bluuebunny/crossref_metadata_2025 huggingface dataset:
Penanganan Tuberkulosis Resistan Obat pada Daerah Terpencil: Mission Impossible?
Authors: Banjuradja Ivan , Purnama Asep
Published: June 2019

Background: Complicated drug-resistant Tuberculosis (TB) management becomes a distinctive challenge for health care provider in rural area. Case: We reported 6 drug-resistant TB cases that were found in Sikka Regency, East Nusa Tenggara, based on rapid molecular test. Each case had unique problem which needs specific management, such as difference between the conventional and rapid drug susceptibility test, appearance of second line injection drug resistant (Pre-XDR TB), Human Immunodeficiency Virus (HIV) co-infection, emergence of serious acute psychosis side effect, and the drop out management. Discussion: We will discuss the management of each individual’s problem that arises during the antitubercular treatment monitoring and the requiring regimen modification under the national guideline. Conclusion: Drug-resistant TB management is a very complex matter. However, with sustainable effort, commitment, and collaboration between referral center and health care provider in rural area, guidelin be appropriate management could be achieved. Despite its possibility, prevention of resistant TB should have been done as early as possible, one of them is completion of regular TB treatment.
Problem Penegakkan Diagnostik Pasien dengan Massa di Paru
Authors: Wulandari Laksmi , Faot Nikson Eduard
Published: June 2019

Background: Lung cancer are divided into 2 groups; i.e. Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). About 30% of NSCLC is squamus cell carcinoma and the other is adeno carcinoma. Late diagnosis makes such a high mortality rate. Early diagnosis plays a very important role in the management of therapy. Case: Patients complain of chronic cough more than 6 months, decreased appetite and weight loss. Chest X-ray and CT scan show a density of round shape mass, with firm border and smooth regular edge, also lympnodes enlargement (T2N2Mx) stage IIb. Appearance of lung mass is benign according to clinically and radiologically. FNAB-CT Guiding results are difference each time examination. The first result is squamous cell carcinoma but the last result is teratoma. Discussion: Based on the multidisciplinary discussion on Tumor Board Meeting, the diagnosis was decide as Squamous cell Carcinoma. The choice management of stage IIb lung cancer is surgery (Lobectomy). Histopathology finding post surgery is a Squamus Cell Carcinoma. Patients were then given adjuvant chemotherapy for 4 cycles with Platinum Base regimen paxuscarboplatin with the aim of clearing micrometastase that may still be left behind. The complete respons of platinum based chemotherapy following surgery in early stage of squamous cell carcinoma. Conclusion: Difficulties of lung cancer diagnostic are still the problem in the management of lung mass. Difference of diagnostic makes difference treatment choice. Multidiscipline discussion is needed to decide the diagnostic and treatment judgment.
Pendekatan Terapi Asthma-COPD Overlap (ACO)
Authors: Amin Muhammad , Sitepu Alamsyah
Published: June 2019

Asthma and COPD are the most common chronic airways disease and have different clinical manifestations and treatments. Asthma is an airway inflammatory disease mediated by Th2 cytokines, CD4 + lymphocytes and eosinophils, whereas inflammation of COPD is affected by Th1 cytokines, CD8 + lymphocytes and neutrophils. Asthma-COPD overlap (ACO) is the presence of persistent airflow limitations with some symptoms resembling asthma and some other symptoms similar to COPD. Current treatment of ACO is to target the dominant inflammatory phenotype of eosinophils and neutrophils. Treatments given to patients with dominant eosinophil phenotype are inhaled and anti-IgE corticosteroids, and the drugs under reasearch are anti-IL-5, anti-IL-13, GATA3 inhibitors, anti-IL-33, anti-IL-25 and anti-thymic stromal lymphopoietin (anti-TSLP). Treatment given to patients with dominant neutrophil phenotype was macrolide, and treatment under reasearch was anti-IL-1, anti-IL-17A, anti-IL-23, CXCR2 antagonists, p38 MAPK inhibitor / JAK inhibitors and PDE4 inhibitors. Paucygranulocyte patient were given LAMA, LAMA + LABA therapy and bronchial thermoplasty. The therapy currently under study for this group is triple inhalation.
Análise do perfil das cirurgias cardiovasculares do Hospital Universitário Walter Cantídio
Authors: Pimentel Matheus Duarte , Leite Caroline Cleophas Lobo , Sousa Carolina Oliveira , Bessa Isadora Lopes , Vieira Gladson Fernandes , Lobo Filho Heraldo Guedis , Lobo Filho José Glauco
Published: June 2019

