bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Hinduism in Creating Awareness About Sex and Its Related Functions
Authors: Chandrasekar P. , Gurusamy P.
Published: July 2019

Hinduism is otherwise known as Sanatana dharma, the oldest of all religions in the world. Its scriptures allow absolute freedom to the rational mind of human to choose the choice as per individual’s choice wherein individual freewill is exercised. The present review article aims at how a Hindu is educated and guided by the scriptures to lead a harmonious life in the society in general and in particular the sexual functions as prescribed. The main focus of this article are the roles of individuals, families, community, the religious, and educational institutions, and the government to create awareness in the areas such sex, sexual functions and sexual problems among men and women. They are essentially important and needed for the healthy practices of sex in our Indian culture. To strengthen it further, some practical measures are suggested to bring in a change, especially adolescent period is a very exciting phase and they are facing lot of difficulties and challenges in the area of sex. Therefore, the educational institutions should conduct training and workshop for teachers, parents and students on reproductive health and healthy sexual function and the state and central should encourage to undertake the scientific research studies in different areas and groups, for different groups.
Phase 1 study of the selective BTK inhibitor zanubrutinib in B-cell malignancies and safety and efficacy evaluation in CLL
Authors: Tam Constantine S. , Trotman Judith , Opat Stephen , Burger Jan A. , Cull Gavin , Gottlieb David , Harrup Rosemary , Johnston Patrick B. , Marlton Paula , Munoz Javier , Seymour John F. , Simpson David , Tedeschi Alessandra , Elstrom Rebecca , Yu Yiling , Tang Zhiyu , Han Lynn , Huang Jane , Novotny William , Wang Lai , Roberts Andrew W.
Published: July 2019

Zanubrutinib is a potent and highly selective inhibitor of Bruton tyrosine kinase (BTK). In this first-in-human, open-label, multicenter, phase 1 study, patients in part 1 (3 + 3 dose escalation) had relapsed/refractory B-cell malignancies and received zanubrutinib 40, 80, 160, or 320 mg once daily or 160 mg twice daily. Part 2 (expansion) consisted of disease-specific cohorts, including treatment-naive or relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The primary end points were safety and tolerability, and definition of the maximum tolerated dose (part 1). Additional end points included pharmacokinetics/pharmacodynamics and preliminary efficacy. Reported herein are results from 144 patients enrolled in the dose-finding and CLL/SLL cohorts. No dose-limiting toxicities occurred in dose escalation. Median BTK occupancy in peripheral blood mononuclear cells was >95% at all doses. Sustained complete (>95%) BTK occupancy in lymph node biopsy specimens was more frequent with 160 mg twice daily than 320 mg once daily (89% vs 50%; P = .0342). Consequently, 160 mg twice daily was selected for further investigation. With median follow-up of 13.7 months (range, 0.4-30.5 months), 89 CLL/SLL patients (94.7%) remain on study. Most toxicities were grade 1/2; neutropenia was the only grade 3/4 toxicity observed in >2 patients. One patient experienced a grade 3 subcutaneous hemorrhage. Among 78 efficacy-evaluable CLL/SLL patients, the overall response rate was 96.2% (95% confidence interval, 89.2-99.2). Estimated progression-free survival at 12 months was 100%. Zanubrutinib demonstrated encouraging activity in CLL/SLL patients, with a low incidence of major toxicities. This trial was registered at www.clinicaltrials.gov as #NCT02343120.
Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study
Authors: Bachy Emmanuel , Seymour John F. , Feugier Pierre , Offner Fritz , López-Guillermo Armando , Belada David , Xerri Luc , Catalano John V. , Brice Pauline , Lemonnier François , Martin Alejandro , Casasnovas Olivier , Pedersen Lars M. , Dorvaux Véronique , Simpson David , Leppa Sirpa , Gabarre Jean , da Silva Maria G. , Glaisner Sylvie , Ysebaert Loic , Vekhoff Anne , Intragumtornchai Tanin , Le Gouill Steven , Lister Andrew , Estell Jane A. , Milone Gustavo , Sonet Anne , Farhi Jonathan , Zeuner Harald , Tilly Hervé , Salles Gilles
Published: July 2019

PURPOSE

The PRIMA study (ClinicalTrials.gov identifier: NCT00140582 ) established that 2 years of rituximab maintenance after first-line immunochemotherapy significantly improved progression-free survival (PFS) in patients with follicular lymphoma compared with observation. Here, we report the final PFS and overall survival (OS) results from the PRIMA study after 9 years of follow-up and provide a final overview of safety.

METHODS

Patients (> 18 years of age) with previously untreated high–tumor-burden follicular lymphoma were nonrandomly assigned to receive one of three immunochemotherapy induction regimens. Responding patients were randomly assigned (stratified by induction regimen, response to induction treatment, treatment center, and geographic region) 1:1 to receive 2 years of rituximab maintenance (375 mg/m2, once every 8 weeks), starting 8 weeks after the last induction treatment, or observation (no additional treatment). All patients in the extended follow-up provided their written informed consent (data cutoff: December 31, 2016).

