bluuebunny/crossref_metadata_2025 huggingface dataset:
Variasi Penambahan CTABr Sebagai Template Terhadap Pembentukan TiO2 Anatase Dari Senyawa Natrium Titanat dan Aplikasinya Sebagai Fotokatalis
Authors: Dewi Widya Puspita , Haryati Tanti , Suwardiyanto Suwardiyanto , Sulistiyo Yudi Aris , Andarini Novita
Published: January 2020

TiO2 anatase mesopori (ukuran pori 2-50 nm) memiliki aktivitas fotokatalitik yang besar. Metode sintesis kimia padat dapat digunakan sebagai alternatif untuk memperoleh TiO2 anatase dari natrium titanat dengan menggunakan prekursor yang murah berupaTiO2 rutile komersial. Surfaktan CTABr (Cetyltrimethylammonium Bromide) mampu menghasilkan TiO2 anatase mesopori dengan kemampuannya sebagai template atau agen pembentuk pori. Penelitian ini bertujuan mengetahui pengaruh variasi penambahan CTABr terhadap distribusi ukuran pori, volume total pori, luas permukaan TiO2 dan dan aktivitas fotokatalitik TiO2 hasil sintetis. Sintesis dilakukan menggunakan metode reaksi kimia padat dengan penambahan variasi perbandingan mol CTABr dan tanpa penambahan CTABr sebagai pembanding. Karakterisasi menggunakan XRD (X- Ray Powder Difraction), SEM (Scanning Electron Microscopy) dan Gas Sorption Analyer (GSA) untuk mengetahui struktur, morfologi dan sifat pori TiO2. TiO2 anatase mesopori hasil sintesis diaplikasikan sebagai fotokatalis dalam mendegradasi metilen biru. Hasil penelitian ini menunjukkan bahwa TiO2 anatase mesopori berhasil didapatkan dengan morfologi partikelnya berbentuk seperti balok, sisi tidak seragam serta ukuran partikel berkisar 200-500 nm. Variasi penambahan CTABr tidak memberikan pengaruh yang signifikan terhadap distribusi ukuran pori, volume total pori, luas permukaan dan aktivitas fotokatalitik dari TiO2 anatase mesopori, dengan hasil distribusi pori mayoritas pada 2 nm dan aktivitas fotokatalitik sekitar 77%
ASEAN E-Commerce Legal Framework and Alignment of Lao PDR: A Review
Authors: Sengpunya Phet
Published: January 2020

In the era of digital, the internet has become a new channel for meeting and social interaction of people all around the world, and it has also become an essential platform for commercial activities, especially e-commerce. E-commerce has become a significant driving force for the growth of the economy for all regions around the world. For example, ASEAN, ICT, and e-commerce are recognized as an essential segment for regional integration. ASEAN developed its legal framework in order to promote and facilitate the development of ICT and the growth of e-commerce within the region. Unlike the European Union, ASEAN is not a supranational organization, and it cannot legislate for a whole community. Thus its e-commerce legal framework is developed by harmonizing the Member Countries' national laws into the regional legal system. This paper aims to introduce how ASEAN designs its legal framework for regional cooperation, with a focus on e-commerce. The paper presents how Lao PDR, as a member country of ASEAN, fulfills provisions agreed under the e-ASEAN framework to help understand the way ASEAN Member Countries undertake action to align with ASEAN e-commerce legal framework. To this end, this paper also provides an overview of the e-commerce of ASEAN as a whole and Lao PDR.

Keywords: ASEAN, Lao PDR, E-Commerce Legal Framework, Regional Legal System.
Analisis Klasifikasi Kanker Payudara Menggunakan Algoritma Naive Bayes
Authors: Oktavianto Hardian , Handri Rahman Puji
Published: January 2020

Breast cancer is one of the highest causes of death among women, this disease ranks second cause of death after lung cancer. According to the world health organization, 1 million women get a diagnosis of breast cancer every year and half of them die, in general this is due to early treatment and slow treatment resulting in new cancers being detected after entering the final stage. In the field of health and medicine, machine learning-based classification has been carried out to help doctors and health professionals in classifying the types of cancer, to determine which treatment measures should be performed. In this study breast cancer classification will be carried out using the Naive Bayes algorithm to group the types of cancer. The dataset used is from the Wisconsin breast cancer database. The results of this study are the ability of the Naive Bayes algorithm for the classification of breast cancer produces a good value, where the average percentage of correctly classified data reaches 96.9% and the average percentage of data is classified as incorrect only 3.1%. While the level of effectiveness of classification with naive bayes is high, where the average value of precision and recall is around 0.96. The highest precision and recall values are when the test data uses a percentage split of 40% with the respective values reaching 0.974 and 0.973.
Optimization of Povidone K-30 and Sodium Starch Glycolate on Levofloxacin Tablet by Factorial Design
Authors: Setyawan Dwi , Soeratri Widji , Nuruddin Mahrus Naufal , Paramita Diajeng Putri , Widjaja Bambang
Published: January 2020