Objetivo: analisar o perfil das cirurgias cardiovasculares (CCV) realizadas no Hospital Universitário Walter Cantídio (HUWC) de 2009 a 2016, comparando este com o verificado no restante do Brasil. Material e Métodos: neste estudo observacional e retrospectivo, analisou-se em banco de dados os tipos de CCV no período citado, sendo estes agrupados por tipo e ano. Análise local foi então comparada com dados do DATASUS. Resultados: realizou-se 680 procedimentos no período analisado. Destes, 392 (57,72 ± 9,4%) cirurgias de revascularização do miocárdio (CRM), 199 (29,28 ± 6,16%) cirurgias orovalvares, 36 (5,54 ± 3,09%) CRM combinada a procedimentos orovalvares, 21 (3,01 ± 2,45%) correções de cardiopatias congênitas, e 33 (4,62 ± 2,70%) outros procedimentos. Nacionalmente, realizou-se, no período analisado, 354.129 procedimentos em CCV, dos quais 181.570 (51,27 ± 1,02%) foram CRM, 85.392 (24,11 ± 0,25%) cirurgias orovalvares, 16.677 (4,71 ± 0,35%) CRM associadas a troca e/ou plastia valvar, 39.086 (11,04 ± 1,29%) correções de cardiopatias congênitas e 31.404 (8,87 ± 0,26%) outros procedimentos. Conclusão: perfil das CCV do HUWC ilustra que as CRM são o procedimento mais realizado, seguido das cirurgias orovalvares, em consonância com o verificado nacionalmente. Análise contínua do banco de dados local amplia perspectivas, permitindo melhores planejamentos e resultados.
Vitamin B12 deficiency: metabolic effects, clinical evaluation, and treatment
Authors: Lopes Synara Cavalcante , Gadelha Daniel Duarte , Carvalho Manuela Dias de , Fernandes Virgínia Oliveira , Montenegro Junior Renan Magalhães
Published: June 2019

Vitamin B12 is a water-soluble essential micronutrient, required by all the body cells. Its deficiency has been implicated not only in hematological and neurological disorders, but also in many metabolic processes, such as insulin resistance and body composition changes, which have aroused particular interest in recent years. This study reviews the physiology of vitamin B12 from its digestion and absorption to its distribution in tissues, metabolic effects and controversies regarding the diagnosis of deficiency, and to dietary and pharmacological treatments.
Apresentação
Authors: Rocha Abdruschin Schaeffer , Ulrich Claudete Beise , Filho José Adriano
Published: June 2019

Apresentação - Reflexus 21.
ALTERIDADE, CONVIVIALIDADE E ESCUTA: PRINCÍPIOS PARA UMA PRÁTICA PENTECOSTAL DO CUIDADO
Authors: POMMERENING CLAITON IVAN , Gunlanda Orlando Afonso Camutue
Published: June 2019

Este artigo tem por objetivo expressar alguns princípios viabilizadores de práticas de cuidado em diálogo com os saberes da Teologia Pentecostal. Assim, em um primeiro momento, o ensaio apresentará alguns apontamentos acerca da Teologia Pentecostal e suas peculiaridades, objetivando uma breve exposição dos principais elementos que permeiam e organizam a reflexão teológica pentecostal. Em um segundo momento, o artigo se ocupa com o diálogo entre os princípios filosóficos e teológicos, que possibilitam a composição de uma perspectiva de cuidado marcada pela experiência ministerial e pela teologia pentecostal, em diálogo com outros saberes acerca do cuidado como a alteridade, a convivialidade e a escuta.
ACONSELHAMENTO PASTORAL HOSPITALAR E TESTAMENTO VITAL
Authors: Herbes Nilton Eliseu , Sanchez Clarissa Peres
Published: June 2019

O presente artigo se propõe a analisar a práxis do aconselhamento pastoral no contexto hospitalar em uma relação com a elaboração do testamento vital. A análise da realidade de cuidado dentro do contexto da saúde, incluindo o cuidado espiritual como um dos importantes componentes, principalmente se tratando de pacientes terminais ou em cuidados paliativos, nos mostra a importância do tema a ser trabalhado. O confronto com a realidade da morte faz com que pacientes vivam entre o medo e a insegurança quanto ao futuro, mas também quanto a forma como serão cuidados na terminalidade da vida. A legalização do testamento vital no contexto brasileiro se torna um novo instrumento de tomada de decisões, quanto aos tipos de cuidados médicos que serão recebidos pela pessoa enferma em caso de não poder mais se manifestar. A dignidade de vida, também no final da mesma, é um tema de preocupação para a maioria das pessoas. O testamento vital pode amenizar esse sentimento e garantir legalmente um cuidado digno e desejado.
Effects of Solidification Cooling Rate on the Microstructure of Nickel Based Superalloy GTD222
Authors: Gao Bo , Sui Yanfei , Wang Hongwei , Zou Chunming , Wei Zunjie , Wang Rui , Sun Yanle
Published: June 2019

The microstructure and solidification behavior of nickel based GTD222 superalloy at different cooling rates are studied. The solidification of the GTD222 superalloy proceeds as follows: L→L+γ, L→L+γ+MC, L→L+(γ/γ ′)-Eutectic and L→η phase. The temperature of liquidus of GTD222 superalloy is 1360 °C while the solidus is slightly lower at 1310 °C, which due to the alloying elements redistribution. It was found that the dendrite arm spacing of the alloy decreased with the increase of cooling rate (From 200 μm at 2.5 K/min to 100 μm at 20 K/min).
NEEDS ANALYSIS OF MODULE TEACHING MATERIALS OF GORONTALO MUHAMMADIYAH ORGANIZATION IN LEARNING HISTORY AT SMAN 1 GORONTALO
Authors: Malae Andris K , Warto Warto , Djono Djono
Published: June 2019

