroxide (H2O2) rescues (from depleted ROS) and induces (from the refractory period) regeneration, TEP increase and JI reversal. H2O2 is therefore necessary for and sufficient to induce regeneration and to regulate TEP and JI. Epistasis assays show that voltage-gated Na+ channels act downstream of H2O2 to modulate regeneration. Altogether, these results suggest a novel mechanism for regeneration via redox-bioelectric orchestration.
Nodal and FGF coordinate ascidian neural tube morphogenesis
Authors: Navarrete Ignacio A. , Levine Michael
Published: November 2016

Formation of the vertebrate neural tube represents one of the premier examples of morphogenesis in animal development. Here, we investigate this process in the simple chordate Ciona intestinalis. Previous studies have implicated Nodal and FGF signals in the specification of lateral and ventral neural progenitors. We show that these signals also control the detailed cellular behaviors underlying morphogenesis of the neural tube. Live-imaging experiments show that FGF controls the intercalary movements of ventral neural progenitors, whereas Nodal is essential for the characteristic stacking behavior of lateral cells. Ectopic activation of FGF signaling is sufficient to induce intercalary behaviors in cells that have not received Nodal. In the absence of FGF and Nodal, neural progenitors exhibit a default behavior of sequential cell divisions, and fail to undergo the intercalary and stacking behaviors essential for normal morphogenesis. Thus, cell specification events occurring prior to completion of gastrulation coordinate the morphogenetic movements underlying the organization of the neural tube.
CERTIFICATION AND CLUSTERING OF TOURIST DESTINATIONS AS THE BASIS OF SUSTAINABLE DEVELOPMENT OF RURAL TOURISM (ON MATERIALS OF STAVROPOL KRAI)
Authors: Варивода Валентина , Varivoda Valentina
Published: November 2016

To classify the territory of a particular cluster a clear delineation of its defining characteristics is required. The methodology of the study includes the development of a passport model of the tourist destination for the certification process, which, in turn, will form the basis of the cluster approach and the division of the territory to the relevant cluster regionalization zones.

The proposed algorithm of clustering of tourist zones based on certification of tourist destinations is the research result. It will allow to form the modern efficient competitive tourist market, providing opportunities to meet the needs of Russian and foreign citizens in tourism services, and will help to increase employment and income levels of a corresponding tourist destination.

The tourism market, which provides opportunities to meet the demand of Russian and foreign citizens for tourism services, is the field of research results application. The proposed by the author mechanism of certification will create a modern effective competitive market of tourist services, and will enhance the employment and income levels of certain tourist destination.

This study is limited by the territory of Stavropol region, but the results can be applied to other regions of the Russian Federation.
Managing hypertension in patients with chronic kidney disease
Authors: Logan IR , Tomson CRV
Published: November 2016

Hypertension is a common clinical problem in patients with chronic kidney disease. This article should equip the non-specialty doctor with the general principles pertaining to the investigation and treatment of hypertension in these patients. It also offers a guide to situations that warrant specialty referral.
Vagus nerve stimulation in clinical practice
Authors: Farmer Adam D , Albu-Soda Ahmed , Aziz Qasim
Published: November 2016

The diverse array of end organ innervations of the vagus nerve, coupled with increased basic science evidence, has led to vagus nerve stimulation becoming a management option in a number of clinical disorders. This review discusses methods of electrically stimulating the vagus nerve and its current and potential clinical uses.
Aphasia therapy: A case study
Authors: Wotton Geraldine
Published: November 2016

Working with people with dysphasia as a speech and language therapist is extraordinarily challenging and yet extremely rewarding. Many of us in independent practice offer impairment-based therapy, working in some instances with clients for many years. Consequently, we often observe the considerable changes this work can bring about; not just in the client's communication per se, but also in the significant recovery of some individuals' speech and language. However, these practices and their successes are rarely reflected within the literature. *

More concerning, however, are the research findings that indicate there is little difference in outcomes, where ‘the work’ has been conducted by volunteers as opposed to fully qualified speech and language therapists. Those of us who work clinically categorically refute that claim, but what we would agree on is that aphasia is a highly complex disorder and each client presents quite uniquely, which calls for a patient-specific treatment plan.

Unfortunately, the often perceived ‘schism’ between some within the research arena and the clinical communities—especially those of us in independent practice—only compounds the difficulty we face clinically, articulating the changes we see and understanding why they are happening.

The following article is a presentation of a case worked on from 2001 to 2016. After which I will highlight several aspects of the work that need to be considered when evaluating the efficacy of work undertaken in this field.
Biological effects and clinical application of negative pressure wound therapy: a review
Authors: Nie B. , Yue B.
Published: November 2016

Negative pressure wound therapy (NPWT) has shown great advantages in the management of a wide range of clinical problems such as wound or chronic wound healing; open wounds with exposed bone, nerve, or tendon; and orthopaedic implants and related infection in the orthopaedics field. Even though it has shown positive efficacy in treating infection (wound infection or orthopaedic implant infection), its molecular mechanisms of action remain unclear and require further exploration. Since NPWT is widely used in the clinical setting, a comprehensive understanding of its biological effect will assist in appropriate clinical application. This review summarises the biological effect of NPWT on bacteria and cell growth as well as the possible mechanisms associated with NPWT applied in wound healing. We also highlight novel antibacterial dressings for NPWT. PubMed, and Web of Science database searches were conducted. Several search terms were used including negative pressure wound therapy, bacterial growth, growth factor, wound healing, dressing. All databases were searched from inception to 2015, references that lacked original resarch were eliminated.
Primary wound closure of diabetic foot ulcers by debridement and stitching
Authors: Ahmed M.E. , Mohammed M.S. , Mahadi S.I.
Published: November 2016

Objective:

The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs.