The aim of this study was to determine the effect of binder and disintegrant excipients toward tablet properties of levofloxacin as the latter tends to suffer brittle fracture upon compression. The excipients used were povidone K-30 as the binder and sodium starch glycolate (SSG) as the disintegrant which the tablets were formulated according to factorial design 22 with two factors and two levels on each factor. Four formulas were prepared by wet granulation method using 2 and 4% of each povidone K-30 and sodium starch glycolate in various compositions. Tablet properties were evaluated for its hardness, friability, and disintegration time as well as dissolution profile. The data obtained was statistically analyzed using Minitab® 17 software to optimize the formulation and resulted in different impacts caused by each excipient. Povidone K-30 exhibited an increment in hardness, friability, disintegration time but a decrease indissolution profile of levofloxacin tablet. SSG decreased hardnessand disintegration time, but increased friability and dissolution profile of levofloxacin tablet. Overlaid contour plot showed that the optimal formula regarding tablet properties of friability, disintegration time, and dissolution profile is in composition of 2.01% povidone K-30 and 2.01% sodium starch glycolate. Keywords: levofloxacin tablet, povidone K-30, sodium starch glycolate, factorial design.
Food Habit of Seluang Batu (Paracrossochilus vittatus Boulenger 1894) in Mentuka River Sekadau Districts West Kalimantan Province
Authors: Pratiwi Diah , Setyawati Tri Rima , Yanti Ari Hepi
Published: January 2020

Seluang batu (Paracrossochilus vittatus) is one of the Borneo endemic fish from Cyprinidae Family that live in high stream water. The aim of this study was to know the food habit and niche breadth of seluang batu in Mentuka River. This study was conducted 3 months from November 2016 to January 2017. The sampling method used in this research was purposive random sampling. Seluang batu was taken from three stations in the Mentuka River using trap nets. The fish was measured in length and weight, then dissected to find out the type of food in the stomach. Food analysis was determined using index of preponderance and the niche breadth using Smith’s index. The results showed that seluang batu in Mentuka River including herbivore because they eat microalgae, namely Synedra was main food. Nice breadth of seluang batu for peryphiton was 0.71 meanwhile plankton was 0.20. Most of peryphiton and plankton in Mentuka River are Bacillariophyceae. The Mentuka River environtment supported the life of seluang batu and their natural food, namely the temperature about 26-28 ̊C, current speed was about 1-2,6 m/s, pH was about 6,8-7,3, dissolved oxygen was about 6,1-7 mg/L and free CO2 was 3,9-5,0 mg/L. Keywords: food habit, Paracrossochilus vittatus, periphyton, plankton.
PERBANDINGAN LINGKAR BETIS DAN LINGKAR LENGAN ATAS SEBAGAI UKURAN PENGGANTI BERAT LAHIR
 [Comparison between Calf and Mid-Upper Arm Circumference Alternative of Birthweight Measurement]

Authors: Putra Wahyu Kurnia Yusrin , Kusharisupeni Kusharisupeni , Fajarini Isna Aulia
Published: January 2020

High proportion of unmeasured birth weight as well as its improper documentation has become a problem in developing countries, including Indonesia. In 2017, a total of 9.9% labour were not assisted by health personnel and 43.4% of newborn did not have proper birth record. This condition increases the possibility of undetected low birth weight (LBW) cases. Therefore, this study aimed to determine an alternative measurement of birth weight which able to detect LBW. The study used cross sectional approach to analyse birth records from maternity clinic. A total of 100 records met the inclusion criteria, such as has complete record of birth weight, calf circumference, and mid-upper arm circumference (MUAC) which were measured within fi rst 24 hours of birth. Data was analysed using correlation test, area under curve (AUC), sensitivity, specifi city, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio. Result showed that calf circumference and MUAC were signifi cantly correlated with birth weight (p <0.001) with r value 0.529 and 0.674 respectively. At cut-off value 10.62 cm, calf circumference had AUC 0.90, sensitivity 66.7%, specifi city 97.9%, PPV 8.2%, NPV 98.2%, likelihood ratio (+) 31.7 and likelihood ratio (-) 0.03. Calf circumference had better performance as alternative measurement of birth weight to detect LBW compared to MUAC.
Introduction to economy. Monograph
Authors: Kaledin Sergey
Published: January 2020