RESULTS

In total, 1,018 patients completed induction treatment and were randomly assigned to rituximab maintenance (n = 505) or observation (n = 513). Consent for the extended follow-up was provided by 607 patients (59.6%) of 1,018 (rituximab maintenance, n = 309; observation, n = 298). After data cutoff, median PFS was 10.5 years in the rituximab maintenance arm compared with 4.1 years in the observation arm (hazard ratio, 0.61; 95% CI, 0.52 to 0.73; P < .001). No OS difference was seen in patients randomly assigned to rituximab maintenance or observation (hazard ratio, 1.04; 95% CI, 0.77 to 1.40; P = .7948); 10-year OS estimates were approximately 80% in both study arms. No new safety signals were observed.

CONCLUSION

Rituximab maintenance after induction immunochemotherapy provides a significant long-term PFS, but not OS, benefit over observation.
How to Undo the History of Sexuality: Editing Edward Taylor’sMeditations
Authors: Stein Jordan Alexander
Published: July 2019

This essay establishes how the scholarly labors that brought Edward Taylor’s works to light in the 1930s foreclosed any understanding of them as queer. The absence of a queer critical reception history is this essay’s subject, and to trace that absence, it focuses on the material and intellectual terms of Taylor’s initial critical reception and on the political forces and critical assumptions that bear on those terms. Taylor’s devotional Meditations offer an exemplary case for understanding how many of the ordinary labors associated with recovery and publication—the scholarly acts that stand, ultimately, behind nearly any interpretation of any literary text, including genre classification, editorial presentation, and genealogical authentication—have often been versions of what Eve Kosofsky Sedgwick described in the late 1980s as “the extremely elusive and maddeningly plural ways in which cultures and their various institutions efface and alter sexual meaning.”
Passions for Justice: Kleist’s Michael Kohlhaas and Coetzee’s Michael K
Authors: Robinson Benjamin Lewis
Published: July 2019

J. M. Coetzee conceived of Life & Times of Michael K (1983) as an “interpretive translation” of Heinrich von Kleist’s Michael Kohlhaas (1808/10). Drawing on Coetzee’s notes and drafts, this essay explores his attempt to generate the literary and political “passion + urgency” of Kleist’s text, which Coetzee felt the times called for but his own writing lacked. While Michael Kohlhaas became a guerrilla out of his “passion for justice,” Michael K, despite the incessant provocations of the state, does not join the guerrillas but emerges instead as a very different kind of figure: a gardener who “just lives.” Between the guerrilla and the gardener, Coetzee elaborates an antinomy of justice not only in apartheid South Africa but inherent to the institutionalization of modern political life.
Colonial Economic Improvement: How Spain Created NewConsuladosto Preserve and Develop Its American Empire, 1778–1795
Authors: Tavárez Fidel J.
Published: July 2019

After implementing comercio libre (free internal trade) in 1778, the Spanish crown endeavored to create multiple new consulados (chambers of commerce) to facilitate commercial exchange within Spain's Atlantic territories. However, while the crown established new metropolitan consulados in the mid-1780s, it approved colonial consulados only in the 1790s, after the death of the minister of the Indies, José de Gálvez, in 1787. Why did the crown initially hesitate to establish colonial consulados? I argue that unlike Gálvez, who was committed to an extractive system of imperialism, the post-1787 ministers were inspired by a distinct kind of soft imperialism, which held that the empire's survival depended on stimulating colonial economic growth while promoting reciprocal bonds among all Spanish subjects. In reconstructing this history, I show how the post-1787 ministers established a new regime of colonial economic improvement to bind the empire during a moment of impending crisis.
An Indian It-Narrative and the Problem of Circulation: Reconsidering a Useful Concept for Literary Study
Authors: Mulholland James
Published: July 2019

For decades scholars have relied on the concept of circulation to explain the operation of texts and to animate the significance of literary studies. Its overuse has elided differences in the virtual relationships created by reading and has blurred empirical details about the production and consumption of texts. Circulation has been turned into a “widespread cultural ideal” and remains one of the least examined stipulations of literary study. For these reasons, reconsidering its role in literary study is essential. The eighteenth century was a vital period for the creation of a modern definition of circulation, so this essay returns to one especially pertinent case from that period, Helenus Scott’s it-narrative The Adventures of a Rupee (1782), which describes the movements of a rupee coin in the world economy. Attending to the linguistic form and publication history of Scott’s novel offers a model of circulation that emphasizes coagulation and stasis rather than liquidity, mobility, and flows. This model explains how texts repeat while altering preexisting forms of circulation, which has consequences for understanding how reading publics arise and reproduce themselves.
The Meaning of Settler Realism: (De)Mystifying Frontiers in the Postcolonial Historical Novel
Authors: Dalley Hamish
Published: July 2019