Method:

This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013. All patients presented with neuropathic diabetic septic foot on the plantar aspect or extending up the leg were included. Initial surgical sharp debridement under intravenous broad spectrum antibiotics was performed and oral antibiotics were given 3 days later after the results of the bacterial culture were received. Regular wound debridement was performed with the aim of pairing the wound edges for stitching. Primary closure was performed when the wound was clean from any necrotic tissues and partial closure when the wound was still oozy to secure drainage and avoid splaying of the wound edges. All patients were using either crutches or wheel chair initially until any sepsis cleared and then proper off-loading by shoes purpose made in our centre.

Results:

A 160 patients with neuropathic DFUs that needed debridement and frequent dressing changes as outpatients were included. Both groups had the same tap water wound dressing either daily, every other day or every two days according to the wound progress. Absorbent dressings and negative pressure wound therapy (NPWT) were unavailable. Half of the patients (n=80) had debridement, frequent dressing change using tap water throughout the period of study (group 1) while the rest (n=80) in addition to wound debridement underwent stitching of their wounds (group 2). Complete healing was achieved in 46 patients in Group 1 (57.5%) compared with 19 patients (23%) in group 2 (p=0.001). The average number of dressings used was 19 in stitch group compared with 30 in the non-stitch group (p=0.000). The average duration of healing in stitch group was 2.9 months compared with 5.7 months in non-stitch group (p=0.000).

Conclusion:

Stitching of neuropathic DFUs reduced the duration of wound healing and the frequency of wound dressing change.
Evaluation of the assessment and documentation of chronic wounds in residential social care in the Czech Republic
Authors: Saibertová S. , Pokorná A.
Published: November 2016

Objective:

Accurate evaluation of non-healing, chronic wounds followed by the selection of an appropriate therapeutic strategy is a must for the foundation of health-care management. Assessment of non-healing chronic wounds in clinical practice in the Czech Republic is not standardised in acute care settings or in residential social care facilities. The aim of the study was to analyse the methods being used to assess non-healing, chronic wounds in residential social services in the Czech Republic, where more patients with chronic wounds are present because of the increasing incidence of wounds in old age.

Method:

The research was carried out at 66 residential social care institutions across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The same methodology was used in previous work which has been done in acute care settings in 2013.

Results:

The results of this research have corroborated the inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to the evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of the wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were improved when a consultant for wound healing was present.

Conclusion:

An effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of ‘non-healing, chronic wound assessment’ algorithm.
Evaluating a native collagen matrix dressing in the treatment of chronic wounds of different aetiologies: a case series
Authors: Ricci E. , Cutting K.F.
Published: November 2016

Objective:

To collate clinical evidence on the use of a native collagen matrix dressing, consisting of a fibrillary collagen network, in patients with a variety of chronic wounds.

Method:

Patients whose wounds had not improved in the eight weeks before the beginning of the evalutaion were recruited. All participants had their dressings changed twice weekly and received standard adjunctive wound care as part of their treatment. Data, collected over a 4-week period, included: patient demographics, wound surface area measurements, Bates-Jensen score, level of wound pain, wound infection status, wound bed preparation staging score, depth of wound according to tissue type, and photographic imaging of patients' wounds.

Results:

We recruited 19 patients with 20 wounds and a mean wound duration of 66.6 months (range: 4–480 months). There was a mean decrease in wound surface area of 29% (median reduction: 47%). A reduction in the Bates-Jensen score was demonstrated in 85% of cases. Wound pain reduced by 66.66% and the wound bed preparation score reduced in 16 wounds with four remaining static. No adverse events arose.

Conclusion:

This case series provides clinical evidence on the use of a native collagen matrix dressing in the management of hard-to-heal wounds that have previously received local standard therapy. The decrease in wound surface area together with other data indicating improved wound status suggests that a native collagen matrix dressing supports healing and improves quality of life through reduction in wound pain.
Sheep flock health planning and the role of sheep veterinary surgeons
Authors: Gascoigne Emily
Published: November 2016

The relationship between sheep farmers and their veterinary surgeons is a challenging enigma in modern day farm animal practice. The necessity for flock health planning, disease surveillance and performance monitoring is ever increasing and demanded by legislation, industry and the consumer, but the working dynamic between both parties may be limited or in many cases non-existent. This article will consider the immense value sheep veterinary surgeons can deliver to sheep flocks, positively influencing productivity and animal welfare. It will attempt to define flock health planning and discuss the challenges for both shepherd and veterinary surgeon in embracing and delivering preventative strategies, considering the potential for engagement in the future and the opportunity to deliver innovative practice.
Documented neurological diseases in camelids
Authors: Bedenice Daniela , Whitehead Claire E.
Published: November 2016