This paper aims to analyze the needs of teaching materials module history of movement organization Muhammadiyah Gorontalo at SMAN 1 Gorontalo.This is done because, in the learning in the school has not used the module as a companion of textbooks. The research method used is descriptive-qualitative, that is by doing observation, interview and document study. The results showed that during the learning process of history at SMAN 1 Gorontalo, less exploration of local history studies, especially related to the movement of the Muhammadiyah organization. On the one hand, students need a new understanding of the local history of Gorontalo. Thus, the use of a module containing the historical material of Muhammadiyah organization movement in Gorontalo becomes important to be compiled, then taught to students. The goal is that students can know that the Gorontalo region also has a variety of history that is not less interesting when compared with other areas in Indonesia. The implications of this study can be used as a guide to the teacher in analyzing the various learning needs required by students during the learning process at school.For students, with the teaching material of this module, more exploring willingness learn according to requirement given by teacher.

 

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IMPROVEMENT EARLY COUNTING ABILITY WITH FUN COOKING ACTIVITIES
Authors: Risina Duana Fera
Published: June 2019

The objectives of the study is to know the process of fun cooking  activities and increase early counting in children with learning math fun cooking activities. Fun cooking is a process of making food and drink until finally produce a product that can be eaten and done with fun. Through cooking the child will learn about language skills, mathematical concepts, skills in the process of science, experimental skills, coordination of physical skills, social skills, food and nutritional concepts. Observations made in five Kindergarten Group B in Kecamatan Selo, Boyolali found that teachers teach counting children still the old way, teachers use activity sheets in learning to count and do not use instructional media. Fun cooking activities using action research design (action research) model of Kemmis and Taggart, covering the planning, action, observation and reflection. Data analysis using quantitative and qualitative analysis (mixed methods). Quantitative data were analyzed using descriptive analysis (frequency tables, mean, percentage, standard deviation) while the qualitative data were analyzed by step 1) data reduction, (2) data display, and (3) verification of data.

 

 

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PROJECT – BASED LEARNING (PJBL) TO IMPROVE STUDENTS’ WRITING CAPABILITY
Authors: Sholihah Umi
Published: June 2019

Writing is considered as a difficult skill in learning English. That’s way the teacher should creative and innovative in teaching writing. One of methods that can be used in teaching writing is PjBL (Project Based Learning). The purpose of this article is to examine the uses of PjBL can improve students’ writing capability. It is based on the classroom action research with the subject is the students of fourth semester of English department of Widya Dharma University. The findings of the research imply that PjBL is very effective. The implementation of PjBL improved the students’ writing capability. PjBL enables the students to be more active to explore their ideas. By doing the project, the students can work together and share their ideas and knowledge with others. It makes the learning activity is not teacher centered but student centered, because most of the activity is done by the students. It can also  improve writing class in a better situation in the way that the classroom situation becomes more alive with various interesting activities, and there is a rising of students’ participation.

 

 

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TEACHER RECRUITMENT IN PUBLIC ELEMENTARY SCHOOLS
Authors: Paramita Petra Patria D
Published: June 2019

In order to get qualified teachers and meet the needs of teachers in schools, it is necessary to establish a teacher recruitment system. Teacher recruitment is an important step in teacher management because from this process teachers will be screened and then later placed in school. Qualified teachers from this process will ensure the quality of education in the school. There are two paths of recruitment for public school teachers: through government test (CPNS) and schools internal recruitment. The purpose of this research is to examine whether these two processes produce different teacher qualities and be able to get teacher who can comply with the requirement specified by the law.

 

 

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Designing Digital Teaching Media for Millennial Teachers: Trends and Sense
Authors: HARYATI SRI
Published: June 2019

Digital-based teaching media possess very high production quality capable of showcasing complex ideas in a short period of time. Later, the digital-based teaching media is well developed in millennial era indicating by the productivity escalation of it. This study aim at  investigating (1) the trending application resorted by the teaching media designers to create the digital-based teaching media; (2)  the problems faced by millennial teachers in creating the digital-based teaching media; (3) the underlying factors of the problems; (4) the efforts of digital teaching media designers to overcome the problems. Using descriptive qualitative, the 129 digital teaching media designers (millennial teachers) within 22-37 years old were investigated about the process and the product of digital-based teaching media. Questionnaire, interview, and document analysis used to assemble the data. The data were analyzed using the Interactive Model of data analysis. Triangulation technique facilitated the data validation and verification later. The result of the research shows that (1) the there are trending applications resorted by designer to create the digital teaching media such as prezi, movie maker and kine toon; (2) Less creativity and understanding towards technology become the major problems; (3) The lack of knowledge in technology and the dependency to make use the ready-made digital teaching media be the prominent factors causing the problem in designing digital teaching media; (4) Enhancing the creativity, innovation and technology sensitivity is the top solution proposed by teachers. The research implies that being the digital teaching media developers need extra efforts. Moreover, improving the technology sensitivity towards the current technology for teaching assists the designer better.
Words Problem Based Creation for Thematic Mathematical Stories: A Collaborative Action Research
Authors: Sumarwati Sumarwati , Budiyono Budiyono , Anindyarini Atikah
Published: June 2019