Dominant theorizations of settler colonialism identify it as a social form characterized by a problem with historical narration: because the existence of settler communities depends on the dispossession of indigenous peoples, settlers find themselves trapped by the need both to confront and to disavow these origins. How might this problem affect the aesthetics of the realist novel? This article argues that the historical novels produced in places like Australia and New Zealand constitute a distinctive variant of literary realism inflected by the ideological tensions of settler colonialism. Approaching the novel from the perspective of settler colonialism offers new ways to consider classic theories of realism and, in particular, reframes Georg Lukács's concept of reification—and the critical distinction between realism and naturalism he derived from it—as an unexpectedly useful tool for analyzing postcolonial literatures. Doing so, however, requires us to jettison Lukács's progressive historicism in favor of a model of literary history shaped by uneven temporalities and a fundamental disjunction between the historical perspectives of settler and nonsettler communities—thus complicating our narratives of the development of the novel genre. This argument is illustrated through an extended analysis of two of the most significant young novelists to engage recently with issues of settler colonial history: Eleanor Catton of New Zealand and Rohan Wilson of Australia.
An Art of Transformation
Authors: Huang Ellen
Published: July 2019

This article examines the phenomenon of yaobian 窯變, or kiln transformations, in late imperial and early modern China as material epistemology and material practice. By providing a genealogical analysis of documentations of yaobian in late imperial texts spanning the twelfth through the nineteenth centuries, the article relates their supernatural connotations to the production of Qing-period Jingdezhen Jun-style wares, variously known as flambé wares or kiln transmutation glazes. The article advances that the significance of such eighteenth-century yaobian porcelain wares lies in their very inexplicability of craftsmanship and ability to index both physical transformation as well as infinite formal transformation for the Qing empire, particularly during the reign of the Qianlong emperor (1736–1795).
Race, Photography, Labor, and Entrepreneurship in the Life of Maurice Hunter, Harlem’s “Man of 1,000 Faces”
Authors: Corbould Clare
Published: July 2019

In 1925, African American newspapers began reporting on Maurice Hunter’s work as a model for prominent visual and commercial artists, illustrators, and art students. By the 1950s, Hunter’s image had appeared on millions of advertising billboards, in all the major magazines, and in murals and statues in banks, parks, and department stores from Wall Street to Rochester to Cincinnati. Because no agency would represent a black model, Hunter was forced to raise his own public profile and create work opportunities. He did so by emphasizing his authenticity as a performer of nonwhite roles and at the same time his versatility as someone who could model for any role, including female and/or white. As well as permitting Hunter some degree of creative control over his work, his approach garnered him considerable esteem among elite African Americans. They also admired Hunter’s effort to control use of his image whenever photographed. This article examines Hunter’s labor, including his own effort to record it through scrapbooks he donated to the New York Public Library.
Afterlives
Authors: Dinshaw Carolyn
Published: July 2019

The GLQ Archive was created by the journal’s founding editors to bring unknown or obscure primary materials to the journal’s readership and thereby enlarge the archive of queer studies. One of the first items published was a medieval record of the deposition of a London sex worker in the late fourteenth century. Eventually making its way to the web, the document is now available globally and has been the subject of numerous scholarly treatments as well as popular adaptations in various media. The sex worker, John Rykener, who went by the name Eleanor and dressed in women’s clothing, has been appropriated variously as gay, as queer, and as trans. GLQ, through the Archive, ideally provides material for new creations, new theories, and productive contestation.
Low-Frequency HIIT Improves Body Composition and Aerobic Capacity in Overweight Men
Authors: CHIN EDWIN C. , YU ANGUS P. , LAI CHRISTOPHER W. , FONG DANIEL Y. , CHAN DERWIN K. , WONG STEPHEN H. , SUN FENGHUA , NGAI HEIDI H. , YUNG PATRICK S. H. , SIU PARCO M.
Published: July 2019

Background

The relationship between the frequency of high-intensity interval training (HIIT) and the resultant adaptations is largely unclear.

Purpose

This study compared the effects of different frequencies of HIIT with those of moderate-intensity continuous training (MICT) on body composition in overweight or obese adults.

Methods

Fifty-six overweight or obese (body mass index = 26.4 ± 2.9) men between 18 and 30 yr old (age = 22.8 ± 3.1 yr) were randomly assigned to the following groups: no-intervention control (CON; n = 14), MICT performed thrice weekly (MICT×3/wk; n = 9), HIIT performed thrice weekly (HIIT×3/wk; n = 14), HIIT performed twice weekly (HIIT×2/wk; n = 10), and HIIT performed once weekly (HIIT×1/wk; n = 9). Each HIIT session consisted of 12 × 1-min bouts at 90% heart rate reserve, interspersed with 11 × 1-min bouts at 70% heart rate reserve. Aerobic capacity, body composition, resting heart rate, vascular function, insulin resistance, and biomarkers of metabolic syndrome risk factor were examined at baseline, after 4 wk, and after 8 wk of intervention.

Results

Aerobic capacity and percent fat-free mass significantly increased in all exercise groups compared with those in the CON group (CON vs all exercise groups, P < 0.05), whereas body fat mass and systolic blood pressure significantly decreased after 8 wk of intervention in all exercise groups compared with those in the CON group (CON vs all exercise groups, P < 0.05). Body fat mass significantly decreased after 4 wk in all HIIT groups compared with those in the CON group (CON vs all HIIT groups, P < 0.05) but not in the MICT×3/wk group.