Neurological disease has a wide range of causes in llamas and alpacas, but is most often related to infectious (viral or bacterial), metabolic, toxic and traumatic causes. As a consequence, the neurological manifestation of a systemic illness has to be differentiated from conditions that principally affect the peripheral or central nervous system. Subtle differences in the clinical manifestation and pathophysiology of neurological diseases do exist between camelids and other species. However, diagnostic tools similar to those used in other species are often essential to establish an etiological diagnosis. For example, while spinal radiography may be sufficient to identify traumatic conditions and bony lysis or sclerosis in animals with advanced degenerative vertebral disease, computed tomography or magnetic resonance imaging may be required to better evaluate patients with subtle changes.
L1CAM in the Early Enteric and Urogenital System
Authors: Pechriggl Elisabeth Judith , Concin Nicole , Blumer Michael J. , Bitsche Mario , Zwierzina Marit , Dudas Jozsef , Koziel Katarzyna , Altevogt Peter , Zeimet Alain-Gustave , Fritsch Helga
Published: November 2016

L1 cell adhesion molecule (L1CAM) is a transmembrane molecule belonging to the L1 protein family. It has shown to be a key player in axonal guidance in the course of neuronal development. Furthermore, L1CAM is also crucial for the establishment of the enteric and urogenital organs and is aberrantly expressed in cancer originating in these organs. Carcinogenesis and embryogenesis follow a lot of similar molecular pathways, but unfortunately, comprehensive data on L1CAM expression and localization in human developing organs are lacking so far. In the present study we, therefore, examined the spatiotemporal distribution of L1CAM in the early human fetal period (weeks 8–12 of gestation) by means of immunohistochemistry and in situ hybridization (ISH). In the epithelia of the gastrointestinal organs, L1CAM localization cannot be observed in the examined stages most likely due to their advanced polarization and differentiation. Despite these results, our ISH data indicate weak L1CAM expression, but only in few epithelial cells. The genital tracts, however, are distinctly L1CAM positive throughout the entire fetal period. We, therefore, conclude that in embryogenesis L1CAM is crucial for further differentiation of epithelia.
High-Sensitivity Troponin I in Stable Patients with Atherosclerotic Disease in the TRA 2°P - TIMI 50 Trial
Authors: Eisen Alon , Bonaca Marc P , Jarolim Petr , Scirica Benjamin M , White Harvey D , Tendera Michal , Dellborg Mikael , Nicolau Jose C , Morais Joao , Fox Keith A A , Bohula Erin A , Murphy Sabina A , Braunwald Eugene , Morrow David A
Published: November 2016

BACKGROUND

Cardiac troponin I, measured with a high-sensitivity assay (hs-TnI), is well-established for risk prediction in acute coronary syndromes. However, its prognostic role in stable atherosclerotic disease, particularly for future myocardial infarction (MI), is less well defined.

METHODS

We measured hs-TnI (Abbott ARCHITECT) in 15833 patients with prior MI, ischemic stroke, or peripheral arterial disease from the placebo-controlled Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)–Thrombolysis in Myocardial Infarction (TIMI) 50 trial of the platelet inhibitor vorapaxar, excluding patients with recent MI (<30 days). hs-TnI was categorized into 5 groups based on the detection limit (1.9 ng/L), 99th percentile reference limit (26 ng/L), and tertiles in between (1.9–26 ng/L), as well as sex-specific reference limits.

RESULTS

Higher hs-TnI concentration was associated with older age, male sex, and increased atherosclerosis burden. hs-TnI identified a graded 3-year risk of cardiovascular death, MI, or stroke from 5.0% to 18.6% (P < 0.001), driven by cardiovascular death and MI (P < 0.001). This risk was independent of established clinical risk indicators, B-type natriuretic peptide and C-reactive protein [adjusted hazard ratio 2.70 (95% CI, 1.96–3.71), P < 0.001 for hs-TnI >26 ng/L vs <1.9 ng/L]. In patients with prior MI, there was a pattern of greater absolute benefit with vorapaxar in patients with an increased hs-TnI (absolute risk difference 1.9% with hs-TnI >26 ng/L vs 0.3% with hs-TnI <1.9 ng/L; P interaction = 0.82).

CONCLUSIONS

In stable patients with established atherosclerosis, hs-TnI concentrations effectively stratified the risk of new or recurrent cardiovascular (CV) events, in particular CV death and MI. High-risk patients with prior MI identified by increased hs-TnI had a substantial absolute improvement in net clinical outcome with vorapaxar.
Gangguan Ginjal Akut pada Demam Berdarah Dengue
Authors: Rydha Harun Arrasyd , Rauf Syarifuddin , Daud Dasril
Published: November 2016