This research aims to improve the classroom practices of rural primary teachers in developing mathematics word problem through collaborative action research. The cooperation between fourth grade teachers and researchers from university focused on examining the results of the implementation of the two activities within the action plans, ‘Creating word problems communicatively based  by teachers’ and ‘Solving word problems easily by students’. From the analysis of qualitative data (interviews with students, observation and journal entries) and quantitative (tests and questionnaires) seen a significant improvement of the results of teacher in word problem creating and students in word problem solving. Developing word problem based on thematic mathematical stories enabled students to guide in using storytelling as a tool for understanding word problems
Performances Based on Ability Estimation of the Methods of Detecting Differential Item Functioning: A Simulation Study
Authors: UYSAL İbrahim , ERTUNA Levent , ERTAŞ F. Güneş , KELECİOĞLU Hülya
Published: June 2019

The aim of the study is to examine differential item functioning (DIF) detection methods—the simultaneous item bias test (SIBTEST), Item Response Theory likelihood ratio (IRT-LR), Lord chi square (χ2), and Raju area measures—based on ability estimates when purifying items with DIF from the test, considering conditions of ratio of the items with DIF, effect size of DIF, and type of DIF. This study is a simulation study and 50 replications were conducted for each condition. In order to compare DIF detection methods, error (RMSD) and coefficient of concordance (Pearson’s correlation coefficient) were calculated according to estimated and initial abilities for the reference group. As a result of the study, the lowest error and the highest concordance were seen in the case of 10% uniform DIF in the test and the method of IRT-LR, considering all other conditions. Moreover, for the method of SIBTEST and IRT-LR in all conditions, it was found that the error obtained by purifying items with C level DIF is lower than the error obtained by purifying items with both B and C level DIF. Similarly, for the method of SIBTEST and IRT-LR in all conditions, it was seen that the concordance coefficient found by purifying C level DIF is higher than the coefficient by purifying items with both B and C level DIF.
RNA-Seq reveals differential expression profile and functional annotation of genes involved in retinal degeneration in Pde6c mutant Danio rerio
Authors: Saddala Madhu Sudhana , Lennikov Anton , Huang Hu
Published: June 2019

Retinal degenerative diseases affect millions of people and are the leading cause of vision loss. Retinal degeneration has been attributed to a wide variety of causes, such as disruption of genes that are involved in phototransduction, biosynthesis, folding of the rhodopsin molecule and the structural support of the retina. The molecular pathogenesis of the biological events in retinal degeneration is unclear. The molecular basis of the retinal pathologies defect can be potentially determined by gene-expression profiling of the whole retina. In the present study, we have analyzed the differential gene expression profile of retina from a wild-type zebrafish and pde6c mutant. The datasets were downloaded from the Sequence Read Archive (SRA), removed adaptors and unbiased bases and checked to ensure the quality. The reads were further aligned to the reference genome of zebrafish and calculated gene expression. The differentially expressed genes (DEGs) were filtered based on the FDR (±4) and p-values (p<0.001). We performed gene annotation (Molecular function, biological process, cellular component), and functional pathways (KEGG pathway) for the DEGs. Our result showed that 216 up-regulated and 3527 down-regulated between normal and pde6c mutant zebrafish. These DEGs are involved in various KEGG pathways like Phototransduction (12 genes), mRNA surveillance pathway (17 genes), Phagosome (25 genes), Glycolysis / Gluconeogenesis (15 genes), Adrenergic signalling in cardiomyocytes (29 genes), Ribosome (20 genes), Citrate cycle (TCA cycle) (8 genes), Insulin signalling pathway (24 genes), Oxidative phosphorylation (20 genes) and RNA transport (22 genes) pathways respectively. Much more of all the pathways genes were down-regulated, but fewer genes were up-regulated in retina mutant of zebrafish. Our data strongly indicate that the among these genes, above mentioned pathways genes as well as calcium-binding proteins, neural damage proteins, peptidase proteins, immunological proteins, and apoptosis proteins are mostly involved in retinal and neural degeneration that cause abnormalities in photoreceptors or RPE cells.
The Comparison between Sepsis 1.0 and Sepsis 3.0 in Database of Severe Infection in Critical Illness: A Retrospective Study
Authors: Zhang Wei , Zheng Yan , Gu Juan , Kang Yan
Published: June 2019