Conclusion

These novel results demonstrated that performing HIIT once weekly, even with a lower weekly volume of exercise, improved cardiorespiratory fitness, body composition, and blood pressure in overweight/obese adults. Low-frequency HIIT might be a feasible and effective strategy for the prescription of an initial exercise program for inactive, overweight, or obese young men.
Acute Soy Supplementation Improves 20-km Time Trial Performance, Power, and Speed
Authors: SEELEY AFTON D. , JACOBS KEVIN A. , SIGNORILE JOSEPH F.
Published: July 2019

Introduction

Isoflavones, a chemical class of phytoestrogens found in soybeans and soy products, may have biological functions similar to estradiol. After binding with ERβ or perhaps independently of estrogen receptors, isoflavones may augment vascular endothelial relaxation, contributing to improved limb blood flow.

Purpose

To determine if acute fermented soy extract supplementation influences 20-km time trial cycling performance and cardiac hemodynamics compared with a placebo.

Methods

Subjects included 25 cyclists and triathletes (31 ± 8 yr, V˙O2peak: 55.1 ± 8.4 mL·kg−1·min−1). Each subject completed a V˙O2peak assessment, familiarization, and two 20-km time trials in randomized order after ingestion of a fermented soy extract supplement or placebo. The fermented soy extract consisted of 30 g powdered supplement in 16 fl. ounces of water. The placebo contained the same quantities of organic cocoa powder and water. Each trial consisted of 60 min of rest, 30 min at 55% W
peak, and a self-paced 20-km time trial.

Results

Soy supplementation elicited a faster time to 20-km completion (−0.22 ± 0.51 min; −13 s), lower average HR (−5 ± 7 bpm), and significantly greater power (7 ± 3 W) and speed (0.42 ± 0.16 km·h−1) during the last 5 km of the time trial compared with placebo. Analysis of the results by relative fitness level (<57 vs ≥ 57 mL⋅kg−1⋅min−1) indicated that those with a higher level of fitness reaped the largest performance improvement alongside a reduced HR (−5 ± 7 bpm).

Conclusions

Ingestion of a fermented soy extract supplement improved sprint-distance performance through improvements in both power and speed. For those with great aerobic fitness, soy supplementation may help to decrease cardiac demand alongside performance improvement.
Clinical experiences of using ports and non-coring needles
Authors: Meade Elizabeth , Munoz-Mozas Gema , Moodley Nicole , Williams Jacqui
Published: July 2019

The following case studies describe the use of the Smith Medical implanted ports and Gripper huber needles. Smiths Medical produces a range of implanted ports that include the Port-A-Cath and P.A.S. Port Power P.A.C. systems. The ports are easy to implant, maintain and remove. They are lightweight and have features that are designed to reduce complication rates, including a highly compressed septum to increase needle retention, a titanium chamber with a gouge-resistant floor, a bevelled chamber for optimal rinsing, a round shape to avoid overturning and the Ultralock connection. They are available in various configurations, with single and dual lumens. There is also a needle for power-injection of contrast media for certain types of diagnostic imaging scans (Smith Medical 18).

The Gripper Plus needle is designed with an emphasis on safety, effectiveness and patient comfort. These non-coring needles have a bevelled tip that sits flush with the back of the port without impeding the flow of fluid; this also prevents holes forming in the septum ( Barton et al, 2018 ). The needle is available in different gauges and lengths, which can be tailored to reflect individual patient needs and the amount of adipose tissue present. It is essential to select the correct size, which will reduce the risk of dislodgement.

The Gripper needles are compatible with paclitaxel and lipid solutions, and are recommended by the National Institute for Occupational Safety and Health (NIOSH) (1999) . They are compatible with both the Port-a-Cath and P.A.S. Port Power P.A.C. systems, and can be ordered from the same manufacturer, which has the potential to make ordering, training and support more efficient.
Translating the Patient Dignity Inventory
Authors: Blomberg Karin , Lindqvist Olav , Harstäde Carina Werkander , Söderman Annika , Östlund Ulrika
Published: July 2019

Background:

The Patient Dignity Inventory (PDI) is based on an empirically-driven dignity model that has been developed and used for clinically assessing the various sources of dignity-related distress. In a recent review, it received the highest score as a useful instrument in both practice and research in palliative care. The PDI has been adapted to and validated for use in various countries, but not yet Sweden.

Aims:

To translate the PDI into Swedish, including cultural adaptation for clinical use.

Methods:

A multi-step process of translation, negotiated consensus, expert group discussion (n=7: four invited experts and three researchers) and cognitive interviewing (n=7: persons with palliative care needs).

Findings:

Discussion, by the expert reviewers, of both linguistic and cultural issues regarding the content and readability of the translated Swedish version resulted in revisions of items and response alternatives, focusing mainly on semantic, conceptual, and experiential equivalence. A pilot version for cognitive interviews was produced. The analysis of data showed that most of the items were judged to be relevant by the persons with palliative care needs.

Conclusion:

The process of translation and adaptation added clarity and consistency. The Swedish version of the PDI can be used in assessing dignity-related distress. The next step will be to test this Swedish version for psychometric properties in a larger group of patients with palliative care needs before use in research.
Single-dose pharmacokinetics of meropenem in porcine cancellous bone determined by microdialysis
Authors: Hanberg Pelle , Lund Andrea , Søballe Kjeld , Bue Mats
Published: July 2019

Objectives

Meropenem may be an important drug in the treatment of open tibial fractures and chronic osteomyelitis. Therefore, the objective of this study was to describe meropenem pharmacokinetics in plasma, subcutaneous adipose tissue (SCT), and cancellous bone using microdialysis in a porcine model.