In the current economic environment, the sphere of management of the economic
and financial state of the enterprise is no longer a special area, but has become
the instrument of management of the enterprise, which most economists and
managers of the middle and highest ranks are obliged to own E.The qualified
manager should be able to determine the financial implications of his decisions
and the financial conditions of their successful realization This monograph is
intended to study and master the complex of economic, financial and commercial
skills of students, to study methods and to perform practical analysis, modeling
and planning of financial indicators. Taking into account the set goals and solved
tasks, the relevance of this monograph does not cause with.
OS OLHARES DA COMUNICAÇÃO ORGANIZACIONAL NO BRASIL PARA O ENSINO SOB O PARADIGMA DA COMPLEXIDADE
Authors: Theodoro Luciana Santos Almeida , Porto Junior Francisco Gilson Rebouças
Published: January 2020

RESUMO
Inseridos em um mundo onde o processo de ensino-aprendizagem carece superar a visão conteudista para se tornar, no mínimo, eficiente, já não é possível pensarmos em pesquisas sobre formação na área da comunicação organizacional sem antes relacioná-la a novas metodologias que objetivam melhorias em sala de aula. Nesse contexto é que esse artigo pretende buscar como o termo Paradigma da Complexidade tem aparecido nos artigos publicados nos Anais do Congresso da Abrapcorp, o mais representativo da área no Brasil.
 
PALAVRAS-CHAVES: Paradigma da Complexidade; Abrapcorp; Congresso.
 
ABSTRACT
Inserted in a world where the teaching-learning process needs to overcome the contentist vision to become, at least, efficient, it is no longer possible to think about research on training in the area of ​​organizational communication without first relating it to new methodologies that aim at improvements in the classroom. In this context, this article intends to look for how the term Complexity Paradigm has appeared in articles published in the Annals of the Congress of Abrapcorp, the most representative of the area in Brazil.
 
KEYWORDS: Complexity paradigm; Abrapcorp; Congress.
 
RESUMEN
Insertado en un mundo donde el proceso de enseñanza-aprendizaje necesita superar la visión contendiente para ser, al menos, eficiente, ya no es posible pensar en la investigación sobre capacitación en el área de comunicación organizacional sin primero relacionarla con nuevas metodologías que apuntan a mejorar En el aula. En este contexto, este artículo tiene la intención de buscar cómo ha aparecido el término Paradigma de complejidad en los artículos publicados en el Annals of Abrapcorp Congress, el más representativo del área en Brasil.
 
PALABRAS CLAVE: paradigma de complejidad; Abrapcorp; Congreso.
Synthesis of Nano Silver using Bioreductor of Tristaniopsis merguensis Leaf Extracts and Its Antibacterial Activity Test
Authors: Fabiani Verry Andre , Putri Megawati Ayu , Saputra Marhan Ebit , Indriyani Della Puspita
Published: January 2020

Synthesis nanosilver from pelawan leaf extract (Tristaniopsis merguensis) has been carried out. The variables of this study were variations in the concentration of AgNO3 1 mM, 1.5 mM and 2 mM. Pelawan leaf extract acted as a bioreductor that converts Ag+ to Ag0. The synthesis was carried out in a ratio of 1: 4 (opposition leaf extract: AgNO3 solution) at 70 °C for 1.5 hours. The results of the UV-Vis analysis showed the maximum at the 1 mM; 1.5 mM; 2 mM AgNO3 concentration were 391 nm, 392 nm and 400 nm, respectively. XRD analysis explained that the resulting nanosilver was crystalline and according the Scherrer equation an average particle size was of 22.8 nm. The antibacterial activity test of nanosilver was carried out by disc method, nanosilver showed the existence of strong antibacterial activity against E. coli and S. aureus bacteria.

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Partial Lateral Meniscectomy Affects Knee Stability Even in Anterior Cruciate Ligament-Intact Knees
Authors: Novaretti João V. , Lian Jayson , Patel Neel K. , Chan Calvin K. , Cohen Moises , Musahl Volker , Debski Richard E.
Published: January 2020

Background:

The effects of a partial lateral meniscectomy on knee kinematics and forces in the lateral meniscus are critical to understand. The purpose of this study was to quantify the effects of varying sizes of partial lateral meniscectomies of the posterior horn and a total lateral meniscectomy on knee kinematics and resultant forces in the lateral meniscus.

Methods:

Using a robotic testing system, loads (134-N anterior tibial load + 200-N axial compression, 5-Nm internal tibial torque + 5-Nm valgus torque, and 5-Nm external tibial torque + 5-Nm valgus torque) were applied to 10 fresh-frozen cadaveric knees. The resulting joint motion and resultant forces in the lateral meniscus were determined for 4 knee states: intact, one-third and two-thirds partial lateral meniscectomies of the posterior horn, and total lateral meniscectomy.