Objective To compared the Sepsis 1.0 criterial with the Sepsis 3.0 criteria predict the efficacy of all-caused mortality of in-hospital in critically ill patients with severe infection. Design This is a retrospective and cohort study based on the database of severe infection. Setting A 48-bed general intensive care unit in affiliated hospital of University. Patients Critically ill patients with suspected infection based on the electronic health records from 1 January to 31 December, 2015. Interventions None. Measurements The variables of exposures included: quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS) score and sequential organ failure assessment (SOFA). Main outcomes and measures: for predictive validity, we found that the discrimination for hospital mortality was more common with sepsis than with uncomplicated infections. Results are reported as the area under the receiver operating characteristic curve (AUROC).Main Results In the primary cohort, 873 patients had suspected infection cohort (n=634), of whom 188 (29.7%) died; and with the non-infection cohort (n=239), 26 patients died (10.9%). Among intensive care unit (ICU) cases in the infection cohort, the predictive validity for hospital mortality was higher for Sepsis 3.0 (SOFA) criteria (AUROC=0.702; 95%CI, 0.665 −0.737; p≤0.01 for both) than for Sepsis 1.0 (SIRS) criteria (AUROC=0.533; 95% confidence interval [95%CI], 0.493−0.572). Conclusions In our study, we found the Sepsis 3.0 criteria is able to accurately predict the prognosis in critically ill patients with severe infection, and its predictive efficacy is superior to Sepsis 1.0 criteria.
Genomic regions related to white/black tail feather color in Dwarf chickens detected using a genome-wide association study
Authors: Nie Changsheng , Qu Liang , Jiang Zhihua , Wang Kehua , Qu Lujiang , Ning Zhonghua
Published: June 2019

Background: The genetic foundation of chicken tail feather color is not very well studied to date, though that of body feather color is extensively explored. In the present study, we used a synthetic chicken dwarf line (DW), which was originated from the hybrids between a black tail chicken breed, Rhode Island Red (RIR) and a white tail breed, Dwarf Layer (DL), to understand the genetic rules of the white/black tail color. The DW line still contain the individuals with black or white tails, even if the body feather are predominantly red, after more than ten generation of self-crossing and being selected for the body feather color. We firstly performed four crosses using the DW line chickens including black tail male to female, reciprocal crosses between the black and white, and white male to female to elucidate the inheritance pattern of the white/black tail. Furtherly, we performed a genome-wide association (GWA) analysis to determine the candidate genomic regions underlying the tail feather color by using black tail chickens from the RIR and DW chickens and white individuals from DW lines. Results: In the cross experiment, we found that (i) the white/black tail feather colors are independent of body feather color and (ii) the phenotype are autosomal simple trait and (iii) the white are dominant to the black in the DW lines. The GWA results showed that seven Single-nucleotide polymorphism (SNP) on chromosome 24 were significantly correlated with tail feather color. The significant region (3.97-4.26 Mb) perches nine known genes and five anonymous genes. The nine genes were: NECTIN1, THY1, gga-mir-1466, USP2, C1QTNF5, RNF26, MCAM, CBL and CCDC153. Conclusions: The study has revealed the white/black tail feather trait is autosome-linked in Dwarf chickens. In the genome significant ~0.29 Mb region, fourteen genes were found and some of them could play critical roles in the formation of white/black tail feather color, especially gene MCAM. Taken together, our research is the first study on genetics of tail feather color and could help the more understanding of feather pigmentation in chicken.
Integrated analysis of the physiology, RNA, and microRNA involved in black locust (Robinia pseudoacacia) rejuvenation
Authors: Zhang Zijie , Sun Yuhan , Han Chao , Dong Li , Guo Qi , Li Xiuyu , Cao Sen , Din Saleem Ud , Munir Zeeshan , Pérez-Pérez José Manuel , Li Yun
Published: June 2019

Background

Rejuvenation is a key process that enables perennial woody plants to regain growth potential. In Robinia pseudoacacia plantations, natural root sprouting individuals provide good material for studying the rejuvenation of woody plants. However, the physiological differences and molecular mechanisms underlying black locust rejuvenation remain unclear. In this study, we compared the physiological conditions and molecular responses of rejuvenated individuals and mother trees.

Results

Our analysis of leaf structures and physiological indices showed that the epidermis thickness, leaf thickness and leaf-tissue tightness of rejuvenated individuals were less than those of mother trees. The soluble-sugar content and total SOD activity of rejuvenated individuals were also lower than those of mother trees. The younger the rejuvenated individuals were, the lower the ABA content, ABA/ZT and GA3/ZT in the leaves. The ZT content increased with decreasing age of rejuvenated individuals. Using high-throughput sequencing strategies, the mRNA and miRNA involved in the rejuvenation of black locust were identified. RNA-seq identified 175,862 unigenes by de novo transcript assembly. Of those, 4,727 differentially expressed genes were identified based on clean reads mapped to the assembled transcriptome for gene expression analysis(fold change≥2 or ≤0.5 and q-value≤0.05). These genes were enriched to 53 gene ontology(GO) terms and 20 KEGG pathways (FDR≤0.01). Among these were a major pathway related to flavone and flavonol biosynthesis. High-throughput miRNA sequencing identified a total of 991 miRNAs, including 671 novel miRNAs. Furthermore, 262 known and 625 novel differentially expressed miRNAs were identified(fold change≥1.5 or ≤0.67 and p≤0.05). The main functions identified in the GO analysis of the target predictions overlapped with differentially expressed genes derived from RNA-seq. KEGG pathway enrichment showed that circadian rhythm-fly and signaling pathways regulating pluripotency of stem cells attracted considerable attention during rejuvenation.