Methods

Six female pigs were assigned to receive 1000 mg of meropenem intravenously over five minutes. Measurements of meropenem were obtained from plasma, SCT, and cancellous bone for eight hours thereafter. Microdialysis was applied for sampling in solid tissues. The meropenem concentrations were determined using ultra-high-performance liquid chromatography.

Results

The penetration of meropenem into cancellous bone, expressed as the ratio of plasma to cancellous bone area under the concentration-curve from zero to the last measured value, was incomplete and delayed. The time with concentration above the minimal inhibitory concentration (T>MIC), for an MIC of 0.5 μg/ml, was shorter for cancellous bone in comparison with both plasma and SCT. For MICs above 0.5 μg/ml, T>MICin cancellous bone was only shorter than SCT. Considering an MIC of 4 μg/ml, no animals achieved the target of 40% T>MICin plasma and cancellous bone, while less than 20% achieved it in SCT.

Conclusion

The main finding of this study was short T>MICin cancellous bone after intravenous administration of 1000 mg meropenem. Consequently, in order to achieve sufficient tissue concentration in the cases of open tibial fractures and chronic osteomyelitis, supplemental application of meropenem may be necessary. Cite this article: P. Hanberg, A. Lund, K. Søballe, M. Bue. Single-dose pharmacokinetics of meropenem in porcine cancellous bone determined by microdialysis: An animal study. Bone Joint Res 2019;8:342–348. DOI: 10.1302/2046-3758.87.BJR-2018-0308.R1.
Study on the ethnobotany of medicinal plants by people in Gunung Kidul, Yogyakarta, Indonesia
Authors: MAIZER SAID NAHDI  , ARDYAN PRAMUDYA KURNIAWAN
Published: July 2019

Abstract. The traditional medicine using plants is becoming the culture for the people of Yogyakarta Special Region, including Gunung Kidul. This research aims to reveal information from the people in the use of medicinal plants with a focus on how medicinal plants are used, managed and felt by the community. The research was conducted in Gunung Kidul, in Saptosari village and Giri Cahyo village from June to September 2018. The method used in collecting data was the exploratory survey and Participatory Rural Appraisal. Data on community involvement were obtained through the in-depth interview and structured interview. The identification was implemented in every plant used. The result of research analysis showed that people's knowledge about medicinal plants has been obtained from elders that have a long experience in concocting and trading the medicinal plants as herbs. In addition, the people have also obtained additional knowledge from any parties to make the medical plants to have economic value that can improve their welfare. The medicinal plants mostly have been packaged into 6 herbal plants called "Jamu" including Turmeric Tamarind, Saffron Rice, Bitter Herbs, Kebyokan, Ginger, and Turmeric with betel leaves with different compositions and efficacies. Most of the medical plants are obtained from outside the village since it is impossible to cultivate in Karst soils.  The results of the study found 46 species consisting of 26 families used by the people for medical treatment in which the highest benefit was represented by the Zingeberaceae family, followed by Fabaceae and Rutaceae.
Drawn to 360°: How can the aesthetics and qualities of traditional 2D animation storytelling add to the immersive VR projection paradigm?
Authors: Young Millie
Published: July 2019

The discussion will explore the aesthetic of hand drawn animation and the qualities this brings to the animation story through the analysis of selected practitioners in the field who bring drawn qualities that (could) crossover into 360°. Through the analysis the discussion will demonstrate the convergence of narrative structures and strategies from conventional animation and film narrative theory that are commonly present, applied or adapted within the emerging film syntax and grammar for VR. The article will go on to discuss how these theories and strategies might aid approaches to creative practitioners to enhance the possibilities for immersive storytelling by utilizing the hand drawn aesthetic in storytelling for the VR/360° world. First, to open the discussion, there is a question of the immersion experience and aesthetics present in the emerging media for 360° and VR and aspects of the whole immersive experience that are opening up for artists and audiences.
Predictors of mortality in children with systemic lupus erythematosus
Authors: Listiyono Fanny , Murni Indah K. , Sumadiono Sumadiono , Satria Cahya Dewi
Published: July 2019

Background Systemic lupus erythematosus (SLE) is a multisystem chronic disease with a relatively high mortality rate in children, despite improvements in prognosis and survival rate over the past decade. Studies on the predictors of mortality in children with SLE, especially in low- and middle-income countries, are limited.

Objective To determine the predictors of mortality of children with SLE.

Methods This was case-control study using data from medical records of children with SLE at Dr. Sardjito Hospital, Yogyakarta, Indonesia, between 2009 and 2017. Subjects were children aged <18 years diagnosed with SLE. Cases were those who died within one year of diagnosis; the controls were those who were discharged alive. From subjects’ medical records, we collected clinical data including age, sex, date of diagnosis, nutritional status, anti-dsDNA antibody, antinuclear antibody (ANA), hypertension, disease activity based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, proteinuria, thrombocytopenia, mortality/survival outcome, date of death, cause of death, and clinical data including fever, seizures, antibiotic used, microbial culture outcomes, and infection-related diagnoses. We performed bivariate analysis of the association between predictor variables (SLEDAI score, proteinuria, infection, hypertension, and seizures) and mortality outcome (survival or death), followed by logistic regression analysis.