Results:

A decrease in lateral translation of the tibia (up to 166.7%) was observed after one-third partial lateral meniscectomies of the posterior horn compared with the intact knee, in response to an anterior load at all knee flexion angles tested (p < 0.05). One-third partial lateral meniscectomies of the posterior horn decreased the resultant forces in the lateral meniscus compared with the intact knee at all knee flexion angles tested in response to an anterior load (p < 0.05) and to an internal tibial torque (p < 0.05). The results of two-thirds partial lateral meniscectomies of the posterior horn were similar to those of one-third partial meniscectomies (p > 0.05). Total lateral meniscectomies further decreased the lateral translation of the tibia (up to 316.6%) compared with the intact knee in response to an anterior load (p < 0.05).

Conclusions:

The changes in joint motion and meniscal forces observed in this study after even small partial lateral meniscectomies may predispose knees to further injury.

Clinical Relevance:

Surgeons should always consider repairing and minimizing the resection of even small lateral meniscal tears to prevent the potential deleterious effects of partial meniscectomy reported in this cadaveric study.
Analgesia in Total Knee Arthroplasty
Authors: Summers Spencer , Mohile Neil , McNamara Colin , Osman Brian , Gebhard Ralf , Hernandez Victor Hugo
Published: January 2020

➢ Implementation of multimodal pain management regimens after total knee arthroplasty has increased patient satisfaction, decreased pain scores, and facilitated faster recovery.

➢ A variety of oral and intravenous analgesics, including nonsteroidal anti-inflammatory drugs, gabapentinoids, acetaminophen, and opioids, can be employed preoperatively and postoperatively.

➢ Neuraxial anesthesia, peripheral nerve blocks, and periarticular injections are effective pain modulators that should be implemented in concert with the anesthesia teams.

➢ There is no consensus on the optimal multimodal pain regimen, and substantial variability exists between institutions and providers.

➢ The goals of minimizing pain and improving functional recovery in the postoperative period must be considered in light of evidence-based practice as well as the risk profile of the proposed analgesic treatment.
Analisis Volatilitas Harga Cabai Keriting di Indonesia dengan Pendekatan ARCH GARCH
Authors: Nugrahapsari Rizka Amalia , Arsanti Idha Widi
Published: January 2020

English
Chili includes a strategic commodity in Indonesia because of its high price volatility that makes it a major determinant of national inflation dynamics. The government always tries to improve its capability in implementing the chili price stabilization policy. The objective of the study is to assess the volatility of curly chili price volatility in Indonesia by using the ARCH GARCH approach with daily price data of January 2011 to December 2015. The results showed that the right model to calculate chili price volatility is ARCH (1). The price volatility was low and price movement was only influenced by the volatility in the previous day, not by the price variant, so the chili price volatility in the future will be smaller. Low volatility indicates that demand and supply characteristics were predictable. Price changes gradually and predictable. Farmers’ protection policy through import restrictions improves stability of domestic supply. The policy reduces the risk of drastic decline in prices due to imported chili, so the price volatility of chili in the period 2011–2015 was lower than the previous period. However, the seasonal price variation remains. Therefore, the policy should be supported with all season chili availability assurance.

Indonesian
Cabai termasuk komoditas strategis di Indonesia karena harganya volatil sehingga menjadi salah satu penentu utama dinamika inflasi nasional. Untuk itu, pemerintah senantiasa berusaha meningkatkan kemampuannya dalam melaksanakan kebijakan stabilisasi harga cabai. Penelitian ini bertujuan untuk mengkaji volatilitas harga cabai keriting di Indonesia dengan pendekatan ARCH GARCH dan data harga harian cabai keriting periode Januari 2011 hingga Desember 2015. Hasil penelitian menunjukkan bahwa model yang tepat untuk menghitung volatilitas harga cabai keriting adalah ARCH(1). Hasil pendugaan model menunjukkan volatilitas harga cabai keriting rendah dan pergerakan harga hanya dipengaruhi oleh volatilitas pada satu hari sebelumnya, tidak dipengaruhi varian harga, sehingga diperkirakan volatilitas harga cabai keriting di masa datang akan semakin kecil. Volatilitas yang rendah menunjukkan karakteristik waktu permintaan dan penawaran cabai keriting dapat diprediksi. Perubahan harga terjadi bertahap dan dapat diperkirakan. Kebijakan perlindungan petani melalui pembatasan impor cabai menyebabkan penyediaan cabai di dalam negeri menjadi lebih stabil. Kebijakan ini mengurangi risiko penurunan harga secara drastis akibat masuknya cabai impor, sehingga volatilitas harga cabai pada periode 2011–2015 lebih rendah dibandingkan periode sebelumnya. Namun, masih terdapat variasi harga musiman. Oleh karena itu, kebijakan ini perlu diperkuat dengan upaya jaminan sediaan cabai sepanjang musim.
Factors that influence the use of community assets by people with physical disabilities: results of participatory mapping in Envigado, Colombia.
Authors: Toro-Hernandez Maria Luisa , Villa-Torres Laura , Mondragón-Barrera Mónica Alejandra , Camelo-Castillo Wendy
Published: January 2020