Conclusion

Our study revealed physiological differences between rejuvenated individuals and mother trees of R. pseudoacacia. Differential genes between mother trees and rejuvenated individuals may vary according to the tree ages, but miRNAs may play a key regulatory role in rejuvenation. The same genotype system composed of root germinating individuals and mother-tree individuals provides a solid starting point for further elucidation of the rejuvenation of woody plants.
Elderly Females Fall More From Heights but Males Survive Less: Insights from an American Level 1 Trauma Center
Authors: El-Menyar Ayman , Tilley Elizabeth , Al-Thani Hassan , Latifi Rifat
Published: June 2019

Background

Approximately one third of subjects ≥65 year old and half of subjects ≥80 years old sustain a fall injury each year. We aimed to study the outcomes of fall from a height (FFH) among elderly. We hypothesized that in an elderly population, fall-related injury and mortality are the same in both genders.

Methods

A retrospective analysis was conducted between January 2012 and December 2016 in patients who sustained fall injury at age of at least 60 years and were admitted into a Level 1 Trauma center. Patients were divided into 3 groups: Gp-I: 60-69, Gp-II: 70-79 and Gp-III: ≥80 years old. Data were analyzed and compared using Chi-square, one-way analysis of variance (ANOVA) and logistic regression analysis tests.

Results

Forty-three percent (3665/8528) of adult trauma patients had FFH and 2181 (59.5%) were ≥ 60 years old and 52% were women. The risk of fall increased with age with an Odd ratio (OR) 1.52 for age 70-79 and an OR 3.40 for ≥80.

Females fell 1.2 times more (age-adjusted OR 1.24; 95% CI 1.05-1.45) and 47% of ≥80 years old suffered FFH. Two-thirds of FFH occurred at a height ≤1 meter. Injury severity (ISS, NISS and GCS) were worse in Gp-II, lower extremities max Abbreviated Injury score (max AIS) was higher in Gp-III. Overall mortality was 8.7% (Gp-I 3.6% vs. 11.3% in Gp-II and 14% in Gp- III). Males showed higher mortality than females in the entire age groups (Gp-I: 4.6% vs 1%, Gp-II: 12.9% vs 4.2% and Gp-III: 17.3% vs 6.9% respectively). On multivariate analysis, shock index (OR 3.80; 95% CI 1.27-11.33) and male gender (OR 2.70; 95% CI 1.69-4.16) were independent predictors of mortality.

Conclusions

Fall from a height is more common in elderly female patients, but male patients have worse outcomes. Preventive measures for falls at home still are needed for the elderly of both genders.
Estimation of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections.
Authors: Pieniawska-Śmiech Karolina , Bar Kamil , Babicki Mateusz , Śmiech Karol , Lewandowicz-Uszyńska Aleksandra
Published: June 2019

Background

Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 300 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 207 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics ward of J.Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with primary immunodeficiency (PID) and children with recurrent respiratory tract infections (RRTI) by assessment of their height and weight. All of parameters were evaluated using centile charts suitable best for the Polish population.

Results

The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 20% of them had their height situated below 3rd percentile. No statistically relevant differences have been found between them and RRTI group. The statistically significant difference was between the nutritional status of PID patients and the control group.

Conclusions

There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.
Isolating promoters from Corynebacterium ammoniagenes ATCC 6871 and application in CoA synthesis
Authors: Hou Yingshuo , Chen Siyu , Wang Jianjun , Liu Guizhen , Wu Sheng , Tao Yong
Published: June 2019

Background：Corynebacterium ammoniagenes is an important industrial organism that is widely used to produce nucleotides and the potential for industrial production of coenzyme A by Corynebacterium ammoniagenes ATCC 6871 has been shown. However, the yield of coenzyme A needs to be improved and the available constitutive promoters are rather limited in this strain.
Results：In this study, 20 putative DNA promoters derived from genes with high transcription levels and 6 promoters from molecular chaperone genes were identified. To evaluate the activity of each promoter, red fluorescence protein (RFP) was used as a reporter. We successfully isolated a range of promoters with different activity levels resulting in different fluorescent intensities. A fragment derived from the upstream sequence of the 50S ribosomal protein L21 (Prpl21) exhibited the strongest activity among the 26 identified promoters. Furthermore, type III pantothenate kinase from Pseudomonas putida (PpcoaA) was overexpressed in C. ammoniagenes under the control of Prpl21, CoA yield increased approximately 4.1 times.
Conclusions：This study provides a paradigm for rational isolation of promoters with different activities and their application in metabolic engineering. These promoters will enrich the available promoter toolkit for C. ammoniagenes and should be valuable in current platforms for metabolic engineering and synthetic biology for the optimization of pathways to extend the product spectrum or improve the productivity in C. ammoniagenes ATCC 6871 for industrial applications.
The prevalence of selected non-communicable disease risk factors among HIV patients on anti-retroviral therapy in Bushbuckridge Sub-district, Mpumalanga province
Authors: Maimela Eric , Mathebula Rudy Londine
Published: June 2019

Background: The rates of non-communicable diseases (NCD’s) appear to be increasing in HIV infected people as compared to non-HIV infected people and this will have major implications for clinical care. The aim of the current study was to profile selected cardiovascular disease risk factors among HIV patients on ART in Bushbuckridge sub-district.