Latar belakang. Demam berdarah dengue (DBD) merupakan masalah kesehatan masyarakat di berbagai bagian dunia, 50 juta orang terinfeksi virus dengue setiap tahun, 500.000 DBD syok (DSS) dengan angka kematian 2,5%.Tujuan. Mengetahui proses gangguan ginjal akut (GnGA) sebagai komplikasi DBD.Metode. Penelitian potong lintang pada 86 pasien DBD yang dirawat di RS Wahidin Sudirohusodo, RS Islam Faisal, dan RS Ibnu Sina Makassar, � �� � � �� � �� ��� � mulai September 2011 sampai Mei 2012. Konfirmasi diagnosis DBD dengan pemeriksaan IgM dan IgG anti virus dengue, dibagi menjadi DSS dan DBD non syok (DBD-NS).Hasil. Di antara 86 pasien, 37(43.%) DSS dan 49(57,0%) DBD-NS. Rerata kreatinin serum dan eKK pasien DBD-NS 1,11mg/dl dan 50,35 ml/men/1,73m2. Rerata kreatinin serum dan eKK pasien DSS 2,48 mg/dl dan 20,335 ml/men/1,73m2; derajat GnGA menurut pRIFLE adalah pRIFLE-F 36,05% pada pasien pasien DSS, pRIFLE-R dan-I 17,44% dan 31,39% pada pasien DBD-NS. Analisis statistik memperlihatkan rerata kreatinin serum pasien DSS (2,481 mg/dl) lebih tinggi secara bermakna dibandingkan pasien DBD-NS (1,116 mg/dl), rerata eKK pasien DSS (20,335 ml/men/1,73m2) lebih rendah dibandingkan DBD-NS (50,351 ml/men/1,73m2), dan derajat GnGA pRIFLE-F secara bermakna lebih banyak (36,05%) pada pasien DSS dan derajat GnGA pRIFLE-R dan pRIFLE-R-I lebih banyak dijumpai pada pasien DBD-NS (17,44% dan 31,39%).Kesimpulan. Gangguan ginjal akut (GnGA) pada umumnya ditemukan pada kasus DSS maupun DBD-NS. Derajat GnGA yaitu pRIFLE-F ditemukan pada DSS sedangkan GnGA pRIFLE-R dan pRIFLE-I pada DBD-NS.
Penilaian Kualitas Hidup pada Anak dengan Penyakit Jantung Bawaan Asianosis dan Sianosis
Authors: Rachmawati Cut Fera , Sofyani Sri , Ali Muhammad
Published: November 2016

Latar belakang. Setiap tahun seribu bayi lahir dengan penyakit jantung bawaan (PJB). Terapi bertujuan mengurangi gejala klinis, mencegah gagal jantung, penutupan defek, dan meningkatkan kualitas hidup. Evaluasi terhadap kualitas hidup menjadi penting karena dengan tata laksana yang baik sekarang ini, anak dengan PJB memiliki harapan hidup yang lebih lama.Tujuan. Menilai perbedaan kualitas hidup anak penderita PJB asianosis dengan sianosis.Metode. Penelitian menggunakan studi potong lintang telah dilakukan dari bulan Maret sampai dengan Juli 2012 di RSUP H. Adam Malik, Medan. Sampel terdiri dari anak usia 5 sampai dengan 18 tahun yang menderita PJB asianosis dan sianosis yang belum dikoreksi dan sudah dikoreksi. Anak dan orangtua mengisi kuesioner PedsQL modul kardio versi 3.0. Penilaian kualitas hidup dilihat dari enam domain yaitu menggunakan T-test independen dengan p<0,05 dan interval kepercayaan 95%.Hasil. Terdapat 52 anak penderita PJB, 17 anak sianosis dan 37 anak asianosis. Kualitas hidup anak PJB asianosis lebih baik daripada anak sianosis dalam empat domain yaitu masalah jantung dan terapi, penampilan fisik, cemas terhadap tindakan terapi dan masalah kognitif.Kesimpulan. Kualitas hidup anak penderita PJB asianosis lebih baik dibandingkan penderita PJB sianosis.
Hubungan Kadar Vitamin C Plasma dengan Serangan Asma pada Anak
Authors: Aruf Azwar , Naning Roni , Sitaresmi Mei Neni
Published: November 2016

Latar belakang. Banyak faktor yang dapat memicu serangan asma. Perhatian terhadap peran nutrisi antioksidan serta stres oksidatif pada kejadian asma beberapa tahun terakhir ini semakin meningkat. Beberapa penelitian melaporkan bahwa kadar vitamin C plasma yang rendah merupakan faktor risiko serangan asma, meskipun masih kontroversial. Belum ada penelitian mengenai vitamin C plasma dan asma di Indonesia.Tujuan. Menilai apakah kadar vitamin C plasma rendah merupakan faktor risiko serangan asma pada anak, dengan cara membandingkan kadar vitamin C plasma anak asma dalam serangan dan anak asma tidak dalam serangan.Metode. Desain penelitian ini adalah penelitian kasus kontrol. Pengambilan sampel dilakukan secara konsekutif. Subyek adalah semua anak yang terdiagnosis asma dalam serangan dan tidak dalam serangan di RSUPDR. Sardjito Yogyakarta sejak April 2012 sampai dengan Agustus 2013. Subyek dibagi menjadi dua kelompok, 39 anak kelompok asma tidak dalam serangan dan 39 anak kelompok asma dalam serangan. Kadar vitamin C plasma diperiksa dengan metode kuantitatif spektofotometer.Hasil. Karakteristik subyek, antara lain umur, jenis kelamin, riwayat kontak hewan peliharaan, riwayat kontak tungau debu rumah, perokok pasif, alergi makanan, infeksi saluran pernapasan, kadar vitamin C plasma. Analisis bivariat dilakukan dengan uji kemaknaan (nilai p<0,05), dan rasio Odds. Kadar vitamin C plasma kelompok asma dalam serangan dan tidak dalam serangan tidak berbeda bermakna dengan nilai p=0,77 dan rasio Odds 1,18 (IK95%: 0,32;3,64). Infeksi pernapasan merupakan faktor risiko serangan asma yang bermakna dengan nilai p=0,006 dan rasio Odds 3,6 (IK 95% 1,41;9,19).
High Sensitivity C-Reactive Protein sebagai Parameter Diagnostik dan Prediktor Luaran Sepsis pada Anak yang Menderita Systemic Inflammatory Response Syndrome
Authors: Sarmen Sofni , Mayetti Mayetti , Bachtiar Hafni
Published: November 2016