Background: Disability is an evolving concept that results from the complex interaction between a person with an impairment and the context in which he/she lives. There is limited understanding on the types, access and use of community assets valuable for people with disabilities, and the role of contextual factors in Colombia. Our goal with this work was to identify the factors at the levels of the socio-ecological framework, and their interaction, that influence the use of community assets among people with physical disabilities and community stakeholders in Envigado, Colombia. Methods: Using participatory mapping, a community based participatory approach, we carried out an assessment of community assets identified by people with disabilities and rehabilitation professionals. In-depth interviews (n=32) informed the design of two participatory mapping activities, one among people with disabilities (n=5) and a second with rehabilitation professionals (n=4). Results were presented in a community forum to receive feedback on the findings. Results: Main findings indicate a chain of contextual factors that limit access and use of assets stemming from the personal (e.g. financial resources, inaccessible housing), interpersonal level (e.g. lack of a personal assistance or aid), and community levels (e.g. lack of accessible public transportation and inaccessible buildings). In most cases these barriers are heightened by system level barriers (e.g. lack of effective enforcement of the legal framework). Conclusions: Identifying these contextual factors, and their interactions, calls for stronger enforcement of the existing legal framework through articulated work between different stakeholders, so that people with disabilities can enjoy community assets.
Tuberculosis among economic migrants: A cross‐sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
Authors: Vo Luan Nguyen Quang , Codlin Andrew James , Forse Rachel Jeanette , Nguyen Hoa Trung , Vu Thanh Nguyen , Truong Vinh Van , Do Giang Chau , Nguyen Lan Huu , Le Giang Truong , Caws Maxine
Published: January 2020

Background: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. Methods: This cross-sectional study evaluated WHO-defined TB treatment outcomes among economic migrants in an urban district of Ho Chi Minh City, Viet Nam. We measured the association of a patient’s government-defined residency status with treatment success and loss to follow-up categories at baseline and performed a comparative interrupted time series analysis to assess the impact of community-based adherence support on treatment outcomes. Results: Short-term, inter-province migrants experienced lower treatment success (aRR=0.95 [0.92-0.99], p=0.010) and higher loss to follow-up (aOR=1.98 [1.44-2.72], p<0.001) than permanent residents. Intra-province migrants were similarly more likely to be lost to follow-up (aOR=1.86 [1.03-3.36], p=0.041). There was evidence that patients >55 years of age (aRR=0.93 [0.89-0.96], p<0.001), relapse patients (aRR=0.89 [0.84-0.94], p<0.001), and retreatment patients (aRR=0.62 [0.52-0.75], p<0.001) had lower treatment success rates. TB/HIV co-infection was also associated with lower treatment success (aRR=0.77 [0.73-0.82], p<0.001) and higher loss to follow-up (aOR=2.18 [1.55-3.06], p<0.001). The provision of treatment adherence support increased treatment success (IRR(β 6 )=1.07 [1.00, 1.15], p=0.041) and reduced loss to follow-up (IRR(β 6 )=0.17 [0.04, 0.69], p=0.013) in the intervention districts. Loss to follow-up continued to decline throughout the post-implementation period (IRR(β 7 )=0.90 [0.83, 0.98], p=0.019). Conclusions: Economic migrants, particularly those crossing provincial borders, have higher risk of poor treatment outcomes and should be prioritized for tailored adherence support. In light of accelerating urbanization in many regions of Asia, implementation trials are needed to inform evidence-based design of strategies for this vulnerable population.
Reducing Barriers to Post-9/11 Veterans’ Use of Programs and Services as They Transition to Civilian Life
Authors: Morgan Nicole R. , Aronson Keith R. , Perkins Daniel F. , Bleser Julia A. , Davenport Katie , Vogt Dawne , Copeland Laurel A. , Finley Erin P. , Gilman Cynthia L.
Published: January 2020