Methodology: The current study followed a quantitative cross-sectional study design using a questionnaire which was adapted from World Health Organization stepwise approach to surveillance (WHO STEPS). Participants were HIV people on ART and data was entered into a computer software Microsoft excel, then imported to Stata 12 for analysis.

Results: Seventy-two percent of the 332 participants were females and the overall age distribution among participants increased with increasing age. The overall prevalence of overweight at the initiation of ART amongst the participants was 18.1% and obesity was 11.5% as compared to the time of the study which was 21.4% overweight and 19.6% obese. The baseline and current body mass index at time of study for females had a significant difference (p-value 0.006).

The overall prevalence of hypertension was found to be 34.6%, overweight was 21.4% obesity was 19.6%. The overall prevalence of abnormal waist circumference was 31.9% and females had a higher prevalence of 42.5% as compared to 4.4% of males. The overall prevalence of smoking 10.8% and alcohol consumption was 21.7%. Males were 22.5 times more likely to be smokers than females (p<0.001) and older people were found to be 0.3 times less likely to consume alcohol as compared to young people. The participant who were divorced were 6.2 times more likely to smoke than married participants (p<0.05). Males were 0.08 times less likely to be obese (p<0.001).

Conclusion: The high levels of selected risk factors for NCDs among adults on ART in the current study area suggest an urgent need for health interventions to control risk factors in an era of HIV with an aim of reducing multiple morbidity of chronic diseases. occurrence of NCDs and their risk factors with an aim to achieve positive effects of the long-term anti-retroviral therapy (ART).
Job Burnout and its Influence on the Working Ability of Copper-Nickel Miners in Xinjiang, China
Authors: Sun Xuemei , Ge Hua , Zhang Li , Zhang Chen , Liu Jiwen
Published: June 2019

Background

Job burnout is common among occupational groups.We conducted a questionnaire survey of copper-nickel miners in Xinjiang to investigate the status of, and relationship between, job burnout and working ability. We provide a theoretical basis for alleviating the former and improving the latter.

Methods

According to the main production process stratification of copper-nickel ore (mining unit, beneficiation unit, smelting unit), a self-administered questionnaire survey on the general situation of miners was conducted on the basis of the Chinese Maslach Burnout Inventory and Work Ability Index Questionnaire among 1400 miners registered in the human resources department of copper and nickel mines by stratified cluster sampling.

Results

A total of 1254 valid questionnaires were collected with a response rate of 89.57%. There were 1116 male miners (89.0%) and 138 female miners (11.0%) aged from 18 to 60 (32.31 ± 9.1) years old. There were 1014 miners with different degrees of burnout, accounting for 80.86% of the total: 432 people reported mild burnout (34.45%), 516 reported moderate burnout (41.15%), and 66 reported high burnout (5.26%). There were significant differences in the degree of burnout according to gender, age, education level, monthly income, and work unit (p < 0.05). There were statistically significant differences in the working ability according to age, number of working years, education level, marital status, title, monthly income, and work unit (p < 0.001). There were significant differences in job burnout among copper and nickel miners with different working abilities and the working ability was negatively correlated with emotional exhaustion, reduced sense of accomplishment, and total burnout score (p < 0.01). Logistic regression analyses showed that the education level, title,work units and job burnout level had a pronounced impact on the working ability of miners (p < 0.001); The lower the educational level and the higher the level of job burnout, the lower the working ability.

Conclusions

Our results indicate that job burnout is common among copper and nickel miners. Furthermore, working ability decreases with an increase in job burnout, and reducing job burnout can improve the working ability of copper and nickel miners.
1g versus 2g Daily Intravenous Ceftriaxone in the Treatment of Community Onset Pneumonia –a propensity score analysis of data from a Japanese multicenter registry
Authors: Hasegawa Shinya , Sada Ryuichi , Yaegashi Makito , Morimoto Konosuke , Mori Takahiro
Published: June 2019

