bluuebunny/crossref_metadata_2025 huggingface dataset:
Verrucose tuberculosis cutis associated with chronic monoartritis of knee in a patient with HIV infection
Authors: Otivo Raul Montalvo , Ramirez Alfaro Jean Piere , Ortiz Raul Gomez
Published: April 2020

Bone component involvement is an atypical form of extrapulmonary mycobacterium tuberculosis and it is rare that it previously affects the skin, its diagnosis is difficult. Lipoarabinomannan (LAM) is a component of the cell walls of mycobacteria, present in some people with active tuberculosis, the test is simple and shows results in twenty minutes, but is not validated in immunocompetent patients. We present the case of a 65 year old man, diagnosed with verrucous tuberculosis and subsequent tuberculous monoarthritis of the left knee with positive analysis of lipoarabinomannan in urine and ELISA for non-reactive HIV with a good clinical response to the treatment of tuberculosis.
Nevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle) over lower back: a rare presentation
Authors: Mandadi Santosh Reddy , Rao G. Venkateswara , Kilaru Krishna Rajesh , Munnangi Pooja
Published: April 2020

Nevus lipomatosus cutaneous superficialis is a rare benign local malformation of the skin characterized by ectopic adipocytes in the dermis. It presents as either a classical type known as Hoffman-Zurhelle or the solitary type. We report a case of the classical type with multiple soft, non-tender, cerebriform, skin-colored papules and nodules over the lower back in a 16 years old female.
Blistering in a newborn: a rare case report
Authors: Kaur Jasleen , Budhwar Jyoti , Maheshwary Ankush , Bhatti Karandeep Singh
Published: April 2020

Epidermolysis bullosa is a heterogeneous group of inherited mechanobullous disorders that present with skin and mucosal fragility, leading to blister formation after minimal trauma. 18 days old female baby presented with fluid-filled blisters of variable sizes over the lower lip, bilateral heels, hands, buttocks, chest, legs and arms, which ruptured spontaneously leaving raw areas. The history and physical examination suggested epidermolysis bullosa simplex and so, skin biopsy was done to confirm the diagnosis. On confirmation, patient’s parents were counselled about the disease and its management.
Congenital true leukonychia totalis
Authors: Vyshak B. M. , Lunge Snehal B.
Published: April 2020

Congenital true leukonychia totalis is very rare hereditary condition characterized by milky white discoloration of all nails. It has mainly autosomal dominant mode of inheritance and autosomal recessive in few cases. It may be inherited or associated with systemic disease or idiopathic. It has been linked to the mutations in PLCD1 gene on chromosome 3p21.3-p22. Leukonychia totalis is associated with multiple systemic diseases such as congenital hyperparathyroidism, Hodgkin's lymphoma, Leopard syndrome, Epiphyseal dysplasia syndrome, Bart Pumphrey syndrome etc. we report a case of sporadic congenital leukonychia totalis in a 24 years female without any systemic abnormalities.
Effectiveness of measles, mumps and rubella vaccine as immunotherapeutic agent for cutaneous viral warts
Authors: Wahengbam Anupama Devi , Jeevan Jeyakumari , Dogiparthi Sowmya
Published: April 2020

Immunotherapy for management of cutaneous wart with measles, mumps and rubella vaccine (MMR) is a promising new modality of management. Evaluation of the same has been done by various studies over the years reporting its effectiveness. A literature search was done using PubMed and google scholar. This short narrative review documents the response rates in various clinical studies done till 2019 which have reported the efficacy of MMR vaccine as an immunotherapeutic agent which ranged from 26-84% graded as complete response which is complete clearance of the treated warts. These studies were performed for evaluating MMR vaccine as single agent or done in comparison with other therapeutic agents. The broad range of responses points to a need of doing further clinical studies which will substantiate the effectiveness of MMR vaccine in the treatment of cutaneous warts.
PERFIL EPIDEMIOLÓGICO DE PESSOAS COM DIABETES MELLITUS ATENDIDAS NAS ESTRATÉGIAS SAÚDE DA FAMÍLIA
Authors: Dal Soto Busnelo Evandro , Moreschi Claudete , De Oliveira Silva Silvana , Ost Rodrigues Sandra , Foggiato de Siqueira Daina , Luiz Ramos Soares Andiara
Published: April 2020

Objetivo: identificar o perfil epidemiológico das pessoas com diabetes atendidas nas Estratégias Saúde da Família de um município do Rio Grande do Sul. Métodos: estudo quantitativo, transversal. Dados coletados por meio questionários aplicados com 222 pessoas com diabetes mellitus, no período de setembro a outubro de 2018, seguido de análise estatística descritiva. Resultados: perfil predominante do sexo feminino (72,0%), idade média de 65 anos, ensino fundamental incompleto (72,5%), raça branca (90,1%), casados (57,2%), aposentados/pensionistas (66,7%), renda mensal familiar de até um salário. A média de tempo da doença foi de 10,1 anos. A maioria é hipertenso (79,7%), não participa de grupos de educação em diabetes (87,4%) e realiza o tratamento com dieta e antidiabéticos orais (73,9%). Conclusão: constata-se a importância de promover ações preventivas e de acompanhamento continuo para evitar agravos provenientes do diabetes com vistas à melhorar a qualidade de vida desta população.
A Produção Científica em Born Globals nos Periódicos e Encontros Científicos Brasileiros
Authors: Sousa Thiago Alberto Viana de , Rocha Thomaz Novais , Forte Sérgio Henrique Arruda Cavalcante
Published: April 2020