Results Eighty-four patients with SLE were included, of which 72 were female.  Median age at diagnosis was 14 (range 4-18) years. Twenty-three patients (27%) died within one year after diagnosis. The most common causes of death were infection and renal failure in 8/23 and 7/23 subjects, respectively. On bivariate analysis, the variables significantly associated with mortality were hypertension (OR 3.34, 95%CI 1.22 to 9.14) and infection (OR 3.71; 95%CI 1.36 to 10.12). Seizures, proteinuria, and SLEDAI score were not found to be significantly associated with mortality. On logistic regression analysis, infection was the only significant predictor of mortality (OR 3.22; 95%CI 1.15 to 9.05).

Conclusion Among the factors studied, infection is significantly associated with mortality in children with SLE.
Baby girl with pentalogy of Cantrell: a case report on an extremely rare condition
Authors: Soewondo Widiastuti , Suyono Suyono , Prasodjo Johannes Berchmans , Widjaja Sri Lilijanti
Published: July 2019

In 1958, Cantrell et al. described an extremely rare syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart malformation.1 The incidence of pentalogy of Cantrell (POC) is one in 65,000 live births.1,2,3 Only one case was reported in Dr. Moewardi Public Hospital between 1999 and 2016. The exact etiology of this condition is unknown, but developmental failure of mesoderm at 4 weeks of gestational age may contribute to the condition.4 The prognosis depends on the degree of heart failure and the malformations that occur. Heart failure, arrhythmia, cardiac rupture, cardiac tamponade, endocarditis, and peripheral emboli are described as the main complications and causes of death.5,6 The aim of this report was to add to reference data about complete POC and the prognostic outcome.
Motor clinical progression in a series of pediatric Duchenne and Becker muscular dystrophy cases
Authors: Istianah Zakiah Nur , Sunartini Sunartini , Nugroho Sasmito
Published: July 2019

Muscular dystrophy is a neuromuscular disorder that begins with muscle weakness and impaired motor function. Duchenne muscular dystrophy (DMD) is more severe and destructive than Becker muscular dystrophy (BMD), and both are progressive in nature. These 2 types of muscular dystrophy are caused by mutations in related to X-chromosome genes.1 The mutations that occur in DMD are nonsense mutations. Deletion is present in 60% of DMD cases, while duplication occurs in 10% of DMD cases, resulting in loss of dystrophin protein. Mutations in BMD are missense mutations, so dystrophin is still formed, but in decreased amounts and quality.2,3

               The prevalence of DMD was reported to be three times greater than that of BMD, with a prevalence of 1.02 per 10,000 male births vs. 0.36 per 10,000 male infants, respectiveley.4 Anatomical pathology examination revealed loss of dystrophin in the examination of muscle biopsy without the presence of evidence leading to other neuromuscular diseases. Clinical DMD symptoms begin to appear at the age of 2-4 years. The child is observed to fall often and has difficulty climbing stairs. Muscle weakness worsens, especially in the upper limbs, continuing with heart and respiratory problems. The main causes of death in DMD are respiratory failure and heart failure.5 The BMD has varied clinical symptoms, beginning with the appearance of myalgia, muscle cramps, and arm weakness progressing towards myopathy. Some patients are asymptomatic until the age of 15, but 50% of patients show symptoms at age 10, and almost all by age 20.6
Factors associated with insulin-like growth factor-1 in children with thalassemia major
Authors: Riza Muhammad , Mulatsih Sri , Triasih Rina
Published: July 2019

Background Insulin-like growth factor-1 (IGF-1) deficiency is the major cause of growth disorders and delayed puberty in children with thalassemia. Hence, identifying factors contributing to IGF-1 deficiency in thalassemia is of importance.

Objectives To evaluate the correlation between IGF-1 level and nutritional status, ferritin level, pre-transfusion hemoglobin, thyroid, as well as alanine transaminase level.

Methods We conducted a study in children aged 2 to 18 years with thalassemia major who visited outpatient clinics at two hospitals in Indonesia, Dr. Sardjito Hospital, Yogyakarta and Dr. Moewardi Hospital, Surakarta, Central Java, from July to December 2015. Clinical, laboratory, and demographic data were reviewed from medical records. IGF-1 levels were measured using an immunochemiluminiscent method.

Results A total of 48 children were recruited into the study. Subjects mean IGF-1 level was 109.28 ng/mL (SD 90.26) ng/mL. Seventy-five percent of the children had IGF-1 level < -2SD. Subjects mean ferritin, pre-transfusion hemoglobin and ALT  levels were 3.568 (SD 2131.31) ng/mL; 7.97 (SD 0.85) g/dL and 49.7 (SD 43.1), respectively. Most of the children (91.7%) was eutyroid, with a mean of TSH and FT4 level was 2.7 (SD 1.5) nmol/L and 12.3 (SD 7.1) μIU/ml, respectively.