Latar belakang. Sepsis merupakan salah satu penyebab morbiditas dan mortalitas pada anak. Diagnosissepsis ditegakkan berdasarkan gejala Systemic Inflammatory Response Syndrome (SIRS) dan penemuan bakteripada kultur darah. Kultur bakteri darah memiliki sensitifitas yang rendah dan membutuhkan waktu yanglama sehingga sering menyebabkan terjadinya overdiagnosis dan overtreatment. C-reactive protein adalahreaktan fase akut yang kadarnya meningkat pada keadaan infeksi. High sensitivity C-reactive protein (hs-CRP) adalah metode yang lebih sensitif untuk mengukur kadar CRP dalam jumlah kecil.Tujuan. Mengetahui peran hs-CRP sebagai parameter diagnostik dan prediktor luaran sepsis pada anakyang menderita SIRS.Metode. Penelitian uji diagnostik dengan desain potong lintang terhadap 85 anak dengan gejala SIRS berusia1 bulan sampai dengan 15 tahun dan dirawat di bangsal anak RS.Dr.M.Djamil Padang sejak Juni sampaiNovember 2012. Pemeriksaan hs-CRP dilakukan dengan metode enzyme-linked immunosorbent assay (ELISA).Data dianalisis dengan SPSS serta dilakukan uji diagnostik. Baku emas sepsis adalah biakan darah.Hasil. Cut off point hs-CRP untuk menentukan sepsis adalah 15,55 ng/ml, (sensitivitas 90,9% dan spesivisitas53,8%). Kadar rata-rata hs-CRP meningkat sesuai dengan beratnya penyakit.Kesimpulan. High sensitivity C-reactive protein dapat dijadikan sebagai parameter diagnostik sepsis padapasien SIRS dengan cut off point 15,55 ng/ml, serta dapat dipakai sebagai prediktor luaran sepsis.
Akurasi Pulse Oksimetri Fingertip Dibandingkan Pulse Oksimetri Generasi Baru dalam Deteksi Dini Penyakit Jantung Bawaan Kritis pada Bayi baru Lahir: Penelitian Pendahuluan
Authors: Rochayati Ina , Putra Sukman Tulus , Supriyatno Bambang
Published: November 2016

Latar belakang. Peningkatan morbiditas dan mortalitas bayi baru lahir dengan penyakit jantung bawaan kritis berkaitan dengandiagnosis yang terlambat.Tujuan. Mengetahui nilai diagnostik pulse oksimetri fingertip dibandingkan generasi baru untuk deteksi dini PJB kritis pada bayibaru lahir.Metode. Penelitian dilakukan di Ruang Rawat Gabung RSCM pada bayi bugar, usia gestasi 􀁴37 minggu, dan berusia 24-72 jam.Oksimetri dilakukan di tangan kanan (preduktal) dan kaki (postduktal). Subjek dengan SpO2 <95% /beda >3% antara tangan kanandan kaki diperiksa lebih lanjut.Hasil. Pada 442 bayi, SpO2 preduktal kedua jenis pulse oksimetri bervariasi secara statistik namun tidak bermakna klinis. Tidak adasubjek dengan hasil deteksi positif dan didiagnosis PJB kritis melalui pemeriksaan oksimetri.Kesimpulan. Uji diagnostik pulse oksimetri fingertip dibandingkan generasi baru untuk deteksi dini PJB kritis pada bayi baru lahirpada penelitian ini belum dapat dinilai.
Prevalensi dan Faktor Risiko Glikosuria pada Remaja Sekolah Menengah Pertama Swasta di Kota Denpasar
Authors: Purnami Made Dwi , Arimbawa Made , Suryawan Wayan Bikin
Published: November 2016