Objetivo: O objetivo deste artigo foi analisar a produção científica em periódicos brasileiros no tema born globals.Método: Foi realizada uma análise bibliométrica de toda a produção científica no Brasil até o mês de outubro de 2019, nos periódicos de Qualis A1 a B3 e anais do ENANPAD.Principais resultados: Dentro da temática abordada nos artigos, verifica-se uma predominância pelo processo de internacionalização das born globals e pela evolução do conceito de internacionalização. As instituições do sul e sudeste do Brasil são as que contabilizam maior número de publicações na temática.Relevância/originalidade: Analisar a produção científica brasileira sobre born globals é útil para pesquisadores em seus futuros estudos sobre internacionalização.Contribuições teóricas/metodológicas: A investigação contribui com a evolução teórica do tema, mostrando o desenvolvimento da pesquisa em born globals no Brasil ao longo dos anos.
Registered Nurses as Optimizers of Gender-Affirming Care within a Transgender and Intersex Specialty Care Clinic
Authors: Zimmerman Alissa R. , Missel Zachary C. , Bauman LeAnn M. , Gonzalez Cesar A.
Published: April 2020

An estimated 1.4 million transgender adults live in the United States; this equates to approximately 0.6% of the U.S. population (Lane et al., 2018). Clinical focus on gender dysphoria has significantly increased over the past 30 years (MacCarthy, Reisner, Nunn, Perez-Brumer, & Operario, 2015), with burgeoning evidence from across disciplines documenting the positive outcomes associated with gender-affirming interventions. The purpose of this article is to illustrate how RNs optimize psychosocial, hormonal, and surgical gender-affirming care through performing comprehensive assessments, coordinating care, and providing education and health coaching.
Increasing Gender Awareness to Reduce Harm in Health Care
Authors: Iantaffi Alex
Published: April 2020

In this guest editorial, the author first discusses how gender is a historical and biopsychosocial construct. This means that there are many aspects of gender besides identity, such as gender expressions, roles and experiences. They address how this issue highlights some of these aspects but that these are not exhaustive, given the topic. They highlight how being able to consider our own gender identities, roles, expressions and experiences is an essential starting point if we are to be competent health-care providers. Finally, they suggest that stories might be one way to learn about aspects of gender we may not be as familiar with, as they allow us to connect emotionally, not just cognitively, with these aspects.
Noción de aproximación del área bajo la curva utilizando la aplicación Calculadora Gráfica de GeoGebra
Authors: Ballesteros Vladimir Alfonso , Lozano Sébastien , Rodríguez Óscar Iván
Published: April 2020

Este artículo presenta los resultados de un proyecto de investigación desarrollado en la Facultad de Ingeniería y Ciencias Básicas de la Fundación Universitaria Los Libertadores (Bogotá, D.C.) cuyo objetivo consistió en describir y analizar los efectos de implementar una estrategia didáctica para la enseñanza de la noción de área bajo la curva, durante un curso de Cálculo Integral, a partir de la integración de teléfonos celulares como dispositivos que pueden apoyar el proceso de aprendizaje y no como artefactos nocivos o distractores y que responden a nuevas formas de reconocerse e integrarse a comunidades alternativas de aprendizaje. Se realizó un diseño experimental de cuatro grupos de Solomon con el propósito de determinar la influencia de una intervención mediada por la aplicación móvil “Calculadora Gráfica” de GeoGebra considerando también el efecto de una prueba de entrada. Los resultados encontrados señalan que los dos grupos que tuvieron la intervención mediada por la aplicación móvil obtuvieron mejor rendimiento en la prueba de salida que aquellos grupos que tuvieron una intervención con calculadora científica tradicional.
(Re)colocando o direito junto às dinâmicas sociais: a institucionalização da sociologia jurídica nos currículos e o atravessamento da pesquisa sócio jurídica na formação em direito
Authors: Dos Santos Thais Lemos
Published: April 2020

O presente trabalho pretende mapear a institucionalização da sociologia do direito nas faculdades de direito indicadas pelo selo OAB Recomenda. Para tanto, foram analisados os dados obtidos a partir de busca nos sites das instituições de ensino objeto do presente estudo, bem como das informações enviadas por e-mail pela secretaria, a respeito do formato e do ensino da sociologia do direito ou da sociologia jurídica (neste estudo utilizadas como sinônimos). Por isso, buscou-se alguns dados específicos sobre essa disciplina nos currículos das instituições pesquisadas, em especial se há na estrutura curricular uma disciplina voltada ao seu ensino; qual a nomenclatura atribuída a ela; se a sua ementa deixa claro qual é o seu objeto e, por fim; se a bibliografia adotada abrange textos e livros próprios de sociologia jurídica ou de sociologia do direito, ou se indicam apenas livros e textos de outros campos do saber. Tal mapeamento mostra-se relevante na medida em que a legislação que rege o ensino jurídico atualmente privilegia a interdisciplinaridade dos saberes, sendo este o lugar da sociologia jurídica nos cursos de direito.
What The Economy of The Rossiyskoy Civilization Should Be
Authors: Grodskiy Vladimir S.
Published: April 2020

The Object of the Study. World economy.