 Ferritin level had no significant correlation with IGF-1 level (r=-0.794; P=0.431). However, a strong, positive correlation was documented between pre-transfusion hemoglobin level and IGF-1 level (r=2.380; P=0.022). Multivariate linear regression analysis revealed that factors with significant correlations to IGF-1 level were pre-transfusion hemoglobin level <8 g/dL (β=-0.090; 95%CI -0.002 to 0.182; P=0.056) and undernutrition (β=0.077; 95%CI 0.045 to 0.109; P<0.001).

Conclusion Low pre-transfusion hemoglobin level and undernutrition are significantly correlated to low IGF-1 level in children with thalassemia major.
Gluten Intake in Early Childhood and Risk of Celiac Disease in Childhood: A Nationwide Cohort Study
Authors: Lund-Blix Nicolai A. , Mårild Karl , Tapia German , Norris Jill M. , Stene Lars C. , Størdal Ketil
Published: July 2019

OBJECTIVES:

Celiac disease (CD) may occur in genetically predisposed individuals exposed to gluten, but it is unclear whether the amount of gluten influences the risk of disease. We aimed at determining whether the amount of gluten intake at age 18 months predicted later risk of CD.

METHODS:

In an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), we included 67,608 children born during 2000–2009 and followed up for a mean of 11.5 years (range 7.5–15.5) after exclusions for missing data. Information regarding CD diagnosis was obtained from the Norwegian Patient Register 2008–2016 and from parental questionnaires at child age 7 and 8 years. We estimated gluten intake at age 18 months from a prospectively collected parental questionnaire.

RESULTS:

CD was diagnosed in 738 children (1.1%, 62% girls). The mean estimated amount of gluten in the diet at 18 months was 8.8 g/d (SD 3.6). The adjusted relative risk of CD was 1.10 (95% confidence interval 1.03–1.18) per SD increase in daily gluten amount at age 18 months. Children in the upper quartile of gluten intake compared with the lower quartile had an increased risk of CD (adjusted relative risk 1.29, 95% confidence interval 1.06–1.58). The association with gluten amount was independent of the age at introduction of gluten. Gluten introduction ≥6 months was also an independent risk factor for CD.

DISCUSSION:

In this nationwide study, increased gluten intake at 18 months was associated with a modestly increased risk of CD later in childhood.
Weak Cytotoxic T Cells Activation Predicts Low-Grade Dysplasia Persistence in Ulcerative Colitis
Authors: Kotsafti Andromachi , D'Incà Renata , Scarpa Melania , Fassan Matteo , Angriman Imerio , Mescoli Claudia , Bortoli Nicolò , Brun Paola , Bardini Romeo , Rugge Massimo , Savarino Edoardo , Zingone Fabiana , Castoro Carlo , Castagliuolo Ignazio , Scarpa Marco
Published: July 2019

INTRODUCTION:

In patients with ulcerative colitis (UC), dysplasia develops in 10%–20% of cases. The persistence of low-grade dysplasia (LGD) in UC in 2 consecutive observations is still an indication for restorative proctocolectomy. Our hypothesis is that in the case of weak cytotoxic activation, dysplasia persists. We aimed to identify possible immunological markers of LGD presence and persistence.

METHODS:

We prospectively enrolled 112 UC patients who underwent screening colonoscopy (T0) who had biopsies taken from their sigmoid colon. Ninety of them had at least a second colonoscopy (T1) with biopsies taken in the sigmoid colon and 8 patients had dysplasia in both examinations suggesting a persistence of LGD in their colon. Immunohistochemistry and real time polymerase chain reaction for CD4, CD69, CD107, and CD8β messenger RNA (mRNA) expression and flow cytometry for epithelial cells expressing CD80 or HLA avidin-biotin complex were performed. Non-parametric statistics, receiver operating characteristic curves analysis, and logistic multiple regression analysis were used.

RESULTS:

Thirteen patients had LGD diagnosed at T0. The mucosal mRNA expression of CD4, CD69, and CD8β was significantly lower than in patients without dysplasia (P = 0.033, P = 0.046 and P = 0.007, respectively). A second colonoscopy was performed in 90 patients after a median follow-up of 17 (12–25) months and 14 of the patients were diagnosed with LGD. In these patients, CD8β mRNA expression at T0 was significantly lower in patients without dysplasia (P = 0.004). A multivariate survival analysis in a model including CD8β mRNA levels and age >50 demonstrated that both items were independent predictors of dysplasia at follow-up (hazard ratio [HR] = 0.47 [95% confidence interval [CI]: 0.26–0.86], P = 0.014, and HR = 13.32 [95% CI: 1.72–102.92], P = 0.013).

DISCUSSION:

These data suggest a low cytotoxic T cell activation in the colonic mucosa of UC patients who do not manage to clear dysplasia. Thus, low level of CD8β mRNA expression in non-dysplastic colonic mucosa might be considered in future studies about the decision making of management of LGD in UC.
From the Editor in Chief
Authors: Doğanay Ahmet
Published: July 2019

Dear producers and consumers of knowledge,

I would like to share the happiness of being with you again with third issue of Pegem Journal of Education and Instruction (PEGEGOG) in 2019. Initially, I want to thank you for the increasing interest for our journal.