Latar belakang. Pemeriksaan urin merupakan salah satu alat skrining yang penting pada DM untuk menentukan glikosuria.Tujuan. Mengetahui prevalensi glikosuria pada sekolah menengah pertama (SMP) swasta di kota Denpasar dan faktor-faktor terkaitDM pada kejadian glikosuria.Metode. Penelitian ini menggunakan desain potong lintang analitik yang dilakukan pada anak usia 12-14 tahun. Pengukuranantropometri berat badan dan tinggi badan dilakukan dan informasi mengenai riwayat DM pada keluarga menggunakan kuesioner.Glikosuria ditentukan menggunakan urin dipstik reagen strip One Med®. Hubungan beberapa faktor terkait glikosuria dianalisisdengan uji chi-square dan uji multivariat.Hasil. Total didapatkan 431 subyek dari 10 SMP yang memenuhi kriteria inklusi. Prevalensi glikosuria 3%. Proporsi obesitas lebihbesar pada subyek glikosuria dibandingkan subyek yang tidak (76,9 vs 23,1%). Rasio laki-laki yang glikosuria berbanding perempuanadalah 2:1. Analisis regresi logistik mendapatkan risiko subyek obes dengan glikosuria bermakna signifikan secara statistik [RO 5,8(IK95% 1,6 -21,3), p=0,008].Kesimpulan. Obesitas merupakan faktor risiko terjadinya glikosuria. Indeks glikosuria massa tubuh (IMT) 􀁴p95 merupakan faktorrisiko kejadian glikosuria.
Perbandingan Fungsi Fagositosis Neutrofil pada Sindrom Nefrotik Resisten Steroid dengan Sindrom Nefrotik Sensitif Steroid
Authors: Mujab Saiful , Wistiani Wistiani
Published: November 2016

Latar belakang. Pasien sindrom nefrotik (SN) mempunyai kelainan fungsi sistem kekebalan tubuh karena kurang protein opsonindan reseptornya. Anak dengan sindrom nefrotik resisten steroid (SNRS) mempunyai prognosis yang lebih buruk dibandingkandengan sindrom nefrotik sensitif steroid (SNSS). Salah satu gangguan sistem imun yang pernah diteliti antara lain fungsi fagositosisneutrofil, tetapi hasilnya tidak konsisten.Tujuan. Membandingkan fungsi fagositosis neutrofil pada anak penderita SNRS dengan SNSS.Metode. Desain cross sectional dengan 2 kelompok, yaitu SNRS dan SNSS. Penelitian dilakukan di RS Dr. Kariadi Semarang padabulan Mei 2013 dengan pengambilan sampel secara consecutive sampling. Fungsi fagositosis neutrofil diukur dengan metode latexyang dinyatakan sebagai indeks fagositosis. Analisis statistik dikerjakan dengan Mann Whitney test.Hasil. Didapatkan 18 anak dengan SN yang terdiri atas 10 anak SNSS, serta 8 anak SNRS. Rerata indeks fagositosis neutrofildari kelompok SNSS lebih rendah daripada anak sehat, tetapi perbedaan ini tidak bermakna secara statistik. Rerata indeks fagositosisneutrofil dari kelompok SNRS bermakna secara statistik lebih rendah daripada anak sehat, tetapi tidak ada perbedaan yang bermaknasecara statistik antara kelompok SNRS dibandingkan dengan kelompok SNSS.Kesimpulan. Tidak ada perbedaan antara fungsi fagositosis neutrofil pada anak penderita SNRS dibandingkan dengan SNSS.
Das Theater der Erziehung
Authors: Schäfer Martin Jörg
Published: November 2016

Die Kapitel zur »pädagogischen Provinz« aus Goethes spätem Roman »Wilhelm Meisters Wanderjahre« präsentieren nicht nur einen eigenwilligen erzieherischen Entwurf sowie einen rückblickenden Kommentar zu den Bemühungen des selbsternannten »pädagogischen« 18. Jahrhunderts. Gleichzeitig markieren die hier aufgerufenen Diskurse und Dispositive ein Spannungsverhältnis zwischen einerseits Theater/Theatralität und andererseits Erziehung/Bildung. Von Goethes Inszenierung dieser Spannung her erweisen sich einige Klassiker der Erziehungs- und Bildungsliteratur als Vorboten für die im frühen 21. Jahrhundert um sich greifenden Theatralisierungstendenzen auf dem Bildungs- und Arbeitssektor: Rousseaus Erziehungsbibel »Émile«, Goethes eigene »Lehrjahre« und andere.
Gesundheitswissen in der Schule
Authors: Hofmann Michèle
Published: November 2016

Stichwort Schulhygiene - welche Folgen hatte der Prozess der allgemeinen Medikalisierung ab der Mitte des 19. Jahrhunderts auf das Schulwesen? Am Beispiel der deutschsprachigen Schweiz untersucht Michèle Hofmann die nachhaltige Einflussnahme von Ärzten - als Vertreter einer zunehmend naturwissenschaftlich orientierten Medizin - auf die Volksschule. Sie zeichnet nach, wie diese Entwicklung zur Ausgestaltung einer Vielzahl schulhygienischer Maßnahmen führte, darunter etwa adäquat konstruiertes Schulmobiliar, gut beleuchtete Klassenzimmer, angemessene Dauer der Unterrichtseinheiten sowie regelmäßige ärztliche und zahnärztliche Untersuchungen der Schülerinnen und Schüler.
Soziale Aktivierung von Arbeitslosen?
Authors: Freier Carolin
Published: November 2016

Das neuartige Arbeitsmarktinstrument »Soziale Aktivierung« versammelt Maßnahmen, deren Wirkungen über die dominierenden Ziele der direkten und zeitnahen Integration in den Arbeitsmarkt hinausgehen sollen. Anhand von Fallbeispielen wie Kung-Fu-Kursen oder Theatergruppen rekonstruiert Carolin Freier, wie Langzeitarbeitslose und andere arbeitsmarktferne Personen hierdurch »sozial aktiviert« und zur sozialen Teilhabe befähigt werden sollen, u.a. durch das (Wieder-)Erlernen von Alltagskompetenzen. Die Studie zeichnet nach, wie diese Maßnahmen in der täglichen Praxis der Arbeitsvermittlung entstanden, auf welche Strategien sie sich zurückführen lassen und welche Folgen sich für die Arbeitslosen ergeben.
Lernbilder
Authors: Umbach Susanne
Published: November 2016