The Subject of the Study. Historical forms of economy.

The Purpose of the Study. The identification of historical significant technologies, “sociology” and production criteria, as well as the rationale for the transition to a new production criterion in the modern information community.

The Main Provisions of the Article are: 1. a new technological and institutional model for the development of social production; 2. the equation of the economic condition of society allowing to determine the trajectory (trend) of the optimal development of the economy; 3. the indicator of "production salary" as a criterion of economic activity in the conditions of predominant growth of human capital. 4. the author’s version of the global financial and economic crisis that began in 2008.
Legalizing Informal Employment in Russia: Basic Results and Unsolved Problems
Authors: Odintsova Yelena V.
Published: April 2020

The Object of the Study. The sphere of informal employment in Rossiya. The Subject of the Study. Measures to legalize informal employment and the dynamics of indicators that characterize the sphere of formal and informal employment. The Purpose of the Study. Analysis of the basic results of the implementation of measures to legalize informal employment in Rossiya. The Main Provisions of the Article. In recent years, the problem of informal employment in our country has been included in the current agenda of the state policy being implemented. Since 2014, according to the instructions of the government of the Rossiyskaya Federatsiya, a lot of active work has been carried out in the regions to legalize informal employment. The basic results of these events have been analyzed. It is shown that despite the efforts made there was no noticeable positive dynamics regarding the legalization of hiring employees and self-employed. As shown in the article, that may be due to the remaining unsolved problems in the field of legal employment, related to the prevalence of precarious employment, low income from employment, etc.
The Influence of Atypical Employment on Socioeconomic Development
Authors: Lyutov Nikita L.
Published: April 2020

The Subject of the Study. The article deals with an issue of impact of atypical employment on the socioeconomic development on micro- and macro levels. The Purpose of the Study is to discover the links between the introduction of atypical forms of employment and socioeconomic development.

The Main Theoretical and Empirical Aspects of Study: as the implementation of various forms of atypical employment is one of the aspects of flexibility in employment relations’ regulation, the author starts with a general analysis of impact of general flexibility of employment on the economy. This section of the article contains the conclusion that a thesis about positive effect of labour law flexibility on the economic effectiveness remains unproven;

– the second part of the article contains an analysis of the relations between the specific forms of atypical employment and the state of economy. The conclusion has been made that ill-considered implementation of such forms into the labour legislation leads to such negative consequences to the economy as the labour market segmentation and volatility, rising incomes gap and lowering the purchasing power.

– the thesis is made that Russian labour legislation modification in the field of atypical employment development is only acceptable with a view to make the already existing atypical employment come out of informal sector, and in a way that takes into account the interests of both parties of the employment relationship.
Stagnation of Social Partnership in Russia
Authors: Neterebskiy Oleg V.
Published: April 2020

The Object of the Study. The system of social partnership in the Russian Federation.

The Subject of the Study. Agreements of the social partnership system of the Russian Federation at various levels (federal, territorial, sectoral).

The Purpose of the Study. Identification of trends and main causes of changes in the agreements of the social partnership system in the Russian Federation at various levels and their impact on basic social standards.

The Main Provisions of the Article. The author analyzes the agreements of the federal, sectoral and territorial levels of the social partnership system of the Rossiyskaya Federatsiya in chronological dynamics and examines the causes and trends of stagnation of social partnership The analysis of specific obligations of the parties to the agreements, shows a departure from the positive practices developed in the past shows the declarativity of social partnership agreements of the last period and the increasing role of the state while reducing the influence of civil society institutions and related social risks.
Digital Technologies: Creating a Human Resource Base
Authors: Kalinkin Yevgeniy V.
Published: April 2020

The Object of the Study is the practice of personnel support for the development, implementation and use of digital technologies, as well as the level of preparation of the population for digitalization in the social sphere.

The Subject of the Study analysis of forms and methods of training specialists and the population to implement digital technologies.

The Purpose of the Study: is determining the most effective forms and methods of personnel support for the digitalization process and the conditions for their replication.

The Main Provisions of the Article. The dependence of the process of digitalizing of the social economy on the training of specialists in digital technologies and digital literacy of the population. It is necessary to provide appropriate personnel support in the implementation of national projects and international agreements.