Objectives: Community-onset pneumonia (COP) is a supplant concept of community acquired pneumonia, which includes the previous classification of healthcare-associated pneumonia. Although ceftriaxone (CRO) is one of the treatment choices for COP, it is unclear whether 1 or 2 g CRO daily has better efficacy. We compared the effectiveness of 1 g with 2 g of CRO for COP treatment. We hypothesized that 1 g CRO would show non-inferiority over 2 g CRO.
Methods: This study was an analysis of prospectively registered data from four Japanese hospitals for patients with COP (the Adult Pneumonia Study Group-Japan: APSG-J). Subjects who were initially treated solely with 1 or 2 g of CRO were enrolled. The propensity score was estimated from the 33 pre-treatment variables, including age, sex, weight, pre-existing comorbidities, prescribed drugs prior to admission, risk factors for aspiration pneumonia, vital signs, laboratory data, and findings from chest xrays. The primary endpoint was the cure rate, for which a non-inferiority analysis was performed with a margin of 0.05. In addition, we performed three sensitivity analyses; using data limited to the group in which CRO solely was used until the completion of treatment, using data limited for inpatient cases, and including a generalised linear mixed-effect logistic regression analysis to assess the primary outcome after adjusting for random hospital effects.
Results: Of the 3,817 adult subjects with pneumonia who were registered in the APSG-J study, 290 and 216 were initially treated solely with 1 or 2 g of CRO, respectively. Propensity score matching was used to extract 175 subjects in each group. The cure rate was 94.6% and 93.1% in the 1 and 2 g CRO groups, respectively (risk difference, 1.5%; 95% confidence interval, −3.1 to 6.0; p = 0.009 for non-inferiority). The results of the sensitivity analyses were consistent with the primary result.
Conclusions: The propensity score-matched analysis of multicenter cohort data from Japan revealed that the cure rate for COP patients treated with 1 g CRO was non-inferior to that of patients treated with CRO.
Analgosedation during flexible fiberoptic bronchoscopy: Comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol
Authors: Lee Hyun , Choe Yeong Hun , Park Seung Yong
Published: June 2019

Background: There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy. The aim of this study was to evaluate the clinical efficacy and safety of remifentanil by comparing it with those of the conventional drugs, midazolam and propofol.
Methods: A retrospective study of 186 patients who underwent diagnostic bronchoscopy at Chonbuk National University Hospital was performed. Patients were classified into the remifentanil group and midazolam/propofol group according to the drugs used during bronchoscopy.
Results: Of the 186 patients, 111 patients received remifentanil and 75 received midazolam/propofol during the bronchoscopy. The proportion of patients who required bronchoscopy for endobronchial inspection alone was significantly higher in the midazolam/propofol group than in the remifentanil group (93.3% vs. 71.2%; p < 0.001). In contrast, the proportion of patients who required more invasive procedures, such as bronchoscopic biopsy, bronchoalveolar lavage, or transbronchial lung biopsy, was significantly higher in the remifentanil group than in the midazolam/propofol group (27.8% vs. 6.7%; p < 0.001). The recovery time was significantly shorter in the remifentanil group than in the midazolam/propofol group (mean 6.4 min vs. 11.6 min, p < 0.001). There was no significant difference between the groups with regard to safety events including desaturation, hypotension, and arrhythmia.
Conclusions: Despite the higher proportion of patients who underwent more invasive procedures in the remifentanil group than in the midazolam/propofol group, there was no significant difference in safety events between the groups. Those in the remifentanil group also demonstrated a faster recovery time than those in the midazolam/propofol group.
Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia
Authors: Getnet Fentabil , Demissie Meaza , Worku Alemayehu , Gobena Tesfaye , Seyoum Berhanu , Tschop Rea , Girmachew Michael , Assefa Gebeyehu
Published: June 2019

Background

To comprehend the effect of delayed care on risk of tuberculosis (TB) transmission in a TB prevalent but low case detection area, this study examined the association of diagnosis delay with patient infectiousness (cavitation and smear positivity) and determined the threshold delay that optimizes infectiousness. It also assessed transmission drivers in Somali region of Ethiopia, an area with ample pastoralist population.

Methods

A cross-sectional study was conducted using 434 new pulmonary TB patients, aged ≥15 years, who were recruited prospectively in five major facilities between December 2017 and October 2018. Data were collected on delays in diagnosis, socio-demographics, clinical and epidemiological information using interview, record-review, anthropometry, sputum microscopy and chest radiography techniques. Log-binomial regression models were used to reveal predictors of cavitation and smear positivity at p<0.05 using Stata/SE®14. C-statistics was applied to determine predictive ability and threshold delay that classifies infectiousness.

Results

Median age of participants was 30 years. Majorities were male (62.9%), nearly half (46.5%) were pastoralist and 2.3% TB/HIV co-infected. Median delay from debut of illness to diagnosis was 49 days (IQR=37). Among all cases, 45.6% [95%CI: 40.9-50.4] had pulmonary cavity and 42.0% [95%CI: 37.3˗46.9] were smear positive. On multivariable analysis, cavitation was higher in patients delayed over a month [P<0.001], ≤35 years [APR (95%CI) =1.3(1.01-1.6)], with chronic diseases [APR (95%CI) =1.8(1.2-2.6)] and low MUAC*female [APR (95%CI) =1.8(1.2-2.8)]. Smear positivity was higher in patients delayed >49 days [p=0.02], ≤35 years [APR (95%CI) =1.4(1.1-1.8)], low BMI [APR (95%CI) =1.3(1.01-1.7)] and low MUAC [APR (95%CI) =1.5(1.2-1.9)]. Delay discriminates cavitation [AUC (95%CI) =0.67(0.62-0.72)] at 43 days optimal cutoff and 74.6% sensitivity.

Conclusion

This study highlights that delay in diagnosis of pulmonary TB remains high and is associated with increased risk of cavitation and smear positivity in pastoral setting in Ethiopia. In pastoral settings, this may call upon a socio-cultural tailored TB prevention and control strategies.