Background - Numerous programs exist to support veterans in their transitions to civilian life. Programs are offered by a host of governmental and non-governmental stakeholders. Veterans report encountering many barriers to program participation. This was the first study to identify barrier reduction strategies offered by programs that post-9/11 veterans report using, determine which strategies veterans use and value, and to examine veteran characteristics that impact their odds of using programs that offer barrier reduction strategies. Method - This study reflects findings from the first wave of data collection of The Veterans Metrics Initiative, a longitudinal study examining the military-to-civilian reintegration of post-9/11 veterans. Veterans were asked to indicate which programs they had used. The websites of these programs were coded for the barrier reduction components. Veterans also indicated which barrier reduction components they found most helpful in meeting their reintegration goals. Results - Of 9,566 veterans who participated in Wave 1 data collection, 84% reported using a program that offered at least one barrier reduction component. Barrier reduction components included tangible supports (e.g., scholarships, cash), increased access to programs, decreased stigma, and encouraged motivation to change. Although only 4% of programs that were used by veterans focused on helping them obtain Veterans Administration benefits, nearly 60% of veterans reported that this component was helpful in reaching their goals. Access assistance to other resources and supports was also reported as a helpful barrier reduction component. For instance, approximately 20% of veterans nominated programs that offered transportation. The study also found evidence of a misalignment between the kinds of barrier reduction components veterans valued and those which programs offered. Veterans from the most junior enlisted ranks, who are at most risk, were less likely than those from other ranks to use barrier reduction components. Conclusions – Despite the evidence that barrier reduction components enhance access to programs and contribute to program sustainability, many programs used by post-9/11 veterans do not offer them. There is also a misalignment between the barrier reduction strategies veterans value and the strategies offered by programs. Veteran serving organizations should increasingly implement barrier reduction strategies that veterans value.
Evaluation of confounding in epidemiologic studies assessing alcohol consumption on the risk of ischemic heart disease
Authors: Wallach Joshua D , Serghiou Stylianos , Chu Lingzhi , Egilman Alexander C , Vasiliou Vasilis , Ross Joseph S , Ioannidis John PA
Published: January 2020

Background: Among different investigators studying the same exposures and outcomes, there may be a lack of consensus about potential confounders that should be considered as matching, adjustment, or stratification variables in observational studies. Concerns have been raised that confounding factors may affect the results obtained for the alcohol-ischemic heart disease relationship, as well as their consistency and reproducibility across different studies. Therefore, we assessed how confounders are defined, operationalized, and discussed across individual studies evaluating alcohol and ischemic heart disease risk. Methods: For observational studies included in a recent alcohol-ischemic heart disease meta-analysis, we identified all variables adjusted, matched, or stratified for in the largest reported multivariate model (i.e. potential confounders). We recorded how the variables were measured and grouped them into higher-level confounder domains. Abstracts and Discussion sections were then assessed to determine whether authors considered confounding when interpreting their study findings. Results: 85 of 87 (97.7%) studies reported multivariate analyses for an alcohol-ischemic heart disease relationship. The most common higher-level confounder domains included were smoking (79, 92.9%), age (74, 87.1%), and BMI, height, and/or weight (57, 67.1%). However, no two models adjusted, matched, or stratified for the same higher-level confounder domains. Most (74/87, 85.1%) articles mentioned or alluded to “confounding” in their Abstract or Discussion sections, but only one stated that their main findings were likely to be affected by residual confounding. There were five (5/87, 5.7%) authors that explicitly asked for caution when interpreting results. Conclusion: There is large variation in the confounders considered across observational studies evaluating alcohol and ischemic heart disease risk and almost all studies spuriously ignore or eventually dismiss confounding in their conclusions. Given that study results and interpretations may be affected by the mix of potential confounders included within multivariate models, efforts are necessary to standardize approaches for selecting and accounting for confounders in observational studies.
Pattern of nucleotide variants of TP53 and their correlation with the expression of p53 and its downstream proteins in a Sri Lankan cohort of breast and colorectal cancer patients
Authors: Manoharan Vahinipriya , Karunanayake Eric Hamilton , Tennekoon Kamani Hemamala , De Silva Sumadee , Imthikab Ahamed Ilyas Ahamed , De Silva Kanishka , Angunawela Preethika , Vishwakula Sameera , Lunec John
Published: January 2020

Background
Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka.

Methods

30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53 . We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients.

Results

Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS ; three of them were on codon 12 and one was on codon 61.

Conclusion

The prevalence of pathogenic somatic TP53 variants was 31% and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5 – 8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.
Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients
Authors: Hou Ji-Fei , Hu Chuan , Zhang Yun , Liu Yan-Zheng , Zhang Chi , Li Jing , Wang Yue , Li Cheng-Cheng
Published: January 2020

Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods: A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results: All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co- morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions: These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.
Isoniazid causes heart looping disorder in zebrafish embryos by the induction of oxidative stress
Authors: Ni Jie , Wang Hongye , Xiyi Wei , Shen Kangjie , Sha Yeqin , Dong Yuxiang , Shu Yimei , Wan Xiaojie , Chen Jingwen , Wang Fang , Yihai Liu
Published: January 2020