The author reveals the dependence of the effectiveness of the process (practice) of developing, implementing and using digital technologies on the level of professional training of the relevant specialists. A systematic approach to their training in colleges and universities is proposed. The forms and methods of searching for young people who are able and willing to work in the digital environment are defined. The necessity and forms of participation of potential employers in the training of specialists in digital technologies are justified, the advantages and content of their targeted training are noted. Variants of interuniversity cooperation in training specialists with the participation of scientific organizations are proposed. The necessity of improving the digital literacy of the population, as well as the features of digital training of citizens of pre-retirement age, is determined. Based on the system analysis of forms and methods of training specialists in digital technologies and improving the financial literacy of the population, the directions of their replication and improvement are proposed. The role of digital technologies in the development of international relations is reflected and methods of joint training of relevant specialists within the framework of the Eurasian economic union are proposed.
KADAR GLUKOSA DARAH MENCIT (MUS MUSCULUS) DIABETES MELLITUS PASKA PEMBERIAN MODEL LATIHAN ISOMETRIK
Authors: Hardiyanti Sonia , Harmayetty Harmayetty , Widyawati Ika Yuni
Published: April 2020

Introduction: Based on the latest research, exercise had significant effect to decrease blood glucose. The aimed of this study was to investigate the effect of isometric exercise model on blood glucose in Diabetic Mice (Mus musculus).Methodes: This research was used a true experimental study with randomize post-test only control group design. The sample was male mice (Mus musculus) in 20-27 grams weight. 27 male mice were divided into three groups; the first group was normal group (control) that injected by NaCl as placebo, the second group was diabetic mice and the third group was diabetic mice with exercise. Both second group and third group were injected by streptozotocin (STZ) to induce Diabetes Mellitus. After 2x24 hours injected, all groups were given oral glucose (Dextrose-40% or D40). One hour after they given by D40, the third group was treated by isometric exercise used treadmill for 23.31 minutes with 21 cm/second speed and 0° elevation angle. Then the blood samples of all groups were taken to measure the blood glucose level. Data were analyzed by One Kolmogorov-Smirnov test, ANOVA test, and Least Significance Difference (LSD) with significance level of α<0.05.Result: The result of One Kolmogorov-Smirnov test showed that there was p=0.94 in normal group, p=0.50 in diabetic group, and p=0.19 in diabetic with exercise group. The result of ANOVA test was p=0.08. The result of LSD for blood glucose revealed was p=0.23 for diabetic group and diabetic with exercise group. The researcher had an assumption that probably it happened because of in second group there were two mice that had normal blood glucose levels and in the third group the initial blood glucose levels were unknown, hence they probably could had normal blood glucose levels too. Discussion: It can be concluded that there is no effect of isometric exercise to decrease blood glucose. Further research should investigate more about the frequency and intensity of isometric exercise that could has effect to decrease blood glucose.
Vital Sign Status by Five Fingers Auditori Hypnosis
Authors: Wahyudi Beny , Hidayati Laily , Bakar Abu
Published: April 2020

Introduction: Five-finger hypnosis is a relaxation technique that can provide a relaxing and calming effect by recalling pleasant experiences that have been experienced so that they can have a positive effect on the vital-sign of respondents with fractures. The purpose of this study was to determine the effect of the influence of five-finger hypnosis auditory on vital signs: blood pressure, pulse frequency, respiratory frequency, and pain in clients with limb fractures. Method: This research uses quasi-experiment with post test only non-equivalent control group design. The total population is 57 patients and 54 respondents were obtained with consecutive sampling. The independent variable is a five-finger hypnosis auditory intervention and the dependent variable is systolic blood pressure, diastolic, frequency of frequency, respiratory frequency, and pain. Data were obtained from the Numeric Rating Scale (NRS) and observation sheets. Then the data were analyzed by the Mann-Whitney U Test. Result: There were differences between the treatment and control groups on systolic (p=0.002), diastolic (p=0.003), pulse frequency (p=0.003), respiratory frequency (p=0.000) and pain (p=0.001). Discussion: So the hypnosis auditory as a relaxation technique can have a positive influence on the respondent's vital sign which includes systolic blood pressure, diastolic, pulse frequency, respiratory frequency, and pain. It is expected that nurses can apply this therapy as a non-pharmacological therapy to patients with extremity fractures and other researchers can apply to patients with all types of fractures as well as the development of cultural cultures.
Kecerdasan Spritual dalam Self-Management pada Pasien Diabetes Melitus Tipe 2
Authors: Ardhiyanto Mohammad Dheni , Kusnanto Kusnanto , Nastiti Aria Aulia , Arifin Hidayat
Published: April 2020