Untersuchungen zum Lernen Erwachsener sind geprägt von einer Scheu davor, nicht-textförmiges Material als Datengrundlage zu nutzen. Gemieden werden z.B. Bilder oder andere Formen des ästhetischen Ausdrucks, insbesondere wenn das Material von Laien gestaltet wurde. Susanne Umbach zeigt, auf welcher theoretischen Basis Collagen als ästhetische Ausdrucksformen in der Forschung zum Lernen Erwachsener Anwendung finden können, wie ein Auswertungsprozess aussehen kann und welche Einblicke in die Lernvorstellungen Erwachsener anhand von Collagen möglich sind. Dabei wird Lernen als ein Geschehen sichtbar, das den Menschen als leibliches, zeitliches und soziales Wesen betrifft und das es ermöglicht, in der Welt zu handeln und diese Welt handelnd zu gestalten.
Partei der Extreme: Die Republikaner
Authors: Lütjen Torben
Published: November 2016

Von den Kreuzzügen des George W. Bush über die schrillen Attacken der »Tea Party« bis hin zur populistischen Mobilisierung Donald Trumps: Amerikas Konservative halten die USA in Atem. Für viele Europäer handelt es sich um ein verstörendes Phänomen, da die Kombination aus radikalem Individualismus, tiefer Religiosität und Hyperpatriotismus hierzulande in dieser Form kaum existiert. Das Buch zeichnet die Formierung einer politischen Bewegung nach, die vom Rande des politischen Geschehens in den letzten Jahrzehnten in das Zentrum der amerikanischen Politik gelangte - und fragt schließlich nach der Zukunft einer Partei, die den Vormarsch des Außenseiters Donald Trump nicht zu stoppen vermochte.
Postirony
Authors: Hoffmann Lukas
Published: November 2016

What is 'postirony'? Foremost, it is a response to the ironic zeitgeist. Moreover, it is the key to understanding a specific form of literature. The contemporary reader is familiar with and - unfortunately - used to postmodernism's ironic, self-reflexive metafiction. Authors like David Foster Wallace and Dave Eggers chose a different path: Despite the reign of contemporary irony, they strive to reach the reader on a level beyond, cognitively as well as emotionally - they claim to be sincere and true. Focusing largely on nonfiction by said authors, Lukas Hoffmann explores the means the texts use to achieve something new - namely, a new form of sincerity.
Protest und Selbstbeschreibung
Authors: Tratschin Luca
Published: November 2016

Wie entstehen und reproduzieren sich soziale Bewegungen? Was ist das Verhältnis sozialer Bewegungen zu anderen Typen sozialer Systeme wie z.B. Organisationen, dem Wirtschaftssystem oder der Gesellschaft? Luca Tratschin präsentiert eine kommunikationstheoretische Antwort auf diese Fragen und zeigt, wie soziale Bewegungen durch die kontingente Entdeckung von Gemeinsamkeiten vieler raum-zeitlich verankerter Protestkommunikationen entstehen können.
Performance als Lebensform
Authors: Leuthner Marion
Published: November 2016

Mittels des Begriffs der »Lebensform« reflektiert Marion Leuthner Performance-Kunst nicht als »Live Art«, sondern als eine Ausweitung der Kunst auf die Lebensdauer der Künstler. Zur exemplarischen Darstellung dieser Perspektive dienen ihr drei existenzielle Fragestellungen und drei Performance-Künstler: Alltag und Religion/Linda Montano, Ich und Anderer/Genesis P-Orridge, Mensch und Maschine/Stelarc. Anhand von Theorien aus unterschiedlichen Gebieten wie Kunst, Religion, Philosophie, Psychologie, Kybernetik und Medientheorie stellt die Studie diese Performance-Künstler in Verbindung zu modernen Denktraditionen, denen gegenüber es den Künstlern gelingt, Theorie und Praxis im Leben zu vereinen.
Miss Perfect - Neue Weiblichkeitsregime und die sozialen Skripte des Glücks in China
Authors: Dippner Anett
Published: November 2016

Chinas »neue neue Frauen« warten nicht auf ihr Glück - sie setzen im Kampf um soziale Anerkennung auf die aktive Arbeit am Selbst. Vor dem Hintergrund des Spannungsverhältnisses zwischen traditionellen Geschlechterrollen, modernen Formen globaler Konsumkultur und den Folgeeffekten der Neuorientierung zur Individualisierungs- und Risikogesellschaft analysiert Anett Dippner die diskursiven Aushandlungen von weiblicher Identität im gegenwärtigen China. Sie eröffnet einen bisher unbekannten Blick auf weibliche Subjektpositionen sowie Handlungsstrategien und erklärt zugleich anschaulich soziale, politische und ökonomische Hintergrundentwicklungen, die zur Herausbildung jener Semantiken des Weiblichen im aktuellen China beigetragen haben.
Using PeerWise to develop a contributing student pedagogy for postgraduate psychology
Authors: McKenzie Wendy , Roodenburg John
Published: November 2016