Background: The cardiotoxicity of isoniazid on zebrafish embryos and its underlying mechanism is unclear. Methods: Here, we exposed zebrafish embryos at 4 hours post-fertilization to different levels of isoniazid and recorded the morphology and number of malformed and dead embryos under the microscope. Results: The high concentration of isoniazid group showed more malformed and dead embryos than the low concentration of isoniazid group and control group. The morphology of the heart and its alteration were visualized using transgenic zebrafish (cmlc2: GFP) and confirmed by in situ hybridization. The negative effects of isoniazid on the developing heart were characterized by lower heart rate and more heart looping disorders. Mechanistically, PCR showed decreased expression of heart-specific transcription factors when exposed to isoniazid. Oxidative stress was induced by isoniazid in cardiomyocytes, mediated by decreased activities of catalase and superoxide dismutase, which were rescued by scavengers of reactive oxygen species. Conclusion: In conclusion, this study demonstrated that isoniazid led to heart looping disturbance by the downregulation of cardiac-specific transcription factors and induction of cardiomyocyte apoptosis.
Community-level socioeconomic inequality in the incidence of ischemic heart disease: a nationwide cohort study
Authors: Gwon Jun Gyo , Choi Jimi , Han Young Jin
Published: January 2020

Background
The purpose of this study was to confirm that inequalities in community-level social economic status (SES) do actually impact the incidence of ischemic heart disease (IHD) using the Korean population-based cohort study of the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.
Methods
This study used the NHIS-NSC database, a population-based cohort database established by the NHIS in South Korea. Community-level SES was classified into three categories, i.e. low, moderate, and high, according to the rank. The outcome measure of interest was IHD, which was defined according to the International Classification of Disease, 10th Revision (ICD-10) codes.
Results
In the low community-level SES group, the incidence of IHD was 3.56 per 1,000 person years (cumulative incidence rate, 1.78%), and in the high community level SES group, it was 3.13 per 1,000 person years (cumulative incidence rate, 1.57%). Multivariate analysis showed that the incidence of IHD was higher in the low community-level SES group (p=0.029). The log-rank test showed that the cumulative incidence of IHD was higher in the low community level SES group than the high community-level SES group (adjusted hazard ratio, 1.16; 95% CI, 1.01-1.32)
Conclusions
People living in areas with low community-level SES show an increased incidence of IHD. Therefore, intervention in active, health-risk behavior corrections at the local level will be required to reduce the incidence of IHD.
The Oxidoreductase DsbA1 negatively influences 2,4-diacetylphloroglucinol biosynthesis by interfering the function of Gcd in Pseudomonas fluorescens 2P24
Authors: Zhang Bo , Zhao Hui , Wu Xiaogang , Zhang Li-Qun
Published: January 2020

The polyketide antibiotic 2,4-diacetylphloroglucinol (2,4-DAPG), produced by Pseudomonas fluorescens 2P24, is positively regulated by the GacS-GacA two-component system. Here we reported on the characterization of DsbA1 (disulfide oxidoreductase) as novel regulator of biocontrol activity in P. fluorescens . Our data showed that mutation of dsbA1 caused the accumulation of 2,4-DAPG in a GacA-independent manner. Further analysis indicated that DsbA1 interacts with membrane-bound glucose dehydrogenase Gcd, which positively regulates the production of 2,4-DAPG. Mutation of cysteine (C)-235, C275, and C578 of Gcd, significantly reduced the interaction with DsbA1, enhanced the activity of Gcd and increased 2,4-DAPG production. Taken together, our results suggest that DsbA1 regulates the 2,4-DAPG concentration via fine-tuning the function of Gcd in P. fluorescens 2P24.
The S68G polymorphism is a compensatory mutation associated with the drug resistance mutation K65R in CRF01_AE strains
Authors: Li Shengjia , Ouyang Jinming , Zhao Bin , An Minghui , Wang Lin , Ding Haibo , Zhang Min , Author) Xiaoxu Han(New Corresponding
Published: January 2020