Introduction. Kesadaran pasien DM tipe 2 yang kurang dan lamanya menderita merupakan faktor yang menghambat penderita DM tipe 2 sehingga tidak menjalankan self-management dengan baik. Tujuan dari penelitian ini adalah untuk mengetahui hubungan kecerdasan spiritual dan lama menderita dengan self-management pada penderita Diabetes mellitus (DM) tipe 2. Methods. Rancangan penelitian menggunakan cross sectional. Populasinya adalah pasien diabetes melitus tipe 2. Total sampel adalah 167 responden, diambil sesuai kriteria inklusi dan ekslusi. Teknik sampling yang digunakan adalah purposive sampling. Variabel independen adalah kecerdasan spiritual dan lama menderita. Variabel dependen adalah self-management. Data dikumpulkan dengan menggunakan kuisioner Kecerdasan Spiritual dan The Summary of Diabetes Self Care Activities (SDSCA), dan dianalisis menggunakan analisis spearman rho. Results.Hasil menunjukan bahwa ada hubungan kecerdasan spiritual dengan self-management (p=0,000) dan tidak ada hubungan lama menderita dengan self-management diet (p=0,879). Discussion. kecerdasan spiritual yang tinggi dapat membuat penderita DM tipe 2 memiliki self-management yang baik. lama menderita DM belum tentu membuat penderita DM memiliki self-management baik. selama penderita DM tipe 2 memiliki kesadaran untuk mejalankan self-management dengan baik, komplikasi dapat dicegah
Pengaruh Progressive Muscle Relaxation terhadap Stres dan Penurunan Kadar Gula Darah pada Pasien Diabetes Melitus Tipe 2
Authors: Herlambang Ungkas , Kusnanto Kusnanto , Hidayati Laily , Arifin Hidayat , Pradipta Rifky Octavia
Published: April 2020

Introduction: Diabetes Mellitus is a disease that occurs because the body is unable to produce insulin or the body cannot use insulin effectively. The purpose of this study was to find out the effect of Progressive Muscle Relaxation (PMR) on stress and blood glucose decrease in patients who have diabetes mellitus type 2 disease.Method: The design of this study is quasi-experimental study. The population of this study were the patients who have type 2 of diabetes mellitus disease at Puskesmas Kedungdoro and Puskesmas Medokan Ayu. There would be 70 respondents chosen based on inclusion and exclusion criteria. The researcher chose the purpose sampling technique in choosing the participants in this research. The independent variable in this study was Progressive Muscle Relaxation (PMR). The dependent variable in this study were stress and blood glucose decrease. The data in this study were collected using questionnaires and measurement of pre-prandial blood glucose level. Data were analyzed using analysis of Wilcoxon and paired t-test for pre-post measurements, then for the inter groups the researcher used Mann-Whitney analysis.Results: The results showed that there was an effect of PMR on stress (p = 0.001) and in decreasing blood glucose (p = 0.021).Discussion: PMR is a relaxation focused on the patient’s attention in distinguishing the group of muscle when they relaxed than while in contraction condition. Thus, the patients are expected to be able to manage the body condition in managing stress and blood sugar decrease. For health officers, they are expected to use the PMR as the combination in reducing stress and blood glucose to improve the quality of life of the patients who have diabetes type 2 disease.
Influence of Electrolyte Type, pH, Temperature and Aging on the Viscosity Property of Okra Gum as a Suspending Agent in Paracetamol Suspension
Authors: Vincent Obaga Nyandoro  , Joshua Ikoni Ogaji  , Jennifer Drambi Audu-Peter
Published: April 2020

The purpose of this study was to investigate the influence of electrolyte type, pH, temperature and aging on the viscosity property of okra gum using paracetamol as model drug. Paracetamol (125 mg/ 5 mL) suspension containing okra gum particles of undersize 180 µm as suspending agent was formulated. Similar suspension of paracetamol was formulated using tragacanth gum as a suspending agent for comparison. Effect of electrolyte type, pH, temperature and aging on the viscosity property of okra gum in paracetamol suspension was evaluated using standard methods. Addition of electrolytes, changes in pH, increase in temperature and increase in storage time were shown to decrease the viscosity of the paracetamol suspension. The effect of temperature and aging on the viscosity of the suspension formulation containing okra gum was more pronounced than on the formulation containing tragacanth gum. Conversely, the effect of alkaline pH and type of electrolyte on the viscosity of the suspension formulation containing tragacanth gum was more pronounced than on the formulation containing okra gum. On the basis of these, formulators and caregivers may consider these factors when designing or using pharmaceutical suspensions containing natural gums such as okra and tragacanth as viscosity enhancing agents.
Developed Process Validation Method of Lamotrigine Extended Release Tablets for Pharmaceutical Manufacturing
Authors: Kiranbala Jain  , Meenakshi Bharkatiya
Published: April 2020

Validation is integral part of cGMP, and assured production of quality based pharmaceutical products special reference to extended release tablets. The quality of pharmaceutical dosage form can be achieved by performing finished product testing and in-process monitoring. Hence, the present study was planned to developed process validation protocol and perform process validation for extended release tablets of Lamotrigine. The three different batches X, Y and Z of Lamotrigine extended release (Lamotrigine XR) tablets were manufactured with identified equipments and control parameters. The appearance, average weight, individual weight variation, thickness, hardness, assay, uniformity content and dissolution of blend stage, compression stage and coating stage of Lamotrigine XR were evaluated. Sampling, testing plan and acceptance criteria for each step were monitored. The findings exhibited that the values of all stages were found to be within the acceptable limit. Consequently, it can be concluded that the process stands validated and the data can be used in regulatory submission for obtaining marketing authorization of Lamotrigine XR tablets.
Metabolic Fitness of T Cells in Autoimmune Disease
Authors: Wu Bowen , Goronzy Jörg J. , Weyand Cornelia M.
Published: April 2020