The importance of the role of peer and self-assessment in developing formative and sustainable assessment practice in higher education is increasingly becoming evident. PeerWise is an online software tool that engages students in contributing to their own and others’ learning by authoring, answering and providing feedback on multiple choice questions. Using a mixed methods approach, 20 students responded to discussion questions and an online survey about their perceptions of using PeerWise compared to online quizzes as part of the blended delivery of a postgraduate psychology unit. Students considered both authoring and answering questions in PeerWise to equally benefit their learning. Answering questions in PeerWise was perceived to be more helpful for learning than questions on a Moodle quiz. This advantage was evident across more complex cognitive skills, understanding, applying, evaluating and creating information, although only significant for facilitating understanding. PeerWise and online quizzes were seen to be equally helpful in facilitating recall. Despite the perceived benefits of PeerWise, students preferred quiz questions to be set by an expert if used as recognition of progress. Introducing PeerWise was effective in promoting engagement with peers; however, refinements to the model should focus on increasing student confidence in their own and peers’ capabilities.
Electronic Reverse Auctions in Public Construction Procurement – Empirical Evidence from the Czech Republic
Authors: Hanák T.
Published: November 2016

Electronic reverse auctions (e-RAs) are considered to be an effective tool for negotiating tender prices and achieving cost savings. Furthermore, if multicritera evaluation is used, it can be expected that e-RAs will also contribute to achieving benefits in other areas, e.g. helping to minimize life-cycle costs. This study aims to analyse the mutual relationships between selected e-RA variables. More specifically, correlation analysis is applied to explore real e-RA data representing public tenders for construction work. This study’s findings reveal that the correlations examined are generally weak or very weak. Furthermore, it has been found that the value of correlation coefficients varies depending on the type of structure, and that public tenders are usually evaluated solely on the basis of the criterion of the lowest bid price. Recommendations for public authorities in using e-RAs in the role of the buyer are also provided at the end of this paper.
Multicriteria Selection of Water Insulation Technology for Foundation Walls in an Existing Building
Authors: Rosłon J. , Seroka M.
Published: November 2016

In the authors’ opinion, the issue of incorrectly functioning water insulation of foundation walls in the existing buildings in Poland is currently rather common. The paper includes a multicriteria analysis aimed at arranging the selected options of the foundation wall vertical water insulation technology in an existing model historic building using the weighted sum, entropy and AHP methods. Each of the studied solutions was evaluated in terms of the following criteria: costs of construction works, time of execution of construction works, popularity of using particular insulation options by other contractors, durability of the executed insulation and the degree of nuisance of the executed works.
Quality of Life of People with Disabilities from Sport Participation Point of View
Authors: Nemček Dagmar
Published: November 2016

The aim of the study was to compare the satisfaction with quality of life indicators (QoLI) and quality of life domains (QoLD) scores between people with physical disabilities (PPD) and people who are deaf or hard of hearing (PD/HH) from sport participation point of view. The study included 315 individuals with PPD (n = 150; male = 76) and PD/HH (n = 165; male = 85) divided into two groups of those who are regularly participating in sport and those who are not participating in any sport activity in their leisure. The second part of the Subjective Quality of Life Analysis (S.QUA.L.A.) was used. The Pearson chi-square test was used to determine the differences in 23 QoLI and 5 QoLD between PPD and PD/HH from sport participation point of view and student’s two-sample t-test was used to compare overall quality of life (QoL). We found that PD/HH who are participating regularly in sport presented significantly higher satisfaction with 7 evaluated QoLI and with all 5 QoLD. Overall QoL score was significantly higher (p < .01) in PD/HH. In the group of people who are not participating in sport we found significantly higher satisfaction with 13 QoLI in PD/HH and with 8 QoLI in PPD. Satisfaction with 4 QoLD was significantly higher in PD/HH and only with domain (physical health) were significantly higher satisfied PPD (p < .01). Overall QoL score did not show significant differences between groups of people with disabilities who are not participating in any sport. The results of our study confirmed that PD/HH have significantly higher QoL comparing PPD no matter if they participating in sport or not. This evaluation measured by S.QUA.L.A shows that it is a suitable tool to asses QoL in people with different kinds of disabilities.
p-Laplacian Equations in ℝ
N
with Finite Potential via the Truncation Method
Authors: Liu Xiangqing , Zhao Junfang
Published: November 2016

We consider the problem

-

Δ
p

⁢
u

+

a
⁢

(
x
)

⁢

|
u
|

p
-
2

⁢
u

=

|
u
|

q
-
2

⁢
u

{-\Delta_{p}u+a(x)\lvert u\rvert^{p-2}u=\lvert u\rvert^{q-2}u}

in

ℝ
N

{\mathbb{R}^{N}}

, where

1
<
p
<
N

{1<p<N}

,

p
<
q
<

p
*

=

N
⁢
p

N
-
p

{p<q<p^{*}=\frac{Np}{N-p}}

,

Δ
p

{\Delta_{p}}

is the p-Laplacian operator, and the potential function a is positive, bounded and verifies suitable decay assumptions. The existence of infinitely many solutions of the equation is proved via the truncation method.