Background The rate of S68G mutation in human immunodeficiency virus type 1 (HIV-1) reverse transcriptase has increased and is closely related to the K65R mutation among CRF01_AE-infected patients who failed treatment. We aimed to explore the temporal association of S68G and K65R mutations and disclose the role of the former on susceptibility to nucleotide/nucleoside reverse transcriptase inhibitor (NRTI) and viral replication with the K65R double mutations among CRF01_AE-infected patients who failed treatment. Methods The occurrence of S68G and K65R mutations was evaluated among HIV-1 of various subtypes in the global HIV Drug Resistance Database. The temporal association of S68G and K65R mutations was analyzed through next-generation sequencing in four CRF01_AE-infected patients who failed treatment with tenofovir/lamivudine/efavirenz. The impact of the S68G mutation on susceptibility to NRTI and replication fitness was analyzed using pseudovirus phenotypic resistance assays and growth competition assays, respectively. Results The frequency of the S68G mutation increased by 1.4–9.7% in almost all HIV subtypes and circulating recombinant forms in treatment-experienced patients, except subtype F. The S68G mutation often occurred in conjunction with the K65R mutation among RTI-treated patients, with frequencies ranging 21.1%–61.7% in various subtypes. Next-generation sequencing revealed that the S68G mutation occurred following the K65R mutation in three of the four CRF01_AE-infected patients. In these three patients, there was no significant change detected in the half maximal inhibitory concentration for zidovudine, tenofovir, or lamivudine between the K65R and K65R/S68G mutations, as demonstrated by the phenotypic resistance assays. Virus stocks of the K65R and K65R/S68G mutations were mixed with 4:6, 1:1, and 9:1 and cultured for 13 days, the K65R/S68G mutants outgrew those of the K65R mutants irrespective of the input ratio. Conclusions S68G may be a natural polymorphism and compensatory mutation of K65R selected by NRTIs in the CRF01_AE strain of HIV-1. This mutation does not affect susceptibility to NRTI; however, it improves the replication fitness of K65R mutants. This study deciphers the role of the S68G mutation in the HIV reverse transcriptase of the CRF01_AE strain and provides new evidence for the interpretation of drug-resistant mutations in non-B subtypes of HIV-1.
Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China
Authors: Han Meng , Zhang Xinping
Published: January 2020

Background: Antimicrobial resistance (AMR) causes serious increase in morbidity, mortality and costs, especially carbapenem-resistant Pseudomonas aeruginosa (CRPA). Medical professionals play an important role in tackling AMR. Available studies overlooked the impact of workload on medical professionals in the relationship between medical professionals and AMR. This study explored the relationship between medical professionals and CRPA rate and the moderation effect of medical professionals’ workload in this relationship from a macro perspective. Methods: Based on panel data in China, hierarchical regression analysis was used to explore moderation effect of workload on medical professionals and CRPA rate. Fixed-effect model was applied to estimate the moderation effect models. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, clinical microbiologists per 1000 populations. Workload was measured by the number of daily visits of physicians. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were signiﬁcant negative with CRPA rate (Coef. = -0.889, -0.775,-1.176, -0.822; P= 0.003, 0.003, 0.011, 0.007, respectively). Workload had significant positive moderation effect between physicians, registered nurses, pharmacists, clinical technicians and CRPA rate (Coef.= 1.270, 1.400, 2.210, 1.634; P=0.004, 0.001, 0.035, 0.003, respectively). Conclusions: Increasing medical professionals may help curb CRPA. Measures to reduce medical professionals’ workload should be implemented to improve CRPA performance further.
It is aging and not antiretroviral therapy the strongest risk factor for chronic pain in HIV-positive population ?
Authors: Kowalski Marcin , Horban Andrzej , Slomka Bartosz , Shahnazaryan Karen , Rongies Witold
Published: January 2020

Background. Chronic pain in HIV-positive patients is a serious health problem that
limits patients’ normal functioning both somatically and psychologically. The current
state of knowledge on the topic is insufficient, with the underlying causes of this pain
unexplained. We have attempted to answer the question if aging is more stronger risk
factor for chronic pain in HIV-infected patients, than antiretroviral therapy (ART).
Methods. This study was prospective, observational, cross-sectional study, including
consecutive HIV-infected patients under specialist care.
During their routine visit all patients reporting any pain were asked to fill in the Brief
Pain Inventory (BPI) form and were subject to a brief examination performed by a
physician who afterwards completed a Douleur Neuropathique en 4 Questions form
(DN4). Logistic regression models were used to identify factors associated with chronic
pain occurrence.
Results. A total of 196 HIV-positive subjects, 96 (48.9% of the study group) of them
reporting pain within the week prior to enrollment. The reported pain was mostly (75%)
limited to a single area of the body (most commonly to the lower limbs). Pain duration
was reported to be >6 months previous to study enrollment by 57 subjects (59.4% of
those reporting pain). The patients with and without pain differed significantly in terms
of age at study inclusion (with the median age of 45.3 years in the pain group vs. 39.6
years in the no pain group; p=0.0002); median duration of specialist care (10.8 years
vs. 4.9 years, respectively; p=0.0008), median nadir CD4+ cell counts (168 cells/mcL
vs. 253 cells/mcL), median duration of ART (8.5 years vs. 3.4 years; p=0.0046), viral
rebound after complete suppression (5.1% vs. 38.3%; p=0.018), as well as previous
treatment with zidovudine (44.6% vs. 30.5%; p=0.063) and ‘D’ drugs (33.9% vs. 11%;
p=0.0004).
Conclusions. The prevalence of chronic pain in the studied population of HIV-positive
Polish patients was high in comparison with other HIV-positive and HIV-negative
patient populations. The most prominent risk factor for chronic pain in the study group
was age, which poses an important clinical and epidemiological problem due to the
aging of the HIV-positive population.