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are relatively common autoimmune diseases, often considered prototypic examples for how protective immunity switches to destructive immunity. The autoantigens recognized in RA and SLE are distinct, clinical manifestations are partially overlapping. A shared feature is the propensity of the adaptive immune system to respond inappropriately, with T cell hyper-responsiveness a pinnacle pathogenic defect. Upon antigen recognition, T cells mobilize a multi-pranged metabolic program, enabling them to massively expand and turn into highly mobile effector cells. Current evidence supports that T cells from patients with RA or SLE adopt metabolic programs different from healthy T cells, in line with the concept that autoimmune effector functions rely on specified pathways of energy sensing, energy generation and energy utilization. Due to misrouting of the energy sensor AMPK, RA T cells have a defect in balancing catabolic and anabolic processes and deviate towards a cell-building program. They supply biosynthetic precursors by shunting glucose away from glycolytic breakdown towards the pentose phosphate pathway and upregulate lipogenesis, enabling cellular motility and tissue invasiveness. Conversely, T cells from SLE patients are committed to high glycolytic flux, overusing the mitochondrial machinery and imposing oxidative stress. Typically, disease-relevant effector functions in SLE are associated with inappropriate activation of the key metabolic regulator mTORC1. Taken together, disease-specific metabolic signatures in RA and SLE represent vulnerabilities that are therapeutically targetable to suppress pathogenic immune responses.
Mathematical Modelling of the Dynamics of Tumor Growth and its Optimal Control
Authors: Irana Ira Jannatun , Islam Md. Shahidul , Misra Jagadish Chandra
Published: April 2020

The dynamics of tumor cell growth and its treatment process is discussed in this paper. We analyze some simple mathematical models and generalized models to understand the growth of tumor cells. A couple of diffusion models are discussed to explain how the tumor cells spread and become more dangerous as well as the treatment process of cancer and how cancer cell behaves in the presence of different therapy and drugs. The optimal control of chemotherapy has been discussed. It has also been explained how much the model is effective in reducing tumor cells over time.
Influence of Biocompatible Coating on Titanium Surface Characteristics
Authors: Petrović Željka , Katić Jozefina , Šarić Ankica , Despotović Ines , Matijaković Nives , Kralj Damir , Leskovac Mirela , Petković Marin
Published: April 2020

Background: Nowadays investigations in the field of dental implants engineering are focused on bioactivity and osseointegration properties.Objective: In this study, the oxide-covered titanium was functionalized by vitamin D3 molecules via a simple self-assembly method with the aim to design more corrosion resistant and at the same time more bioactive surface.Methods: Surface properties of the D3-coated titanium were examined by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and contact angle measurements, while a long-term corrosion stability during immersion in an artificial saliva solution was investigated in situ by electrochemical impedance spectroscopy.Results: Results of all techniques confirmed a successful formation of the D3 vitamin layer on the oxide-covered titanium. Besides very good corrosion resistivity (~5 MΩcm2 ) the D3-modified titanium surface induced spontaneous formation of biocompatible bone-like calcium phosphates (CaP).Conclusion: Observed in vitro CaP-forming ability as a result of D3-modified titanium/artificial saliva interactions could serve as a promising predictor of in vivo bioactivity of implant materials.
Treatment of Dupuytren's Disease
Authors: Gocke Thomas V.
Published: April 2020

Update

This article was updated on June 12, 2020, because of a previous error.

An erratum (JBJS JOPA. 2020;8[2]: e0024ER) has been published for this article.

Dupuytren's disease is a benign fibromatosis that affects the palmar and digital fascia. The pathology associated with the development of Dupuytren's disease is the cause of some debate. Patients usually present with firm dense nodules or cords that cause flexion contractures of the metacarpal phalangeal (MCP) joints or proximal interphalangeal (PIP) joints. The severity of contracture, amount of functional impairment, and patient desired treatment will have an effect on the overall recovery following treatment. Historically, the standard of care for Dupuytren's disease was open surgical fasciectomy, percutaneous/open fasciotomy, and needle fasciotomy. Indications for surgical intervention include patients with functional impairment and metacarpophalangeal joint contractures of 30° or more. Collagenase Clostridium histolyticum (CCH), (enzymatic fasciotomy), which lyses collagen and leads to disruption of contracted cords, is an office-based, minimally invasive, nonsurgical option for the treatment of advanced Dupuytren's disease. Many of the studies looking at treatment with collagenase/manual manipulation have reported favorable 5-year outcomes. These studies have shown near-normal return of range of motion at the MCP and, to a lesser extent, PIP joints. The side effect/adverse effect profile has been promising. Injection sight pain and skin tears are the more commonly reported events associated with CCH therapy. Surgical fasciotomy has reported the most severe adverse effects consisting of sensory, motor, and vascular injuries. Physicians have used extension orthoses postoperatively to maintain finger extension following fasciotomy vs. fasciectomy. Some research studies have questioned the value of extension splinting indicating that the tension placed on the contracted tissue can lead to local tissue hypoxia. This has been reported to trigger a flare reaction and thus lead to more increased scar tissue formation. The treatment of Dupuytren's disease requires a comprehensive assessment of the patients' physical limitations; most consider cost-effective therapies that have limited adverse effects and provide long-term improvement in their daily functional activities.
Perbandingan Hasil Belajar Peserta Didik Menggunakan Problem Based Learning Dengan Contextual Teaching and Learning Dalam Pelajaran Geografi
Authors: Zalmita Novia , Rizkia Novra
Published: April 2020