The popularity of the journal of PEGEGOG continues to grow, with over a hundred papers received in last one year. Of these, about 30.00% were accepted for publication. This is good news for our journal. On the other hand, I have to indicate that there were critical problems in terms of format within these articles as stated in the previous issue. First of all, unfortunately we had to reject some articles as in many of them there were texts very similar to ones in different articles. At first step, we scan all articles in i-Thenticate program to determine the exact quotations from other resources. After this scan, we reject the articles detected to have exact quotations at a high rate without initiating peer-review process. Apart from that, we also send back the articles not written in an academic format not to disturb our reviewers unnecessarily.

One of the problems with the articles submitted to our journal and we had to reject was about data analysis. The data is the raw information collected from related resources through research aims. These should be analyzed in parallel with these aims. It is necessary to analyze them using statistics for quantitative data and methods such as content analysis or descriptive analysis for qualitative data. Analysis provides the data being transformed into findings and make sense. Especially, in some of document analysis and some qualitative studies, it is seen that data are presented as findings. In some others, data are presented being only described. It is essential that the studies are formed in an article format obeying the rules by the journal and presented for publication afterwards.

As always, we present the ten articles got through peer-review process and given DOI number to you dear producers and consumers of knowledge. I wish these studies conducted in various fields of educational sciences will be useful and contribute to theoretical knowledge within the field. Hope to meet within the next issue.

Sincerely yours.
ANALISIS PERBANDINGAN KINERJA CART KONVENSIONAL, BAGGING DAN RANDOM FOREST PADA KLASIFIKASI OBJEK: HASIL DARI DUA SIMULASI
Authors: Jatmiko Yogo Aryo , Padmadisastra Septiadi , Chadidjah Anna
Published: July 2019

The conventional CART method is a nonparametric classification method built on categorical response data. Bagging is one of the popular ensemble methods whereas, Random Forests (RF) is one of the relatively new ensemble methods in the decision tree that is the development of the Bagging method. Unlike Bagging, Random Forest was developed with the idea of adding layers to the random resampling process in Bagging. Therefore, not only randomly sampled sample data to form a classification tree, but also independent variables are randomly selected and newly selected as the best divider when determining the sorting of trees, which is expected to produce more accurate predictions. Based on the above, the authors are interested to study the three methods by comparing the accuracy of classification on binary and non-binary simulation data to understand the effect of the number of sample sizes, the correlation between independent variables, the presence or absence of certain distribution patterns to the accuracy generated classification method. results of the research on simulation data show that the Random Forest ensemble method can improve the accuracy of classification.
Effects of LED light on Acacia melanoxylon bud proliferation in vitro and root growth ex vitro
Authors: Li Shubin , Zhou Lili , Wu Sipan , Liu Li , Huang Meng , Lin Sizu , Ding Guochang
Published: July 2019

This study examines the effects of light emitting diodes (LEDs) on tissue culture proliferation of Acacia melanoxylon plantlets among five different clones (FM1, FM2, FM4, FM5, and FM10). Shoot bud apex cuttings were transplanted onto Murashige and Skoog basal medium containing 0.1 mg L-1 6-benzyladenine and 0.5 mg L-1 naphthalene acetic acid and cultured in vitro for 40 days. Root growth was studied under different light intensities and photoperiods ex vitro. The bud proliferation coefficient was greatest under a light intensity of 45 μmol m-2 s-1 photosynthetic photon flux and photoperiod of 16 h light, but decreased as the light intensity increased. However, the greatest light intensity was beneficial for the growth of robust plantlets. Plantlets exposed to red and blue LED combinations grew tall and green, with a small number of roots. Plantlets also grew taller and some roots expanded under the longer photoperiod. Increased light intensity had positive effects on root number and rooting rate, and prolonged light greatly increased root number. Therefore, lower light intensity and a short photoperiod were beneficial for bud proliferation, while red/blue LED combinations, increased light intensity, and longer light illumination were beneficial for plantlet growth and root growth of Acacia melanoxylon.
The effects of various mouthwashes on osteoblast precursor cells
Authors: Song In-Seok , Lee Ji Eun , Park Jun-Beom
Published: July 2019

This study examined whether or not various mouthwashes have significant effects on the viability or morphology of mouse osteoblast-like cells. Mouse calvarial preosteoblast cells were cultured and prepared, then treated with a 0.12% chlorhexidine digluconate solution containing essential oils with or without alcohol, and a cetylpyridinium chloride solution, and sodium fluoride, respectively. Each well was treated with one of six mouthwashes for either 30 sec, 1.5 min, or 4.5 min. The viability of the treated cells was quantitatively analyzed by a Cell Counting Kit-8. The viability of osteogenic progenitor cells decreased significantly irrespectively of the types of mouthwashes. The changes of cell morphology were seen in all groups of mouthwashes; however, they were more noticeable on the chlorhexidine digluconate-treated group. A progressive increase in treatment time over 30 sec did not seem to deteriorate cellular viability. There was no significant difference in viability or morphological change between different formulations of the same brand. Although various mouthwashes without alcohol as an ingredient are available, nonalcoholic mouthwashes were not likely to be less harmful to the cells. Collectively, commercially available mouthwashes could inhibit cell viability and alter the morphology of osteoblastic precursor cells irrespectively of brands, treatment time, or alcohol content.