Teaching and learning practices today are often found problems such as the use of models that are still minimal and not in accordance with the characteristics of students. Generally teachers teach using only conventional learning models, while the Kurikulum 2013 requires students to be able to think at a high level. This can certainly be achieved by applying learning models such as Problem Based Learning and Contextual Teaching and Learning in the learning process. This study aims to compare the learning outcomes of the two models in Class X Geography in SMAN 5 Banda Aceh. The research method uses a quantitative approach to the type of experimental research that is quasi-experimental design with the initial assumption that learning outcomes taught using Problem Based Learning are better than those taught using Contextual Teaching and Learning. The population in this study were all grade X students at SMAN 5 Banda Aceh. Sampling using a purposive sampling by considering the initial ability of students is the same. Samples were taken as many as two classes totaling 46 students. Hypothesis testing techniques using non-parametric statistical tests according to Mann-Whitney (U test) using the Z test because the sample> 20. The results obtained from the results of the U Test namely Zhitung = 5.81 and at a significance level of 5%, obtained Ztable = 1.65. So it is obtained Zhitung> Ztabel so accept Ha. Thus, it can be concluded that learning outcomes of students taught with Problem Based Learning (PBL) are better than Contextual Teaching and Learning (CTL) in Geography Class X in SMAN 5 Banda Aceh
Antibiotic susceptibility Patterns against Upper Respiratory Tract Pathogens in Tertiary Care Hospitals of Lahore, Pakistan
Authors: Ullah Kalim , Baloch Marvi , Iqbal Javeid , Khan Ayaz Ali , Saeed Hamid , Islam Muhammad
Published: April 2020

The authors have withdrawn this preprint due to author disagreement.
The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute
Authors: Wang Zhu , Xie Ya-Wen , Lu Qing , Yan Hai-Lin , Liu Xin-Bin , Long Yi , Zhang Xian , Yang Jinlin
Published: April 2020

Background: To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding. Methods: Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were systemically reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. For patients with rebleeding, the amount of albumin and red blood cell used before rebleeding was also documented. The primary outcome was the occurrence of rebleeding, and the second outcome was in-hospital mortality. Univariate and multivariate logistic analysis was performed to identify risk factors associated with rebleeding and in-hospital mortality. Results: A total of 2239 cirrhotic patients were included in the analysis. There were 245 episodes of in-patient rebleeding occurred, while 135 patients died. Overall, more red blood cells and albumin were prescribed to patients who suffered rebleeding. In terms of the amount before rebleeding, the red blood cell was higher in patients with rebleeding, but the albumin infusion was similar. In the multivariate model, the albumin infusion was an independent risk factor associated with rebleeding (adjusted OR for ≤40g, 0.385 [0.252-0.588], p<0.001; OR for >40g, 0.295 [0.169-0.514], p<0.001). The use of albumin more than 40g during hospitalization associated with a lower risk of in-patient mortality (adjusted OR for ≤40g, 0.730[0.375-1.423] , p=0.356; OR for >40g, 0.389 [0.180-0.838], p=0.016). Conclusions: Albumin infusion was associated with a lower risk of rebleeding and in-hospital deaths in cirrhosis admitted for acute gastrointestinal bleeding.
Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Authors: Adedimeji Adebola Alade , Ajeh Rogers , Pierz Amanda , Nkeng Relindis , Nde Jackson Jr. , Fuhngwa Norbert , Nsame Denis , Nji Miriam , Dzudie Anastase , Anastos Kathryn M. , Castle Philip E.
Published: April 2020

Background Cervical-cancer is a leading cause of death among Cameroon women. The burden of cervical-cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical-cancer prevention in women at risk in a high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical-cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical-cancer, lack of access to information on and excessive costs for cervical-cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical-cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical-cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical-cancer as a public health problem, our findings highlight challenges and opportunities that can inform the design of effective interventions to increase uptake of cervical-cancer screening.
Diagnostic Test Accuracy of New Generation Tympanic Thermometry in Children under Different Cutoffs: A Systematic Review and Meta-analysis
Authors: Shi Dan , Zhang Liyuan , Li Haixia
Published: April 2020

Purposes: To identify and quantify studies reporting the diagnostic accuracy of the new generation of infrared tympanic thermometer (IRTT) in children and to compare the sensitivity and specificity of IRTT under different cutoffs and give the optimal cutoff. Methods: Articles were derived from a systematic search in PubMed, Web of Science Core Collection, and Embase, and were assessed for internal validity by the Quality Assessment of Diagnostic Accuracy Studies-2　（QUADAS-Ⅱ）. The figure of risk of bias was created by Review Manager 5.3 and data were synthesized by MetaDisc 1.4. Results: Nineteen diagnostic studies, involving 4,639 pediatric patients, were included. The cut-offs varied from 37.0℃ to 38.0℃ among these studies. The cut-off 37.8℃ was with the highest sROC AUC (0.97) and Youden Index (0.83) and was deemed to be the optimal cutoff. Conclusion: The optimal cutoff for infrared tympanic thermometers is 37.8℃. New Generation Tympanic Thermometry is with high diagnostic accuracy in pediatric patients and can be an alternative for fever screening in children.
Comparing the Effect of Methadone, Buprenorphine, and Opium Tincture on QTc Interval in Addicted Patients Undergoing Maintenance Therapy
Authors: Hosseini Leila , Seyedi Malihe , Hojjat Seyyed Kaveh , Rezaeian Nahid , Khalili Mina Norouzi , Zadehbagheri Fatemeh , Asadian Sanaz , Bakhtiarpour Saeed
Published: April 2020

The authors have withdrawn this preprint due to author disagreement.
Healthcare Providers’ Perspectives on Family Presence During Resuscitation in the Emergency Departments of the Kingdom of Bahrain
Authors: Abuzeyad Feras , Elhobi Ahmed , Kamkoum Wael , Bashmi Luma , Qasim Ghada Al , Alqasem Leena , Mansoor Naser Mohamed Ali , Hsu Stephanie , Das Priya
Published: April 2020

Background: Worldwide, policies exist on family presence during resuscitation (FPDR), however, this is still lacking in the Gulf Corporation Countries (GCC) in general and in the Kingdom of Bahrain in particular. The aim of this study is to assess the perspectives of healthcare providers (HP) on FPDR among those working in the emergency departments (EDs) in the Kingdom. Methods: A self-administered anonymous electronic survey was collected from 146 HPs (emergency physicians and nurses) working in the three major EDs in the Kingdom of Bahrain. Besides demographic data, 18 items measuring HPs’ perceptions of FPDR were generated using the 5-point Likert scale.Results: Surveys (n= 146) from physicians and nurses were analysed (45.9% vs. 54.1%, respectively). There were significant differences between physicians and nurses in terms of personal beliefs, FPDR enhancing professional satisfaction and behaviour, and the importance of a support person and saying goodbye (p< 0.001). However, general responses demonstrated that the majority of HPs encouraged and supported FPDR, but with greater support from physicians than nurses. Conclusion: The study reflects that many HPs in EDs participated in and are familiar with FPDR, with the majority of ED physicians supporting it. Further studies should investigate the reasons for the lack of support from nurses. Results may contribute to the development of hospital ED policies that allow FPDR in the region.
Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey
Authors: Nguyen Co Thach , Moi Meng Ling , Le Thi Quynh Mai , Nguyen Thi Thu Thuy , Vu Thi Bich Hau , Nguyen Hai Tuan , Pham Thi Thu Hang , Le Thi Hien Thu , Nguyen Le Manh Hung , Ly Minh Huong Phu , Ng Chris Fook Sheng , Takemura Taichiro , Morita Kouichi , Hasebe Futoshi
Published: April 2020

Background : Between 2016 and 2019, 265 cases of Zika virus (ZIKV) infection were reported in Vietnam, predominantly in southern Vietnam. In 2016, a case of ZIKV-associated microcephaly was confirmed in the Central Highlands, and several members of the infant’s family were confirmed to be infected with ZIKV. The study aims to determine the level of immunity to ZIKV in the general population of the ZIKV epidemic region. Methods: A total of 879 serum samples were collected from 801 participants between January 2017 and July 2018, during and after the ZIKV epidemic in Vietnam. The samples were tested for anti-ZIKV immunoglobulin M (IgM) and immunoglobulin G (IgG), and anti-dengue virus (DENV) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Plaque-reduction neutralization test (PRNT) for ZIKV was performed on all samples, and for DENV on the samples that ZIKV neutralizing antibody positive. Results: A total of 83 (10.3%) participants had anti-ZIKV IgM. Of the 83, 6 were confirmed to be ZIKV antibodies positive using PRNT and anti-ZIKV IgG ELISA. Of the 718 participants who were anti-ZIKV IgM negative, a further 3 cases were confirmed as positive for antibodies against ZIKV. Of the 9 participants with ZIKV infection, 5 lived in the same village as the infant with ZIKV-associated microcephaly and the other 4 lived in 2 neighboring communes. Repeat samples were collected from the 83 ZIKV IgM positive participants 1.5 years after the first collection. No new cases of ZIKV infection were detected. In addition, 2 of 3 participants with anti-ZIKV NS1 IgG demonstrated a 4- to 8-fold increase in ZIKV neutralizing antibody titer. Conclusions: ZIKV was present in the area around Krong Buk, with the rate of ZIKV-specific antibodies was 1.1% in the community since at least 2016. While the low levels of circulation together with low seroprevalence suggests a limited outbreak in the region, the results also reflect on low levels of protective immunity to Zika within the population. These results provide a better understanding of the current ZIKV epidemic status in the region and demonstrate a need for implementation of more effective ZIKV infection control measures.